KOKOY - NEW EPI DIAGNOSIS, MEAL CALCULATOR HELP?

[kokoys_mom]

Hi everyone! My name is Lorén and my dog Kokoy just got diagnosed with EPI last week and was put on Pancreatic Enzyme Powder, B12 capsules, and Tylan powder. He is tapering off Prednisone from His issues with diarrhea before his diagnosis. His stool is pretty solid, but I am absolutely overwhelmed with the home-cooked meal process. He was on kibble before but from what I am understanding, RAW or home cooked is the best way to go around here. Would anyone be able to help me make sure that I am on the right track? Everyday I do research and then I think I got it, but then I keep reading and then all of a sudden I don't think I know anything anymore. Please see diet below:

Breed: Labradoodle
Ideal Weight: 65 pounds
Current Weight: 50 pounds
Diet: Home-cooked meals
Allergies: he just got his allergy results back, literally intolerant to SO MUCH. this is the meal that I am going to start creating for him based off what he can tolerate.

For cooked meals, can I use the raw feeding calculator to understand how much food he needs? According to the raw feeding calculator on this website, he needs about 40 ounces of food each day.

total ounces: 41.6 oz
based off of 4% ideal body weight
i divided up the calculations to be 4 meals a day, so that is 10.4 oz a meal
0.52 oz organ meat (5 %) - beef liver or chicken heart
0.52 oz veggies (10%) - sweet potato)
8.32 oz protein (80%) - chicken breast
oil - 1 pump of salmon oil
vitamin/probiotic super supplement - ANIMAL HEALTH SOLUTIONS NATURAL DIET SUPPLEMENT https://animalhealthsolutionsinc.com/ec ... e-1_lb_bag

^ (see link above) i bought this and it essentially contains everything that i may be missing, including calcium, im assuming i can use this daily instead of adding bone meal to my meals here?

so my main questions are:

1. when i do this calculation, this essentially means i need to be feeding like 4 chicken breasts a day to my dog. that seems quite excessive, or is this normal?
2. again is it okay to use a raw feeding calculator for home cooked meals?
3. is this vitamin/probiotic supplement okay? or is it advised that i really separate bone meal, probiotics, and vitamins?
4. should i consult a nutritionist, there are so many out there? has anyone tried the ohio state people?
5. the vet prescribe the enzymes to be 2 teaspoons, but the bottle says 1 teaspoon. from what i read, it is advised to be doing 1 teaspoon per cup. is 2 teaspoons too excessive? i've been adding this to EVERY meal.

thank you all! i am so overwhelmed, i've been trying to take time off work to do more research and do whatever i can. i just dont want my pup to go, i need him to gain weight, he is just so so skinny it is frightening.

[Olesia711]

Hi Lauren and BIG KUDOS to you for doing this... home-feeding is a lot of work, but the benefits are often times profound!

I am so glad that you are using the guidelines on the https://epi4dogs.com/diet-raw-home-prepared-recipes/ page. the 4% of Kokoy's wieght is correct... for now... this will/can taper off once all the weight has been gained back.

Your diet of:
total ounces: 41.6 oz
based off of 4% ideal body weight
i divided up the calculations to be 4 meals a day, so that is 10.4 oz a meal
0.52 oz organ meat (5 %) - beef liver or chicken heart
0.52 oz veggies (10%) - sweet potato)
8.32 oz protein (80%) - chicken breast
oil - 1 pump of salmon oil

Is very good.... and just know, if Kokoy can tolerate dairy... you can always mix and match the chicken with something like cottage cheese and or add eggs maybe 3 times a week.... just to mix it up a bit . You can also throw in a little other veggies like a little bit of cooked kale, or squash.

WIth regards to the ratio...after a few weeks, you can also try changing the ratio bit to where you reduce the protein to 60 to 75% and increase the sweet potato a bit..... this will help you save a little money and "should" be okay.


I looked up the supplement you are giving.... and had to research to see what P Mono-Dical is.... it is phospherous and bone... so YES.... you are now all set and do not need to give bone meal, nor do you have to give any other vitamins....at this time ...except do give the extra fish oil...like you are doing cause EPI dogs are depleted in lipid soluble vitamins...but you do not want to increase any of the other fat vitamins without your vet's blessing....

The meal looks GREAT!....

However... no matter how great a meal looks to us or what we suggest.... please, ALWAYS share this with your vet to make sure that they too are on board with this.

Regarding the enzymes. Home-made food or raw has a LOT of water content to it vs. over processed and dried up kibble... SO... when feeding home-made or raw.... you always give a pinch less.

For example, when feeding :
1. kibble, you start with 1 tsp of enzymes per 1 cup of food and add enough liquid to moisten the food enough to mix the enzymes in and let sit for 20 minutes.
2. homemade (minced) or raw food (minced) start with 1/2 tsp to 3/4 tsp of enzymes per 1 cup of food and you may need to add a tbsp of water or not., mix and let sit for 20 minutes.... mostly to avoid any possible mouth sores.

I personally would start with 3/4 tsp with homemade .... jsut because in the beginning we often need the full does of enzymes, but once things settle down, you often can reduce the amount of enzymes needed to still properly maintain the EPI condition. (more on this later.... dog needs to be stable at least a month before trying to reduce the amount of enzymes.

IN short.... too much enzymes can give a dog loose stools and not enough can give a dog loose stools.... so these are guidelines to start with and then we adjust accordingly.

Over the years, we have found that most nutritionists do not designed the best "diets" for EPI dogs.... so many times they included ingredients that just don't work well with our dogs.....

But i do have 1 question for you..... what is the brand name enzymes you are giving Kokoy????? Please check the bottle and make sure that the Lipase enzymes is approx 71,400 USP units.... and that the AMylase and Protease enzymes are somewhere more than 280,000 ......
If the potency is not correct.... then that will change the dosing.

I Hope this helps and please feel free to ask any questions and we will help you as best we can....

P.S.... Kokoy looks like such a cutie.... love the tongue licking picture

[Tuckaboo Pam]

Welcome! What a cute pup!

[kokoys_mom]

Hi!

Thank you @Olesia711 for the speedy and generous response! You helped my worries, I also think my kitchen scale is off so it probably isn't 4 chicken breasts, but it's a lot more than I wanted it to be, just because food is so $$$ these days! I just ordered a better kitchen scale so I can be more accurate. Your advice is so helpful. Thank you for the tip about the nutritionist and everything about the amount of enzymes. No wonder I went through one bottle in a week! I am blown away, it cost me $130 at the vet. I will have to take a look at Enzyme Diane. The brand of the enzyme I am currently using is from a brand called "Covetrus", and yes it falls within those units you mention. Im glad to know that I am on the right track though.

Do you guys like to give your probiotics in the evening, or with every meal (outside of anitbiotics)?

And thank you Pam for the warm welcome

Best,

Lorén & Kokoy

[Olesia711]

Loren,

Yes, you have the proper enzymes....

THe other thing that you can try, maybe a little bit down the road, if you want is to do a combo of fresh real food with some kibble.


My Izzy lived for over 14 years with EPI and passed away at 15 years old.
I fed her all kinds of food, as i am a firm believer in variety. But then as luck would have it my Izzy developed Diabetes in her 8th year and lived another 7 years, but although all homemade kept the diabetes in check, and was most agreeable with EPI, she started losing too much weight, but if i fed her more volume of food it would mess up her diabetes.... so i finally resorted to a combination of 20% quality kibble and 80% homemade food.... she lived for 7 more years with not only EPI but Diabetes and she beat IMHA (which has a high mortality rate) too along with low thyroid and some other issues..... ALthough i cannot prove it, i do feel that feeding her a "majority" of quality real food was a big part of why she did so well with so many things stacked against her and she also was the most happiest, vibrant dog, right until the last few days of her life..... when she succumbed to kidney failure.......

With regards to the probiotics.... typically we say ALWAYS give probiotics about 2 hours away from any antibiotic...... HOWEVER... because you are giving Tylan and Tylan is a macrolide antibiotic... it does not kill all bacteria like most antibiotics.... so you can actually give them together around/near a meal.... however... because you can do this... i would just follow whatever the instructions are regarding giving the probiotics.... and if no instructions then just give with the morning meal.

However, that supplement you are giving does contain some probiotics in it.... but i have no idea how viable or not they are...... so maybe hold off on the separate probiotics until a week or so after on the supplement and then slowly introduce the separate probiotic product . And watch how thigs go.

REgarding giving a probiotic ALWAYS start off with less than half the dose and work your way up to a full dose over the course of a week or two. SOme dogs will have diarrhea when started on a probiotic.... so it is best to try weaning into it when you are ready to use it.

[REGIFLOR]

Welcome loren!!! kOKOY is lucky to have you as such a dedicated and well informed care giver : )
I will be following your success with home cooked meals closely as I too have a food sensitive dog who is currently limted to Hydrolized protein (Royal Canin) but i would much prefer to feed her whole foods and maybe raw too. Your calculations are so precise - congratulations.
I wish you all the patience and success on this journey. We are all here for you. The weight loss is so frightening, I agree...but it's amazing how miraculously they can bounce back too! Best of luck.

Thank you Olesia for all the wonderful guidelines as always - may I ask on this thread a related question re: antibiotics...
Hannah is now on Tylan but in an pink pill form, not powder, twice a day (12hrs with food) The vet said it would be good for her due to high Folate, which we had not yet treated (She started enzymes in early Feb).
Her tummy still gurgles quite a bit. I try to give her a Pepcid with her meal...what else is behind the unsettled tummy, or are these sound effects somewhat normal? They're definitely less intense than before but I wonder if she's in discomfort. I wonder if the B12 will help settle, but I doubt they're directly correlated.
We have not started pre or probiotics....one step at a time to keep examining her stool quality.

Thank you,
Regina

[Olesia711]

Hi Regina, the symptoms (gurgling) that you are describing sounds like typical SID still out of control...... SID is why your vet put Hannah on Tylan...... although we no longer go by the folate score to determine if an EPI dog has SID... since recently we have discovered all dogs with EPI have SID........and we treat SID when there are SID symptoms meaning that SID is out of control.

Anyway.... if Hannah had a high Folate score, we used to use that as a guideline telling us the dog had SID.... so... no need to think you still have to address the high folate score, your vet is already doing that when he prescribed Tylan.

Yes, some tylan pills are pink in color... i think those might be chewable. ANyway.... your vet is correct to recommend that you give them 12 hours apart, however, since Hannah is still showing SID signs, i am wondering what is the dosage (potency) on the Tylan pills that you have.... you may need a stronger dose. What does Hannah weigh? WHen did your vet start her on Tylan? She will need to be on it for 45 days/twice a day.... so the other issue may be that it is helping but that she hasn't been on it long enough.

Next.... Yes.... do check that her B12 levels are in the upper mid range....
Also..... halfway thru the Tylan 45 regimen...... do start a course of pre+probiotics (talk to your vet about Proviable or Visbiome- -these are the two that we are currently recommending)

SOmetimes a Tylan regimen has to be done twice but frequently, if you do the Tylan , then introduce the pre+probiotics.... usually that really helps get things under good control.

If all of the above doesn't work or doesn't work as well as expected.... then that usually means that whatever food you are feeding is not optimally agreeing with the dogs' digestive issues.... and you need to change the food.

It can be mind-boggling and tedious to figure things out, especially since we tell everyone to always make only one-change-at-a-time.... but this really does work. Keep a journal and you will be amazed at what you can figure out.

Hope this helps a little.

[REGIFLOR]

Hannah's pink TYLOSIN PILLS are 100mg each "Give 1 every 12 hours with food for 10 days" but the vet gave me 40....
We started Mar 2 (still have 8 days worth and more waiting at Vet office if i need them) Pills were quite expensive...
Do you think we should have stopped after 10 days as the bottle/vet indicated, or keep going to full 45 days as most others seem to do with the TYLAN POWDER
(My vet does not seem to know alot about EPI and this forum has corrected his diagnostic path multiple times already - and that's why I'm dounting whether I should go to the internal medicine specialist however our finances are fragile currently and it's $300 just to be seen and they insist on an ultrasound $700, which I believe she doesn't absolutely need at this stage since she has only improved since February 7th on enzymes...and seems to be on a steady stable path - but if you think I should do that consult to ensure we're not missing anything else?) I plan to follow with slippery elm - if others can confirm that dogs with food sensitivies/allergies (unconfirmed) do OK on this....and I also plan on starting pre/pro biotics gradually if this will help her too....

I hope I'm not missing anything....

Thank you kindly for your help!
REGINA AND HANNAH!


(Folate is not necessarily irrelevant in diagnosing SIBO, it simply is not the only factor, correct? given that most (or ALL?) EPI dogs have it inherently....?

[Olesia711]

Hi Regina (and Hannah too!)

With regards to the Tylan..... you are dealing with a problem (SID), not the very early signs of a flare up of SID... so yes... give the Tylan pills you have twice a day (with breakfast and dinner) like your vet recommended and give them for 45 days.

About halfway thru the 45 day regimen, introduce a pre+probiotic (ask your vet for Proviable or Visbiome).... sorry if i am repeating this.... but it is important ... and be sure to start ANY probiotic with less than 1/2 the recommended dose and work up to a full dose over the course of a week or two.

If Hannah is doing better now (stools are looking normal or almost normal) and since your finances are fragile at the moment.... then to me it sounds like you probably can hold off on further testing temporarily UNLESS you do not see any resolution from what you are doing..... BUT..... first, before holding off on any further testing.... ask your vet WHY he wants you to have more tests done. He may have another reason other than suspecting possible IBD.... and if so.... then you probably should have the testing done when you can afford it.

BUT..... if your vet suspects IBD, but wants to do further testing to make sure nothing else is going on..... then i think you might be able to wait a bit.

SO.....If you and your vet suspect that Hannah does have EPI + IBD (which often displays with food "sensitivities") ... then what you can try before spending a lot of money on tests.... and this is only if all this wonderful home cooking doesn't work and then (next step) if you strip everything down to only two ingredients... with hopefully good results... and then you add one ingredient back into the mix at a time.... to see which ingredient might be the culprit (food sensitivity)...... if this step also fails to yield any answers... then the next step would be to have your vet place Hannah on a true Hydrolyzed food (we suggest trying Royal Canin "Ultamino") first before the other hydrolyzed brands..... and if this doesn't work then try the other hydrolyzed brands of food, once at a time until you find one that works.... but then if this too fails..... THEN..... i would have more tests done.

[Barb]

Hi Loren,

A very warm welcome to you and Kokoy. He is one lucky pup to be part of your family.

You have received excellent advice as always from Olesia......I just wanted to let you know that all of us have been where you are right now and the feeling of being overwhelmed is very normal. The first stage of treatment is the hardest because you are on a sharp learning curve and are trying to absorb tons of new information as you worry about your pup. It will get better! You have already learned so much. Once you start to get everything balanced, it will become much easier, and managing Kokoy's treatment will become part of your routine.

I also want to highly endorse Enzyme Diane's enzymes. She has an excellent product at reasonable cost. We gave them to our German Shepherd, Kolby, for 10 of his 11 years and he did extremely well on them, so don't be afraid to switch.

Kokoy is so fortunate to have you. Hang in there and ask all the questions you have.

Barb