Possible EPI diagnose? Please Help

[Eddiespaghetti]

I am unsure about capsules, I never went that route. I used to feed frozen meals. I would just defrost them and add hot water. The hot and cold would make it room temperature or so. From an efficacy standpoint point, you do not need to incubate at all. You do need to make sure all the powder is moistened though. Dry enzyme powder can cause the enzymes to stick to their mouth and eat away at it, causing sores. I use dog food toppers, wellness core makes a grain free chunks in gravy. It has enough moisture to fully coat the powder, tylan, enzymes, and probiotics. I have three dogs; which means I can't incubate the food for long. All the nuts will go nuts once I start making the food. It's usually 5-10 minutes and Eddie does fine.
His poop being worse, could be from the enzymes not being strong enough, SIDs, or even sometimes with treatment, the poop gets a lot worse. It seems to be all the yuck leaving the body. It's not uncommon for things to get worse before they get better.
Tylan also works slower than Metronidazole. Tylan works by stopping bacterial growth. It just doesn't allow any of the bacteria to reproduce, as opposed to killing everything. You might not see an immediate improvement right away, but that doesn't mean it isn't working.

[Olesia711]

i the dog's digestion system has a pH of about 1.... and the powdered porcine enzymes are the best particle size and activate at the best time with the food in the dog's gut.
I understand what you are saying about preserving the enzymes ... but the powder is still the best way to deliver pancreatic enzymes to a dog with EPI. i'll explain some further details.

When we give dogs powdered enzymes, we give them something that has approx 71,000 USP units of Lipase (and the other enymes are in the 400,000's) ..
WHen we give dogs enteric coated enzymes (like what humans get, such as CREON) we only need to give approximately 10,000 to 25,000 USP units of Lipase.

The reason why the powder is so much higher is because approx 70% is destroyed did to the pH level in the dog's digestion system...and the remaining powdered enzymes is properly and effectively utilized at the right time. The powder is the best because what does hit the gut is most effective

The reason why with the enteric coated enzymes use so much less USP units of Lipase (and the others) is because none of it is destroyed going thru the pH in the digestion system. HOWEVER.... due to the size of the particles of the enteric coated enzymes.... one needs to play around with the technique to figure out which is the best way for the dog's system to effectively utilize these enzymes.

regarding the TYlan powder.... i understand completely that your dog doesn't want to take it... my dog stopped eating for 2 days when i put the tylan in her food just once! She acted as if i was trying to poison her. SOOOOOoo what you do with a dog that hates tylan is to pour the designated amount into an empty gel cap.... and then enclosed the gel cap in something soft and malleable. I personally used cream cheese.. but you can use a soft pate meat or anything like that... that your dog likes.... HOWEVER..... what i also learned is that Tylan powder get airborne and sticks to your fingers from handling it... so after you are done pouring it in the gel caps, wash your hand good with soap and water before enclosed the capsule in cream cheese or a soft meat... or else your fingers will transfer that nasty tasting tylan dust onto
everything you touch...

or... if you can afford it, your vet can order tylan pills ... usually from a compounding pharmacy....

Hope this helps.

[Tuckaboo Pam]

Hang in there, and things will get better. My Tucker was a Tylan lifer. It's a ways down the road, but try and remember not to stop the Tylan suddenly. Rather, you will want to wean Leo off it slowly. Tucker would have a couple of flares per year, when the maintenance "pinch" we were giving stopped sufficing, and when that happened we'd have to do a 45 day therapeutic application.

The triad of B12, enzymes, and tylan, along with a good quality grain-free kibble, got Tucker through his epi experience just fine.

The enzymes won't be as complicated as you think they will/ I teaspoon enzyme, per 1 cup kibble, add liquid, stir, and let sit on the counter for 20 minutes.

Is Leo underweight? If he is, you should feed 150% of his daily recommended amount if he were at his ideal weight. If he should weigh 90 pounds, and the bag says feed 4 cups, you would feed 6 cups, divided into three meals if possible. Always with enzymes. The trick of tuna fish, parmesan cheese, sardines, yummy meat, as a topper, is always good advice, too.

Keep asking your questions. The forum is full of people who want to help you. Take Care---Pam

[lylzzf3841]

i the dog's digestion system has a pH of about 1.... and the powdered porcine enzymes are the best particle size and activate at the best time with the food in the dog's gut.
I understand what you are saying about preserving the enzymes ... but the powder is still the best way to deliver pancreatic enzymes to a dog with EPI. i'll explain some further details.

Thanks for the info! Those are really helpful. And also sorry about the confusion in my previous post - I wasn't specifically looking for using Creon. I was interested in putting Enzyme powder (from enzyme Diane) in a delayed released capsule. e.g. I found this product online - AnimalBiome™ Extra-Small Delayed-Release Empty Capsules. Altho I think I'll need to figure out how long it takes for these capsule to dissolve in small intestine maybe it needs to be fed before meal? Anyways, I think I'll stick to powdered enzyme for now and learn about the incubation, and maybe try something new in the long run once the dog is stable enough

Hang in there, and things will get better

Thank you Pam. I'm tearing up reading your reply. My stress level has been through the roof ever since I got his lab results back. Leo is certainly underweight at this point. He was already on the thin side before the diarrhea because we noticed some weakness in his back leg, and vet suggested he could lose couple of pounds. Now for the past 3 months or so, he definitely lost another 5lbs at least. I can see his ribs now when he's stretching

So here's another update - Leo didn't get any enzyme yesterday for lunch or dinner, because the delivery was messed up and the enzyme won't arrive until tomorrow evening But he did get his first Tylan dose last night with food (1/8 tsp, as doctor prescribed). He somehow only pooped a little this morning, but what came out was still runny. I think this is the first time I understand what 'pale' poop looks like, I've never seen that color before...

This also kinda reminds me, altho I'm pretty sure he's got EPI at this point, I still haven't really seen an EPI poop (pale voluminous) from him. He usually defecates once or twice a day, and even with the soft/watery stool, the volume seems to be normal. But I did notice some undigested vegetables in his stool for past couple of days.

[lylzzf3841]

I am unsure about capsules, I never went that route. I used to feed frozen meals. I would just defrost them and add hot water. The hot and cold would make it room temperature or so. From an efficacy standpoint point, you do not need to incubate at all. You do need to make sure all the powder is moistened though. Dry enzyme powder can cause the enzymes to stick to their mouth and eat away at it, causing sores. I use dog food toppers, wellness core makes a grain free chunks in gravy. It has enough moisture to fully coat the powder, tylan, enzymes, and probiotics. I have three dogs; which means I can't incubate the food for long. All the nuts will go nuts once I start making the food. It's usually 5-10 minutes and Eddie does fine.
His poop being worse, could be from the enzymes not being strong enough, SIDs, or even sometimes with treatment, the poop gets a lot worse. It seems to be all the yuck leaving the body. It's not uncommon for things to get worse before they get better.
Tylan also works slower than Metronidazole. Tylan works by stopping bacterial growth. It just doesn't allow any of the bacteria to reproduce, as opposed to killing everything. You might not see an immediate improvement right away, but that doesn't mean it isn't working.

Ah good to know that about Tylan! His poop today didn't improve too much with first Tylan dose last night. I feel so bad that his enzyme delivery was messed up and he couldn't even get the right ones until tomorrow. But I'll keep the Tylan going, and be patient about myself. He also started the Wonderlabs B12 this morning altho he already got the injection couple of days ago - I figure since it won't hurt... why not...

[Olesia711]

Hi again Uto,

Regarding your post about DEAYED RELEASE EMPTY CAPSULES:
"I was interested in putting Enzyme powder (from enzyme Diane) in a delayed released capsule. e.g. I found this product online - AnimalBiome™ Extra-Small Delayed-Release Empty Capsules. Altho I think I'll need to figure out how long it takes for these capsule to dissolve in small intestine maybe it needs to be fed before meal? "

YES... this should work.. we actually had another member here on the forum that purchased the empty enteric coated gel capsules so that she could put the powdered enzymes in. It worked for her dog and then i also spoke to one of the EPI Researchers, and he said that in theory, YES, this should work. So he confirmed what she confirmed.....

The only concern i would have with this technique is that since the capsule would protect the powdered enzymes from being approximately 70% destroyed going down the dog's digestive system of pH 1..... then how much less enzymes should be used when using this method.

(1) I suspect you probably can use less enzymes than if you were using the powdered enzymes as we suggest, mixed directly in the food..... BUT....
(2) i also suspect that you cannot use as little as enteric coated pellet enzymes (like CREON) since only the outside capsule is enteric coated not each little enzyme particle ( like with CREON..) ...........

i hope this makes sense....

[lylzzf3841]

YES... this should work.. we actually had another member here on the forum that purchased the empty enteric coated gel capsules so that she could put the powdered enzymes in. It worked for her dog and then i also spoke to one of the EPI Researchers, and he said that in theory, YES, this should work. So he confirmed what she confirmed.....

The only concern i would have with this technique is that since the capsule would protect the powdered enzymes from being approximately 70% destroyed going down the dog's digestive system of pH 1..... then how much less enzymes should be used when using this method.

(1) I suspect you probably can use less enzymes than if you were using the powdered enzymes as we suggest, mixed directly in the food..... BUT....
(2) i also suspect that you cannot use as little as enteric coated pellet enzymes (like CREON) since only the outside capsule is enteric coated not each little enzyme particle ( like with CREON..) ...........

i hope this makes sense....

Thanks for the info! The enzyme I ordered finally arrived today so I'm starting on treatment right away. I think at this point I'll start with the powder since the process is more established, and maybe change to capsules once my dog is more stable. Interestingly enough, now Leo has been on Tylan for 3 days, and his BM last night and this morning went back to normal, solid, but a little lighter in color. I guess it could be due to I've been feeding him white rice and plain chicken, or some undigested fat.

Another question I have - how do you all get the long term of Tylan supply? My vet only prescribed a really low dosage (1/8 tsp per 24h)of 20 days, and I wasn't able to get any from Chewy. How did you all convince your vet that this is needed for 45 days to stabilize an EPI dog?

[Eddiespaghetti]

My vet just gave me the whole tub. I didn't have to convince them of everything. It might be because your vet doesn't think it will work, so why give you more?

[Olesia711]

i just told my vet i want the dog on Tylan for 45 days/ twice a day. My dog, my dollar..... AND this is also what Texas A&M recommends for SID in EPI dogs when nothing else works.... you do the tylan!
"Antibiotics

"Oxytetracycline used to be the therapy of choice for small intestinal dysbiosis, but oxytetracycline for oral use has become largely unavailable. Tylosin (25 mg/kg q12h for 6 weeks) is the new antibiotic agent of choice. Tylosin is extremely safe and is not used in humans for the most part - thus, creating resistant bacterial strains is not a big concern. In one study, a group of dogs was treated with 400 mg/kg daily for a period of 2 years and none of them developed any side-effects. The superb efficacy of tylosin has been well-demonstrated in studies from Finland. Some of those newer studies would suggest that smaller dosages may also be beneficial"

[lylzzf3841]

I'm talking to the vet again tomorrow and hopefully I can get them convinced about the EPI treatment and protocol.

And today I went in for the 2nd B12 shot for and was told they are running out of stock.... I'm seriously considering changing vet now...