Need help to stabilize our newly diagnosed dog

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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Dagny
Member
Posts: 1
Country: United States
State: Rhode Island
Pet name: Dagny
My name: Jess

Need help to stabilize our newly diagnosed dog

Post by Dagny » 02 Jun 2023, 14:52

Hello,
First, thanks to all for such great information! We've only been on this EPI journey for a few weeks, so this is very helpful.

Our German Shephard mix, Dagny got diagnosed on May 17th. Although our vet has never treated an EPI dog, he had been suspecting she may have it for some time, since she was a bit thinner than he would have liked. I immediately ordered by Enzyme Diane 6x order, but also went to the store and bought the closest thing to it I could find. I feel this was a mistake because the next day she got really sick and had symptoms of colitis (vomiting and diarrhea with blood). The vet put her on a 7 day course of Metronidazole, and we injected some fluids, which did the trick as she was back to herself in a couple days.

A few days later, our enzymes arrived. The vet prescribed Purina Pro Plan EN Gastroenteric, Low Fat.

We've made some good progress (much less poop than before the enzymes), and a much darker color. BUT, we're not there yet. I read the low fat wasn't necessary and since we're trying to put weight on her I've been mixing:

1 cup Purina low fat with 1/2 cup Whole Hearted, lamb & brown rice. I'm now using 2 tsp of enzymes and 1/2 cup of water. I feed her 3 times a day.

Her stools are still softer than I want them, leaving lots of residue on the ground when I pick them up, although they look well formed and segmented, I'd say a 3.5 on the scale.

My question is, how do I know what to adjust? I was doing 1.5tsp of enzyme, so decided to move up to 2tsp. I'm not sure there's a consistent difference. I'm also confused on food choice. I see here lots of recommendations on no grain to avoid interference with the enzymes. I also see avoiding fat isn't necessary.

My other question is related to how long I should wait after making a change to know if it worked or not and to try something new. I think I may be making small changes too often (ie adding in some full fat food, changing enzyme amt, using different foods) and that I don't really know what's working. I am logging everything.

We did a B12/folate test this week and will get the results soon. Does that have any impact on stool?

In general, Dagny has always had a similar amount of energy and a good appetite, and the only symptom we saw (until the bout of colitis) was that she was a little skinnier than she should be.

Am I right to keep tweeking to get the poops the right consistency? They're a pain to pick up, so for my sake as least, I'd love to get them a bit more firm!

Any thoughts on next steps would be greatly appreciated!

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Olesia711
Founder & Research Director
Posts: 4212
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Need help to stabilize our newly diagnosed dog

Post by Olesia711 » 02 Jun 2023, 20:21

Hi Jess and welcome to our EPI family.

I will try to answer your questions. In short we like to recommend "starting" with a food that does not have grain in it because the grain can interfere with the efficacy of the enzymes from anywhere between 0% to 50%..... and because we have no idea which dog may or may not have this issue and to what degree, it's easiest to start with no grain food.

Also.... limiting fat is old school for EPI, they have since learned that EPI dogs actually do better with normal amounts of fat... especially since they also are now known to have a deficiency in the Lipid soluble vitamins. :(
check out the research here:
https://epi4dogs.com/epi-research/

SO..... to help you get started, the Purina Pro Plan EN Gastroenteric, Low Fat. prescription food your vet started Dagny may be just fine.....or not.... due to the ingredients. However....do keep the food, but there are 3 different things you can try. Pick one at a time!

1. you can adjust the food (in case this is the food composition that is not 100 % agreeable)
2. try giving some slippery elm powder (this could help with either the food composition or dysbiosis/SID)
3. or ask your vet for Tylan antibiotic ... NOT metronidazole! You can order it from Chewy with your vet's script
https://www.chewy.com/tylan-tylosin-tartrate-soluble-powder/dp/173768

CHANGING THE FOOD
if you want to try a more agreeable for "most" EPI dogs.... and if you can afford spending $93.... order a bag of Castor & Pollux Pristine grain free kibble.... from Petco or Chewy (sweet potato and beef or chicken)

Or... if you cannot.... then get the smallest bag possible of small bag of Taste of the Wild - High Prarie (grain free)
https://www.chewy.com/taste-wild-high-prairie-grain-free/dp/34245
Or try Taste of the Wild - Pacific Stream.

With these foods use 1 level tsp of enzymes per 1 cup of food. and add just enough room temp water to the food to moisten it then add the enzymes, mix al together, let sit for 20 minutes and serve.

WHen trying a new item (food or otherwise) Give it 3 to 5 days to see if you see any improvement... if the poos improve on a new food (then it means you need to avoid food with grain in it).if poos get worse or do not improve at all (then it is not the grain but rather most likely SID=small intestinal dysbiosis which a prebiotic may help (like SLippery Elm powder) or if that doesn't work, then Tylan should.

Also, if Dagny CAN handle grain... you can use the Purina prescription food and no need to mix in with some other food, to increase fat, but rather just add your own cooked chicken or beef ... shredded...(for more/better protein) you can try giving 1 level tsp of coconut oil and also look into giving Omega 3s.(i like Welactin liquid for adding Omega 3).

When adding extra ingredients though, try things one at a time for 3 days in a row and see how things go.
Glad you had the B12 tested because YES that too can cause loose stools. the B12 levels needs to be at a minimum in the upper 500's to 600's... anything less will require B12 supplementation.

I hope that this answers some of your questions.
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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jilbert57
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Posts: 2216
Country: United States
State: Washington

Re: Need help to stabilize our newly diagnosed dog

Post by jilbert57 » 03 Jun 2023, 08:59

Good morning Jess and welcome to you and Dagny.
Olesia has covered your questions I just want to add if you keep a daily journal sometimes it helps keep track of things. Here ate a few templates.

https://epi4dogs.com/epi-log/

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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Montgomery
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Posts: 433
Country: Canada
Pet name: Montgomery (I'm a CAT!)
My name: V

Re: Need help to stabilize our newly diagnosed dog

Post by Montgomery » 03 Jun 2023, 09:17

Change one thing at a time and write it down, when and what you did, then you'll have the best idea of what is good, bad, or indifferent.
Montgomery was born 20 March 2012. He is SUPPOSED to be eating a home-cooked diet, but refuses. He eats Purina True Instinct Grain-Free Chicken and whatever chicken-based tinned food we can entice him with. Nine pounds of pure stubbornness. He gets two size 0 capsules of Enzyme Diane at each meal and one size 4 capsule of Tylosin three times daily. Sometimes he gets Petromalt. He's our little Spitfire, and when he purrs you KNOW he's got a real Merlin engine. Lately, he's taken to giving hugs. His hobbies include shooting marbles, shredding cardboard, and irritating his sister.

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