Introducing Changes - Is Mushy stool good enough to expect?

[Mackie's Mom]

I would really appreciate feedback, as Mackie Mac has had five weeks of consistently mushy stools, score of 6 on Purina fecal scoring system. Although, she has gained 3 lbs in that five weeks time. Her weight pre-EPI was 79 lbs, 70 lbs at the time of diagnosis and 73 lbs gained back at the five week regimen mark.

(Except for two days ago, after I introduced ¼ cup Kirkland Ancient Grains to her ProPlan SSS meals. She had lethargy, hemorrhagic diarrhea, vomiting and anorexia, that lasted one day. I stopped that right away and switched her back to 100% Proplan SSS and she was back to her “normal” mushy stools, with energy and appetite back.)

I am trying to adjust her regimen to best care for her.

Here is her current regimen:
2 cups Proplan Salmon Sensitive Stomach Kibble, 3x/day - w/little less than 1 tsp Panatex per cup kibble
Omeprazole
1/4 tsp Tylosin, 2x/day
1 packet Fortiflora
B-12 weekly injections

My plan of action - thinking prebiotics may be helpful to her and possibly going grain-free.

Discontinue Fortiflora and introduce Proviable-DC (after I figure how to introduce it properly). Monitor how she does for a week - all fine, then...
Stop the Tylan - will be around the 45 day mark of taking it - monitor how she does for a week, all fine, then...
Transition her to a Salmon based, grain-free kibble and see if it might be the grain that is bothersome to her system - monitor how she does for a week
Stop the B-12 weekly injections and start the Wonderlabs B-12 with intrinsic factor

How do I make the prebiotic introduction? I ordered Proviable-DC through Amazon.

Mackie Mac has been getting FortiFlora (her whole life) and continuing along with her other regimen for EPI. Do I discontinue the FF and straight away introduce the Proviable, or break open a capsule and give half dose for x number days?

Please let me know if this is a good course of action for her. I will be taking in to my Vet on Friday for bloodwork and want to know what else I should or could be doing. Thank you so much for all of you who take the time to help those of us, who are at a loss!!

[jilbert57]

This is just my thought.

I would transition to a grain free, pea, lentil, legume free food with 3.5% fiber or less first off over the course of a week.

Keep the Tylan in 2 times a day for 45 days.

Keep up the B12 shots for 6 weeks then go to Wonderlab B12w/ Intrinsic Factor 1 a day.

Go with 1 teaspoon of enzyme per cup of kibble incubated.

Stay with the Omeprazole if it is working.

In my opinion not all dogs need a probiotic. I would hold off on that and see if the grainfree kibble takes care of the poop.

Also you can add Slippery elm at meals as a prebiotic but to begin with I would keep it as simple as you can and only add in something if needed.

This is just my opinion and another staff might come on with a differing/ better suggestion.

Jill

[Olesia711]

okay.... First, thank you so much for posting exactly what you are doing!!!

But...if you don't mind, looking at what you are currently doing, this is what i would recommend and why,

1st and foremost.... before you make ANY changes that you are thinking of, the very first thing i would do is change the enzymes dose. You are under-dosing the enzymes. "2 cups Proplan Salmon Sensitive Stomach Kibble, 3x/day - w/little less than 1 tsp Panatex per cup kibble"

1. PLEASE start with 2 tsps of Pan-tenex Enzymes per 2 cups of food.. give this at least 3 days and let us know if this improves the poo.
2. If no improvement.... then the very next thing i would try is switching the food to a grain free food, as fiber in food can destroy the efficacy of the enzymes from anywhere between 0% to 50% and since we have no idea which dog is affected by how much... we tell everyone when starting EPI management to start with low fiber (grain free) food with 4% or less fiber content and AVOID foods with grain in it. .... later on.... you can try introducing rice... and if that goes well (you don't see undigested pieces of rice in the poo) then try a grain food..
3. if the increase enzymes, and the a food change does nothing..... THEN i would try the remainder options ... ONE-AT-A-TIME!
i'll start another post with the other options to try

[Olesia711]

continuation.....

If increased enzymes doesn't work, and then if a food change to a grain free food doesn't work

the next step i would take is to
1. stop the probiotics (give this a few days and then ascertain if it helps or not) some dogs simply do not do well on probiotics.
2. if stopping the probiotics do nothing....before reintroducing more probiotics.... the next step i would look at is changing the B12... at which juncture i would switch to the Wonderlabs Pet Factor B12.... and again, after a few weeks on the pills ascertain if this changed helped or not.
3. after switching the B12..... and after you ascertained if changed the B12 source helped or hindered.... THEN i would try putting your dog back on a probiotic, but this time i would try PROVIABLE.... and.... be very sure, when starting out with this probiotic (or any probiotic) always start with less then 12 the recommended dose and work your way up to a full dose of probiotic over the course of a week or two.
4. Omeprazole should not be promoting loose stools.... but over the course of the years, i have learned never to say never with EPI! SO.... as a final "trial" if you want.... stop the Omeprazole for 3 weeks... and see if it makes a difference.... although i doubt this has anything to do with it... but the good thing about stopping Omeprazole for 3 weeks is that sometimes, it becomes ineffective. (and this is where we recommend trying a different acid reducer temporarily) because then when you return to giving Omeprazole, it works. NOt a clue why this happens, it just does.......

BTW........ if your dog can handle beef.... the food that i currently like (since SPORT has trouble being available) is Castor & POllux Pristine Grass Fed Beef and Sweet POtato.... as it does not have any peas in it and it is only 3.5% fiber content.

[Tuckaboo Pam]

Don't stop the Tylan cold turkey!!! After day 45, you do a slow tapering, to see if they can do without it. Olesia has a magic formula for weaning off Tylan, but if you stop it abruptly, the symptoms may come right back. ---Pam & Tucker

[Olesia711]

good point!!! Thanks Pam for the reminder.

[Mackie's Mom]

THANK YOU! EVERYONE! For your recommendations. I will implement them in order, as instructed!

One question though, when transitioning from the old kibble to the new grain-free, what is the recommended percentages of each and over what time period approximately should this occur please?

[Olesia711]

25% new 75% old day one.
50% new 50% old day two
75% new 25% old day three
100% new day four


hope this helps!

[Mackie's Mom]

Should included in my next steps, be taking her off Tylosin? How does one know to do that? Should I do this after 45 days, tapering her off slowly? I think I read in another member's post, that you had recommended a Tylosin transitioning-off regimen. Before my post asking about my game plan for Mackie Mac, my Vet recommended taking her off Tylan powder because some dogs get loose stools from taking it, which prompted me to ask you all here!

[Mackie's Mom]

Since I have a f/u appointment with my Vet tomorrow morning, are there tests I should ask him to run? I should also add, that Mackie Mac within the last week, started drinking about 3 qts of water a day. (I measured it.) Do EPI dogs get diabetes? She is 2 years old and 70-73 lbs.