timing of seeing effects of changes: which enzyme

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.
Trish
Member
Posts: 6
Country: United States
State: Massachusetts
Pet name: Flurry
My name: Snapperblue

timing of seeing effects of changes: which enzyme

Post by Trish » 02 Mar 2023, 10:10

I adopted a dog with EPI from a shelter 4 weeks ago. At the shelter, Flurry was stabilized with fecal score typically 3 (based on your photo classification.) With an increase in food and slightly more enzyme (per amount of food), she approached a score of 2 (roughly 2.3 to 2.5.)

1. Which enzyme is the cheapest, but obviously still reliable and effective, in the US? Is a prescription always necessary?

2. Sometimes her stool gets worse- it is bulkier, less segmented, lighter colored (even with yellow.) How long does it take for a change in diet or stress to show up in her stool? Occasionally, it's very soft and yellow. (This seems to have happened right after high excitement/stress.)

I have a log and a photo of each poop, but I often can't figure out what caused the change. Is this likely to be something that happened 36 hours ago? 24 hrs? Can't tell?

Each meal is 1 1/4 cup Purina Chicken and Rice kibble, 1/4 can Pedigree, 3/4 tsp PancrePlus. My vet wanted to put her on a special diet, low fat, diet, but I had read on this forum that this is not necessary (just expensive) and she did well on the random brands of kibble and canned she got at the shelter.

Thanks for all the information and support you provide here!

User avatar
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: timing of seeing effects of changes: which enzyme

Post by Olesia711 » 02 Mar 2023, 22:08

Hi Flurry's care-giver,

Thanks for writing us.

It appears that you might be under-dosing the enzymes.... and the food may not be optimal for her... or it might be just fine and there is no need to put her on low-fat food, unless Flurry has another condition besides EPI that requires her to have a low fat diet.

1. ENZYMES..... stick with powdered enzymes, BUT.... the better deal is food grade vs. prescription grade. We have a list of enzymes here:
https://epi4dogs.com/enzyme-list/
but many of us use EnzymeDiane's enzymes (the 6x is the same as prescription enzymes and as other brand's 10x)

2. Sometimes her stool gets worse- it is bulkier, less segmented, lighter colored (even with yellow.) How long does it take for a change in diet or stress to show up in her stool? Occasionally, it's very soft and yellow. (This seems to have happened right after high excitement/stress.)
YES!!!!! stress (good or bad stress) can definitely cause stools to go soft sometimes even to the point of diarrhea.
HOWEVER.... a couple of things, start with a ratio of 1:1 with the enzymes and food... in other words, 1 level tsp of powdered enzymes to 1 cup of food (kibble) or 3/4 tsp of enzymes per 1 cup of wet food. For what you are feeding now.... try giving 1+1/2 tsp of enzymes per the 1+1/4 cup Purina dry with 1/4 cup of canned... see if this dramatically improves the poo over the course of a few days... if poo becomes rock hard, then drop down to 1+1/4 tsp of enzymes and see if that still works well...

Regarding the food.... i would stick with regular OTC dog food- -not prescription low fat food.... HOWEVER.... what you might want to try is a different food, something with less fiber content and no grain.... and see if it is better tolerated. An inexpensive choice to try would be Taste of the Wild-Pacific Stream. If the poo remains the same on a no grain/low fiber food....

What were the TLI test results and the B12 test results? Is she getting B12?
Also is she getting any probiotics?
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.........

Trish
Member
Posts: 6
Country: United States
State: Massachusetts
Pet name: Flurry
My name: Snapperblue

Re: timing of seeing effects of changes: which enzyme

Post by Trish » 03 Mar 2023, 09:26

Thanks for the detailed reply!

More background: At the shelter, Flurry was stabilized (though with poop more like #3) at 1/2 teaspoon enzyme for one cup of random kibble plus 1/4 can (usually Pedigree or Wellness brand.) So I have increased that some. When I suggested increasing the enzyme, they said that could make things worse.

She was so overexcited about food that I increased the amount in each meal by 25% and (I forgot to mention) started giving her a small lunch. I know that the food obsession is expected after her period of starvation and she is calming down about it. All her food is incubated with a somewhat higher dose of enzyme than the shelter provided. Sometimes her stool is close to the "perfect" score of 2.

The kibble I am giving has crude fiber 3%: I knew from reading here it should be low- how low?

Blood tests:
cobalamin 379 ng/L
folate >24.0 ug/L H
TLI 1.2 ug/L L

The town shelter (Plymouth, MA) took her in in August 2022, diagnosed in October, weighing 24 lbs. She now weighs 38 lbs.

I am impressed that they stuck with her and cared for her for so long, paying vet, lab, and medication bills for nearly 6 months.

She is not getting B12 or pre- or probiotics. Thanks for explaining the x6 enzyme rating.

Thanks, Pat

User avatar
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: timing of seeing effects of changes: which enzyme

Post by Olesia711 » 03 Mar 2023, 22:59

Hi PAt,

Thanks for the details..... WOW!!! you are doing a great job caring for her AND you are correct... sounds like the shelter did a great job caring for her and treating her EPI condition.

Since she is eliminating a #2 poo.... that is perfect.... so the mix of food and enzymes that you are giving her now must be very agreeable with her digestive system and condition. Many of these dogs when first diagnosed, need the 1 level tsp of enzymes per 1 up of kibble (or 3/4 tsp with wet food)... however... once they become stable (and this means that they have gained some weight and that they are pooping normal looking poo at a normal frequency (1 to 3 times a day).... THEN.... we suggest to people to slowly "try" and reduce the amount of enzymes they are giving to the dog (reduce by 1/8 of a tsp at a time and give it 3 to 5 days to assess) until they find that they have reduced the enzymes too much cause the stools go sloppy again. And this will be the new dose of enzymes needed.

It sounds like Flurry stabilized pretty quickly... and doesn't need the level tsp, but rather the amount that you are currently giving her since she is pooing #2 :)
So i would continue what you are doing!

If the food that you are feeding now is 3% fiber content.... that usually works VERY well. I personally noticed that when i went from 4% fiber content to 3.5% fiber content, it made a big difference in my EPI dog's poo. The only problem with this is that every dog is different... so some can tolerate more fiber than others, while many cannot..... so it's kind of trial and error... but we suggest to everyone to "start" with a low fiber content food of 4%.. but if you do lower, that is often even better. SO again, i would continue what you are doing.

But... the B12, at 379 is low normal.... this is something i would start supplementing. You can do B12 shots or pills... i would recommend doing the WOnderlabs B12 pills.
https://www.wonderlabs.com/itemleft.php?itemnum=K9688
B12 pills are given according to the dog's weight. This page explains the dosing:
https://epi4dogs.com/b12-protocol/

SOunds like you are doing a great job! Please feel free to ask us any other questions that pop up.
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.........

Barb
Staff
Posts: 918
Country: United States
State: New Jersey

Re: timing of seeing effects of changes: which enzyme

Post by Barb » 04 Mar 2023, 11:23

Hi Pat. A warm welcome to you and Flurry. Congratulations. You are doing an amazing job with her. And so did the shelter. So glad to hear it.

Olesia mentioned this already, but I will endorse enzymes from Enzyme Diane. We used them for almost 11 years with our German Shepherd, Kolby, and he thrived on them. Diane has an excellent product and is so helpful. She publishes her phone number on her website so you can talk to her and ask questions.

I also recommend keeping a log/journal. Record everything you give her and the amounts each day and the resulting poos. This will tell you what is working and what might need to be adjusted, if things change. It was a great help to us.

Thank you for giving Flurry such a good home. Let us know how she does.

Barb

Trish
Member
Posts: 6
Country: United States
State: Massachusetts
Pet name: Flurry
My name: Snapperblue

Re: timing of seeing effects of changes: which enzyme

Post by Trish » 05 Mar 2023, 17:52

Thanks very much Olesia and Barb for the very friendly welcome! Though Flurry's stool is sometimes a #2, she often is #3- I can't figure out why. Often the first part to emerge is better, and the last part is yellower and softer (but still shaped like #3.)

The shelter told me EPI treatment was really simple- just sprinkle some enzymes on her food and incubate. After reading this forum (and other sources), I think this is not completely true!!! There was no mention of the co-occurring problems (like B12 and BID). I'll order Enzyme Diane and the B12.

The rest of my questons are about Flurry's behavior.

The folks at the shelter did not mention her behavior problems, even those I asked about, including how she was on leash and with other dogs. On leash, she pulled like a Belgian draft horse- add to this very aggressive lunging at people and dogs (on leash and from inside our fence with is 30 feet from the sidewalk.) She had no basic obedience training.

I learned to sit or kneel by her and hold her collar when people or dogs went by (50 feet away)- she'd always get in a complete frenzy. Several times, she pulled me over, and dragged me several feet across the grass while I held a death grip on her collar, fearing she'd attack someone. (At these times I considered changing her name to Vlad the Impaler.)

However, when I have had a friend stand and let us approach, Flurry actually quiets down and, by the time we are within a few feet, she turns friendly. I think she's not going to attack a dog, but unless I get a muzzle, I am reluctant to try this.

My approach to the frenzied barking has been holding her and telling her to calm down. I am trying to habituate her to people and dogs also by staying in the car at the park and telling her there is no need to get upset.

Also, I began feeding her more- at first up from the shelter's 1 cup to 1/14, now up 50% to 1 1/2 cup kibble. I have doubled the enzyme from the shelter's 1/2 t to 1 t.

She is really calming down.

SO- Is this aggression typical of EPI dogs that have been starved? In recent days, at the park and in the yard, she may give a short burst of barking, but settles down.

Is this improvement likely to be because of my fantastic dog training skills, or because she just needed more food?? Was she hyper because she was still hungry? Also, recently at the park (with no one else there) she produced some thick drool, which I have found typical of anxiety in my other dogs.

I'm sorry for the length of this message. I came close to returning her to the shelter because of the beating my body was taking trying to control her, so any hope about her future behavior would be most welcome!

Otherwise she is sweet, playful, and has the cute ears and fluffy tail that lured me into this! Pat

User avatar
jilbert57
Staff
Posts: 2092
Country: United States
State: Washington

Re: timing of seeing effects of changes: which enzyme

Post by jilbert57 » 05 Mar 2023, 18:56

Some of the aggression can be caused by the low B12 and getting the level up nearer the high range should help out.

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
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: timing of seeing effects of changes: which enzyme

Post by Olesia711 » 05 Mar 2023, 20:03

Hi Pat,

Thanks so much for sharing these details with us... and yes... MANY EPI dogs in the beginning show what we "think" is aggressive behavior simply because they are not feeling well, without treatment or with limited treatment EPI hurts, when their B12 is low, they get very cranky, and when they are hungry they can get even more cranky and feral like too! SO... much of this happens because they are sick, but the bad part is when not corrected it can become a behavioral pattern. Most of the time, once they start feeling better (and as Jill mentioned, the B12 is a huge part of this!) you can start to see them mellow out.... but then if they still have some scardy-cat behaviors (which is what it sounds like FLurry is doing) then you have to slowly work on desensitizing them to what terrorizes them... and from what you wrote it DOES sound like you are sort of doing this and seeing some success.

BUt i would like to suggest some things to what you wrote:
1. I learned to sit or kneel by her and hold her collar when people or dogs went by (50 feet away)- she'd always get in a complete frenzy. Several times, she pulled me over, and dragged me several feet across the grass while I held a death grip on her collar, fearing she'd attack someone. (At these times I considered changing her name to Vlad the Impaler.)
If she is in a frenzy at 50 ft... back up further.... try 75 ft or more and SLOWLY lessen the distance as she calms.
Instead of sitting/kneeling... try teaching her at home first with no distractions to "look at me" and give her a reward (a tiny piece of meat- very near a meal time so she has enzymes in her system).... carry tiny pieces of meat with you (even freeze dried) and when you think she is ready to go out in public.... start at a far away distance, but if / when she gets too close, ask her to "LOOK AT ME" and give her a tiny piece of meat reward.... (and maybe have a little mini meal with enzymes prepared waiting in the car or something) so you can cover this"look at me treat" with enzymes shortly there after. OR.... if she is toy motivated... then distract her with a tuggy!

2. However, when I have had a friend stand and let us approach, Flurry actually quiets down and, by the time we are within a few feet, she turns friendly. I think she's not going to attack a dog, but unless I get a muzzle, I am reluctant to try this.
You are correct ... don't try her near other dogs UNTIL she is ready and do it with someone who can really handle this type of situation.... maybe call an APTD Dog trainer service near you, explain the situation and tell them you need someone experienced with experienced dogs to work with you and help you dog get over fear of other dogs.

3. My approach to the frenzied barking has been holding her and telling her to calm down. I am trying to habituate her to people and dogs also by staying in the car at the park and telling her there is no need to get upset.
Your philosophy here of desensitizing is EXCELLENT... just be careful to do it from a very far distance to start with to where she doesn't get upset and slowly lessen the distance... HOWEVER..... don't do from the inside of a car only because some dogs treat the car as "their" territory... so it is better to desensitize in a neutral area.

4. Also, I began feeding her more- at first up from the shelter's 1 cup to 1/14, now up 50% to 1 1/2 cup kibble. I have doubled the enzyme from the shelter's 1/2 t to 1 t.
Excellent and perfect!!!!!!!

5. The puling so hard on a leash to where she is hard to control.... my current dog (non-EPI) male/standard poodle... he'd pull so hard he'd pull me down! NOTHING worked ... until my groomer said to get a gentle leader.... i followed the directions exactly, he hated it the first time i took him outside with it on, but OMG... it worked.... he does not pull me around anymore...
THis is what it is... but you can get it at any pet store:
https://www.chewy.com/petsafe-gentle-leader-padded-no-pull/dp/52156

6. SO- Is this aggression typical of EPI dogs that have been starved? In recent days, at the park and in the yard, she may give a short burst of barking, but settles down.
Very often yes.... but you have to take the time to help her get over this... which is what you are doing :) and doing a good job of!

7. Is this improvement likely to be because of my fantastic dog training skills, or because she just needed more food?? Was she hyper because she was still hungry? Also, recently at the park (with no one else there) she produced some thick drool, which I have found typical of anxiety in my other dogs.
hahaha! YES! your diligent training skills are definitely contributing to her improvement.... it just all takes time... but also your observation and re-evaluation of her dietary needs are also helping!
Yes the thick drool can be stress related... but it can also be SID (small intestinal dysbiosis) like acid reflux due to EPI and this too can be treated with the EPI protocol of proper diet, B12, pre/probiotics... and sometimes acid reflux meds are needed and if all else fails, a course or Tylan. If she is farting, making tummy noises, then this is definitely SID related... And stress can make this worse too ....

Hope this helps a little!
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.........

Trish
Member
Posts: 6
Country: United States
State: Massachusetts
Pet name: Flurry
My name: Snapperblue

Re: timing of seeing effects of changes: which enzyme

Post by Trish » 07 Mar 2023, 09:48

Thanks for the replies, Jilbert andOlesia... wait! what? Did you say she can have TREATS??? This is huge!

1. Treats. The only thing that motivates Flurry about training (sit, stay, come, touch, look at me when I say her name) has been food- I set aside some of her meal for this. If I go out in the yard with a small dish of this, she is a different dog. (I don't know who she is, but not the Flurry I know.) She is attentive and responsive. If I go out without food, she acts like she has never heard these commands.

However, this is a gooey mess, so I have never tried bringing it to the park.

My vet told me she could have low fat treats. I was not sure of this and haven't tried. Can I use these, cut into slivers, after a meal?

2. Pulling and Frenzied Barking. I have tried a front clip harness, but she pulls so hard it loosens. I have a gentle leader that my last dog was able to evade. I will start getting her used to it today.

Flurry used to go nuts if a dog was 200 feet away and she is now much better. Instead of the park, I have tried sitting on my front porch with a sidewalk about 20 feet away. In our least sesssion, she ignored people and strollers and reacted less to dogs! I sit with her on a leash, but also tie her to the railing so I won't be dragged around if she loses it!

Next time at the park, I will use the long leash to tie her to a 3.5 foot diameter Eastern White Pine. I will sit with her as usual, holding the other leash, but she's not dragging that tree anywhere!

In the car, at first she lunged whenever we passed a pedestrian. Now she ignores most- occasionally growls at a dog- and will be quiet when we are parked and people pass.

3. Food. I am keeping her on the 1 1/2 c low fiber kibble, 1/4 can wet food, and 1 t. enzyme for 5 days. So far, so good. I record all her food and poop a notebook and have an iPad full of pictures of every pile she has produced. If a friend should want to see another photo in the iPad, we will have to wade through 60 or 70 pictures of dog droppings.

4. Enzyme Diane and b12. I will order as soon as I can. My email was hacked on Valentine's day- the hackers didn't get anything but attempted to use my credit cards. This should have been easy to fix, since I immediately changed my password and canceled my old cards, but has turned into a nightmare of long calls to agents who don't know what is going on. Very stressful and frustrating. Just venting!

5. No farting or tummy noises!

Writing this helps me realize the progress she has made. Thanks for your very helpful advice and feedback- and for just being there!! Pat.

User avatar
Olesia711
Founder & Research Director
Posts: 3858
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: timing of seeing effects of changes: which enzyme

Post by Olesia711 » 07 Mar 2023, 10:14

hahahaha! "wait! what? Did you say she can have TREATS??? This is huge!" When an EPI dog is first diagnosed, we strongly advise NO treat until it is stable (delivering normal looking poos 1 to 3 times a day).... however, once stable then "try" giving treats without enzymes but within 1 hr of an enzymed meal (so that the enzymes are still in her system and can cover the treats).... start with something pure protein (like meat... like what your vet suggested... and yes, slivers of meat is perfect!) but very very small amounts.... do this for a few days and see if it is well tolerated. if well tolerated, and once your dog has been stable for at least a month THEN... you can try giving just a very few treats away from 1 hour of an enzymed meal. SOme can, others cannot. but you will not know until you try.
For example.... i was doing Schutzhund. tracking training and i was able to use 10 pieces of grain free kibble in the tracks.... not 11 only 10.... but it worked... but every dog is unique, so you have to just try when the time is right.

Because you are having strong behavior issues... and food is her only motivator... IMHO you have to make a choice and giving limited treats in a limited time-period is the lesser of two evils..... but also why i stressed also making a little food to bring with you that has enzymes in it....

Another trick if you HAVE to use treats as a reward is make a squeezable mush of some food with enzymes, blend it into a paste and put in a squeeze bottle. Every time you need to use a treat to encourage/reward, etc. squirt a blob of this enzymed mush into her mouth :)

the only thing you have to be careful of is when making this treat mush, or bringing a small amount of prepared enzymed meal is to NOT let it sit around for more than an hour (unless you keep it in a cool pack) and then take out maybe 15 minutes before you are going to use it.

Excellent on the no farting.... you are REALLY making great progress with the diet AND with your training..... WOW! baby steps works!
Let me know (after a few days) if the gentle leader helps.
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.........

Post Reply

Who is online

Users browsing this forum: No registered users and 231 guests