Epi4Dogs

I have a 3.5 yr old GSD. He was diagnosed with EPI at just under a year old (I had to fight to get him tested). He initially started out with B12 injections but I transitioned him to Wonderlabs B12 w/intrinsic factor. He's had a couple courses of Tylan. For enzymes, we've used EnzymeDiane 6x and 8x (I could never find a dose that worked) and now Pan-tenex (I've had better luck with this enzyme). I've tried grain-free and grain-inclusive dog foods (Royal Canin, Nutro Ultra, Purina Pro Plan Salmon & Rice, Taste of the Wild multiple flavors, Victor (grain free and grain inclusive), Zignature (multiple flavors), and currently Merrick beef and sweet potato. Recently he underwent the Antech CE-IBD assay (test now discontinued) and Antech suggested a novel protein diet-went with Zignature turkey. My vet was really against grain-free. He has not had a scope/biopsy to confirm IBD but it is strongly suspected. My vet suggested Proviable probiotic and he is receiving one capsule a day as part of his evening meal and so far so good. We have also tried slippery elm but that made the diarrhea worse. Fortiflora probiotic made his poop worse too. Also have included pumpkin in his meals.

My boy is not gaining weight. Nothing I do, nothing I change works. His poops are formed, but very soft, and usually the last couple are diarrhea. The only type of food he hasn't tried is hydrolyzed or raw, neither of which I can afford. He eats his poop. My female eats his poop. He eats 3 cups in the morning with 1 tsp pan-tenex, 3 cups in the evening with 1 tsp pan-tenex-if I use any more or any less, he has diarrhea. On doggy daycare days, he gets an additional 2 cups with 3/4 tsp pan-tenex for a mid-day snack. He gets no treats. He basically poops everything he eats out.

Is there any hope? He's a walking skeleton. If he didn't have so much hair (he's a long-haired shepherd) I'm sure people would turn me in for animal cruelty and neglect.

What am I missing? I've tried more enzyme (both kinds) and never found a dose that was truly effective. If the dose strays too far from the "recommended" dose, he ends up with diarrhea. But sticking with the recommended dose he isn't gaining weight.

hi Tracy,

i just responded and then proceeded to hit the wrong button and deleted everything.... UGH!!!!!!!!!!!
So let me try again.

Based on what you wrote, i think your vet i probably correct in that Huck might just have IBD, hence why nothing agrees with him... HOWEVER.... the fact that you can't give him the correct amount of enzymes or else he also gets loose stools makes me suspicious that he might have a pork sensitivity. And not giving enough of the correct enzymes explains why Huck and everyone else is eating his stools... his food is not being properly digested

SO.... this is when we have to get creative.
1. i will email you privately to get your physical mailing address so i can send you some CREON to try. CREON is for EPI, but made for people, and it is porcine enzymes BUT, it is enteric coated so a much lesser concentration is used since 70% of it will not be destroyed via digestive pH level like al the doggie enzymes... We have had quite a few dogs with a true pork allergy that were finally able to get in enough proper replacement digestive enzymes (pancreatin) without having a sensitivity issue. The problem with CREON is that it is designed to be timely utilized in a human's digestive track with a pH level of 4. Our dog's pH level is 1.... so we have to play around with "how" we administer CREON to get it to optimally work with our dogs. Which we can and do do! Many countries outside of the USA cannot get the dog enzymes like we have here and they have no other choice but to use CREON and it works

2. the second option is to use the Pantenex amount that you are currently usig and supplement it with a plant enzyme. ... and hopefully this combo will be enough to "maintain" his EPI.... the plant enzymes that appears to work best with these EPI dogs that have sensitivities using pork enzymes is called:
Dr. GoodPet https://www.chewy.com/dr-goodpet-diges ... lLEALw_wcB

Hopefully one of these suggestions will help!!!!!!!!

I really feel for you, we’ve all been desperate at first.
Have I missed something? Is he on antibiotics for SIBO?
If he has irritation in the bowel, has the vet considered using a short course of steroids,. At least they are cheap and effective for some inflammation .
Does he have manic craving for water or food?
My dog s skin went raw and bald. I used to take her out with a t- shirt on , to avoid the stares. My little avatar photo shows how well she pulled through.
Don’t despair, you are in good hands with Olesia.
When an epi dog has complex conditions, it’s difficult to keep track of the treatments. Keep it simple, concentrate on treating the most life threatening symptom first

Thanks Patsy for chiming in........ and that is a great reminder.... Steroids short term often can really help straighten things out if all else fails with the loose stools.....that gives you time to figure what the cause is.............

Olesia711 wrote: ↑14 Sep 2022, 21:11 hi Tracy,

i just responded and then proceeded to hit the wrong button and deleted everything.... UGH!!!!!!!!!!!
So let me try again.

Based on what you wrote, i think your vet i probably correct in that Huck might just have IBD, hence why nothing agrees with him... HOWEVER.... the fact that you can't give him the correct amount of enzymes or else he also gets loose stools makes me suspicious that he might have a pork sensitivity. And not giving enough of the correct enzymes explains why Huck and everyone else is eating his stools... his food is not being properly digested

SO.... this is when we have to get creative.
1. i will email you privately to get your physical mailing address so i can send you some CREON to try. CREON is for EPI, but made for people, and it is porcine enzymes BUT, it is enteric coated so a much lesser concentration is used since 70% of it will not be destroyed via digestive pH level like al the doggie enzymes... We have had quite a few dogs with a true pork allergy that were finally able to get in enough proper replacement digestive enzymes (pancreatin) without having a sensitivity issue. The problem with CREON is that it is designed to be timely utilized in a human's digestive track with a pH level of 4. Our dog's pH level is 1.... so we have to play around with "how" we administer CREON to get it to optimally work with our dogs. Which we can and do do! Many countries outside of the USA cannot get the dog enzymes like we have here and they have no other choice but to use CREON and it works

2. the second option is to use the Pantenex amount that you are currently usig and supplement it with a plant enzyme. ... and hopefully this combo will be enough to "maintain" his EPI.... the plant enzymes that appears to work best with these EPI dogs that have sensitivities using pork enzymes is called:
Dr. GoodPet https://www.chewy.com/dr-goodpet-diges ... lLEALw_wcB

Hopefully one of these suggestions will help!!!!!!!!

I'm feeling dumb right now because I couldn't figure out how to reply to your reply.

An update: Huck has been on the Dr. Goodpet enzymes and haven't really seen much of a change in his poop. It's slightly more formed, but still very soft and the volume suggests he is still not absorbing nutrients. We have used a full bottle and are about 3/4 of the way through the 2nd bottle so I figure this was enough to see if adding the plant enzyme would work in conjunction with the pan-tenex.

I am curious about Creon. How difficult is it to figure out the dosage? I am single and live alone. I work 40 hours a week. 3 days a week my dog goes to doggy daycare while I'm at work and the other two days I drive home at lunch to allow for 30 minutes potty break outside. Will the Creon cause diarrhea?

Also, the cost of Creon? How expensive is it? Does my vet give me a prescription to take to pharmacy? I want to do what I can for my boy, but this is becoming overwhelming. He's still skinny as a rail and it's just so depressing.

Thank you.

Creon: it can take a few attempts to get the right dose; just like any other enzyme. But a little goes a long way! It took me some trial and error; but overall quite easy! If you are getting very close to the right dose and want to increase, do so in teeny tiny measurements! 5,000 lipase units can be BIG change!

I was giving 4.5 capsules of the Creon 10,000. When it came time to renew the script, the vet said, let's just give 2 capsules of 25,000. It will be easier! I agreed, it made sense.

The dog didn't agree. 50,000 proved to be way too much. Had to call the vet again, explain everything and get another script for Creon 10. I then tried 1.5 capsules of Creon 10 and 1 Creon 25 (for a total of 40,000 units). That proved not quite enough. I went back to 45,000 (2 x Creon 10, and 1 x Creon 25). That's his magic number!

My dog's dose is considered "high", but he is on a very high fat raw diet. I do believe that's part of it. But we also know he's got no digestive enzymes of his own. He's full blown EPI.

For your dog, since IBD is suspected, my guess I'd you can start lower. Often IBD might respond better with less enzyme required by EPI. if EPI is a factor, then enzymes will be required for life. (We do know that prior to EPI diagnosis, my dog did not have IBD).

I feed a homemade raw diet. It's a lot cheaper than expensive kibble brands. I control all ingredients. And the only preservative is my freezer! So no carcinogenic preservatives!

I feed a home-made cooked diet to Montgomery, after years of being better but not where we needed to be. It's been a game-changer. It isn't any more expensive than the food he was eating before. He's gained three pounds since December.
Another thing we did with him was red light therapy, which really seemed to help calm things down. I'm currently using it on another cat we rescued in the winter who has IBD and she's improving greatly. I don't know if either of these things are an option for your pup, but it might be worth looking into.

Hi,
Just an opinion, you said you did some courses of Tylan, but maybe your dog needs a small dose of Tylan, daily, for life( just to keep SID away ).I ve read that for some dogs , it is recommended that after you did the 45 days treatment with Tylan, you slowly decrease the dosage in a a week. Then after a few days, you stop the administration and if the poop goes south again…. the Dog is a Tylan for life, with a small dose.
Sorela

Montgomery wrote: ↑18 Nov 2022, 23:18 I feed a home-made cooked diet to Montgomery, after years of being better but not where we needed to be. It's been a game-changer. It isn't any more expensive than the food he was eating before. He's gained three pounds since December.
Another thing we did with him was red light therapy, which really seemed to help calm things down. I'm currently using it on another cat we rescued in the winter who has IBD and she's improving greatly. I don't know if either of these things are an option for your pup, but it might be worth looking into.

Red light, for the belly? Where did you go for that? I know some physio's have it, commonly used for joints.

How often and for how long did you go? We know Chance does not have IBD...but he's also not stable yet with EPI

No sure who posted the red light suggestion..... but i know that cold laser therapy, if positioned correctly by the vet, can help with IBD... i know it is done with cats, and yes, we had it done on a GSD who was dealing with PLE and nothing else helped, whereas the cold laser did, however... it is tricky to do with dogs (larger and deeper set area, more water/liquid for the light rays to navigate) because for the light therapy to pass thru correctly (unless done correctly) the light can get refracted and then it won't work as well or won't work........

HOWEVER, aside from this, it is something i would ask the vet to try as at this point, you have nothing to lose, cold laser does not hurt anything and it is cheap to do, as long as the vet has a cold laser machine. we have used cold laser with great success on multiple dogs and i personally have used cold laser myself.

the only other thing i can think of is to talk to your vet about this also possibly being bile acid diarrhea... in addition to EPI.... in which case, you might want to talk to your vet about trying bile acid sequestrants, (cholesterol meds) but this is something that you have to work with your vet and for the vet to decide which product would or would not be appropriate for your dog.....