Bile vomit, b12 or diet?

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
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maggiebv11
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Country: Canada
Pet name: Chandler
My name: Maggie

Bile vomit, b12 or diet?

Post by maggiebv11 » 10 Sep 2022, 16:16

Hi again! So my dog Chandler has begun taking pig enzymes (pantenex 3/4-1 tsp) with all his meals for the last week now and ive already seen an approvement. However i also switched his diet after all his diarrhea because i assumed his prescribed kibble was the issue (as well as not being on proper enzymes). I weened him on Taste of the Wild pacific stream this week and he was doing SO much better, good poo, no stomach issues as usual, but today he threw up bile (he hasnt done that in a few weeks since he was on his old Hills digestive care I/d low fat kibble.)

Now, i had a vet app the other day and told my vet about wanting to use Tylan and not metro and she didnt believe me that it was a better medicine for him. I even gave her printed sheets from this website and sources but she wasnt convinced and didnt prescribe it to me.... so he stayed on metro this week but i stopped it yesterday because his poos have been fine.

I also asked for his b-12 levels because i read on here it should be in the higher range like 600. She emailed me his levels today and its 295 (he gets 1000mg b12 shots every month) but clearly he needs higher dosage or added supplements, right? I phoned them about it and they said they would get back to me....

So my question is, is his new diet the cause of the bile? I knew i was risking vomit by switching to a higher fat kibble (he had pancreatitis last year and was prescribed low fat food)

Or will the bile keep happening regardless possibly because of too low b12?

I know its really just trial and error with diet and epi, but if anyone has suggestions, id love to know!

Just to add: he wasnt completely eating kibble this week, it was part white rice and chicken due to his diarrhea last week, and he was slowly working up to it being all kibble
My name is Maggie, we live in east coast canada :)
My dog: Chandler, age 6, black lab retriever mix
Diagnosed with pancreatitis in Oct 2021, then with EPI in March 2022

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jilbert57
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State: Washington

Re: Bile vomit, b12 or diet?

Post by jilbert57 » 10 Sep 2022, 16:40

Does Chandler have pancreatitis right now or did he test ok in a follow up?

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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maggiebv11
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Posts: 17
Country: Canada
Pet name: Chandler
My name: Maggie

Re: Bile vomit, b12 or diet?

Post by maggiebv11 » 10 Sep 2022, 17:53

Hi jill! Great question, it made me think... so last October, he was throwing up non-stop one day, we went to the vet, and since he was bloated, the vet told me it felt like he had a tumour in his abdomen. Of course this worried me, so i wanted an ultrasound. that vet didnt have an ultrasound for big dogs so we travelled 12 hours to the nearest one... THAT vet did a SNAP test and diagnosed him with pancreatitis, which they gave me food and gabapentin for, but he wasn't getting better, he lost a lot of weight, and was on a lot of meds, needed an IV drip at one point too.

Then this march a new vet diagnosed him with EPI, but she didn't test him with a new SNAP test. So now i'm wondering if it's worth re-testing for, or does it not matter if i just keep him on a low fat diet? He's been on the pancreatitis prescribed food this whole time (because she said its good for EPI too) and still in need of pain meds all year... UNTIL i correctly got him the right enzymes thanks to this forum. Since hes been on the enzymes, he hasnt needed gabapentin. However he threw up today which i think is from the new food... but i read on this forum low b12 levels can cause acid reflux, so it's hard to know why.
My name is Maggie, we live in east coast canada :)
My dog: Chandler, age 6, black lab retriever mix
Diagnosed with pancreatitis in Oct 2021, then with EPI in March 2022

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Olesia711
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Location: North Carolina
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Pet name: Izzy
My name: olesia

Re: Bile vomit, b12 or diet?

Post by Olesia711 » 10 Sep 2022, 20:04

Hi Maggie..... ahhh the bile...... EPI dogs tend to have issues with their bile functionality .... and in some of the dogs we see symptoms, like what you are describing and yet with other dogs, even though there is a problem, we don't notice anything amiss.

With EPI dogs, they all have SID (small intestinal dysbiosis) to one degree or another. WHen a dog has SID (like ours) the SID tends to munch away at whatever B12 they have..... add this problem to the fact that over 80% of EPI dogs NEED B12 supplementation.

So you are correct on so many fronts.... with the B12 level of 295... Chandler most likely needs more than just monthly shots.... i would ask the vet to increase them to weekly or bi-weekly. And since EPI + SID + B12 are ALL connected.... CHandler won't feel optimal until everything gets addressed.

See if the vet will sell you the serum so that you can give the injections yourself at home.
If they won't do this... then go ahead and order the proper B12 pills from WOnderlabs. https://www.wonderlabs.com/itemleft.php?itemnum=K9688
In many cases, these pills work better than the shots.

Also.... sometimes no matter what you do, they continue to have SID related acid reflux.... in which case, you can give an acid reflux med (omeprazole seems to work well) or give a bile sequestrant, such as Cholestramine

Since one vet diagnosed Chandler with PAncreatitis and another diagnosed with EPI, and the enzymes appear to be helping... because of the "possible" pancreatitis background... for now, it might be better to stick with foods that are not too high in fat content. it appears that TOTW-Pacific stream is 15% fat.. so maybe try something with less 10% or 12 %? I think the Hills gastro food was mentioned on an earlier post....

But, B12 doesn't help, and if acid reflux meds don't help....( and if it is SID acting up)... i would then push for Tylan. if all else fails..........
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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maggiebv11
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Posts: 17
Country: Canada
Pet name: Chandler
My name: Maggie

Re: Bile vomit, b12 or diet?

Post by maggiebv11 » 10 Sep 2022, 22:03

Okay this helped so much! I will order those b12 pills! And retest his levels after a bit so see how they are. My vet is moving soon so i will be assigned a new vet at the clinic, so hopefully they will be open to Tylan or other issues i have. Chandler had been taking 2 omeprozole a day for months until the last month or two we cut it down to 1 so maybe ill start doing 2 again! I didnt know it helped with acid reflux, so im glad he already has that. Ill stick to the lowfat food in the meantime, hopefully the enzymes will make the food better this time
Thanks so much!!!!!!!
My name is Maggie, we live in east coast canada :)
My dog: Chandler, age 6, black lab retriever mix
Diagnosed with pancreatitis in Oct 2021, then with EPI in March 2022

Chance
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Posts: 197
Country: Canada
Pet name: Chance
My name: Andrea

Re: Bile vomit, b12 or diet?

Post by Chance » 10 Sep 2022, 22:51

maggiebv11 wrote: 10 Sep 2022, 22:03 Okay this helped so much! I will order those b12 pills! And retest his levels after a bit so see how they are. My vet is moving soon so i will be assigned a new vet at the clinic, so hopefully they will be open to Tylan or other issues i have.
If SID is still an issue, honestly I would increase frequency of the injections before starting the pills. I was doing 2 capsules a day religiously, but he had a setback - which got bad, as my vet refused to give anything but enzymes and probiotic. (Now former vet. After having to fight for 3 days for antibiotics for pneumonia in a dog with a comprised immune system, and now this. I always admired him for not always wanting to resort to pills for every problem. But when it carries over to life threatening conditions, I have a problem)!

He did get quite bad, and despite giving the capsules very religiously, his B12 levels plummeted. I gave him a B12 injection, and the next day he was a completely different dog. It is quite likely the SID that rendered the capsules useless...but I still won't risk it until I know he's fully stable and without antibiotics. (New vet prescribed 3 antibiotics. Right now we're doing good on just one...Tylosin. and a new probiotic).

I stopped the pills and went back to basics...weekly injections for 6 weeks. Not to mention, the injections are a fraction of the cost... especially with the shipping/import charges to Canada!

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maggiebv11
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Posts: 17
Country: Canada
Pet name: Chandler
My name: Maggie

Re: Bile vomit, b12 or diet?

Post by maggiebv11 » 11 Sep 2022, 09:24

Ahhh okay this is useful!! Do you give your dog the injections at home yourself?

Thanks for the reply!!
My name is Maggie, we live in east coast canada :)
My dog: Chandler, age 6, black lab retriever mix
Diagnosed with pancreatitis in Oct 2021, then with EPI in March 2022

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jilbert57
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Posts: 2095
Country: United States
State: Washington

Re: Bile vomit, b12 or diet?

Post by jilbert57 » 11 Sep 2022, 10:08

Hi Maggie, did you already post the results that confirmed Epi? If not will you?

Please read this article on canine pancreatitis. It has good information especially on things that might possibly aid pancreatis such as diet and certain meds( Metro specifically)

https://www.whole-dog-journal.com/healt ... s-in-dogs/

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

User avatar
maggiebv11
Member
Posts: 17
Country: Canada
Pet name: Chandler
My name: Maggie

Re: Bile vomit, b12 or diet?

Post by maggiebv11 » 11 Sep 2022, 13:56

Hi Jill! Back in March my vet suspected EPI so did a blood test for folate/b12, and she said it was super low so we did weekly b12 shots for 6 weeks then to monthly. Then in June she tested only his b12 again and it was up to 295, so we continued doing monthly shots (though now i am aware that is still too low)
I checked out your link and the comments confirmed how i feel about Hill i/d food. I am going to test another food with less by-products since Hills isnt amazing for him. Thank you!!
My name is Maggie, we live in east coast canada :)
My dog: Chandler, age 6, black lab retriever mix
Diagnosed with pancreatitis in Oct 2021, then with EPI in March 2022

User avatar
maggiebv11
Member
Posts: 17
Country: Canada
Pet name: Chandler
My name: Maggie

Re: Bile vomit, b12 or diet?

Post by maggiebv11 » 11 Sep 2022, 13:57

jilbert57 wrote: 11 Sep 2022, 10:08 Hi Maggie, did you already post the results that confirmed Epi? If not will you?

Please read this article on canine pancreatitis. It has good information especially on things that might possibly aid pancreatis such as diet and certain meds( Metro specifically)

https://www.whole-dog-journal.com/healt ... s-in-dogs/

Jill
Hi Jill! Back in March my vet suspected EPI so did a blood test for folate/b12, and she said it was super low so we did weekly b12 shots for 6 weeks then to monthly. Then in June she tested only his b12 again and it was up to 295, so we continued doing monthly shots (though now i am aware that is still too low)
I checked out your link and the comments confirmed how i feel about Hill i/d food. I am going to test another food with less by-products since Hills isnt amazing for him. Thank you!!
My name is Maggie, we live in east coast canada :)
My dog: Chandler, age 6, black lab retriever mix
Diagnosed with pancreatitis in Oct 2021, then with EPI in March 2022

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