Dog with EPI and IBD

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.
Ben j v
Member
Posts: 5
Country: Australia
State: Washington
Pet name: Rorschak
My name: Ben

Dog with EPI and IBD

Post by Ben j v » 09 Nov 2019, 23:47

Hello everyone.
Let me start by saying it is a huge relief to find this website and know that there are many caring people fighting the same fight.
I have a lot of reading to do here, but wanted to make this post asap to introduce us, and revieve any advice possible, as we are growing derperate.
My name is Ben, my doggo mates name is Rorschak, but he goes by pup.
He is 4 years old now, and a mixed breed. We can guess as to a few of the breeds in him.
He was diagnosed with epi about 18 months ago, he was terribly skinny before he was finally diagnosed and given the (creon) pancreatic enzymes he needed.
The creon undoubtable saved his life, and we managed to get him back up to a reasonable weight, although i think never to his ideal healthy weight.
He constantly suffered diarreah and the loudest gurgling tummy i have ever heard, which was accompanied by alot of gas.

We tried every different meat and food, kibble that we could think of, as well as opening the creon capsules(against the vets advice) and incubating the food.
Nothing seemed to work, and the only relief he got was during one of his many antibiotic cycles, which were given to him to treat suspected sibo, when his diarreah became exceptionally bad, he lost weight and was just generally and obviously miserable.

We recently ( about 4 or 5 weeks ago) opted for exploratory surgery to gain a final and conclusive diagnosis.
The vet was able to inspect all his internal organs as well as take biopsies of his small intestine.
The results are as follows
1) Stomach - normal.
2) Small Intestine - Lymphoplasmacytic enteritits
3) Colon - Lymphoplasmacytic colitis

The vet explained this to us as severe ibs, pups guts were gurgling and chirning away in his hands even as he lay under general anisthetic on the operating table.
He said his immune system is over active and attacking the protein he is normally fed, so all the regular diets are now out the window and he needs a whole new protein source. He has eaten alot of stuff, Including kangaroo, as we live in australia.
sO now he is on hills zd as his immune system should not be able to recognise the protein.
He is also on a steroid, prednisolone 20, to help his ibs settle down.

Even on this diet his guts were terrible and he lost weight and had diarreah, we suspected he reacted badly to the zd kibble, so we stopped that and just gave him the canned zd, which he is much better on.

SO now finally he is having formed stools, the first few were brown and our hopes were high. Mabey we finally dialed it in.
But a few more days have gone by, he is so so skinny, just like when he was first diagnosed. And his stools are now much more yellow, infact no brown at all. They kinda smell like when he had a flare up, or before he was even on creon, so i call the smell “Undigested” while still being formed, but very soft.
He is fairly happy and playful, until today, where he just seems to have no energy left to play or talk to us. But not utterly miserable like when he had bad ibs.
So it seems he still is not absorbing nutrients, even though is ibs is for the most part under control.
He was ravenous on the origional dosage of pred -x which was 2 tablets a day.
Now on 1 tablet he is begging less. But we are still feeding him a tonne, just to try get him to bulk up a bit.

HE has never had probiotics following any if his many courses of antibiotics. Our vet didnt think it of any importance. Yesterday in our desperation we got him some.
I know this story iss a bit all over the show. Sorry about that, i just want to get it out there.
Any help or advice at all is greatly appretiated.

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Jean
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Posts: 675
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: Dog with EPI and IBD

Post by Jean » 10 Nov 2019, 04:14

huge welcome from Liverpool UK

blimee you have really been through the mangle

this is from our concurrent condition page

https://epi4dogs.com/ibd-allergies-food-intolerance/

I have sadly no experience of IBD, as to the gurgling tummy , have you tried an antibiotic called Tylan ? if his tummy is sore he wont want to be bothered, God love him, I am going to ask our founder to jump in and give her wisdom


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

Ben j v
Member
Posts: 5
Country: Australia
State: Washington
Pet name: Rorschak
My name: Ben

Re: Dog with EPI and IBD

Post by Ben j v » 10 Nov 2019, 04:23

Thank you so much Jean.
No i only heard about tylan yesterday as i was reading through the forum. We have asked at a few places and no luck finding it yet. We will see the vet tomorrow and il call some farm supply warehouses.

We have tried one long term antibiotic, i cant remember off the top of my head what it was, but il ask the vet tomorrow.
Thanks for your reply

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Jean
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Posts: 675
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: Dog with EPI and IBD

Post by Jean » 10 Nov 2019, 05:38

was it Matronadazole ?

we have members in Aus, which part are you from ?

I will see if I can get inspiration form any of them as to Tylan

j
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

Tuckaboo.
Member
Posts: 95
Country: United States
State: Florida
Pet name: Tucker

Re: Dog with EPI and IBD

Post by Tuckaboo. » 10 Nov 2019, 07:41

Ben, I'm not sure if you realize that Tylan is a prescription antibiotic, at least it is here in FL. I hope your vet is able to come up with a regimen that helps Pup and you. My Tucker takes Diane's enzymes, Tylan and a B12 capsule opened into his food, twice a day, and he is mostly under control after several months. When I've given him, or any of my dogs, probiotics they have had bad diarrhea, but I'm not sure why. Are there grains in his kibble? If so, aren't some grains implicated in cases of IBS? I believe I've heard that. I'm sorry I don't have more help to give, but if any of Tucker's details give you ideas, maybe that is a good thing. Best to you and Pup---Pam
Tucker is a shepherd mix, and has not had a blood test for EPI. In May 2019 we started on sulfasalazine to eliminate IBS as diagnosis. Symptoms returned at end of course, so started on Tylan alone...no luck, so added enzymes, and progress was shown. Currently taking Diane's Enzymes 4t/day, Wonderlab B12 capsules 2/day, and Tylan 1/2 t/day. No more coprophagia, he has gained 8 pounds, and he is a happy member of the family...no more grumpies with his much smaller brother & sisters, who do not have EPI.

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

Re: Dog with EPI and IBD

Post by Olesia711 » 10 Nov 2019, 09:12

Hi Ben, and welcome to you AND your pup... but so sorry to hear that he is dealing with both EPI + IBD...... that's like a double whammy, but please know that there are lots of people that have dogs with this dual condition.

First, i commend you and your vet for all that you have to so far, because the right protocol has been taken. Unfortunately the problem with this is many times even though you do all the "right" things, sometimes things STILL do not come together until you "tweak" things a bit.

Because of the Lymphoplasmacytic enteritits & colitis (and your vet explained it perfectly; severe IBD) you are on the right path with a hydrolyzed food ... BUT.... and please share this with your vet, although there are now about 5 different brands of hydrolyzed foods and all with the same desired"outcome"... they each tend to work a little bit differently on individual dogs and some do better on one and not the other while another dog will have the opposite response........so often, you jsut have to try one brand after another.

SO.....Since you had to switch to Hills Z/D canned vs. the kibble, and the calorie count is much less in canned (kibble is concentrated).... please let your vet know that "if" you want to try a different a different hydrolyzed food.... please try Ultamino by Royal Canin....(another hydrolyzed food).... however this food appears to agree more readily with many of our EPI + IBD dogs when the Z/D (and some of the others) don't seem to work as well. SUpposedly the Ultamino food hydrolyzation is processed to a much smaller degree than all the others and supposedly this might be why our dogs respond better on it. Of course, not every single dog will respond accordingly. SO, if you and your vet do want to try it, see if your vet can order the smallest bag possible first just to see if it does indeed agree.

NEXT..... to also help with he weight gain.... you might want to "try" 1/2 tsp of cold pressed coconut oil with each meal. BUT watch the poos very carefully.... to see if this agrees or causes loose stools. This usually (but not always) agrees with our dogs and helps slowly put on good weight and is very beneficial for the skin and coat. BUt if loose stools happen, after the first meal with coconut oil, then stop giving it.

NEXT... if you are going to try a probiotic.... try Proviable by Nutramax first over other off the shelf probiotics....the trick is that you want a product that is viable AND that has prebiotics in it. Unfortunately, right now all probiotics are "one-size-fits-all" and all dogs have individualized gut floras so probiotics may or may not work...but what DOES work is prebiotics..what you might want to do is treat with antibiotics and then 2 hours away from when you give the antis with food, give a probiotic with prebiotics.
In the meantime, i am patiently waiting for someone to come up with probiotics that are more tailored to various health conditions.... as each health condition has (overall) different concentrations of bacteria and variety.... and we really need probiotics/prebiotics that more readily address this missing/lacking components, not just throwing all the same probiotic concentrations at every dog..... this just doesn't really work in the end............
.
REgarding antibitoics what you "might" want to do is ask your vet to try to get some Tylan (Tylosin tartrate 100g) and give twice a day with breakfast and dinner for 45 days.... to reduce the out of control SID (small intestinal dysbiosis)... this is all that gurgling in the gut that is prevalent in both EPI + IBD cases... The Tylan that we use in the USA is made by Elanco. It is originally designed for honeybees, chickens, pigs, etc.... but there is enough evidence that on dogs that it appears to REALLY get SID under good control vs. something like Metronidazole (Flagyl)... althou that too appears to work when sometimes the TYlan doesn't. But usually these EPI + IBD dogs respond much better to Tylan... not always, but most of the time. Tylan in other countries often come under slightly different brand names.

And last but not least, was your pup's B12 level's checked? Over 80% off all EPI dogs (and many with IBD) have insufficient B12 and this too contributes to loose stools AND lack of weight gain. You can do simple cyanocobalamin B12 shots or high dose methycobalamin B12 pills that have folate and intrinsic factor in them....

Hope some of this info helps, PLEASE be sure to share everything we are suggesting to you with your vet.... and keep us posted. Getting these dogs stable/well managed can be a process, but we will try to help you as best we can.
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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Madelon
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Posts: 618
Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Dog with EPI and IBD

Post by Madelon » 10 Nov 2019, 09:22

Hi Ben - sorry I'm late to reply. Gosh you and your boy have been through a lot. I'll try to address everything but first and most important, here is a link to our Quick Guide for Australia members and in it is information on where to get Tylan https://epi4dogs.com/wp-content/uploads ... t-2016.pdf. It definitely sounds like you're dealing with SID (small intestinal dysbiosis - formerly called SIBO) - be sure to use the Tylan for 45 days and SLOWLY wean off. We have found over the years that when you stop the Tylan instead of weaning off the dog can have a set back. In the meantime, you might want to try Slippery Elm Bark powder - a recent study has shown in some cases Slippery Elm works better than antibiotics in treating SID. Slippery Elm is a prebiotic mucilage that coats the gastro tract and is often used in treating IBD. Here's a link to our page regarding SE https://epi4dogs.com/slippery-elm/. Just be sure to get the powder not capsule and mix with 1-2 tablespoons of water and then put directly on the food - no need to incubate. Recent research has shown that EPI dogs always have SID - their guts are just a mess - and it's a matter of finding the right combination of things to keep it under control.

Okay, with regard to the IBD, we have found most EPI dogs with concurrent IBD do best on Royal Canin Ultimino so you might want to ask your vet about trying it.

With regard to enzymes, if you're interested in trying for cost saving purposes, Chemeyes now ships the powder enzymes to Australia and is a lot less expensive and easier to dose than Creon. Here is a link to their website https://www.chemeyes.co.uk/product/high ... -powder-2/. The owner Suj is amazing and will help with any questions you might have.

Next I'm wondering about B12. Are you supplementing B12? If not, this could be a possible cause of the recurring SID flare ups. B12 supplementing is critical to properly managing EPI. Chemeyes also has a great B12 pill that has intrinsic factor which helps with B12 absorption, which is what most of us use. Here's the link to their website with B12 https://www.chemeyes.co.uk/product/vita ... ic-factor/.

Please keep us updated on how things are going.
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

Ben j v
Member
Posts: 5
Country: Australia
State: Washington
Pet name: Rorschak
My name: Ben

Re: Dog with EPI and IBD

Post by Ben j v » 10 Nov 2019, 10:26

Guys thank you all for your replies. It really is so encouraging.

We will take this all to the vet tomorrow to discuss with him. The creon is fairly affordable, and is covered by his insurance, for the most part. Hills zd cans were a shock though, i must admit. Looks like 500 dollars worth will last him a maximum of 40 days. But now im really interested in the royal canine, regardless of cost, i was not aware of the canned zd having significantly less calories than the kibble, he is a very energetic dog when in full health.
His b12 levels were tested , if i recall they were slightly on the low side. We were gives a series of injections to give him at home, i think it was more of a trial than a treatment and since then he has had no supplementation.

I recognise the brand name flagyl, he has definitely been on that. I dont recall if its the one that seemed to have little or no effect though, but il certainly be requesting tylan, and ordering some slippery elm.

I Dont see grain spelled out in the ingredients on his zd, it has corn starch and soybean oil. The rest is mostly chemical compound names. That is something we will keep an eye on now though, as we trial and error our way through this.

We live in yallingup, western australia. Its close to perth.

I cant thank you guys enough, all this infomation is really exciting and has taken a massive load off our minds. I will keep you updated.

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Jean
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Posts: 675
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara
My name: Jean

Re: Dog with EPI and IBD

Post by Jean » 10 Nov 2019, 11:10

just noticed that you are in Washinton in Australia, so appologies

Pam, Tylan is only available from the vets here in UK, and madly its made in Liverpool, still cant get it !

Cant remember what it is in Australia, but someone will know, i have thrown it open to 2 members over there

Olesia might know

jx
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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Olesia711
Founder
Posts: 929
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy

Re: Dog with EPI and IBD

Post by Olesia711 » 10 Nov 2019, 13:37

Hi Ben,

I just realized (while looking up Tylan in AUS) i made a typo in my description of Tylan.... it is Tylosin Tartrate 100 g (not 100 "mg" like i originally typed in my post). I have since gone back into my post and corrected it.

SO....... talk to your vet and if you decide to try the Tylan antibiotic.... here is a source in AUS that your vet can look into:
h[url]ttps://www.discountpetmeds.com.au/tylan-solubl ... ion_tabbed[/url]
Do not get the liquid Tylan, that is more for respiratory issues, vs. gastrointestinal issues........you will want the soluble powder, although why they call it soluble is beyond me as it doesn't mix well in water................ my dog HATES the taste of it... so i have to pour the proper amount of Tylan into an empty gel cap(according to dog's weight on our website https://epi4dogs.com/antibiotics/), and this is how i can get my dog to take the Tylan antibiotic powder. SOme dogs will eat it sprinkled on their food, but many others then won't touch their food (like my dog- -she then acts like i am trying to poison her!)

Also... i did not mention SLippery Elm, cause i wasn't sure if you can get it th in AUS... but.... if you can it is WELL worth trying before you go the antibiotic route.
https://epi4dogs.com/slippery-elm/ For all the reasons Madelon explained. It has prebiotic properties AND it is a mucilage and they (researchers) think that it might be protecting the gut from bad metabolites from getting thru :)
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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