Cannot get my dog stable

[kaylamacdonald]

Hi everyone,
I'm at such a loss on what else I can be doing for my dog and REALLY need some help. I apologize for the long post.
My GSD, Remmy, was diagnosed with EPI 4 months ago. He is 1 year old. We have spent the last 4 months trying everything we can think of to stabilize him, but haven't had much luck.

When he was first diagnosed he was on a fully raw diet and regardless of adjusting enzymes, treating with Tylan, a course of b12 shots, we just couldn't even get a single day of stabilization. So we transitioned him off of raw onto a mix of kibble plus raw. Right away we seen an improvement. The kibble that we give is Go Solutions Limited Ingredient Salmon and it has 4% fibre. He eats 3 meals a day and receives 1 cup of this kibble, plus 0.5 cup of a raw herring and green tripe mixture. Remmy completed a 6 week course of b12 injections and then we moved him onto the Wonderlabs b12 capsules. He also completed a 45 day course of Tylan when he was first diagnosed and was slowly weened off of it. In the beginning of December, he was finally stable for a period of 3 weeks or so. However after this period of stabilization he went back to having bad poops. Not as bad a pre diagnoses though. His food did not change, his enzyme amount did not change, the only thing that had changed was that he was coming off of Tylan.

So thinking that he may need to be on Tylan again, we started him back on it about 2 weeks ago now. However, we still have not been having much luck and I know Tylan should be working fairly quickly. What we are now noticing is that his poops are for the most part brown, however they are very soft and sometimes even liquidy. He is pretty much "maxed out" on enzymes as he is currently at 1 tsp per 1 cup of food of Enzyme Dianne. Anything less than this amount did not work for him. A couple of days ago we began to add 1 tsp of pumpkin to his food, and for a couple days this helped clear things up, however now we are back to the same soft poops. We tried slippery elm for a week as well and this did not help either. We also got an additional b12 shot from the vet. Remmy is still gaining weight.

I cannot even think of a single other thing we can be doing to try and help him, so I'm hoping maybe someone looking on this from the outside may be able to suggest some ideas.

[Olesia711]

oh dear, i am so sorry....getting some EPI cases stabilized can be very frustrating....

What is jumping out at me is "maybe" SID (small intestinal dysbiosis) and it just sounds like "something" in the routine is perpetuating it.
Thank you for the details.... like the brown runny poo... and Tylan not addressing it the second time around..... this kind of makes me wonder if this is possibly one of two things that "might" be perpetuating things.....

1. something in the food that you are feeding might not be agreeing, even if it agreed before, and consequently triggering the loose stools.

2. the other possibility, is, even though we constantly tout low fiber food, since fiber can inhibit the efficacy from anywhere between 0% to 50% and the problem is that we have no idea which dog is affected (if affected) by how much..... it is possible that your dog might actually need a little more fiber in the food.

SOOOoooooo... figuring this out can be a real pain..... first, start keeping an EPI log.... (go to this page: https://epi4dogs.com/epi-log/) and then start recording every single ingredient that goes into your dog. Keep track of it all and make one-change-at-a-time... record it and watch the poos..... as there might be some sort of sensitivity going on..... or...........if you want to take a short cut with this, talk to your vet about "trying" the smallest bag possible of a true hydrolyzed food. the food that we suggest to try first would be "Ultamino" by Royal Canin.

or.... as another one thing at a time to try:
is cook some rice and just add a wee bit to a meal, chop a few pieces of raw carrots and add it also to this one meal. Watch all the poos afterwards for a couple of days. WHen you see pieces of carrots in the poo- - then that poo is from the meal with the rice.......ascertain if the rice (more fiber) helped or hindered the poo.

I am not sure if either of these will help but worth trying.... at this point you need to figure out what is triggering the loose brown stools..............

[Olesia711]

oh... and another possibility is the B12..... the shots might not be working.... sometimes this happens and the type of B12 given needs to be changed.
If you can (and if neither of the 2 suggestions above make any difference, then i would re-check the B12 levels..... and see if that is the underlying problem.

[kaylamacdonald]

I'll give those things a try! In regards to the carrot suggestion, what would I be looking for to indicate if it is hindering or helping? Would seeing pieces of the carrots be considered helping, or would helping be considered if I don't see pieces of the carrot?

Would pumpkin be the same type of fibre as the rice? Should it be brown or white rice (if it even matters)?

I have a log of every single thing he's eaten dating back to October, however the only trend we were able to find was that he did not tolerate the fully raw diet. He also has some sort of allergies going on, whether it be environmental or food related, so he is on apoquel. We tried the elimination technique to see what could cause his allergies, however just like with his EPI there does not seem to be a rhyme or reason.

[Olesia711]

i feel for you with the possible allergies...... they are SOOOoo difficult to figure out
Since there are suspected allergies.... maybe ask the vet if you can try a hydrolyzed food as your next step.

The carrot trick explained: the dogs don't really digest raw carrots very well.... so we use chopped up pieces of carrot to mark which poo elimination is from "that" meal. Dogs can eliminate a meal anywhere from almost immediately (if they are very sick) to anywhere from 12 to 72 hours ... so undigested carrot pieces kind of helps us figure out when that meal is eliminated.