newly diagnosed- so many questions

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.
Post Reply
chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

newly diagnosed- so many questions

Post by chrisPC » 13 Mar 2023, 19:48

First of all, thank you for this websight and all of the information and research found here.
My dog Layla is a standard golden doodle, 4.5 years old. She was diagnosed 2 weeks ago with a Tli of 2.1
Because of this group I had already guessed her diagnosis and was prepared. I asked the vet to check her B12 and folate.
B12 is 198 and folate is 19.5

Currently Layla is eating 3-4 times daily. We are using Enzyme Diane 6x, 1 tsp per 1 cup of food. I add 1 cup of lukewarm water and let her food incubate for 20 minutes. Her food is PUrina Proplan sensitive skin and stomach Salmon. it is 4 percent fiber.
She is also taking the Vitamin B12 with intrinsic factor from Wonderlabs, 2 capsules daily.
and Slippery Elm from Wonderlabs, 1/2 tsp twice daily in her food.
it has been a little up and down these first two weeks, but I am happy to report that she is seeming much better.
Her poop has been between 2 and 3 on the purina poop scale for the past 4 days, and she is not as voraciously hungry as she used to be.
here are the things I have questions about.
We noticed an odor on her, and trimmed all extra hair from her long nose and mouth area. I clean her face with baby wipes after she eats, and these two things have helped some. I am guessing the partly digested salmon food gets on her face and stinks? I read some forum replies on a post on this subject. sounds like this isn't unusual?
If her poop is looking solid and mostly normal, am I to assume that she is digesting the food and getting calories and nutrients? Problem solved and don't change anything?
How long should I use slippery Elm?
How long should I wait to have her Vitamin B12 retested?
I've read that you can add a tablespoon of Pumpkin to food to firm up stools. If you do this, and it firms up the stool, is that masking what is causing the softer stools, and falsely making you think the enzymes and other things you are using are working?
sorry for all of these questions. As you all know, this is very overwhelming at first and there is a lot to learn.
Thank you again for this wealth of information. Also, I would be very happy to participate in any research you are involved in but I get an error when I tried to fill out a form here.

User avatar
jilbert57
Staff
Posts: 2090
Country: United States
State: Washington

Re: newly diagnosed- so many questions

Post by jilbert57 » 13 Mar 2023, 20:35

Hi Chris, so the transition from the enzyme tablets to the powder went ok?
You might have seen a odor study in your looking around on the website. Some dogs hold the smell and sometimes it fades but you are doing right by cleaning Layla's face off after eating. You can also try feeding on a flat plate this limits some face exposure to the enzymes.
If I was you I would keep up on the Slippery elm for awhile. Give the B12 some time to raise. Also keep in mind the grains in the food if you still can't get consistent poop. The grains interfere with the enzymes.
Glad to hear things are improving.
PS it helps if you can keep your original thread going and post on that in the future. Then we can look back at what you have already done :)

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: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: newly diagnosed- so many questions

Post by Olesia711 » 13 Mar 2023, 20:48

Hi Chris and thanks so much for writing in about Layla (love the name!!!) and thank you for all the specific details, that helps a LOT!!! BTW... You are already doing a great job!

First, i'd like to address the following (in red) :
"Currently Layla is eating 3-4 times daily. We are using Enzyme Diane 6x, 1 tsp per 1 cup of food. I add 1 cup of lukewarm water (no need to add a cup of water... way too much... just add enough water to moisten the kibble so that the enzymes are not sitting "dry" on the food) and let her food incubate for 20 minutes. Her food is PUrina Proplan sensitive skin and stomach Salmon. it is 4 percent fiber."

if this is the same product: https://www.purina.com/pro-plan/dogs/dry-dog-food/sensitive-skin-stomach-large-breed
then it has grain in it and is 4.5% fiber content... We like to "start" EPI dogs on grain free products first HOWEVER.... if Layla is eliminating #2-#3 poos... that's pretty good and i would not worry about changing the food.. or at least not at this time... or not yet.... only if her poos start being all #3's or getting sloppier.

Your question" We noticed an odor on her, and trimmed all extra hair from her long nose and mouth area."... that most likely is the enzymes... many dogs when starting on the enzymes start to smell like baby vomit, sour milk, etc. what you are smelling is putrefaction.... it's from SID (small intestinal dysbiosis) that all dogs with EPI have. What will eventually happen is that the stench will go away, or you will get used to it.... usually once you get SID under good control, the smell will subside. In your case, i'd give it more time, to allow the B12, the enzymes, etc. to all start working.... if the stench is still there a few months from now., let us know and we will work with you to try adjusting the protocol so that you can get SID under better control.

If her poop is looking solid and mostly normal, am I to assume that she is digesting the food and getting calories and nutrients? Problem solved and don't change anything? For now a mostly #2 with sometimes #3 is okay......so give her body a longer chance to settle out... but you will eventually want #2 poos is possible... we can help you get there in time.... but for now, a #2 and #3 is definitely good :)

How long should I use slippery Elm? Some people use it intermittently to fix things (loose stools, acid reflux) while other find they need to use a maintenance dose forever. You just started this journey 2 weeks ago. i'd give it another few weeks and then if you want to try not giving it ... see what happens.

i strongly advise you to start keeping a journal. Effectively managing EPI is all about finding the right balance of the recommended protocol for each EPI dog. The way to do this is start with the recommendations, but then if things in approx month or so are not going as well as expected... then you need to start "tweaking" things one at a time to find the right balance for YOUR dog.... here is a page on EPI logs:
https://epi4dogs.com/epi-log/

How long should I wait to have her Vitamin B12 retested? i'd wait at least 3 months, but more like 5 or 6 months. Remember, if giving B12 pills you need to stop the pills 1 weeks prior to the blood being tested. If giving shots (which you are not at this time) then stop the shots 1 month prior to the B12 blood test.

I've read that you can add a tablespoon of Pumpkin to food to firm up stools. If you do this, and it firms up the stool, is that masking what is causing the softer stools, and falsely making you think the enzymes and other things you are using are working? No.... the pumpkin is a fiber and fiber is one of the things that actually helps with SID (dysbiosis). Unfortunately all dogs with EPI have SID and most of the out-of-control symptoms of SID is identical to untreated EPI symptoms... that's what gets confusing,....

HOpe this helps and looking forward to hearing more successful stories about Layla!!!
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.........

chrisPC
Member
Posts: 7
Location: Port Clinton
Country: United States
State: Ohio
Pet name: Layla
My name: chris

Re: newly diagnosed- so many questions

Post by chrisPC » 17 Mar 2023, 17:53

Wow, thank you so much for your replies and encouragement. I really appreciate it!
I am a nurse and am all about documenting and using the flow sheet/ journals from enzymeDiane and your sight. I’m a bit obsessive but want to carefully track everything thing I do and it suits me to write it all down.
I’m happy to report that Layla is doing very well. She has been gradually eating less and less frequently, more like how she used to eat. She’s gone from 8 cups per day in the very beginning to about 5 cups now.
I stopped by the vet today to weigh her and she has put on 4 pounds in two weeks. (From 56 to 60#)
Her poop is still #2’s so I don’t plan to change anything right now. Never thought I’d be so proud of dog poop and my dogs weight.
Is it okay to let her dictate how much she eats? 60# is pretty good for her. [attachment=0]FAC7E23B-F3A1-449F-BBF9-FB49B101198E.jpeg[/attachment
Attachments
FAC7E23B-F3A1-449F-BBF9-FB49B101198E.jpeg
FAC7E23B-F3A1-449F-BBF9-FB49B101198E.jpeg (2.94 MiB) Viewed 673 times

User avatar
jilbert57
Staff
Posts: 2090
Country: United States
State: Washington

Re: newly diagnosed- so many questions

Post by jilbert57 » 17 Mar 2023, 18:40

Layla is beautiful! Good job on the weight gain.

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: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: newly diagnosed- so many questions

Post by Olesia711 » 18 Mar 2023, 09:55

Hi Chris... Oh my Layla is GORGEOUS!!!!!!! Great report... thrilled to hear about the weight gain and yes, when they start healing, that is the correct thing to do, let them determine how much food they need. As their body replenishes all that it has lost... their need to consume massive amount of food starts to subside.

AND.... now that you are getting excited about dog poo.... you are officially an EPI poopologist ! :lol: Welcome to the club..............
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: newly diagnosed- so many questions

Post by Barb » 20 Mar 2023, 11:45

Layla is so beautiful. Congratulations on the weight gain. You are doing a terrific job with her. I was going to suggest keeping a journal, but you are already doing that. She is lucky to have you.

Barb

User avatar
NanaKB
Member
Posts: 1
Country: United States
State: Oklahoma
Pet name: Bella4
My name: Kathleen

Re: newly diagnosed- so many questions

Post by NanaKB » 22 Mar 2023, 08:53

Just wanted to add a tip that has really helped my Bella. I have her on 8x enzymes 3/4 teaspoon per cup of grain free kibble. In order to distribute the enzymes more evenly before adding moisture i grind the kibble. This turned her around in a couple of days from #3 poops to #2. I stopped the slippery elm in the meals as my vet told me it coats the stomach and inhibits absorption of nutrients. Hope this helps.

User avatar
Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: newly diagnosed- so many questions

Post by Jean » 23 Mar 2023, 09:55

A huge welcome from the UK

TOTALLY manageable , and what a trully gorgeous girl Layla is

Just ask away


Jean
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

Post Reply

Who is online

Users browsing this forum: No registered users and 240 guests