Epi4Dogs

My German Shepherd guy is 10yrs old. I have always had trouble keeping weight on him. He has always had seasonal allergies that affect his eyes and ears but the last couple of years he has had terrible itchy skin with inflammation + hair loss that the vets can't figure out. I found a different vet who suggested benedryl. It hasn't helped much.
Now the last few months he has had chronic diarrhea and huge weight loss + gurgling stomach and hunger and the vet said it could be pancreatic insufficiency and suggested enzymes and probiotics. He has lost so much weight that his ribs and hip bones are showing. After much research this totally fits and I am frustrated that it wasn't caught sooner. The problem is that no matter what I try I can't get the loose yellow stools to stop and he is barely gaining. There is also lots of stomach gurgling and a little belching/reflux after eating.
Please can someone give me a clear step by step ? I am so overwhelmed that i don't know which supplements etc are important.

Here is what I am currently doing:
Food: Barker's brunch raw signature blend ground - 50% beef trim w organ/tripe 50% ground chicken necks
3lbs per day (almost double the norm what he should be) split in 3 meals (he is always ready to eat)
Enzymes: about a tbsp of pork pancreas pureed with a little water and split between meals. I mix it in and let it sit for 20 mins. Seems if I give more enzyme than that the stool gets looser.
Probiotics: 2 kinds since I couldn't find the stains the vet suggested in one brand. I am almost at a capsule of each in each meal.
AOR probiotic 3 - enteroccocus feacum 18 mil, clostridium butyricum 0.6 mil, baccilus subtillus 0.6 mil
cyto matrix multi strain 11 - 3 strains bifidobacterium , 9 stains of lactobacillus
Slippery elm: 1/2 tsp mixed in each meal ( seems to make his stools looser but I just started today)
Electrolytes: a package of unflavored pedialyte in his bowl of drinking water because he has had the runs for so long. Just started the last couple of days but it seems to perk him up a bit. I know this doesn't "solve" anything. Just supportive
Benedryl: 500 mg 3 times per day
Additional: I have put in an order for
enzymediane powder
tylosin powder
b12 with folate and intrinsic factor

I am especially concerned about his b12 but I can't afford anymore vet bills atm. The problem is that I am in Canada and despite submitting customs paperwork the b12 is being held in customs ! I suspect it will be the same prob for the tylosin and possibly the enzymes.

I have read all sorts of things about b12 being the "turning point" . I have to admit that I got desperate and bought the "regular" cyanocobalamine b12 in liquid form and am giving 1000mg with each (3) meals. I don't know if he can even absorb any of this ?

He gets his last meal late before bed and his morning poop is usually formed and browner. but after his first and second meal his poops get really loose and yellow. The yellow poops + skin problems and inflammation and itching, goopy eyes/ears = sibo ?

I have been doing double food+enzymes+probiotics for 2 weeks
slippery elm & b12 liquid & pedialyte for 1-2 days
He has (maybe) gained a pound or 2

I have tons of supplements suggested in the past by homeopathic vet - but he didn't catch epi and was treating his skin like an allergy (a,e,c,d, 2 kinds of zinc etc) with no improvement.
also sunday sundae and feedsentials (but don't know if they are good anymore had them for over 2 yrs in the cupboard)

I am scared he is going to die if I can't get some nutrients into him. He is getting 3lbs of ground meat and organ and bone per day ... how can he possibly not be gaining weight ? This is frightening.
Please tell me what to do step by step ? Should I change his food ?
I really didn't want to go back to kibble but I don't know what to do.
He has not been officially diagnosed but his vet feels that if it walks like a duck and quacks like a duck...it is probably a duck. Or in this case epi/sibo.

Hi and SOOOO sorry your pup is struggling so much.... i suspect, if this is EPI, once you start the powdered enzymes....and you get him started on Tylan antibiotic powder you (hopefully) will start to see a difference. Most of the time raw pancreas works, but every so often, with some dogs, it doesn't work as well as expected. And if this is EPI (or IBD or PLE, etc, etc) the Tylan should help with the SID (i am thinking along the same lines as you are that this sounds like SID)

So glad you ordered the powdered enzymes... BUT.... as you mentioned customs might hold them up.... if the enzymes are coming from outside of Canada. We had another person on the forum from Canada who's vet jsut contacted and said they now can get Pank Aid enzymes.... you might want to call your vet and ask him to get some for you too, just in case your other order of enzymes get held up at customs.

Since you are also concerned about the B12 getting thru customs (i am assuming Wonderlabs Pet Factor B12 which works great on most of our dogs, yes?).... if yes, then what you can do is give a HIGH dose of cyanocobalamin B12... since the liquid B12 you purchased is 1000mcg... that should be high enough so it should work to some degree or another. Fingers & paws crossed on this.... give it anywhere between a few days to maximum up to 3 weeks to notice a difference.

HMMMM....... all that itching..... what i would like to do is suggest to you to call your vet Monday and ask him/her if they think that your dog might have a problem with storage mite allergies (or some other skin allergy)... if they think this is a possibility with all the itching... normally i would next suggest asking them if they would be comfortable giving you 1 weeks worth of Apoquel to see if it subsides the itching.... HOWEVER..... considering all the loose stools AND the itching..... what i am wondering is if it would be better for you to ask your vet if they would prescribe Prednisone. Sometimes in severe cases of loose stools, when nothing else is helping, prednisone is used and it works..... and prednisone is also used to stop sever itching.

SO.... because of these 2 issues going on....maybe have a conversation with your vet about giving prednisone for both (temporarily) and if the pred does stop the itching... and since it is not good to stay on prednisone long term, if it does help with the itching.... then you can switch from prednisone to Apoquel for the itching. i(this is what happened to us and it worked) .

The itching kind of makes me wonder if maybe the problem is a storage mite allergy which would be triggered by all kibble and even prepared whole foods if anything was used that storage mites could be in .....look up storage mites and you will understand why i am wondering this.......

It sounds like you are starting to put thing in place to properly treat if this is EPI.
In the meantime..... just in case it is not EPI.... please read the concurrent conditions page, specifically PLE https://epi4dogs.com/ple/ cause that displays like EPI, constant loose stools and EPI treatment will not help.... see if it kind of sounds like this is a possibility and maybe read about IBD https://epi4dogs.com/ibd-allergies-food-intolerance/ too.... just in case:

Not sure how helpful this is but i hope something suggested helps.

Please keep us posted.

Hi and welcome. I am so sorry you can't get you pup squared away. Olesia gave you great advice. Try keeping a daily log also, you might be doing that already.
At the beginning of Spring my jack russell goes on Apoquel 1- 3.6 mg tab a day for a week. Then he gets half a tablet after that per fay. I use it a couple months as sparingly a dose I can get him down to.

Jill

I just spoke to Diane (EnzymeDiane) and she said her enzymes are getting thru going to Canada with no problem with customs, etc... ...BUT..... ask for them to be shipped via UPS not via the postal service..........

Is your dog better?spin the wheel

If I can't get some nourishment into him, I'm afraid he'll pass away. How is it possible that he isn't gaining weight when he consumes 3 pounds of ground flesh, organs, and bones every day? This is terrifying. I'm so happy I found this topic! You gave me a very good advice.

What is the percentage of bone? Many dogs, my own included, does not do great with too much bone. It's not digested well. Occasionally I do still give him meals with a high (ground bone) percentage. I do increase the enzymes when I do that; but usually do still wind up with some issues a couple of days later. All meals have some (finely ground) bone; but if it's too much, we pay for it.

For some reason, if I give a meal of only green tripe, again we do have to increase the enzymes slightly for that meal (otherwise we end up with problems after a couple of days). If I up the enzymes that meal, there's no issues. (I do not know why that is, as there's virtually no fat in the tripe I get).

With beef, that's another one that usually requires a slight enzyme boost. That, I suspect might be because beef tends to have a little extra fat.

You mentioned a tablespoon of pancreas. What type of pancreas? Especially if it's beef, I am not certain it's enough. Beef pancreas doesn't offer much in the way of lipase. Cows aren't designed to eat fat...their liver won't allow for it. So they don't need much lipase. Pork pancreas does offer more, so less might be required. (I did try beef pancreas once, as it was all I could source. I found that about half the meal had to be pancreas in order to get semi decent poops.

I have found calcium bentonite clay to be a godsend. It helps to get things improved again when something gets messed up. It helps draw out the bad bacteria if there's a SIBO infection. It is also absorbent, and draws out extra moisture from the colon, making poop less runny. This, I typically only need 1/2 tsp per day, usually a few days a week. (Mixed in ceramic bowl, not using any metal utensils). I also found a probiotic that works well for my dog (it was probiotic #5 that finally seemed to actually help! So it can take some patience. Not all probiotics work as well, and every dog is different. For example, Proviable was probiotic #4. It is one that many EPI dogs have success with. But it wasn't strong enough for my dog. I had to go for something a lot stronger).

You also mention 500mg Benadryl 3 times a day. I suspect that's a typo! That's the dose for a 500 lbs dog! If it's not a typo, and you do actually give 60 Benadryl per day; I would question what side effects that has to offer. Normal dose (during bad times) is 1mg per pound of body weight.

If problems persist, I would also visit the vet again. Addison's disease can cause many of the same type of symptoms as EPI, except normally that causes loss of appetite. But there's more than one illness that can mimic EPI. It's also possible to have more than one illness!

we got pig pancreas from a slaughter house but maybe your local butcher might be able to source it for you

without sufficient enzyme things will not improve, i have never fed bones or bone meal, what about scrambled egg and mashed potato ?

what you are seeing coming out is undigested food