What to do if EPI dog refuses to eat?

[LisaDorn2024]

Levi refused to eat his dinner tonight and it had ALL of his medications mixed in it. Do I prepare him another dinner in an hour or two, or do I wait and feed him at breakfast? He has not eaten since 1:30 pm today which was his lunch.

Prior to his hospitalization, Levi would go on hunger strikes that lasted for days sometimes. Usually he refused to eat when he was becoming allergic to a new protein source. Sometimes he would not eat due to nausea or abdominal pain.

He is not responding to any of the EPI medications because of his other health conditions: lymphoplasmacytic infiltrates and eosinophilic enteritis are the two causing him the most trouble right now. I did give him a Cerenia injection in case he was nauseous and to prevent non-stop vomiting that can go on for hours.

Since Levi and I are new to EPI, I don't know if he can skip meals and his medications. Please advise. Thank you.

[jilbert57]

I am sorry Levi doesn't want to eat. It is not a good feeling for sure.
So Epi medication- do you mean his enzymes? If he isn't eating food he doesn't need enzymes.
What else is he taking, B12?

Jill

[LisaDorn2024]

Hi Jill,
Levi takes the following medications at dinner:
1/4 tsp Tylan
10 mg. of Prednisone
20 mg of Omeprazole
1/2 tsp slippery elm
3 Creon capsules (I know he doesn't need the Creon if he doesn't eat - he is going to have to start earning an allowance if he wants to waste Creon at $15 per meal. LOL)

I feel like he needs to eat something, but his stomach/abdomen are so bloated and there's lots of rumbling , but no gas. He has lost so much weight and is so fragile I feel like he cannot afford to miss a meal. His behavior was really irritable tonight so I know his gut is really off.

I did give him a Cerenia injection around 7:30 pm in case he was feeling nauseous. Did not want the vomiting to start.

Levi has 2 other more serious intestinal diagnoses than the EPI and I know he is in a lot of pain.

He has not eaten since 1:30 pm and will not get breakfast until around 9:00 am. That will be almost 20 hours without eating.

Can EPI dogs go that long without eating and getting their medications?

Thank you,
Lisa

[Eddiespaghetti]

If puppos don't eat they really shouldn't get prednisone either. It can wreck havoc on an empty stomach. What you could try is cutting back each feeding until they eat all their meals. Eddie does this a lot and we are consistently changing how much we feed him per meal in order to get him to eat when it has his medication in it. Having them more active is also an option but that isn't always easy especially when trying to get everything dialed in.
When you say the stomach/abdomen is bloated. I need to ask if their back is hunched downward? If it is you might be dealing with false Cushing's. It's from the Prednisone. It could also be Cushing's disease. It usually makes them more hungry, but if they aren't feeling well overall they won't want to eat. Some dogs are really suspectable to the side effects of Prednisone and others can be on it for years and you wouldn't know. It will have other symptoms too. Thining skin and hair loss are the most common. Melatonin is a good at home remedy to help alleviate the side effects of prednisone.

[Patsy]

So sorry to read of your problems. I know nothing of the concurrent conditions, but are they something to do with the bloat? My dog had developed fluid in the abdomen and chest cavity, in her case it was PLE, protein losing enteropathy, which showed the fluid build up on a scan. If all this is pressing on the guts, stomach or other organs and the heart, it is a vet situation to check everything out, as you doubtless know. Whatever the cause, call your vet because they have the medical history.
Incidentally, my dog was treated successfully with pred.

[LisaDorn2024]

HI Patsy,
Thank you for your response. Levi's other conditions do not have anything to do with bloat (that I know of) but I will ask his veterinarian at our Monday appt. His stomach and abdomen fill up with gas and you can hear the rumbling. He often passes very foul smelling gas, but not last night.
Thank you so much!

[LisaDorn2024]

If puppos don't eat they really shouldn't get prednisone either. It can wreck havoc on an empty stomach. What you could try is cutting back each feeding until they eat all their meals. Eddie does this a lot and we are consistently changing how much we feed him per meal in order to get him to eat when it has his medication in it. Having them more active is also an option but that isn't always easy especially when trying to get everything dialed in.
When you say the stomach/abdomen is bloated. I need to ask if their back is hunched downward? If it is you might be dealing with false Cushing's. It's from the Prednisone. It could also be Cushing's disease. It usually makes them more hungry, but if they aren't feeling well overall they won't want to eat. Some dogs are really suspectable to the side effects of Prednisone and others can be on it for years and you wouldn't know. It will have other symptoms too. Thining skin and hair loss are the most common. Melatonin is a good at home remedy to help alleviate the side effects of prednisone.

Thank you for sharing the information about no prednisone on an empty stomach. But what do you do when you are not supposed to stop the prednisone abruptly? Which is worse?
I did have a golden once who had "atypical Cushings" but his symptoms were so different than what I am experiencing with Levi. I will bring this up to Levi's vet on Monday when we have an appt. I will ask her about the possibility of "false Cushings."

What dose of Melatonin would you give for 10 mg of prednisone b.i.d.? I am hoping we will be changing the prednisone to a different medication on Monday. He is going downhill fast since EPI is the least concerning of all of his diagnoses. I do believe if the lymphoplasmacytic infiltrates and the eosinophiic enteritis could be medially treated appropriately, the EPI could be easily managed.

Thank you for these great ideas to bring to Levi's vet. I appreciate your suggestions and thoughts.
Lisa

[Patsy]

Aaaah…. Rumbling and room-emptying foul farts are classic Sibo/SID. Antibiotics!! Tylan in the US otherwise Oxytetracycline. In Uk. Metrobactin is not advised because of side effects.

[LisaDorn2024]

Aaaah…. Rumbling and room-emptying foul farts are classic Sibo/SID. Antibiotics!! Tylan in the US otherwise Oxytetracycline. In Uk. Metrobactin is not advised because of side effects.

Yes, Levi has severe SIBO/SID. That's why he needs to get the Tylan in him, When he does not eat he does not get the Tylan as its mixed in his food. He has now refused to eat last night's dinner and this morning's breakfast. I just went to the vet and was able to pick up some Entyce (appetite stimulant.) Hopefully he will each lunch.

How would I get the Tylan into him if he does not eat? It is a powder with an awful taste.

Thank you.

[jilbert57]

Put the dose in an empty gel cap and pop it on the way back of his tongue. Then gently hold the muzzle closed until he swallows or follow it with a syringe of food or Entyce.
You can order empty capsules on Amazon or swing by a pharmacy and ask for some.

Jill