Allergies to enzymes

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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Olesia711
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Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Allergies to enzymes

Post by Olesia711 » 12 Aug 2019, 17:49

VERY IMPORTANT! There is no accurate test to confirm SID.... there are flaws with all 3 ways of testing for it, and EPI research has already determined that in EPI dogs they ALL have SID.... in lay terms, every single one has a messed up gut flora... not enough bacteria and not enough variety of bacteria... and giving probiotics is not always the answer since currently all probiotics are pretty much a one size fits all... and that doesn't work for a lot of EPI dogs.... they have an over abundance of lactic acid... (read the SID page, specifically look at the research done by Dr. Suchdolski... EPI dogs have off the charts readings :(

SO.... our goal is (with EPI dogs) to try to manage their SID and the best way to manage it is to find a food that best agrees with each individual EPI dog. Sometimes probiotics help, other times they don't. Prebiotics on the other hand tend to more readily help (SLippery Elm has prebiotic properties :))

SO... to assess whether or not an EPI dog has uncontrolled SID and needs serious help (like antibiotics) what you need to do is
1. Assess the health issue concern, like EPI. Is SID prevalent with EPI cases? YES!!!!
2. Are you seeing "repeated" symptoms/signs of SID in your dog, if yes, and if a prebiotic has not been able to fix the problem, then a course of anti's are warranted.... and then once you get it under control, try to figure out what triggered SID to become uncontrolled.

Here is an important "read" on SID:

SID”small intestinal dysbiosis”/SIBO & TREATMENT

Because of the very nature of EPI (pre-diagnosis/treatment) undigested food/ bacteria imbalance/not enough different bacterial strains/ excessive fermentation causes SID/SIBO in all EPI dogs. Goal is to get SID under good management.

In some cases, if EPI is detected very early on, once proper treatment (enzymes) is administered the good gut flora sometimes “may” re-populate the gut flora (bacteria) imbalance rendering antibiotics not necessary. Much success is seen with Slippery Elm powder. Slippery Elm is given with breakfast and dinner. The following are suggested doses for Slippery Elm: 1/8 tsp for dogs under 10lbs, ¼ tsp for dogs 10lbs to 30lbs, ½ tsp for dogs 30lbs to 80lbs, 3/4 tsp for dogs 80lbs to 100lbs, and 1 tsp for dog 100/+lbs. Mix in meal, add 1 to 2 tablespoons of water, mix and serve meal as you normally would. Incubating not necessary. Note: sometimes even less Slippery Elm powder works better. Do not give if the pet has an allergy to the American ElmTree.

However, many will still have to resort to an antibiotic regimen to get SID/SIBO under good management.

The best way to assess SID/SIBO is by (1) symptoms and (2) accompanying medical ailment, in this case EPI, and treat early on for best results. Folate test results such as Culturing, Counting bacterial numbers, and Duodenal juice collection all have majors flaws in their technique rendering them inaccurate indications of SID/SIBO. Recent studies have determined that it is not the number of bacteria but rather “the type of flora and/or how the host and flora interact that are more important than numbers.”

If the dog displays any repeated signs such as yellowish-coloring to the stools, loose stools, gelatinous stool coating, flatulence, lack of appetite, stomach noises, low or low normal B12 then treat for possible secondary SID/SIBO (with Tylosin [preferred] or Metronidazole, or in some cases Amoxycillin. Tylosin appears to work best for the majority of EPI dogs with SID/SIBO.

The current recommended Tylosin dosage has recently been changed to “25mg/kg BID with food for 6 weeks”, but some still prefer to administer twice daily [every 12 hours] with food:
30 lbs – 1/8 tsp 60lb – 1/4 tsp
90 lb – 3/8 tsp 120 lb – 1/2 tsp
A response to the antibiotics should be seen within 7 to 10 days- -if improvement is seen during this time period, indicating that SID/SIBO is present, the antibiotics should be continued for a total 6 weeks, or at the very least a minimum of 4 weeks.
If a positive response is not seen within 7-10 days, change the antibiotic. Most EPI dogs appear to respond best to Tylosin, but if not, switch to Metronidazole (or switch from Metro to Tylan). With exceptionally difficult SI/SIBO cases, historically it has been recommended to continuously repeat or consistently continue antibiotic treatment for life. Although not clinical proven, what has been observed by diligent pet owners is that some are able to completely remove a SID/SIBO-prone dog from antibiotics through a methodical process of slowly reducing the antibiotic dose and interval while slowly introducing an increased inclusion of a safe, stable, and “agreeable” with the individual dog’s intestinal gut flora” pre and/or probiotic
Prebiotics are non-digestible food components (dietary fiber) that are being fermented by intestinal bacteria. Slippery Elm is a prebiotic. This can lead to more normalization of the intestinal microbiota. In a recent study the use of fructooligosaccharides (FOS) in the diet showed a lasting advantageous effect. This syndrome is also a potential target for probiotic therapy but one must be careful when administering probiotics. Too much FOS can cause the opposite effect. Per Dr. Jorg Steiner of Texas A&M University “…unrealistic expectations have been replaced with well-defined requirements for probiotics and controlled studies of their beneficial effects. A probiotic must be efficacious. In order to be efficacious, the bacteria must reach the intestinal lumen. This requires that the bacterial species being used in the formulation are both acid- and bile-acid resistant. Also, the bacterial species of the probiotic preparation should adhere to the intestinal mucosa to prolong the time of interaction.
When possible use a 3rd party laboratory such as http://www.consumerlab.com/ to verify product “claims”
Olesia, owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.3, Doing great 12+ years later! Once stable at 3+ months, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each cup of food, but as she aged- -had to go back 1 tsp enzymes per cup of food. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil / fish oil daily .... until she developed Diabetes and she now cannot tolerate higher fat foods. Currently feed an 80% home-made diet of sweet potato, a lean meat/fish, 1/3 of a raw egg, fat free cottage cheese, fish oil+vitamins and bone meal with 20% Annamaet Lean & Grain Free kibble. This combo has regulated her Diabetes (takes Vetsulin) and EPI and is very well managed. In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. This is when we discovered that she also developed Diabetes & Low Thyroid. Izzy was able to receive excellent care because of the generosity of folks on Epi4dogs! Izzy continues to wake up every day full of joy. I am not a vet. All of my suggestions/recommendations are based on personal experiences, observations, information gleaned from EPI researchers & pet parents alike, and EPI research. Please share with your vet everything we suggest.

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Paulag
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Posts: 26
Location: Montreal
Country: Canada
Pet name: Lyra
My name: Paula

Re: Allergies to enzymes

Post by Paulag » 12 Aug 2019, 21:51

Thank you so much for taking the time to send me this information. It will be valuable to myself and my dog in the next few weeks.

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Paulag
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Location: Montreal
Country: Canada
Pet name: Lyra
My name: Paula

Re: Allergies to enzymes

Post by Paulag » 14 Aug 2019, 13:42

I’ve got Lyra on tylosin twice daily now. Started yesterday. This am her poop was consistently pudding style. I am continuing 2x10000 Creon capsules ten minutes before feeding. The vet advised waiting 4 days to see if her poop improves and if yes, slowly change her food completely off grain of any kind. Not too sure that’s a good plan!! She lost one pound so far. I am stead fast but even the vet says the difference in lipase from 75000 from Pantenex to Creon is huge. She scared me a little.

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Madelon
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Pet name: Doc

Re: Allergies to enzymes

Post by Madelon » 14 Aug 2019, 21:40

Hi and welcome to our EPI family. Sorry I'm so late to welcome you. You've been given the best advice from some of our BEST experts so I won't muddy the waters, however, I noticed in your last post you said your pup is still on a grain food. That might or might not be part of the problem. Is the food 4% fiber or less? Fiber/grains can interfere with the efficacy of the enzymes. We typically recommend switching to grain free with 4% fiber or less because over the many years we've discovered EPI dogs tend to do best on this type of food. So without making any other changes, you might want to change the food - being sure to do it slowly over 7 days - and see if things improve.

As for the allergy to the enzymes - I am so so sorry you are so allergic and going through that. I do recall another member who was extremely sensitive to the powder enzymes and wore gloves and a mask when preparing the food.

Keep us posted on your extremely adorable girl and don't forget to keep a detailed log.
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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Paulag
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Posts: 26
Location: Montreal
Country: Canada
Pet name: Lyra
My name: Paula

Re: Allergies to enzymes

Post by Paulag » 14 Aug 2019, 22:10

Thank you, the food does have some grains so I am presently switching her slowly. I just started a course of Tylan so don’t want to rock the boat with already a flare up. It’s been a Rocky start to this switch in enzymes. She’s losing weight and coat fast. I am however taking everyone’s advise. I’m praying to god this works for my girl

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

Re: Allergies to enzymes

Post by Madelon » 14 Aug 2019, 22:19

Keeping you and your sweet pup in my prayers. Whatever happens, we are here for you and will help guide you as best we can.
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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Olesia711
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Posts: 893
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Allergies to enzymes

Post by Olesia711 » 14 Aug 2019, 22:28

just a little reassurance here regarding powdered enzymes potency vs. CREON potency.

Your vet is vet is right and wrong.... please let me explain.....
The powdered enzymes are very high in potency (lipase USP units are usually somewhere around 71,000 ) where are CREON lipase units are much less..... but the CREON is enteric coated and not destroyed by the digestive pH like the powder enzymes are (approximately 70% of the powdered enzymes are destroyed because of the dog's pH level before the enzymes get to do their job: On our Enzyme page (the "Enzyme Conversion section") there is an explanantion of the difference between the powdered and the enteric coated enzymes and why CREON has a lot less is Lipase (especially) enzymes in it, but why it still can work:

The units of the enzymes in enteric coated products (such as CREON) are vastly less – – then the powders/tablets due to the fact that the majority of the potency of enteric coated products reach the digestive system in it’s entirety, whereas powders/tablets potency can often be up to 70% destroyed by pH levels in the digestive tract- -before the enzymes can reach the small intestine.

On the flip side, the powders/tablets are better absorbed due to the size of the powder/dissolved tablet grains vs. the enteric coated pellets.

CREON (enteric coated pellets in capsules) are designed for human consumption and are processed to be effective in the human digestive system. The pH level in the human digestive tract is approximately 4 where as the pH level in the canine digestive tract is approximately 1. Because of this variance in pH levels, we as pet owners need to adjust the CREON administration timing technique to try and figure out how best to administer the CREON to our pets to achieve optimal digestion.

To see how enzymes work with food in the body, please click on the CREON link and watch this excellent CREON action video https://www.creon.com/hcp/mechanism-of-action


In short, CREON does work with or dogs.... people in countries outside of the USA that cannot get the porcine powdered enzymes often have to use CREON because there is not anything else that is sufficient enough to work on their dog's EPI .... the only problem is that the dog owners have to play around with different administering techniques when giving CREON to see which method works best with their dog (due to the pH difference of humans that CREON was designed for vs. dogs so that it can be correctly timed for the coating to dissolve at the right time to activate with the food) ....

This pic explains it: Image
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Olesia, owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.3, Doing great 12+ years later! Once stable at 3+ months, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each cup of food, but as she aged- -had to go back 1 tsp enzymes per cup of food. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil / fish oil daily .... until she developed Diabetes and she now cannot tolerate higher fat foods. Currently feed an 80% home-made diet of sweet potato, a lean meat/fish, 1/3 of a raw egg, fat free cottage cheese, fish oil+vitamins and bone meal with 20% Annamaet Lean & Grain Free kibble. This combo has regulated her Diabetes (takes Vetsulin) and EPI and is very well managed. In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. This is when we discovered that she also developed Diabetes & Low Thyroid. Izzy was able to receive excellent care because of the generosity of folks on Epi4dogs! Izzy continues to wake up every day full of joy. I am not a vet. All of my suggestions/recommendations are based on personal experiences, observations, information gleaned from EPI researchers & pet parents alike, and EPI research. Please share with your vet everything we suggest.

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Paulag
Member
Posts: 26
Location: Montreal
Country: Canada
Pet name: Lyra
My name: Paula

Re: Allergies to enzymes

Post by Paulag » 15 Aug 2019, 09:46

This is very reassuring information. I actually sent it to my vet and my friend “who’s a pharmacist” to give them some in-site. Maybe it will help my vet as she wasn’t very sure about the Creon.
Day 2 yesterday with tylosin and I saw a more formed stool this am. I think I have my answer that it is SIBO. So I will speed up the food change with no grains in day 4 if her still improves. I feel it’s better tondo the food change while she’s on tylosin.
Presently giving two capsules 10 minutes before feeding. I’ll keep this regime for now .
Thank you everyone for all this valued information

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jilbert57
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Country: United States
State: Washington

Re: Allergies to enzymes

Post by jilbert57 » 15 Aug 2019, 09:56

Thanks for the encouraging update!
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 12 yrs young. TJ is a 3 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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Paulag
Member
Posts: 26
Location: Montreal
Country: Canada
Pet name: Lyra
My name: Paula

Re: Allergies to enzymes

Post by Paulag » 15 Aug 2019, 19:25

Day three Tylosin and I got an almost normal poo!!! Yippee.

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