New to Epi- Crockett

[rebeccal]

Chance
Can you tell me how you weaned off of acid reducing medications?

[Chance]

Sure. Antacids...

Rylee's first symptom was acid reflux. She had 3 GI bleeds before by 15 weeks of age. With the 3rd bleed, she was prescribed Omeprazole, twice daily - "indefinitely" (first 2 bleeds she was given Omeprazole and Sulcrate for 5 or 7 days. But 3rd time was worse. And we knew then whatever was wrong was a chronic condition). Omeprazole did prevent further bleeds, and improved the red blood cell count, but it did nothing for the terrible reflux symptoms!

Anyway, fast forward to 6 months old, EPI diagnosed and enzymes prescribed. Was told to keep Omeprazole while getting enzymes in and see what that would do. I was too paranoid to stop Anyway, so I was fine with it!

Enzymes was the instant cure for all acid reflux symptoms! It was like someone flipped a switch. Zero symptoms. A month later, we started talking about weaning her off Omeprazole.

First thing we did was drop to once a day dosing, instead of twice daily. We did okay with this. I ordered Gastro Elm (which has slippery elm, marshmallow root, dandelion root and milk thistle). I gave Gastro elm (at half recommended portions) twice a day - 1 to 2 hours before breakfast and dinner. (Her empty belly pukes were always about an hour before meals, so this timing made sense for us). Then started giving half dose of Omeprazole once daily, usually at night, a couple hours after the Gastro elm.

From there, I switched from Omeprazole to Pepcid. Because I was paranoid, I gave Pepcid twice a day for that first day. The next day I went to once a day (Gastro elm stayed the same). After a few days, I was confident we were ok off Omeprazole, and started giving Pepcid every other day. I did that a couple of times, but realized I was often forgetting the Pepcid, without repercussions; so I just stopped it completely.

I continued the Gastro elm for another couple of weeks, just because I was paranoid of "rocking the boat. But when I did ultimately stop giving that; again there was no issues at all. (I still have tons left of that bag of Gastro elm; but really haven't had a need for it)!

[rebeccal]

He is currently still on twice daily omeprazole as he still gets the wet mouth symptom. He is down to pepcid only once a day though versus every 8 hours on top of the twice daily omeprazole. He is also off the cerenia and the Zofran.
We are hoping to stop the last pepcid dose tomorrow and then slowly go down to once a day on the omeprazole.
From there we will be titrating off ursodiol and denamarin we hope.

[Chance]

Oh, so you're on a lot more antacids than I was.

I'm not sure, but I'm thinking you might want to start omeprazole reductions first, before Pepcid. If you and your vet are OK with that

One reason is that Omeprazole is the most problem for other issues later. But it's also the one they are more likely to get dependent on.

As result, it's more challenging to reduce than. So it's nice to have the Pepcid to fall back to, to help with Omeprazole reductions. Pepcid is unlikely to cause a "rebound" affect when you reduce that

[Olesia711]

Hi Rebecca,

What you are describing "How do we know that he is getting too much enzymes? His stools were doing really well but today has much less output very thin in size and he has had increased nausea as evidenced by increased salivation and burping." is most likely SID/SIBO dysbiosis."

Anytime you see "increased salivation" that is almost always a sign of an upset stomach and with EPI... it is almost always SID. And then of course, the burping, can be another sign as EPI dogs inherently have messed up bile acid functionality..... and then with the upset stomach many will start, farting, a lot,, some vomit, some have tummy noises and some go off their food. and yet others don't show any of these symptoms. etc.

Typically we suggest next trying a
Prebiotic (like Slippery Elm powder)... if no positive results within a few days then try a https://epi4dogs.com/slippery-elm/
Pre+Probiotic (many brands out there, we suggest but no guarantee, to try Proviable or Visbiome.. talk to your vet) if no positive response within 5 days.... then
Ask the vet for a course of Tylan (Tylosin Tartrate antibiotic powder) https://epi4dogs.com/antibiotics/




There are always a few exceptions but usually too much enzymes would be like giving double the amount.... which may or may not cause looser stools.

[rebeccal]

So we ordered the gastroelm after talking with his Holistic Vet. It should arrive today. I am finding that the big Veterinary medical center lacks knowledge in treating epi. His holistic vet has worked with epi in the past and is willing to help. His traditional vet has been supportive as well.
We have tylan powder that he had previously been prescribed but he won't eat anything we mix it in and won't take it from a syringe (Stubborn Doggo). It's a lot of trial and error at this point as to what he tolerates and doesn't as far as his food goes.


He has gained 1.5 lbs since hospitalization about a month. His stools are now consistently between a 2 and 3. We are still working on his diet with his Holistic vet.

[Tuckaboo Pam]

Maybe you can put the Tylan into capsules?

[rebeccal]

I actually hadn't thought about doing that. We will give the gastroelm a chance but if that doesn't work I may just try to put his tylan in capsules. Thank you for that great idea. He is so stubborn sometimes.

[rebeccal]

The gastroelm arrived started it this evening. We chose to use gastroelm as he needs the milk thistle for his liver.

[Olesia711]

let us know how the Gastroelm works out