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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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Olesia711
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Location: North Carolina
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My name: olesia

Re: New to the forum

Post by Olesia711 » 01 Jul 2023, 10:22

Hi Marie,

Based on what you are observing with the mostly 2's (poop) and then at the end of a walk (and anxiety) 3's ending with 4 or 6.... i agree with your assessment.... i think it is mostly due to her anxiousness.... BUT..... it also does sound like the diet needs a little tweaking and doing Home-Made is the best way to (1) control the ingredients (2) control the amount of the ingredients (3) proof one-at-a-time which ingredients best agree with your dog's digestive system.

was going to recommend stripping everything down and starting simple with just 75% coalfish (since this agrees with her) and 25% sweet potato).... but you are almost already doing this but with egg added.... so lets see how she does with these 3 ingredients and enzymes..

The Alphamix you are giving looks fine.... i noticed it has psyllium in it.... which is comparable to Slippery Elm...... so you may or may not need to add slippery elm. and of course the salmon oil is always good cause EPI dogs are depleted in fats....

WHen first starting out.....What you want to do with home-prepared BUT if you are also simultaneously trying to figure out which foods agree or not... is to strip it down to 1 protein, 1 carb... this is highly unbalanced, but okay for a short while... it will not hurt a dog as long as it is short term.

THen what you do is add 1 food item at a time and give it 3 to 5 days, watch the poop out-put and assess if the added ingredient is helping or hindering... and keep "testing" each ingredient one at a time. Keep an EPI journal.

For the first few days.... i would stop the alphamix only to assess how bad (or good) the poops are without this supplement.... then add it (as your next ingredient) to see how beneficial it is...(which i am guessing it is :) ) then i would start adding and testing the food ingredients one-at-a-time.

Another thing to consider is that sometimes, these EPI dogs can have an ingredient but just not too much or else they will not digest it very well if given too much of something.....

So overall, first you want to test/proof which proteins agree with her (fish, chicken, beef, pork, etc). Then start proofing carbs, veggies... in small amounts... (try veggies one at a time.... then try white potato, and you can even try a little cooked, and double rinsed white rice ... some dogs can handle some fiber, others can't handle any fiber.)

You are already trying egg, so i am guessing that agrees with her... but if her poop isn't good right now with the coal fish, sweet potato eliminate the egg and see if that helps.......

Also try dairy as another food group, a little cheese, cottage cheese, goat milk, etc.....
And last but not least, try fruits too, apples, bananas, blue berries, etc ...

Once you assess which food items agree with her, then you build your diet for her. Try to follow the approximate %'s for a home-made diet with foods that agree with her :)

-----------------------
Epi4Dogs Home-prepared meal “approximate” ratio’s
https://epi4dogs.com/diet-raw-home-prepared-recipes/


5-10% organ meat (liver, kidney, lungs, pancreas, gizzards, heart) Some consider heart a muscle meat other consider it as one of the top organ meats to serve. Kidney has the most packed nutrition)

10-20% bone. Normal dogs should have approx 25% bone matter.. many EPI dogs have issues with too much bone, so start with half the amount (or use Bone Meal) and work your way up to see exactly how much bone your dog can or cannot handle.

0-30% vegetables All veggies need to be cooked and mashed. Green veggies, work best, or small amounts of sweet potato may be used. Which veggies and how much all depends on your individual dog.

The remainder % should be all Protein (meat/fish) skinned, de-fatted and must be ground or minced. We have found that many EPI dogs on a home-prepared meal tend to do best when the protein portion ranges anywhere from 85% to 75%.

Vitamins & Minerals Be sure to add a good source multivitamin with minerals or ask a vet nutritionist which supplements should be added to the diet to make sure it is balanced.

Oils With EPI dogs, we find that adding daily (unless another concurrent condition prohibits fats/oils)… either or / or alternate EFA (fish oils) and/or cold-pressed coconut oil as this greatly helps dogs with poor skin and coat.
The recommended dosages are: EFA’s suggested at 180mg per 10 lbs per day, or on alternate days give ½ to 1 teaspoon of cold pressed (virgin) coconut oil.
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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Vossiesmom
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Pet name: Vos
My name: Marie

Re: New to the forum

Post by Vossiesmom » 02 Jul 2023, 06:03

Thank you for your quick response, Olesia! :D
I TRIED TO RESPOND IN THIS POST IN RED CAPITAL LETTERS :)


Starting today we're doing just coalfish (75%) and sweet potato (25%). Her first poop today was excellent (#2), just a bit orange from the sweet potato. THIS HAPPENS ... But regurgitation is also a lot worse now DID YOU EVER GET HER ON ACID REFLUX MEDS? ... Don't know if that's a sign that this food isn't working for her, or the bile acid dys that was already a problem... ALSO...... YOU STILL DO HAVE HER ON SUPPLEMENT ENZYMES IN THE HOME-MADE FOOD... YES? FROM cHEMEYES OR ZYMORAL ?

Good that you noticed that the Alphamix has something similar to slippery elm in it! Do you think we need to leave out the slippery elm too? TRY LEAVING THE SLIPPERY ELM OUT FOR A FEW DAYS AND THEN ADD IT BACK IN SEE WHAT THE DIFFERENCE IS- -BETTER OR WORSE. I also forgot to mention that we also add (Greenfield's) probiotics to her food once a day. THIS IS ANOTHER THING YOU CAN TRY JUST FOR A DAY OR TWO ANED SEE IF IT IS HELPING OR HINDERING. Should we maybe leave out everything (except salmon oil) and then reintroduce one thing at a time? This morning we did add all the supplements we normally do, because I thought if I change that too (leave everything out) and Vos' poop get's bad we don't know if it's: GOOD WAY TO APPROACH AS SOMETIMES SOME PROBIOTICS DON'T HELP AT ALL...AND SOMETIMES THEY ACTUALLY TRIGGER MORE LOOSE STOOLS
- leaving out the supplements except for salmon oil (Alphamix, slippery elm and (greenfields) probiotics) TRY LEAVING OUT ALPHAMIX FOR A COUPLE OF DAYS AND SLIPPERY ELM... THEN ADD ALP BACK IN AND THEN A FEW DAYS LATER ADD IN THE EXTRA SLIPPERY ELM.
- the sweet potato (also a new element)
- not enough enzymes, because Vos is not getting raw pancreas in her diet anymore.... ... IF YOU ARE GIVING THE POWDERED ENZYMES BUT JUST NOT THE EXTRA RAW PANCREAS ENZYMES.. THEN GO AHEAD AND INCREASE THE POWDERED ENZYMES SLIGHTLY.....

My head is spinning again :roll:

I drafted the following, hope I understood it well
Steps in finding the diet that works (3-5 days try out for every change) YES
1. find good proteins (fish, egg, beef, chicken, pork(chart))
AS SOON AS YOU FIND 1 PROTEIN THAT WORKS WELL .. THIS IS WHEN YOU GO AHEAD AND ADD BACK THE ALPHAMIX... THEN AFTER A FEW DAYS IF ALL OKAY... THEN GO BACK TO TESTING FOR OTHER PROTEINS. IF NOT OKAY, FIND A DIFFERENT MINERAL/VITAMIN SUPPLEMENT TO GIVE
2. find good carbs (sweet potato, white potato, LEAVE THE WHITE RICE "TRIAL" UNTIL AFTER VOS IS POOPING NORMAL FOR A WHILE white rice(chart))
3. find good veggies (see Designed by boo chart), in small amounts
4. find good organ meat (kidney, pancreas, liver, lungs, heart(chart))
5. add bone meal, figure out how much is needed
6. find out if diary can be added (cottage (cheese), goat milk(chart))
7. find good fruits (apple, banana, blueberries (chart))
8. if necessary change Alphamix to different multivitamin

9. if necessary change supplements to help with SID (slippery elm, probiotics, if necessary anitbiotics) < what we were figuring out before this sudden food change :roll: YES...........

And my last question/worry: if we're taking 3-5 days for every change, figuring out just what works with proteins would take (5 days x 5 proteins) JUST TRY 2 OR 3 TO START WITH.... THEN LATER YOU CAN TRY OTHERS. almost a month. Then follows carbs, veggies, organ meat, diary and fruits. THE SAME FOR FRUITS & VEGGIES... INITIALLY TEST JUST A FEW TO GET A BASIC DIET PLAN GOING... THEN ONE YOU DO AND THINGS ARE GOING ALONG FINE... THEN YOU CAN TRY TESTING AND BUILDING UP THE DIET PLAN :)... THIS IS HOW YOU DO IT QUICKER.... Sounds like that's at least 2/3 months of experimenting. That is fine with me, but I worry about Vos not getting enough nutrition that whole time...

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Olesia711
Founder & Research Director
Posts: 3933
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New to the forum

Post by Olesia711 » 02 Jul 2023, 08:48

hi Marie,
i am going to try and respond in RED in your post above......
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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Vossiesmom
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Country: Netherlands
Pet name: Vos
My name: Marie

Re: New to the forum

Post by Vossiesmom » 02 Jul 2023, 13:16

Vossiesmom wrote: 02 Jul 2023, 06:03 Thank you for your quick response, Olesia! :D
I TRIED TO RESPOND IN THIS POST IN RED CAPITAL LETTERS :)
Wonderful, thank you! Then I'll go ahead and respond to you in blue :)

Starting today we're doing just coalfish (75%) and sweet potato (25%). Her first poop today was excellent (#2), just a bit orange from the sweet potato. THIS HAPPENS ... But regurgitation is also a lot worse now DID YOU EVER GET HER ON ACID REFLUX MEDS? ...
Not yet, but I will call the vet tomorrow
Don't know if that's a sign that this food isn't working for her, or the bile acid dys that was already a problem... ALSO...... YOU STILL DO HAVE HER ON SUPPLEMENT ENZYMES IN THE HOME-MADE FOOD... YES? FROM cHEMEYES OR ZYMORAL ?
Yes, I'm using 1/8 tsp of Zymoral, the same amount as I gave her when she was on Carnibest (with the raw pancreas), so I will increase the dosage

Good that you noticed that the Alphamix has something similar to slippery elm in it! Do you think we need to leave out the slippery elm too? TRY LEAVING THE SLIPPERY ELM OUT FOR A FEW DAYS AND THEN ADD IT BACK IN SEE WHAT THE DIFFERENCE IS- -BETTER OR WORSE. I also forgot to mention that we also add (Greenfield's) probiotics to her food once a day. THIS IS ANOTHER THING YOU CAN TRY JUST FOR A DAY OR TWO ANED SEE IF IT IS HELPING OR HINDERING.
Should we maybe leave out everything (except salmon oil) and then reintroduce one thing at a time? This morning we did add all the supplements we normally do, because I thought if I change that too (leave everything out) and Vos' poop get's bad we don't know if it's: GOOD WAY TO APPROACH AS SOMETIMES SOME PROBIOTICS DON'T HELP AT ALL...AND SOMETIMES THEY ACTUALLY TRIGGER MORE LOOSE STOOLS
- leaving out the supplements except for salmon oil (Alphamix, slippery elm and (greenfields) probiotics) TRY LEAVING OUT ALPHAMIX FOR A COUPLE OF DAYS AND SLIPPERY ELM... THEN ADD ALP BACK IN AND THEN A FEW DAYS LATER ADD IN THE EXTRA SLIPPERY ELM.
And then the probiotic? (after of course first stopping it)
- the sweet potato (also a new element)
- not enough enzymes, because Vos is not getting raw pancreas in her diet anymore.... ... IF YOU ARE GIVING THE POWDERED ENZYMES BUT JUST NOT THE EXTRA RAW PANCREAS ENZYMES.. THEN GO AHEAD AND INCREASE THE POWDERED ENZYMES SLIGHTLY.....
Will do

My head is spinning again :roll:

I drafted the following, hope I understood it well
Steps in finding the diet that works (3-5 days try out for every change) YES
1. find good proteins (fish, egg, beef, chicken, pork(chart))
AS SOON AS YOU FIND 1 PROTEIN THAT WORKS WELL .. THIS IS WHEN YOU GO AHEAD AND ADD BACK THE ALPHAMIX... THEN AFTER A FEW DAYS IF ALL OKAY... THEN GO BACK TO TESTING FOR OTHER PROTEINS. IF NOT OKAY, FIND A DIFFERENT MINERAL/VITAMIN SUPPLEMENT TO GIVE
Great!
2. find good carbs (sweet potato, white potato, LEAVE THE WHITE RICE "TRIAL" UNTIL AFTER VOS IS POOPING NORMAL FOR A WHILE white rice(chart))
3. find good veggies (see Designed by boo chart), in small amounts
4. find good organ meat (kidney, pancreas, liver, lungs, heart(chart))
5. add bone meal, figure out how much is needed
6. find out if diary can be added (cottage (cheese), goat milk(chart))
7. find good fruits (apple, banana, blueberries (chart))
8. if necessary change Alphamix to different multivitamin

9. if necessary change supplements to help with SID (slippery elm, probiotics, if necessary anitbiotics) < what we were figuring out before this sudden food change :roll: YES...........

And my last question/worry: if we're taking 3-5 days for every change, figuring out just what works with proteins would take (5 days x 5 proteins) JUST TRY 2 OR 3 TO START WITH.... THEN LATER YOU CAN TRY OTHERS. almost a month.
Then follows carbs, veggies, organ meat, diary and fruits. THE SAME FOR FRUITS & VEGGIES... INITIALLY TEST JUST A FEW TO GET A BASIC DIET PLAN GOING... THEN ONE YOU DO AND THINGS ARE GOING ALONG FINE... THEN YOU CAN TRY TESTING AND BUILDING UP THE DIET PLAN :)... THIS IS HOW YOU DO IT QUICKER....
Trying just 2/3 of each category makes a big difference!! :D
Sounds like that's at least 2/3 months of experimenting. That is fine with me, but I worry about Vos not getting enough nutrition that whole time...

Thanks again for all the info, you're the best!!!

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Olesia711
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Posts: 3933
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New to the forum

Post by Olesia711 » 02 Jul 2023, 13:25

Hi again Marie.... none of the other colors showed up nicely... so now i will answer in a separate post :lol:

YES, YES YES!!!!!!!! DO CPNTACT THE VET AND GET HER ON AN ACID REFLUX MED.. THIS MIGHT SOLVE THE ISSUES YOU ARE HAVING NOW (EXCEPT FOR THE YELLOW POO)...LIKE THE REGRUG, VOMITING, ETC...... OMEPRAZOLE IS BEST BUT PEPCID AC WORKS TOO OR WHATEVER YOUR VET SUGGESTS ..

YES SLIGHTLY INCREASE THE ENZYMES SINCE SHE IS NO LONGER GETTING THE RAW PANCREAS AT THE MOMENT IN ADDITION TO ZYMORAL.

YES... WHEN YOU ADD BACK ALPH... DO FOR 1 OR 2 DAYS AND THEN ADD BACK THE SLIPPERY ELM AGAIN, ALL YOU NEED WITH THE SLIPPERY ELM TO ASSESS WHEN ADDING BACK IS 1 DAY 2 AT THE MOST... SLIPPERY ELM, IF IT IS GOING TO WORK, WORKS VERY VERY QUICKLY :)
THEN... AFTER THE ABOVE... ADD IN THE PROBIOTIC TO SEE IF IT MAKE ANY DIFFERENCE OR NOT.

YEAH... IT'S IS JUST TAKES TOO MUCH TIME TO TEST ALL FOOD INGREDIENTS NOW.... FIND WHAT WORKS... WITH A FEW 2 OR 3 WHICH IS MORE THAN ENOUGH TO FEED A WELL ROUNDED DIET WITH ALL THESE FOOD SOURCES.... AND THEN ONCE YOU GOT THIS FIGGURED OUT... THEN TRY MORE FOOD SOURCES TO EXPAND HER DIET OPTIONS.
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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Vossiesmom
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Country: Netherlands
Pet name: Vos
My name: Marie

Re: New to the forum

Post by Vossiesmom » 04 Jul 2023, 01:53

Since yesterday evening Vos is on antacids (Zitac) and it seems to have helped her with her regurgitation after dinner. Curious to see how it goes today.

And thanks for the clarifications Olesia, I finally understand it now :D
The sweet potato and coalfish are both going well, her poop looked great yesterday! And the slight increase of enzymes seems go well too.
Just one poop over the whole day though, but I’m guessing fish is such a light food that it doesn’t produce a lot?
One more day of no supplements (except salmon oil) before reintroducing Alphamix, then slippery elm, then probiotics. And then on to finding more good foods!

Another problem developed over the past two days: Vos’ is leaking uncontrollably. She already leaked drops of urine and last year an occasional small puddle, most likely because she got spayed at a very young age (at 5 months or so, when she still lived in Greece). Last year we gave her Propalin for a while, which helped mostly, but also made her a lot more anxious and at one point she got blood in her stool, so we stopped. (Shortly after that the 7 month EPI downward spiral started)
The past two days it’s different: she wet her bed, the pillows and blanket she’s on during the day, our bed… her vulva looks irritated, which happened too when we first started enzymes. I think the enzymes cause it and that they get on there when she licks herself after a meal. So we started giving her water again right after a meal to wash her mouth and to further prevent irritation. I feel stupid that we forgot about this.

Calling the vet today, I worry that it caused an UTI. I also worry that Vos gets prescribed an antibiotic that messes with everything we’re trying to build up again. Are there any (UTI) antibiotics that we should avoid?

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Olesia711
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Location: North Carolina
Country: United States
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Re: New to the forum

Post by Olesia711 » 05 Jul 2023, 13:05

the only antibiotic that i know of to avoid is metronidazole and that is when you are trying to treat a gastrointestinal issue, not UTI.

I suspect there are many other antibiotics that can cause some adverse effects in some dogs... not specifically just EPI dogs... but with a UTI... you always want to treat it :)

My Izzy had juvenile incontinence... long before she was diagnosed with EPI... we tried ALL the natural products and nothing worked... finally my vet placed her on PROIN and she was on it for 14 years and it )thankfully) controlled all her "leaking".

HOWEVER... if this leaking problem just appeared after she started the enzymes.... it is possible that this is a combination of what happens to many, many EPI dogs when started on enzymes.... they have to pee a lot more, (i think cause they drink more water in the beginning) and some even have accidents like what you are mentioning...

The good thing is that this having to pee so much more once starting on enzymes subsides after a few weeks/or even a month.... i am not sure exactly what is transpiring in their bodies, but it is almost as if their body has to get acclimated to it first.

Anyway...my guess is that what might be going on is a little bit of existing mild incontinence and getting used to the enzymes......
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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Vossiesmom
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Posts: 23
Country: Netherlands
Pet name: Vos
My name: Marie

Re: New to the forum

Post by Vossiesmom » 09 Jul 2023, 06:44

Luckily it wasn't an UTI and her kidneys seem okay as well. So I think you're right about getting used to the enzymes! Big relief.
The leaking is going a lot better now, no accidents since Friday evening!
Thanks for the tip on the Prion too! Good to know what to try whenever this is a problem again.

Acid reflux is a loooooot better with Zitac. It took a few days, but finally we're seeing a big change.

It seems that the Alphamix is making Vos' poop a lot worse right now. The poops much better when she didn't use it and when we started her on it again her poops got bad. Today I decreased the dosage to see if that makes any difference. If it doesn't I think we'll switch to a different multivitamin/mineral that doesn't have the psyllium in it. I think we originally (when we adopted her as a pup and way before she got EPI) got the Alphamix to go with raw food and I remember Vos getting very solid/hard poops, so I imagine dogs need something like psyllium to help with that. Now that she is not getting raw food anymore it's maybe too much of a laxative.

Sadly I can't get my hands on Vetri Science. But these have most of the ingredients that VS has:
https://www.medpets.nl/groene+os+multivitaminen+mineralen/
https://www.dierapotheker.nl/multivitamines-en-mineralen-dierapotheker-huisdierenmerk-200-dragees
https://www.dierapotheker.nl/vetra-systum-vegan-multivitamine-hond-kat-60-capsules

User avatar
Olesia711
Founder & Research Director
Posts: 3933
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New to the forum

Post by Olesia711 » 09 Jul 2023, 23:08

ahh... so Alphamix that appears to trigger the loose stools... in which case... just stop using it completely, as you have decided.

Glad to hear that it is not a UTL, kidneys are fine.... and the "excessive leaking" appears to be slowing down... in which case, it most likely was just her body getting used to the enzymes.

And i am thrilled to hear that the Zitac is helping a lot..... :). With EPI these dogs have bile acid issues.. but with some, there are no symptoms so we don't treat... but when there are symptoms- -we treat with acid reflux meds.

thanks for sharing the vitamins you are thinking of.... i like the 3rd one best
https://www.dierapotheker.nl/vetra-systum-vegan-multivitamine-hond-kat
because it contains amino acids :)
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.........

User avatar
Vossiesmom
Member
Posts: 23
Country: Netherlands
Pet name: Vos
My name: Marie

Re: New to the forum

Post by Vossiesmom » 06 Sep 2023, 10:12

Hi again!

We have made some changes and found some good foods for Vos. Right now we're giving her canned beef (https://www.bestpetfoods.nl/producten/725/herrmanns-bio-puur-rund-400-gr) and sweet potato, adding a Vetra multivitamin, bone meal, Greenfields probiotics, slippery elm and salmon oil. Trying out the turkey variant of the Herrmann's canned food today.

We do notice that Vos is losing weight again. We gave her 500 grams a day, which is about 3% of her ideal body weight (15kg). We are now doing 150% of that, and giving her closer to 750 grams, 5% of her ideal body weight.
However, giving her that much canned food is going to be pretty expensive, so we want to start giving part kibble, part wet food. Today we ordered a small bag of this kibble: https://www.bestpetfoods.nl/producten/1459/nd-prime-hondenvoeding-wild-zwijn-mediummaxi-12-kg?gad=1

Now I'm wondering, how does giving enzymes work with a combination of wet food and kibble? With just wet food we're doing 1/2 tsp of enzymes per meal (375 grams), that is going well.
I also read on this forum that adding coconut oil to a diet can also help with weigh gain. Do we add more enzymes when adding coconut oil?
And are there any other tips to help with putting on some more weight? We tried 1/2 tsp peanut butter last week, but didn't add extra enzymes > bad poops for 4 days :(

About the acid reflux/regurg: we have been giving Vos Zitac for the last two months. It's helping her a lot, though she's still not completely free from it. The vet warned for the stomach getting to 'base' when using Zitac long term. The alternative however is horrible regurg/reflux... We've gone from 3 pills to 2 a day, but that increased the symptoms, so we're back to 3 again.
To help with her stomach, we were thinking about putting the enzymes in capsules. What are your thoughts on this?
We did that last week when we took her to the vet last, where she needs to get food as a distraction to get her blood drawn. We put the capsuled enzymes in a piece of banana and gave her some (unenzymed) canned food on a licky mat right after that. No bad poops after that, so we're hopeful that it can work for her.

The incontinence issue: Vos has been having pee accidents (both during the day and at night) for the last two months. We're currently trying some homeopathic meds, if that doesn't work we're going to ask the vet about Prion. Besided the enzymes, the cooked veggies (according to the homeo doc) also stimulate the production of urine. So that's just something we have to deal with I guess...

Then some good news:
ALT went way down! (1500 to 600), suggesting that her digestion is finally calming down!

And the last thing I want to share could be helpful for other Dutch EPI parents:
voerwijzer.com
This website helped me a lot in finding (organic) food without legumes, grains, gluten etc. Before I found this site I felt like I was going crazy going from website to website to check ingredients. This one has all the nutritional info of every food, good filters and also has the links for where to buy it.

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