New member. Looking for advice

[Bill]

My name is Bill. My 3 yr old Australian Labradoodle was recently diagnosed with EPI. The vet prescribed some enzymes tablets for her and a new dog food. After 2 weeks we were not seeing much improvement. Her weight loss subsided but she wasn’t gaining and her stools were still predominantly yellow and watery. I found Pan-tenex10 enzymes through doing some research and switched her over to that. I have seen great improvement in just a few days. Her stools are much more normal looking and she has put on half a pound. My question is this. Although her stools look much better. She still has some watery. Portions usually. It’s typically log shaped but some parts will be brown and normal looking and some half crown half yellow and soft. She has been on the new enzymes for almost a week. Do I need to give it more time or start playing with her diet more? I feel the enzymes are working just wondering more about the food? Also she has a bad smell sometimes. This seems to come and go but can be really bad at times. Here is a pic of her food stats.

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[Olesia711]

hi Bill,

Thanks for writing in about Piper and for posting the food and treatment details.

When they have very stinky poos and some of the poos are still yellowish and or soft...... in an EPI dog, this usually indicates that their SID/SIBO/Dysbiosis (which all dogs have when they have EPI) is out of control. Currently no one knows how to eradicate SID, so what we try to do is get it under good control.

Now, once a dog develops EPI and you place the dog on enzymes..... too much fiber in a diet can destroy the efficacy of those enzymes by anywhere between 0% to 50%. THe problem is that we have no idea which EPI dog is affected by this and if affected, then by what %.

SO.....although this does not mean that an EPI dog cannot have any fiber, as some do just fine with food with grain in it........but rather, when first starting to treat an EPI dog, start with a low fiber content food that avoids all grains. Once you get the SID under good control (perfectly formed and good brown colored poos) ... then... try introducing a food with some rice in it and just watch the poo out put to see if your dog can tolerate grains or not.

SO... for now.....reading what you described about Piper's situation, and reading the dog food ingredients you are feeding her, although the fiber content is okay... the ingredient may be what is perpetuating the still out of control SID especially since the 1st 2 ingredients are grain and the 4th ingredient is peas....SOOOOOOOOoo.... my suggestion is as follows:

1. immediately slightly increase the amount of enzymes you are giving to compensate for these ingredients and then...
2. look for a different food, something with 4% or less fiber content, something that doesn't have grain in it, and if you can (although this part is difficult).... something that avoid peas, or has peas listed no higher than the 4th or 5th ingredient... and also avoid products that have variations of peas listed multiple times... like pea, pea flour, pea protein, etc, etc.............

[Olesia711]

.... more..............

if you switch to a less fiber/no grain food.... and the SID problem continues.... THEN our typical recommendation is as follows:

1. introduce a prebiotic (we suggest starting with Slippery Elm powder) https://epi4dogs.com/slippery-elm/
2. if the above doesn't work, THEN talk to your vet about starting Piper on a Pre+Probiotic product, some of our recommendations are: Visbiome, Proviable, Mercola Complete, Vetr-Science Mega Probiotics. Issue with probiotics is that they are mass produced for 1-size-fits-all and although every EPI dog does have a messed up gut flora composition, Each one has their own unique gut flora composition so you never know which product will or will not work. sometimes you have to try multliple product to find one that works for your dog. you should know within 2 weeks if that particular probiotic product will work, if no improvement at all.... it is just not working.
3. If all of the above fails and the dog continues to have loose stools.... THEN talk to your vet about treat with a course of Tylan (Tylosin Tartrate soluble antibiotic powder) 45 days/twice daily with food. https://epi4dogs.com/antibiotics/
4. If your dog continues to struggle this and nothing is working... THEN talk to your vet about FMT, a fecal transplant... the enema kind... this is a rather inexpensive procedure.

Hope this helps

[Bill]

Thanks for the advice. I think I’ll look at some of the different food recommendations here on the site and see if a change in food helps. I appreciate your response. Thought I’d throw up a pic of Piper as well.

Piper

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[Jane&Clyde]

Hello, and welcome! Piper sure is a cutie. You are in great hands with Olesia.

I noticed that you are using Pantenex enzymes. The instructions on the their website and container are incorrect. Just wanted to be sure you knew that. The correct starting dose for enzymes is 1 teaspoon per cup of kibble. Dampen the kibble with a little room temperature water, mix in the enzymes, and let it sit for about 20 minutes before feeding.

[Bill]

Thanks for the response. I have been doing what you said with the exception of the amount. I am giving Piper 1 1/2 cups of food to try to put weight on her but only 1 teaspoon of enzymes. I will up it to 1 1/2 teaspoons and see if that helps. Thanks again.

[Olesia711]

WOW! Piper is gorgeous!!!!!!!!!!!! Hope she feels better soon.

So glad Jane mentioned that the Pantenex recommended dosing is not exactly optimal...... since she explained and you confirmed.... the SID could very well be from under-dosing the enzymes...... SOOOOOOOOOOOOoooooooooooooo before going thru the trouble of changing foods.....

change the ratio of the enzymes to 1;1... in other words, if you are giving 1+1/2 cup of food.... go ahead and give 1+1/2 tsp of enzymes.... and watch the poos for a few days. If the poos improve then this was what was perpetuating SID and you might not need to change the food.
Definitely worth trying first

Thanks Jane for bringing the dose issue to Bill's attention.

[Bill]

I’ll give that a shot and let ya’ll know if it helps. You guys are awesome! Thanks for the help.

[Olesia711]

keep us posted.... oh.... and since you are just starting this journey.... effectively managing EPI is all about finding the right balance or the recommended protocol..... so before you drive yourself nuts.... start keeping an EPI Log (journal) and just keep track of what you are giving, the results etc. cause many of our dogs require slight adjustments for optimal results.

If you go to this page, we have some EPI Log templates that you can use:

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

tip: always make only 1 change at a time... and give it a few days to assess before making the next change.

[Jane&Clyde]

Sounds like a great starting point...increase the enzymes, then consider changing foods.

Another thing that I haven't seen mentioned...was Piper's B12 (cobalamin) level tested? This is usually done at the same time as the TLI test for EPI. Dogs with EPI need their B12 to be towards the high end of normal, say 550-600 or so. So, even if the test came back "normal", it may not be high enough. Over 80% of dogs with EPI will need long term B12 supplementation. This can be done through shots from the vet. Another option which a lot of us on here have had good luck with is an oral supplement called Wonderlabs Pet Factor B12. The dosage is based on weight. The good news with B12 is that if too much is given, the excess is just peed out in the urine.

Also, how many times a day is Piper being fed? Often dogs with EPI do better with smaller meals more often, 3 or more per day. If you work, dinner could be given as soon as you get home, then another meal shortly before bedtime. If Piper lost a significant amount of weight, you might want to start with a total of 150% of what you normally feed her per day, divided into 3-4 meals. Some dogs eventually do just fine on 2 meals per day, while others continue to do better if fed more often.