The Maya Metabolomic Study in Honor of Maya, an esteemed member of Epi4Dogs
Epi4Dogs is pleased to announce that we are collaborating with Dr. David A. Williams and Dr. Patrick Barko of the College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois. Together we are embarking upon a new research study, the Maya Metabolomic Study, http://vetmed.illinois.edu/cmmi/ in their Clinical Metabolomics and Microbiomics Initiative to further investigate possible environmental factors that may be involved in EPI. Metabolomics is an emerging field in which a very large number of small chemicals can be analyzed from samples of body fluids and tissues. This new technology has the potential to identify previously undetectable abnormalities associated with development of various diseases, including EPI, and it is hoped that this new information will provide clues as to why this disease develops and what we can do to prevent it.
We know that there are some genetic indications with EPI in dogs from the research done by Dr. Leigh Anne Clark of Clemson University Genetics and that it is strongly suspected that EPI is a combination of both genetics and environmental causes. The Maya Metabolomic Study will hopefully help to identify the environmental “trigger(s)” as to why EPI occurs and what causes the acinar cells in the pancreas to start destroying themselves.
To learn more about the complex field of metabolomics technology, interested readers can go to Metabolon’s website section that succinctly explains the study of metabolism and the metabolomics research process: http://www.metabolon.com/technology/about-metabolomics.aspx and http://www.metabolon.com/technology/the-science-of-metabolism.aspx
Phase One participation in this study has been completed. What was required was one or two short visits to your veterinarian, or at a designated and authorized location, where samples of blood, feces, urine, and DNA will be collected by trained veterinary professionals. These samples were then shipped to Dr. Barko for analysis. There will be multiple testing and analysis with these samples.
To submit a dog to qualify for participation in future phases of this study and other studies, you will need to fill out the EPI REGISTRY located here: http://www.epi4dogs.com/epiregistry.htm (even if you filled it out a few years ago, please feel free to fill it out again, as i have recently included additional features to benefit the study). Dr. Barko continues to sort the database in various ways as there are multi-levels of candidates needed for various phases of the study, and he will contact those via email who fit the needed criteria. This will be an on-going process.
Neverbefore has such an all inclusive/comprehensive EPI study been undertaken with every single body fluid collected. This will allow for further testing to be pursued with samples already on hand based on these study results. This was never possible before and a huge thank you to Dr. Patrick Barko for working diligently getting everything properly set-up for this extraordinarily comprehensive study!
SEPTEMBER 2021: Research Update
EPI cats benefited from a mini-side research that was conducted with the Maya research. The following research was published on September 30, 2021 on PLOS ONE “Untargeted analysis of the serum metabolome in cats with exocrine pancreatic insufficiency” by Drs. Patrick C. Barko & David A. Williams. (full study is listed here ” Epi4Dogs – Cats get EPI too! – Managing EPI | Non-Profit Educational Resource & Forum” The EPI dog research soon to be published and noted here.
July 2021: Research Update
The Maya EPI research has been in progress for 5 years. This research has been extremely extensive and has taken many twists and turns.
2018, because of the Maya EPI research, they discovered that EPI dogs are lacking in lipid-soluble vitamins A, E, & D
2021, because of the Maya EPI research, they identified microbial metabolites associated with associated with intestinal permeability.
Spring/Summer 2022 publications from this research will be announced and published on this site.
Please go to the EPI Research page Epi4Dogs | EPI Research | Managing EPI | Non-Profit Educational Resource & Forum to see the actual research studies, posters and / or abstracts.
October 2017: Research Update
Results from Phase One of this Maya Metabolomic Study are estimated to be released the end of 2017 first to those that participated in the study. We will then share with the general public on the research results are analyzed, written and published.
I would like to especially and gratefully thank Maya’s family along with Drs. Williams and Barko. Because of each of them, this study is now possible. And I would like to further extend a thank you to the University if Illinois, Toby’s family, and the entire membership of Epi4Dogs for contributing much needed data for this study submitted on the Epi4Dogs “EPI Registry.” Again, Thank You!!!
The Research Investigators
Dr. Patrick Barko Dr. David A. Williams
Veterinary Resident MA VetMB PhD, Diplomate ACVIM, ECVIM-CA
Veterinary Clinical Medicine Professor in Small Animal Internal Medicine
College of Veterinary Medicine College of Veterinary Medicine
University of Illinois Urbana-Champaign University of Illinois Urbana-Champaign
Champaign, Illinois Champaign, Illinois
Dr. Patrick Barko graduated from the Washington State University College of Veterinary Medicine in 2013 and completed a rotating internship in small animal medicine and surgery at the University of Illinois. As a small animal internal medicine resident at the University of Illinois Veterinary Teaching Hospital, he is working with Dr. David Williams and other researchers on a number of innovative investigative projects. His research interests include small animal gastroenterology, developmental microbiomics, and the application of cutting edge technologies, including metabolomics and DNA sequencing technology, to veterinary clinical research.
Dr. David Williams founded the “GI Lab” in 1985 at the University of Florida, when he introduced assay of serum trypsin-like immunoreactivity (TLI) in the dog to the United States. His research has been focused on the development and application of new tests for gastrointestinal diseases, particularly those affecting the pancreas, small intestine, stomach and liver of dogs and cats. Students and staff working in his other GI Laboratories at Kansas State, Purdue, and most recently Texas A&M Universities established several other novel tests for gastrointestinal diseases for use by veterinarians internationally. These included feline serum TLI, canine and feline serum pancreatic lipase (PLI), canine and feline fecal alpha1-proteinase inhibitor, unconjugated serum bile acids, canine thyroid stimulating hormone (TSH), and canine and feline serum cobalamin and folate assays.
He received his veterinary degree from the University of Cambridge and his PhD from the University of Liverpool (where he first developed the canine TLI assay). He was an intern and resident at the University of Pennsylvania, and has held Faculty positions at the University of Florida, Kansas State University, Purdue University, Texas A&M University (where he served as Head of Small Animal Clinical Sciences), and currently at the University of Illinois (where he served as Head of Veterinary Clinical Medicine). He continues to work as an Adjunct Professor and consultant with the GI Lab at Texas A&M University, providing telephone consultations with veterinarians regarding management of patients diagnosed using the GI Lab services.
Dr. David A Williams’s research interests are Development and application of new tests for gastrointestinal diseases, particularly those affecting the pancreas, small intestine, stomach and liver of dogs and cats.
Slippery Elm / SID Pilot Study
(Winter 2017)
NAME OF THE SURVEY STUDY:
EPI Microbiome Slippery Elm / SID Pilot-Study
OVERVIEW AND PURPOSE:
In 2016, Epi4Dogs Foundation Inc collaborated with Dr. Suchodolski of (TAMU) Texas A&M Gastrointestinal Laboratory to assist with identifying the composition of microbiota clusters in the EPI dog. Dr. Suchodolski identified a dramatic anomaly in the fecal matter of EPI dogs, vastly different from the healthy dog, and also quite different from the IBD dog too. Based on these findings and a better understanding of the gut microbiome, our ultimate goal is to see if there is a non-antibiotic alternative to address SID (small intestinal dysbiosis), formerly referred to as SIBO a prevalent secondary condition in the EPI dog, instead of having to prescribe antibiotics such as Tylosin Tartrate (Tylan) and/or Metronidazole (Flagyl). Our concern with these antibiotics is that much too often, after the administration of antibiotics is completed, SID returns.
We are now ready to embark upon new mini-study to ascertain whether Slippery Elm, a natural herbal powder, might warrant in-depth investigation as a possibility in addressing SID vs. antibiotics. Slippery Elm is a natural herbal powder made from the inner bark of the American Elm tree. If there are positive results from this pilot-study we will likely pursue an extensive study examining the chemical properties of Slippery Elm and why it works on SID and how we can best utilize it in treating SID in EPI dogs.
PROTOCOL:
We will be enlisting 6 to 12 confirmed EPI candidates with and without SID, along with 6 control dogs to participate in a non-invasive microbiome Slippery Elm fecal-matter pilot-study. Candidates must not have been on Slippery Elm for 1 month prior to participating in this study, but may have had Slippery Elm earlier.
CANDIDATES:
- Confirmed EPI dogs via TLI test.
- Non-EPI dogs.
Participation in this study will require the pet owners to report confirmed TLI test results of their EPI dogs. If a Cobalamin (B12) test was also done, we would like those results too. Epi4Dogs Foundation, Inc will purchase the NOW brand of Slippery Elm powder directly from Amazon.com and Amazon.com will mail the Slippery Elm directly to the owner once these test results and the owner questionnaire are received. The owner will then collect two naturally eliminated baseline stool samples from their EPI dog—one sample one week before administering Slippery Elm, and the second sample 1-2 days before administering Slippery Elm. The pet owner will then be obliged to give the designated dose of Slippery Elm . The Slippery Elm dose will be determined according to your dog’s weight noted on the participant record keeping worksheet, mixed in with breakfast and dinner meals for one week. The owner will collect naturally eliminated stool samples from their EPI dog approximately 24 hours, 72 hours, and 1 week after the first dose of Slippery Elm was given. After one week of giving Slippery Elm powder, the owner will stop the administration of Slippery Elm to their dog. The owner will also collect one naturally eliminated stool sample one week after the last dose of Slippery Elm was given as a post-treatment baseline, for a total of 6 stool samples.
For all stool samples:
- Please collect samples immediately after your EPI dog defecates so that samples are not exposed to the outdoor environment for a prolonged period of time.
- Label a small zip lock bag with date and time of sample collection and freeze a small portion of the collected stool sample (approximately 1 gram; equals ½ inch in size, or approximately 1 teaspoon) in this bag. Be sure it is well sealed and then put that in yet another baggie and seal that also before putting in the freezer.
- Keep all stool samples frozen until shipping.
This study will take place over the course of 3 weeks. On the first day, the owner will write a full assessment of the dog’s condition on the participant record keeping worksheet. Any changes to this original condition or changes in the dog’s regular routine (i.e., stool quality, diet, medications) throughout the course of the study must be recorded on this worksheet. Owners will also observe the fecal score (chart provided) and record at least one fecal score per day of the study. Stool pictures are welcomed! During the 2nd week of stool collection, the owner will contact Epi4Dogs requesting pre-paid label and shipping container. TAMU will then send the pet owner, a pre-paid shipping label and container so that at the end of 3 weeks of stool collection, the pet owner can mail the frozen stool samples to TAMU gastrointestinal laboratory free of charge.
There will be no special requirements on the pet owner’s behalf to make any change to any treatment protocol the EPI pet is currently receiving. TAMU will mail the participant a Styrofoam cooler and ice or dry ice pack with a pre-paid mailing label when it is time to submit the stool samples.
- There are no known risks to your dog in this study.
- Participation in this survey is voluntary and your dog (dog’s stool samples) can be withdrawn at any time, at your discretion.
- Any and all information collected for this survey will be confidential. The results of the analysis are subject for publication in the veterinary academic literature, though any personally identifying features will be concealed.
- There are no financial incentives for participation in this survey.
INSTRUCTIONS
- Upon agreeing to participate in this Survey Study, please complete the 3rd page of this consent form and the owner questionnaire and email to the President of Epi4Dogs Foundation, Inc: [email protected]
- After two weeks collecting stool samples, please contact [email protected] to alert TAMU to send you the pre-paid mailing label and shipping container.
- When sending the stool samples to TAMU, please include the original signed copy
of ( 1) the consent form, (2) the participant record keeping worksheet, and (3) the owner questionnaire
SURVEY STUDY CONSENT (please fill out everything!)
I hereby consent to the participation of the following animal in the study cited above.
Dog Name: _______________________________________
Dog Breed: _______________________________________
Dog Age: ________________________ Weight: _________________________
Pet Owner’s Name (Print): ___________________________________________ Date: ____________________
Pet owner’s Email Address: ____________________________________________________________________
Pet Owner’s Name (Signature): ___________________________________________________________________
NAME OF THE SURVEY STUDY:
EPI Microbiome Fecal Matter Survey
INVESTIGATOR:
Dr. Jan Suchodolski, MedVet, Dr Vet Med, PhD, AGAF, DACVM, Texas A&M Gastrointestinal Laboratory, College Station, Texas, USA.
OVERVIEW AND PURPOSE:
Epi4Dogs Foundation Inc collaborated with Dr. Suchodolski of Texas A&M Gastrointestinal Laboratory in supplying candidates from Epi4Dogs to assist with identifying the composition of microbiota clusters in the EPI dog. Dr. Suchodolski has recently identified a dramatic anomaly in the fecal matter of EPI dogs, vastly different from the healthy dog, and also quite different from the IBD dog too. Based on recent findings and a better understanding of the gut microbiome, our ultimate goal is to see if there is an alternative non-antibiotic way to address SID (small intestinal dysbiosis), formerly referred to as SIBO a prevalent secondary condition in the EPI dog, instead of having to prescribe antibiotics such as Tylosin Tartrate (Tylan) and/or Metronidazole (Flagyl). Our concern with these antibiotics is that much too often, after the administration of antibiotics is completed, SID returns.
However, before we embark upon new trials to ascertain whether alternative methods vs. antibiotics might be a possibility in addressing SID in the EPI dog, we need to further assess EPI dogs fecal microbiota to support and proof Dr. Suchodolski’s findings.
Page 1 of 3
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EPI Microbiome Fecal Matter Survey
PROTOCOL:
We enlisted 3 different groups of confirmed EPI candidates to participate in a
non-invasive microbiome fecal-matter survey study. The 3 groups were:
· Confirmed EPI dogs in stable condition with no (chronic) problems with repeated SID
· Confirmed EPI dogs with repeated (chronic) SID issues
· Newly confirmed EPI dogs
Participation in this study required that the pet owners report confirmed TLI test results of their EPI dogs. If Cobalamin tests were done, we asked that those results also be reported. The pet owner was then be responsible to collect twice-weekly naturally eliminated stool samples from their EPI dog, label and freeze a small portion of the collected stool samples (approximately 1 gram; equals ½ inch in size, or approximately 1 teaspoon). When storing a stool sample it was required to date it and place in a small zip lock baggie (zip lock snack bags work well) be sure that it was well sealed and then placed in yet another baggie and seal that also before putting in the freezer. This process took place over the course of 2 months. Participant owners were asked to observe the stool quality and only make a notation in the record keeping if something changes, either with the stool quality or if there is any change implemented to the regular treatment protocol during the survey, for whatever reason, it must be noted in the owner’s record keeping. Stool pictures were welcomed! At the end of the 2 months, TAMU made arrangements to send the pet owner a pre-paid shipping label so that the pet owner can mail the frozen stool samples to TAMU gastrointestinal laboratory free of charge. There were no special requirements on the pet owner’s behalf to make any change to any treatment protocol the EPI pet was currently receiving.
1. There were no known risks to any dog in this study.
2. Participation in this survey was voluntary and a dog’s stool samples could have been withdrawn at any time, at owner’s discretion.
3. Any and all information collected for this survey will be confidential. The results of the analyses are subject for publication in the veterinary academic literature, though any personally identifying features will be concealed.
4. There are no financial incentives for participation in this survey.
INSTRUCTIONS
1. Upon agreeing to participate in this Survey Study, please complete the 3rd page of this consent form and email to the President of Epi4Dogs Foundation, Inc: [email protected]
2. At the end of 2 months of collecting stool samples twice a week, please contact [email protected] to alert TAMU to send you the pre-paid mailing label, Styrofoam container and freeze packs..
3. When sending the stool samples to TAMU, please include both the original signed copy
of ( 1) the consent form and (2) the worksheet
Page 2 of 3
SURVEY STUDY CONSENT (please fill out everything!)
SID group your dog is in (please check one):
( ) SID is well-regulated in this EPI dog
( ) SID is not well-regulated in this EPI dog
( ) This is a newly diagnosed EPI dog
Pet owner’s name:
Owner’s address:
Owner’s email & tel:
Dog’s first name: Dog’s age :
Other health conditions?
Date trial started :
Dog’s TLI score : TLI test date:
Dog’s B12 score: B12 test date (if available):
Is the dog on antibiotics? If so brand?:
Antibiotic current dose & dose routine:
Current diet (brand name of food or if home prepared, list portions of individual ingredients:
List size and number of meals fed daily:
Pet Owner’s Name (Print): Date:
Pet Owner’s Name (Signature):
Page 3 of 3
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EPI Microbiome Fecal Matter (stools) Survey/Study
Participant EPI (Twice-Weekly) Record Keeping
SID group your dog is in (please check one):
( ) SID is well-regulated in this EPI dog
( ) SID is not well-regulated in this EPI dog
( ) This is a newly diagnosed EPI dog
1. Pet owner’s name ____________________________________________________________
2. Owner’s address______________________________________________________________
3. Owner’s email & tel___________________________________________________________
4. Dog’s first name ________________________________ Dog’s age _______________
INSTRUCTIONS
1. Twice a week over the course of 2 months collect a teaspoon size sample of naturally eliminated stools.
2. Seal stool sample in a zip lock baggie, and place in another zip lock baggie seal, date and freeze.
3. At the end of 2 months, please contact [email protected] to alert TAMU for the pre-paid mailing label.
4. Pack the 2 months of stool samples in a small Styrofoam cooler with dry ice pacs (to keep cold) and Send this worksheet and the original consent form signed and dated with the stool samples to TAMU via the pre-paid mailing label.
On the following pages are two monthly charts for you to record observations regarding your dog’s physical health. Please start the trial by writing on the first day a full assessment of your dog’s current condition in the following 4 categories (Stools, Stomach, Appetite, Overall Health)… and then just make a notation (in any of the following days) if/when you observe a change in any of the 4 categories for better or worse, or note if there has been a change in the regular routine (treatment protocol) :
| STOOLS | STOMACH | APPETITE | OVERALL HEALTH |
| color | flatulence (farting) | good appetite | acts normal |
| volume | stomach noises | poor | acts ill / subdued |
| form/texture | vomiting | ||
| frequency | bile acid |
FIRST MONTH
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Please contact Epi4Dogs ([email protected]) when your 60-day survey is completed. Epi4Dogs will contact TAMU to send you a pre-paid label with instructions for you to properly and free of charge ship your dog’s stool samples to TAMU.