Please advise! Newly diagnosed EPI Found Bloody Stool!

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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Mom of a Tibetan
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Posts: 23
Country: United States
State: Colorado
Pet name: Molly

Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Mom of a Tibetan » 14 Apr 2019, 22:16

Hello! I have a 5.5yr old Tibetan Terrier Molly. I just did the home EPI test and she tested positive so we have a vet appointment for Wednesday. I have not had the Vitamin B12 test done nor a recent fecal parasite test done. The vet appointment couldn't come sooner I will call tomorrow to see if I can get her in sooner than Wednesday.

I am really concerned because the past two days she's had blood on the outside of her stools. The first day it was just a drop on the fecal matter then today her afternoon stool had at least 2" of blood encasing the last half of the stool, but not the first half of the stool. She ate a meal of Elk and veggies with the supplements listed below. Her stool from that meal was perfectly formed no mucus at all. I was shocked to see blood and that much blood! She has had diarrhea recently alternating every other day(over the past 4 days) I fed her no added salt/packed in water wild caught canned Salmon and veggies. She's been eating that Salmon for 3 months just fine. She was having normal stools and doing really well on the enzyme Dianne 6x enzymes too until this week.

MY main questions for the forum are...Has anyone had problems with bloody stools with a EPI dog? If so could you share your experience with me? i.e. cause and course of treatment?
Does anyone know if the enzymes could be a factor maybe causing her intestinal lining to bleed? I wonder if the lining is thin and inflamed from on and off diarrhea will the enzymes cause it to bleed? I have not seen blood in/on her stools before! It is odd it just showed up the past two days! I hope it is not a indication of a worse problem! I have been giving her slipper elm bark powder for the past month so her intestines should have been healing with that.

I have always fed her a raw diet. She started to have on and off diarrhea as a pup but only once or twice in 6 months. When she was 3.5-4 yrs old she started having middle of the morning 3-4 am needing to go out and she had watery foul smelling diarrhea. I put her on a low fat diet, she couldn't process meat with fat content higher than 6% fat. She also started to eat other dogs fecal matter although she has never eaten her own. I I didn't know about EPI and none of the 4 vets I took her too suggested it so I've been focused on her gut biomatter, I gave her 3 Fecal transplants 2 years ago and they did help! I got the fecal matter from a vet who tested it for bad bugs before I did the transplants. But the transplants could not address permanently her eating other dogs stools and the on and off diarrhea from eating any meat with fat content over 6%. Before I did the fecal transplant I had a vet test her for parasites etc her stool came up fine.
Approx 45 days ago she had 4 teeth pulled in a cleaning and they gave her some heavy duty antibiotics and probiotics.

A friend suggested EPI and I did the home test and then started her on Enzyme Diane's 6x enzymes approx a month ago....her daily meal supplement regime is 1/2 tsp in her morning meal of raw meat and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder and (finishing up Biomatter capsules aka fecal matter/poop capsules).

I'm determined to give this dog her best life and am relieved to have a EPI diagnosis with options. I am concerned about the bloody stool today! I really hope the bloody stool is not a indication of a worse problem!

Thank you!!
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

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Jean
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Pet name: Kara
My name: Jean

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Jean » 15 Apr 2019, 04:47

good morning from the UK

What a cutie Molly is

we have had bloody stools which was the result of bad bugs in the gut, and Kara was shedding her bowel, antibiotics sorted that one out, but the vets is your next call and see if you can get a quick appointment, take a sample with you

can I ask what colour the blood is, is it red or mqaybe nearer dark red/ black

however you have mentioned antibiotics for teeth issues, maybe they were too much for her

realistically I dont know

please let us know

Jeanx
My name is Jean we live in Liverpool in Uk

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We use Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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jilbert57
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Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by jilbert57 » 15 Apr 2019, 09:19

I agree with Jean. Please get a sample of the blood poop before you go to the vet.

Sorry, I can only guess on whether or not the enzymes caused some blood. I wouldn't think so. By the time the meal has moved to lower intestine enzymes will already have done their work on the food.

If it was the Schebo poop test you used, it can indicate if it is possibly EPI. Somewhere down the line you will need to have the vet run the Tli test to confirm definitely. When the vet runs that test at some point please be aware you need to fast the pup 12 hours prior.
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 13, TJ is a 4 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

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Mom of a Tibetan
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Country: United States
State: Colorado
Pet name: Molly

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Mom of a Tibetan » 15 Apr 2019, 10:34

Good morning Jilbert57! Thank you for your helpful reply!! I am so grateful for your support!!

I will gather a sample to take to the vet. Can't believe I didn't think to save a sample of it!

Yes I used the Schebo poop test. The enzymes are helping. I will look up the Tli test. Hope the new vet we are going to see has experience about EPI and we can create a good team to get Molly stabilized! Yes, it probably isn't the enzymes causing the blood....I think I was reaching with the idea of the enzymes in my panic about the volume of blood on the stool.

Thank you!!

jilbert57 wrote:
15 Apr 2019, 09:19
I agree with Jean. Please get a sample of the blood poop before you go to the vet.

Sorry, I can only guess on whether or not the enzymes caused some blood. I wouldn't think so. By the time the meal has moved to lower intestine enzymes will already have done their work on the food.

If it was the Schebo poop test you used, it can indicate if it is possibly EPI. Somewhere down the line you will need to have the vet run the Tli test to confirm definitely. When the vet runs that test at some point please be aware you need to fast the pup 12 hours prior.
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

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Mom of a Tibetan
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Posts: 23
Country: United States
State: Colorado
Pet name: Molly

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Mom of a Tibetan » 15 Apr 2019, 10:40

Good morning Jean! Thank you! I can't tell you how it touched me to get your reply and to know others have gone through this and there is this kind of support!!!

Ah yes bad bugs! It is so helpful to know the lining can shed.

The blood on her stool looked like fresh fairly bright red, it was not dark red and I didn't see any mucus on the stool at all. There didn't seem to be any blood in the interior of the poop just on the outside of it and it was only on the end portion.

I will gather a sample to take to the vet. Can't believe I didn't think to save a sample of it!

Thanks again! I will keep you posted.

Have a great day,
Ann
Jean wrote:
15 Apr 2019, 04:47
good morning from the UK

What a cutie Molly is

we have had bloody stools which was the result of bad bugs in the gut, and Kara was shedding her bowel, antibiotics sorted that one out, but the vets is your next call and see if you can get a quick appointment, take a sample with you

can I ask what colour the blood is, is it red or mqaybe nearer dark red/ black

however you have mentioned antibiotics for teeth issues, maybe they were too much for her

realistically I dont knbow

please let us knowe

Jeanx
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

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Riley's Mom
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State: Virginia

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Riley's Mom » 15 Apr 2019, 17:24

Welcome to the forum, so sorry you had this scare!
My girl hasn't had bloody stool, so I can't advise, but I just wanted to offer support and welcome you.
If your vet doesn't know much about EPI, that doesn't necessarily mean they aren't going to be a good one to stick with. If they are willing to learn along with you, they can become a good partner!
Keep us posted on how things go!
Elisabeth

Riley is a 10 year old Labradoodle. She was diagnosed with EPI in 2014.
She currently eats Taste of the Wild, I cup in the morning, 2 cups in the evening, each meal with 1 Wonderlabs B12 sprinkled over her dinner. Enzymes are EnzymeDiane, 1 tsp per cup of food, mixed in home made bone broth. No other supplements or meds at this time.
Riley currently weighs about 44 pounds, which is pretty heavy for her.

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Mom of a Tibetan
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Posts: 23
Country: United States
State: Colorado
Pet name: Molly

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Mom of a Tibetan » 15 Apr 2019, 22:52

Hi Elizabeth,
Thank you so much for reaching out with this warm welcome and support, it means the world to me! It is such a relief to have options and communicate with people who are working with the challenges of EPI. Good point that the new vet may develop into a good partner. I'm hopeful!
I wasn't able to get in to get in to see the vet today. I'll have to wait till Wednesday. I will post updates!
I hope all is well with you and Riley!


Riley's Mom wrote:
15 Apr 2019, 17:24
Welcome to the forum, so sorry you had this scare!
My girl hasn't had bloody stool, so I can't advise, but I just wanted to offer support and welcome you.
If your vet doesn't know much about EPI, that doesn't necessarily mean they aren't going to be a good one to stick with. If they are willing to learn along with you, they can become a good partner!
Keep us posted on how things go!
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

Barb
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Posts: 364
Country: United States
State: New Jersey

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Barb » 16 Apr 2019, 19:33

What a sweetheart Molly is! Please let us know when you get in to see the vet and what information they give you. Hang in there. It is always hard when our pups are not feeling well.

Barb

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Madelon
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Location: Nashville, TN
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State: Tennessee
Pet name: Doc

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Madelon » 17 Apr 2019, 21:36

Hi and welcome to our EPI family. Oh gosh that little girl is just the cutest little ball of fluff. As for the Schebo test - it is only accurate at ruling out EPI (and it is very specific on the timing of when to check it otherwise you get a false read). So if it indicated EPI, then we recommend following up the the cTLI, B12 and Folate blood test. Be sure she is fasted at least 12 hours before they draw the blood and we recommend testing on a Monday or Tuesday so that the blood is not sitting over the weekend without being properly stored. As for the blood in the stool, if it's a brighter red then it's typically from the lower part and not as much worry, however, if it's dark red/blackish then that could indicate something serious. I don't think there should be any correlation between the blood in the stool and the enzymes - my guess would be more likely the bad gut infection or straining from diarrhea but a trip to the vet is a must.

I would check your probiotics - if they contain a prebiotic then I would either just use SE or just use the probiotics. SE is a prebiotic and I'm not sure if using that plus a probiotic that contains a prebiotic could be too much. Sometimes too much of a good thing isn't a good thing :)

I'm glad you are getting the proper test done. Please know that EPI is affordable and manageable and we are here to help guide you along the way.
MADELON and Doc. DX EPI and SIBO: 5/22/2015
Test Results: (1st) 7/2014 = TLI 16.5, B12 894, Folate > 24; (2nd) 5/2015 = TLI < .4, B12 406; Folate >24; (3rd) 10/2015 TLI < .4; B12 >1000; Folate 14.4. Prior to DX: May 2014 (2mos) - DX coccidia/bladder infection; July 2014 (3mos) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Dx SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May 2015 vomitted several times, diarrhea and eating poop. Regimen: 4 cups Sport Dog Food Elite Herding - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 1/2tsp Slippery Elm 2xday; Multivitamin; 1 Zyrtec 10mg 2x day; Salmon Oil

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Mom of a Tibetan
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Posts: 23
Country: United States
State: Colorado
Pet name: Molly

Re: Please advise! Newly diagnosed EPI Found Bloody Stool!

Post by Mom of a Tibetan » 20 Apr 2019, 15:05

Hello Madelan,
Thank you for the welcome! As for the Schebo quick test, I don't know for sure if it was a accurate test, I did follow the directions to the "T". I'm not sure that Molly has EPI. She is responding to the enzymes from Enzyme Diane. She has had a number of the tale tell signs though i.e. intermittent loose foul smelling feces, eating other dogs feces, can't tolerate meat with fat content above 6%!

The blood in her still was bright red the first day it was only a drop at the end in mucus. The second day it was only on the outside of the stool and about 2" long end section of the stool. The third and last day it was a small stool and was darker read mixed through out. She hasn't had blood I could see since and there wasn't any in the sample I took to the vet nor where there any bad bugs in it. The vet said there is not as much concern if there is blood from a dog's stool vs human.

I wonder if the salmon I gave her irritated/scratched her intestinal lining. It's wild caught canned salmon steaks which has 5-6 of the spine bones in it. The bones are soft and crush very easily but they have sharper edges too. I'd been giving her that salmon for 2-3 months though.

Currently the probiotics I am using is from Dr. Mercola and has fermented probiotics, papain, bromelain and kelp in it. Hm, no mention of pre-biotics on the label. I am giving her slippery elm bark powder and it can act as a pre-biotic but it's benefits out weigh the challenge I think.

I took her to a new holistic vet on the 17th. The new vet wanted to take a more cautious and slower route, so I agreed. I did share with the new vet the EPI testing protocol info to research. We decided to continue the enzymes and add in two glandular products one specific for vit B12 from Standard Process. I'm going to give the combo a go and see if she can hold on these. I don't know if they will do the trick, I'm cautiously hopeful! Since adding in the glandulars she's been doing great

So for now I'll wait to see if I need to have her tested for the complete work up as we go forward.

I can't thank you enough for the support and in depth testing info!

Hope you have a great Easter weekend!
Ann


Madelon wrote:
17 Apr 2019, 21:36
Hi and welcome to our EPI family. Oh gosh that little girl is just the cutest little ball of fluff. As for the Schebo test - it is only accurate at ruling out EPI (and it is very specific on the timing of when to check it otherwise you get a false read). So if it indicated EPI, then we recommend following up the the cTLI, B12 and Folate blood test. Be sure she is fasted at least 12 hours before they draw the blood and we recommend testing on a Monday or Tuesday so that the blood is not sitting over the weekend without being properly stored. As for the blood in the stool, if it's a brighter red then it's typically from the lower part and not as much worry, however, if it's dark red/blackish then that could indicate something serious. I don't think there should be any correlation between the blood in the stool and the enzymes - my guess would be more likely the bad gut infection or straining from diarrhea but a trip to the vet is a must.

I would check your probiotics - if they contain a prebiotic then I would either just use SE or just use the probiotics. SE is a prebiotic and I'm not sure if using that plus a probiotic that contains a prebiotic could be too much. Sometimes too much of a good thing isn't a good thing :)

I'm glad you are getting the proper test done. Please know that EPI is affordable and manageable and we are here to help guide you along the way.
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

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