Possible EPI, Vet Waiting to Test due to Steroids?

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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MamaOfGomo
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Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 03 May 2023, 20:48

Hey!

I did notice the bentonite and remembered (for my own stuff) that it's really not good to take too much, so she is only getting what is recommended. We have noticed a huge change in her poops lately since we've been using new stuff. I'll write what our routine is just to document.

AM
*1/2 teaspoon of enzyme replacement from Enzyme Diane (supposed to be 1.5 teaspoons but we are slimming it down since she tested negative for EPI)
*1/8 teaspoon of Four Leaf Clover Liver Cleanse (since she just got off 2 months of medications)
*1 scoop of the weight gain powder I mentioned in a previous post (recommended amount for her weight)
*1 B12 vitamin with 1000mcg of B12 and some folate (vet recommended dose, plus B12 is one of those things that they can easily pee out if there is too much, so we arent too worried about over doing this one)
1/2 teaspoon of the probiotics I mentioned (recommended dose)

PM

Food + Enzyme Replacement as mentioned above.

The enzymes go into her Natural Balance bison and sweet potato food and sits for 20 mins with warm water and mixed, then all other stuff gets added in.

Her poops before all of this were MASSIVE. I'm talking... huuuuuge. Its been so long since shes had a "normal" poop... and honestly at this point I cant even remember what that looked like. They were soft-ish coming out and then once out very soft. Sort of like a pile of thick hummus. Never easy to pick up.

Now, her poops are quite dark, like a darker milk chocolate. They were EXTRA dark when we first put her on the enzymes, which had me concerned about internal bleeding, possibly from an ulcer? But we lowered the enzymes and that seemed to lighten it to a nice dark milk chocolate color. The biggest change though is the size. Instead of a HEAP coming out every single time, with no real form, it's now formed pieces of really well constructed poop AND less poop overall. This makes me think she is absorbing more than she was before. I did notice when I lowered the enzymes that what came out wasn't fully digested. I found a half of a june bug butt in one of her poops, so maybe the enzymes really were helping her body get all of the things worked through. I'm honestly not sure.

It's all speculation at this point! I should have went to school to be a vet!

I'm going to keep in mind the high fiber diet if all of this testing doesn't work out. Our vet suggested today that we see a specialist, so its clear they are running out of ideas.
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

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

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 03 May 2023, 23:09

Hi Cassidy,

Glad to hear that the poos have dramatically improved.... WAHOO!!!!!!!!!! And your regimen sounds good.
Perfect poos ... well... "think tootsie rolls" :)..... and it sounds like you are pretty much there! Just know that some dog never have perfect poos, but if you can get them close enough, that is great.

you are keeping a daily record for yourself, .... in addition tom sharing with us today... yes? if i have not mentioned it (although i think i did, and if so, sorry for repeating myself).... anyway... do try to keep an EPI Log/Journal, even though this is not EPI.... recording everything you give and then recording the daily results can REALLY help you identify what works and what doesn't and "trends".... if you need an idea of what or how to start... check out our EPI Log page for some examples:

https://epi4dogs.com/epi-log/

Paws and fingers crossed that the good poos continue...... and do keep us posted. And yes, just in case, do keep the high fiber food in mind, just in case.
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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MamaOfGomo
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Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 06 May 2023, 13:29

Thanks for the advice!

I am logging the changes and the constant vet visits also help them stay informed. We should be getting her dysbiosis result soon. Yesterday she went in and weighed a little over 29lbs... so almost 3 pounds gained since we started using the probiotics about 2.5 weeks ago and enzymes about a week ago! This is the first time we've seen her weight go up and not down in a long time. It's very exciting!
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

User avatar
Olesia711
Founder & Research Director
Posts: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 06 May 2023, 22:31

WAHOO on the weight gain!!!!!!!!!!!! and good poo's :)

But do keep us posted and glad you had the dysbiosis test done... hopefully it will give some clues as to what in the world is going on.

Even though the poos are good.. continue to keep up with writing everything down in a journal... the reason why i am mentioning this is because sometimes the probiotics work and things continually improve... once the gut flora gets back on track..... but.... sometimes the probiotics work great... for a while and then everything goes south again.... which means, probiotics are not the answer/fix. .....

you are doing such a great job taking care of your little one....paws and fingers crossed that you find some answers soon!
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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MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 15 May 2023, 13:39

Hey there. We finally got the DI test back today, but am still waiting on the Drs call to sort of explain it.

The only thing that was off was Clostridium hiranonis. It should have been between 5.1-7.1, but it came back as 3.7.

"Peptacetobacter (Clostridium) hiranonis is a normal component of healthy canine guts (1–3) and performs primary to secondary bile acid conversion via 7α-dehydoxylation (4, 5)." https://journals.asm.org/doi/10.1128/MRA.00067-21

Additionally, yesterday Gomo's poops began getting fatty and soft again with NO changes in what we've been giving her. Disappointing, but I'm glad she's gained some weight in case this goes south again. I'm wondering if the enzyme replacements and probiotics are attempting to compensate for "bad" food, but can only help for so long. I'm thinking I should switch her to a hydrolyzed diet.

I did find a probiotic with C. hiranonis as the main type, so maybe I'll put her on that instead of what she is on right now, or maybe in conjunction with it. I'm not sure if there is a way to "overdose" probiotics.

I gave her breakfast without the enzyme replacements this morning since she shouldn't be on them long term with a negative EPI result, so we will see how that goes.

I'll update with the Drs suggestions later today after he calls.
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

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Olesia711
Founder & Research Director
Posts: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 15 May 2023, 14:03

thanks for the update.... and i agree, sine not EPI, no need for the enzymes

BUT since "Clostridium hiranonis" was off..... not sure how much of an effect this has on everything.... but while on the phone with the vet.... ask the vet, if they think a fecal transplant might be warranted if a change in food ( to highly digestible or hydrolyzed food) & probiotics don't seem to help.

A Fecal Transplant is not as scary as it sounds.... usually they are just given pills or an enema.... and it is not expensive........ Texas A&M recommends this when a food change fails.


Go to this page
https://vetmed.tamu.edu/gilab/service/assays/canine-microbiota-dysbiosis-index/

.... and in the Dysbiosis section you can read about the:

1. Therapeutic approach to microbiota dysbiosis
"Dietary modifications should always be the first treatment option. A highly digestible diet reduces undigested nutrients in the GI lumen, reducing the potential for excessive bacterial proliferation......"
2. Fecal Transplantation FMT:
"This procedure can aid in restoration of the normal microbiota. FMT is the transfer of stool from a healthy donor into the gut of a recipient via oral capsules, endoscopy, or enema. ......."
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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MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 19 May 2023, 22:06

I have read about the FMT and would be very open to doing it. Right now the vet and I are waiting to hear back from A&M about their suggestion given the last two tests, which I can imagine goes... 1.) DIET 2.)PROBIOTICS 3.) THEN FMT

We stopped the enzymes recently (per my last post) and its been hell since. The poops are completely soft... and she's lost a pound. After 3 consecutive weeks of gaining weight with the enzymes. I really thought she had EPI and now I'm doubting the test. Her mood is back to "sad" and the farts are back. If it's not EPI then why are the enzymes helping so much?

She gets very bioavailable and lasting probiotics with each meal. Her food is hydrolyzed... I'm tempted to do another test for EPI at this point.
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

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jilbert57
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Posts: 2081
Country: United States
State: Washington

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by jilbert57 » 19 May 2023, 22:19

Have you thought of trying plant enzymes like Prozyme or Total Zymes?

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: 3843
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by Olesia711 » 20 May 2023, 11:26

Hmm............ so things are now going south since you stopped the enzymes??? I am so sorry to hear this but what you can do is put her back on enzymes..... maybe start with the full dose of pig enzymes and once the poos are normal again... then try reducing the the lowest amount needed to maintain her.

And/or skip the pig enzymes and try a plant enzyme like Jill suggested and see if that is enough to sustain her............ if you want to try plant enzymes, my 1st suggestion would be Dr. Goodpet:

https://www.chewy.com/dr-goodpet-digestive-enzymes-dog/dp/158600?show-search=1&utm_id=401602589&msclkid=d5c1e60855341f9362658260b05bc284&utm_source=bing&utm_medium=cpc&utm_campaign=Shopping_NC_All_HC_Health%20%26%20Wellness_Brand&utm_term=4585444530739746&utm_content=Dr.%20Goodpet

If when back on the enzymes.... please tell your vet what is happening and also, please tell him or her that we have had cases here on Epi4DOgs where the dog did NOT have EPI, and the TLI values was not even in the "teens" to where it might be segueing into EPI.... However.... they did have proximal small intestinal disease ... and the dog's stools went sloppy and they did not do well every time they tried stopping the enzymes.... so these dogs were kept on pig enzymes.. i have no idea why this works with "some" proximal small intestinal disease cases, but it does..... Please share this with your vet in case this is what might be going on......................
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
MamaOfGomo
Member
Posts: 22
Country: United States
State: Texas
Pet name: Kagome
My name: Cassidy

Re: Possible EPI, Vet Waiting to Test due to Steroids?

Post by MamaOfGomo » 21 May 2023, 11:08

Thanks to both of you for your suggestions and info. I'll look into plant enzymes and see if thats something we'd like to try instead of the pig.

We changed her food to a hydrolyzed kibble 6 days ago and she still hasn't adjusted at all. This is on top of not doing the enzymes. Her poop is 100% light tan, sort of the same color as the new food. Very soft, sort of like hummus. Same color too... So yesterday I added the enzymes to sort of see what would happen, and after dinner, she was clearly extremely uncomfortable in her stomach. It was gurgling like crazy, death farts, throwing up in her mouth, whining, and uncomfortable to lie down or get up. I was watching her very closely in case we needed to go to an ER. I only did 1/2 teaspoon for each meal yesterday, which is under the recommended and what we were doing before. I do recall her having some gurgling when we first tried the enzymes, but nothing like this! This morning she seems to be feeling less uncomfortable but is tired and lethargic.

I'm fasting her this morning since I think maybe its the new food and will be leaving here soon to get the Hill's Science Prescription brand hydrolyzed food. She's been on that before and seemed to do just fine on it. I've only avoided it because of the price, but looks like it might be necessary. I'm going to leave out the enzymes again just in case that was also upsetting her stomach.

I haven't heard back from the vet about what A&M suggests, but I'm going to email on Monday.
I'm Cassidy and I live in Austin, TX.

My pup is Kagome, a 9-year-old Pittie Mix who I foster failed in 2015.

She was tested for EPI on April 19th, 2023 and it came back negative for the usual markers.

She did however have low B12 and high Folate... so now we are chasing this trail... or tail?

More journey to come.

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