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Husdon GSD and new EPI diagnosis

Posted: 22 Jun 2022, 17:04
by jpandmk
Today we received confirmation of our suspicion that our German Shepherd puppy, Hudson, has EPI. He’s now 8 months old, and two months ago he weighed 85 pounds at his last vet visit (to get the last of his puppy shots) before he started exhibiting the worst loose stools we’ve ever seen in any of our dogs. He was going 10-12 times a day with loose, watery, yellow stools, ranging from pure liquid to cow plops. And eating 4 cups of Purina ProPlan Puppy at each meal, 3x a day. We quickly got our vet involved, and after 4 weeks of fecal test (negative), probiotics, Royal Canin Gastrointestinal and Purina Hydrolyzed, and a week of Metronidazole with no effect, I purchased some frozen ground beef pancreas. In three days we started to see some improvement. A week ago, we convinced our vet to test for EPI and got the results today: TLI < 1; B12 = 306; and folate = 29.8.
We estimate that he probably lost about 9-10 pounds in the four weeks before we started the beef pancreas, and has already regained 5 pounds in a week. He is now eating a more normal 3 cups of kibble with 4 ounces of beef pancreas in each meal- twice a day and having only 3 or 4 poops a day with much less volume. The last few days he is actually sleeping 6 or 7 hours! Stool is still light color and of the cow plop variety. Today I ordered Pantenex which should get here in a few days and we’ll switch from raw pancreas to the powder and also switch him from the Royal Canin to a low fiber, grain free dog food. He has always been a great eater, takes medication easily so we’re hopeful we can make these changes without him rebelling too much. I do have a couple of questions since our vet has only suggested starting the enzyme supplements and no B12 injections or antimicrobial such as Tylosin. Since his B12 is in normal range (but low), does he need B12 injections, or possibly oral B12? And should we wait to see if the enzyme powder improves his stool consistency and color before going back to the vet to try Tylosin?
Thank you so much for the vast amount of information on this site, and it really helped us to understand what was going on with Hudson, and relatively quickly get to this stage where we can start to manage his condition. Any reply or further information would be immensely appreciated, or if there are any other things we can do to make this process better for him.

John and Mary Kay
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Re: Husdon GSD and new EPI diagnosis

Posted: 22 Jun 2022, 17:23
by jilbert57
Welcome to the site and good for ypu for reading and being proactive. Yes I would recommend doing the B12 shots or daily supplementation of oral capsules. The N12 needs to be in the upper range so 600 or greater if you can. You can wait a week or so to see if the enzymes help firm up the poop with the addition of the grain free diet.

https://epi4dogs.com/b12-in-brief-2/
The above link provides the name of a good oral B supplement.

Jill

Re: Husdon GSD and new EPI diagnosis

Posted: 22 Jun 2022, 19:16
by Olesia711
thanks for writing in and OMG... Hudson is gorgeous!

That is wonderful that the raw pancreas already improved his situation to some degree.... and that is great and a very good thing that you also ordered the proper porcine enzymes. The "powdered" porcine pancreatic enzymes are more consistent so you should find even more improvement with the Pantenex.
And YES! Do wait until you start the Pantenex before starting TYlan (give the Pantenex at least 5 days!) ....there is actually a recommended protocol which i cover in the paragraph below ....

fair warning to all newly diagnosed EPI dog owners.... even once you do EVERYTHING correctly.. and even after you "tweak" things to best suit your dog (we will help you with this!).....sometimes the light colored loose stools persist, or... things dramatically improve and then after a few weeks or a month of normal, all of a sudden everything goes south once again. If this happens, please know that this is typical and what is happening is that you are seeing the results of uncontrolled SID (small intestinal dysbiosis). If/when this happens, what is now recommended to do is start the dog on a prebiotic, if that doesn't improve the stools, etc., then try a pre+probiotic (we are currently recommending Proviable, Visbiome, VetriScience MegaProbiotics, ) and if the poo's still don't; firm up, then TELL your vet you want your dog started on Tylan for 45 days.... and halfway thru the 45 day, then implement (again) one of the probiotics suggested.

In reality, EPI itself is not that difficult to manage, but SID that they now know every dog with EPI has SID... can be a lot trickier to get under good control. I strongly suggest reading everything in the SID/SIBO page under the MAnaging EPI tab.

YES! as Jill recommended, 306 is low normal, and with EPI dogs you need the B12 level to be upper-mid range, which would be around 600.... so YES, your dog really needs B12 supplementation. Either the simple cyanocobalamin shots or oral WOnderlabs B12 "Pet Factor" that is made with methylcobalamin, intrinsic factor and folate. THe pills you will give every day... and the shots you will start off with weekly..... the shot protocol is on this page. https://epi4dogs.com/b12-protocol/.... with either or.... you should re-test to make sure the shots or the pills are working as expected. Usually with the pills, many of these dogs B12 sky rockets to 900's-1,000 which is very good.

Oh... one of the best things you can do to get EPI under good control is to start keeping a journal... this will greatly help you figure out what needs to be tweaked or not and help you get a handle on how best to manage your dog's EPI https://epi4dogs.com/epi-log/

Hope your current questions have been answered and please feel free to ask about any other concerns........

Re: Husdon GSD and new EPI diagnosis

Posted: 26 Jun 2022, 17:49
by Tuckaboo Pam
Hi Mary Kay, John, & Hudson, and welcome!

Hudson is a hunk! I am so glad you are getting things under control, and seeing improvement. No doubt, you'll see even more in the weeks to come.

We give Tucker Wonderlabs Pet Factor B12, found easily on Amazon or direct from the company. Tuck's test was normal, but we supplement him anyway, since if he gets too much he'll just tinkle it out.

Some of us include our entire regimen at the bottom of our posts, in our signatures. You can get a lot of tips there, too. More anecdotal, but it's good to know what works for others. Glad you're here. --- Pam & Tucker

Hudson update after 1 week

Posted: 30 Jun 2022, 07:54
by jpandmk
It’s been a week since we received Hudson’s test results (Day 1), and have been seeing substantial improvement. Today is Day 9. He has been having only 2 or 3 poops per day for the last week, and last night and this morning, they were firm and darker in color – I would call them normal. Also, to us, he looks like he is putting on weight, although I haven’t figured out how to accurately (and easily) weigh a 90 pound dog at home. We’re still in the process of converting him to new food (Taste of the Wild grain free), B12, and Pantenex, which will be happening over the next week or so. He finished his course of Metronidazle on Day 1.
Summary:
Day 1-3 – continued Royal Canin Gastrointestinal and Purina Hydrolyzed – 3 cups kibble with 4 oz raw ground beef pancreas (2X daily) with Fortiflora probiotic in evening meal- observed slight improvement in stool.
Day 4-6 – received Pantenex and continued with the same feed and Fortiflora, but reduced raw pancreas to 2 oz with 1 teaspoon Pantenex at each meal – on Day 5 substantial improvement in stool – much firmer and darker – 3 poops per day. We are adding chicken stock, mix and let stand for 15 minutes. At the end of day 6, we finished our supply of raw pancreas.
Day 7 and 8 – Started introducing small amount of new feed with 2 teaspoons Pantenex and Fortiflora in the evening – still 3 cups moistened with homemade chicken stock. On day 7, stool was “normal” – normal size, firmness and color – 3 poops per day. We plan to transition him to his new food gradually over the next week and introduce WonderLabs B12 with intrinsic factor when he is on the new food.
Overall, we are very pleased with progress so far, but we still have to complete the transition to new feed and start B12. We should get a weigh in at the vet in the next week of so.
Normally, with a fast growing GSD puppy, we would keep him on large breed puppy food for about 18 months before switching to adult feed. Any suggestions about supplements that he might need (particularly extra calcium or something else)?

Re: Husdon GSD and new EPI diagnosis

Posted: 30 Jun 2022, 10:16
by Olesia711
yes, a supplement would be a great addition especially for a growing puppy AND one that has EPI.....as EPI dogs have a depletion of fat soluble vitamins.

Please share with your vet the following research on EPI dogs: 2018 (Aug 22) EPI Vitamin Research EPI & Fat Soluble Vitamins that is located on this page:
https://epi4dogs.com/epi-research/ and maybe your vet can recommend a quality doggie vitamin for growing puppies.

BTW.... you are doing a FANTASTIC job with your dog and i am thrilled to be reading how well things are going! Keep up the great work!