Change in enzyme needs

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.
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TrixEPIMama
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Country: United States
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Pet name: Trixie

Change in enzyme needs

Post by TrixEPIMama » 06 Jan 2023, 11:46

We've been fortunate with Trixie. From the moment, a little over a year ago, that we realized she might have EPI, her needs have been very easy to manage.

We began giving her freeze-dried pork pancreas capsules we had on hand as a human supplement. Within days her poops went from 6-7 on the scale to 3-ish and we never looked back.

Until late November 2022.

Trixie -- who'd never been a wanderer -- followed her nose through the fence to the neighbor's yard, where the neighbors' adult children had left the remains of a huge and spicy BBQ bagged up in the trash. I'm talking pork rib bones with pungent sauces, brisket with a highly peppered crust, and who knows what else.

That night Trixie was direly ill -- bloated, belching, squirting, and hiding under and behind furniture. Fortunately she never went as far as clinical bloat, though we watched her closely thinking we might need to race to an emergency vet. By the next day she was almost back to her normal self, except that her poops (unsurprisingly) returned to being yellow, greasy, soft, and stinky enough to smell from 40 feet away.

We temporarily (for a week or so) upped her pork pancreas intake. After a week, we went back to our normal amount, though we've been giving her slippery elm with every meal since then.

But although everything else returned to normal, her poops have remained on the softish yellow side (some 5s, mostly 4's but with the sickly color) for six weeks and she's gone back to eating them as if she means it, rather than just occasionally snacking on them.

We were giving her two of the freeze-dried pork pancreas capsules a day before her garbage raid. Now, to keep her poops normal we have to give her 50% more with every meal.

What could account for her continued need for more pancreas, this long after her BBQ dinner? Do you think we'll ever be able to cut her back to the amount that worked so well before? Is this SID/SIBO (though she's not showing any other signs)? Is there something else we should be giving her?
Trixie is an Australian cattle dog or mix, likely born in the Fall of 2020. Picked up as a stray, she was already suffering undiagnosed EPI when we adopted her. Test later showed TLI <1 and cobalamin 189.

Her (non-standard) treatment is 1900 mcg of pure freeze-dried pork pancreas from Allergy Research Group per day. Also 1/4 teaspoon of slippery elm powder and 1/2 (previously one) capsule a day of WonderLabs TrinFac-B, all mixed into her food and served immediately, without the usual 20-minute wait.

We feed Canidae Angus Beef and Barley, which may not yet be the perfect food, but she's doing well and has "happy" normal poops.

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jilbert57
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Re: Change in enzyme needs

Post by jilbert57 » 06 Jan 2023, 19:16

Are you supplementing daily with a B12 of any kind? It might be low B12.
Also has he ever had the Tli tested to see if it is Epi? There are Other conditions that can mimic Epi.
What food do you feed?

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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TrixEPIMama
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Re: Change in enzyme needs

Post by TrixEPIMama » 06 Jan 2023, 20:25

jilbert57 wrote: 06 Jan 2023, 19:16 Are you supplementing daily with a B12 of any kind? It might be low B12.
She gets half a capsule of WonderLabs Trin-Fac B every day, and last time she was checked her B12 was on the high side -- around 900 IIRC.
Also has he ever had the Tli tested to see if it is Epi? There are Other conditions that can mimic Epi.
Yes, When tested, her TLi was less than 1.
What food do you feed?
Canidae Angus Beef and Barley. And while I'm told this may not be the ideal food for an EPI dog (because of the grain), she's been doing quite well on it,

Nothing has changed in her diet or medications except that one foray, many weeks ago now, into nasty garbage.
Trixie is an Australian cattle dog or mix, likely born in the Fall of 2020. Picked up as a stray, she was already suffering undiagnosed EPI when we adopted her. Test later showed TLI <1 and cobalamin 189.

Her (non-standard) treatment is 1900 mcg of pure freeze-dried pork pancreas from Allergy Research Group per day. Also 1/4 teaspoon of slippery elm powder and 1/2 (previously one) capsule a day of WonderLabs TrinFac-B, all mixed into her food and served immediately, without the usual 20-minute wait.

We feed Canidae Angus Beef and Barley, which may not yet be the perfect food, but she's doing well and has "happy" normal poops.

Barb
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Re: Change in enzyme needs

Post by Barb » 07 Jan 2023, 13:51

It sounds like her BBQ escapade might have triggered a bout of SID/SIBO. You might want to do a round of tylosin since her poops have not been good for 6 weeks. You can keep a log/journal record of how her poops respond to it so you can see if SID is indeed the culprit.

Barb

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Jean
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Re: Change in enzyme needs

Post by Jean » 08 Jan 2023, 06:03

i would agree with the Tylosin which is weight dosed

https://epi4dogs.com/antibiotics/

scroll down

it may be time to reconsider enzymes , and a test for EPI , what exactly are the freeze dried enzymes you are using ?

Jeanxx
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

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 used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

Chance
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Re: Change in enzyme needs

Post by Chance » 11 Jan 2023, 23:23

As others have said, be mindful of SIBO.

When my dog had his first bad SIBO setback, my vet refused treatment. "Just give enzymes and probiotic". I called back a week later, pleading. No dice.

Took a while for me to find another vet locally willing to take on a new client. By this time he was severe. Poops were terrible; he was in pain. Out of desperation, I increased enzymes. That was an instant cure! For 3 days, his poop was ok-ish. Still uncomfortable though. After 3 days, it was bad again. Increased enzymes again, and finally got a vet appointment with a new vet.

Blood work was done and antibiotics started. White blood cell count was low. Recheck 2 weeks after being on antibiotics, everything good! But 3 days into antibiotic treatment, I was quickly forced to reduce enzymes back to normal! Suddenly the new dose proved too high.

Increasing enzymes helps ease the symptoms of SIBO; but the infection is left to fester. So you might still end up back at your original dose.

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TrixEPIMama
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Re: Change in enzyme needs

Post by TrixEPIMama » 13 Jan 2023, 11:21

Jean wrote: 08 Jan 2023, 06:03 i would agree with the Tylosin which is weight dosed

https://epi4dogs.com/antibiotics/
I think you are all probably right on Trixie needing a course of Tylan. At least we should probably have some on hand. Does it keep for a while or expire quickly?

However, I also got another clue about why her poops may have continued being less than ideal. I do most of the feeding, and I was giving Trixie one cup of kibble per meal with three capsules of the freeze-dried pork pancreas. But recently I was laid up with a virus and a broken bone and during much of that time (I just learned) my partner was giving Trixie about 1-1/4 cups per meal and only two pork pancreas capsules. That may explain a lot. Her poops have improved and her frantic poop-eating has abated since we got back on the same page.
it may be time to reconsider enzymes , and a test for EPI , what exactly are the freeze dried enzymes you are using ?
I know someday we might need to reconsider enzymes, and we're prepared to switch to Diane's enzymes if need be, but until Trixie got into that garbage (and until my partner got her treatment out of balance in the aftermath), she was doing fantastically on what we've been giving -- which isn't enzymes per se, but is simply freeze-dried, ground pork pancreas from Allergy Research Group. We know it's an unconventional choice, but it has worked very, very well for Trixie.

As to the EPI test you recommend, I'm puzzled. Since Trixie's TLi tested at less than 1 a year or so ago, is there ever a need to re-test? I thought that test was forever.

Thank you all for your advice. I knew we'd been very fortunate with Trixie and that something was likely to go wrong eventually.
Trixie is an Australian cattle dog or mix, likely born in the Fall of 2020. Picked up as a stray, she was already suffering undiagnosed EPI when we adopted her. Test later showed TLI <1 and cobalamin 189.

Her (non-standard) treatment is 1900 mcg of pure freeze-dried pork pancreas from Allergy Research Group per day. Also 1/4 teaspoon of slippery elm powder and 1/2 (previously one) capsule a day of WonderLabs TrinFac-B, all mixed into her food and served immediately, without the usual 20-minute wait.

We feed Canidae Angus Beef and Barley, which may not yet be the perfect food, but she's doing well and has "happy" normal poops.

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Olesia711
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Re: Change in enzyme needs

Post by Olesia711 » 15 Jan 2023, 12:22

Hi Trixie's human care-giver,

Actually the Allergy Group "freeze-dried, ground pork pancreas from Allergy Research Group" is a very good product that i have recommended to others as an emergency pill to temporarily "Hold the dog in check" until the real or approved enzymes arrive. THe fact that this product worked for so long is testament that Trixie most likely has anywhere between 8% to 10% of the "elsewhere in the body" digestive enzymes that were active and helping along with the Allergy Research Group product. HOWEVER..... that BBQ fiasco... that most likely, as everyone else suggested, caused a major SID (small intestinal dysbiosis) flare-up.. and yes, this can last a long time and even change things. All dogs with EPI have SID to one degree or another .... SID actually changes the structure and function of the lining of the small intestine that further impairs nutrient absorption..... depending on how severe it is will determine how difficult it is to get under good control..

So.... first i would have done the slippery elm powder (for it's mucilage properties & prebiotic properties)..... AND then if that didn't work, i would include a commercial pre+probiotic....... just like what you have done... BUT..... since it has not really worked and the poos are still not 100% .... i would, do one of 2 things..... give it a bit more time to clear up- -since you are seeing improvement with the right dose of food and Allergy Research pills, or... do as everyone else suggested, tell the vet you want to do a course of Tylan...

In the meantime..... and i would also order real enzymes.... it sounds like you most likely will not have to use much..... but better to have on hand in case things never go back to the way they were. No sense perpetuating SID........... if this is what is going on and it does sound like it.

REgarding retesting.... my thought is, No, you do not have to retest.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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