Epi4Dogs

Sushi, my 3 y.o sheepadoodle started to have big piles of yellow/orange soft stools in June and intermittently, leaked yellow/orange liquid from her anus. She had bowel movements up to 6 times a day. Her weight was 20kg. (In March, she weighed 21.2kg.)

July 2-Saw the vet, was given metronidazole and probiotic. She weighed 18.8kg. Sushi has been fed Royal Canine Medium Adult kibble am and pm. Afternoon, home cooked meals with meat, oatmeal and veggies. Snacked with treats, fruits, yogourt, peanut butter and ok, we are bad, little human food here and there.

Vet suspected food allergy so we stopped all food except for kibble. No change in stools for one week. I did not bring her back to the vet after metronidazole was done hoping that she would get better. Fecal test did not contain any abnormal microorganism.

We added apple for snacks and she leaked oil. So we went back to kibble only. Still same problem with big piles of soft stools and oil leakage here and there.

End of July, I had to wash her a lot and noticed that her hipbones were showing. As she has a fluffy coat, we never noticed her weight loss. We could feel her ribs. So we decided to re-introduce meat back into her afternoon meal. Pork, beef then turkey over one week. Sushi leaked oil every day running down her hind legs and soiled her bedding.

August 9- back to the vet. Sushi weighed 15.5kg. We were admonished for not bringing her in earlier. Other than another round of metronidazole, change food to 1 meat/1 carb, CBC and a comprehensive fecal test, otherwise vet can’t do anything else. Maybe Sushi can be referred to an internist. Blood test done and anal glands checked since the yellow oil maybe came from the anal glands.

Day before scheduled vet appt, I landed on epi4dogs a 2nd time following a search for "dog leaking yellow oil”. I read as much as I could. The poo pictures just floored me. Sushi has these clinical signs.

When we met the vet, I asked her if she would be testing the TLI and B12. She didn’t know what the TLI was and she never tested B12 in any of her patients. Vet did say that she has never had a patient that had diarrhea this long.

CBC results-except for mild elevations in ALT and neutrophils, everything else was normal. So vet decided to put Sushi on a 1 protein/1 carb diet along with another metronidazole course. A fecal test was strongly recommended.

In the meantime, I bought a bottle of pancreatin (2600 lipase units /capsule) from the health food store. I gave her 4 capsules with her dinner. Next day, oil leaking was less and her poop was solid enough that I could pick it up.

So I told the vet I would try for the enzymes for 2 weeks.

After a week of 9 enzyme capsules each meal,

1. No oil leaking from the anus.
2. Poo frequency about 2 times a day mainly in the morning after breakfast and during walks.
3. Poo-wide spectrum of
a) soft formed stools that leave a residue and could be picked up
b) gray formed soft stools with mucus lining-could be picked up
c) yellow soft, grainy-had to be scooped up
d) watery diarrhea
e) first part firm and runny afterwards

Received Schebo pancreatic elastase test and enzyme 8X from enzymediane.

Pictures of Sushi’s poo after 1 day of enzymediane’s 8X and result of the Schebo test. (30 minutes after 1st poo)
Many thanks to this website. Now, I know what to focus on and to get Sushi formally diagnosed.

Wow great job on being an advocate for Sushi. She is adorable! Have you read the different tabs of information from the Home page here?

So please food fast her 8-12 hours the night before her Tli and B12 test, you can add folate in there if you want.

All dogs have SID when diagnosed which is an overgrowth of bad bacteria in the small intestine. If an antibiotic is needed please ask your vet for Tylan(Tylosin,) at least a 45 day course 2 times a day.

A grain free diet without peas, lentils legumes is recommended as the grains interfere with how the enzymes work. The food needs to be less than 4% fiber.

B12 needs to be kept in the upper range so can be supplemented daily with B12 with Intrinsic Factor after/in place of B12 shots. The shots are once a week for 6 weeks.

It helps to keep a dsily diary slso.
Again good job on getting what your dog needed through your research.

https://epi4dogs.com/epi-log/
https://epi4dogs.com/sidsibo-in-brief/
https://epi4dogs.com/dog-food-options/

You got the enzymes covered.

Jill

Beatrice---A warm, warm welcome to you and Sushi! You have definitely landed in the right place, and all the things you've done so far are spot on.

Here's a link I like to share. You may want to share it with your vet, and DEFINITELY share this website with her!

https://healthypets.mercola.com/sites/h ... -dogs.aspx

(before I forget, PLEASE ask your vet to prescribe a 45 day round of Tylan antibiotic, and stop giving her the metronidazole. Metro wipes out the good gut flora as well as the bad. Tylan does not)

Start a journal, and write down everything you do, making only one change at a time, and record the result.

EPI treatment is made up of four main components---

ENZYMES---You've ordered 8X, so the ratio is 3/4 teaspoon enzymes/1 cup kibble. Add room temperature water & let stand for 20-30 minutes before serving. If she turns up her nose, add something yummy on top to get her juices flowing. Sardines, parmesan cheese, tuna, a cooled off fried egg, some meat...

FOOD---Grain-free with no legumes or white potatoes, and less than 4% fiber. Two good ones are Sport Dog Elite, herding dogs, and Taste of the Wild Pacific Stream. Some EPI dogs do poorly on poultry, some are fine. Feed 150% the amount you would if Sushi were at her IDEAL weight, not what she currently weighs. Divide daily food into 3 or 4 meals. EVERYTHING Sushi eats must have enzymes in it.

B12---EPI dogs need to be well above normal, at least 600. Tucker's score was 666, but I give him a capsule daily, anyway. If they get too much, they tinkle it out. Wonderlabs B12 with Intrinsic Factor. I get the food & the B12 on Amazon.

SID---The metro was given to control the bacteria, but we now know it is harmful in the long run. So, you will need some Tylan.
https://epi4dogs.com/antibiotics/

That is some good looking poop, but if things backslide don't despair. Most dogs need their routine tweaked, sometimes again & again, but you will get there. Like I said, you will get tons of help from this group, and it will be great if your vet gives it a look, too. There's lots of research backing up the stories & recommendations.

I came here 3 1/2 years ago, and personally I have gotten the best results from following the advice from other EPI dog people.

Ask all the questions you have, no matter how small. This is a very warm group of dog-loving people here.

Take Care---Pam & Tucker in FL

Thanks very much Jill and Pam.

Jill-I've read most of the tabs on the website

What a relief since we thought all the human food snacks we gave caused her diarrhea.

Her Royal Canin medium adult has 3.5% fiber but does not say grain-free. Currently, she eats kibble + ground beef and egg. Homemade broth to wet the food. This girl doesn't need any top-up ingredients to get her to eat the enzymed food. She licks the bowl clean. I don't even have to wash it.

Pam-Sushi is not taking metronidazole. I didn't want to start another round of metro when it didn't work at all the first round.

I am going to keep this diet for 1 week then start to tweak things.

Yes my non Epi dogs eat Royal Canin dental diet so I am familiar with the ingredients. First ingredients are brewers rice, chicken meal, oat groats, corn. Are you letting the food incubate with the enzymes and water 20 minutes before feeding?
Just keep in mind the grains might be an issue down the line.
Snacks, human food or dog treats all need to be incubated with enzymes on them before your pup eats it.

Good job!

Jill

Definitely incubating for 20 minutes. Poor girl follows me around making all kinds of noise as if to remind me that she hasn't been fed yet.

I was at Petsmart going through all their brands for grain-free with less than 4% fiber and do have a couple of candidates. So I will be looking to change soon.

Slippery Elm-I was wondering if there's a standardization for slippery elm i.e. 1 teaspoon will give __mg of FOS. Sushi is taking Aventi GI which has FOS in it. She gets 540mg/day according to manufacturer's instructions. I am finishing up the probiotic so not sure if I should continue with it or just restart with a prebiotic.

Hi Beatrice and welcome to you and Sushi!

You have been given great advice suggestions already...... SO.... i will try to answer your additional questions in your last post.

Regarding the probiotics... since she has already been on them, i would continue.... as having Suchi on probiotic and pre biotics jsut might help her not have a bad flare-up with SID (small intestinal dysbiosis) which often happens a few weeks or so AFTER they start on the enzymes ..things are improving and then WHAM! out of nowhere (or so it seems) sloppy poos re-appear. this is just SID, and the protocol is to first introduce a prebiotic (many use slippery elm powder since it is a mucilage) and if that doesn't work well enough then include a pre+probiotic. .. and if that doesnt work THEN ask the vet for a course of Tylan.... SO.. you are ahead of the game already by having her on probiotics.. so i would continue using a probiotic.

What probiotic are you using?
Some of the ones that "appear" to work well with "some" of our dogs are:
Proviable, Visbiome, VetriScience MegaProbiotics, and i personally use Mercola Complete Probiotics

Yes, go ahead and get SLippery Elm but no need to give it UNLESS you see the stools getting a little soft or sloppy..or if they just aren't really good
and YES... there is a dosing protocol .. it goes by weight of the dog.... unless Sushi is huge, 1 tsp of Slippery Elm is WAYyyyyy to much. Please look read the SE page for instructions and understanding : https://epi4dogs.com/slippery-elm/

Here is a link to an overview of EPI in a nutshell: https://epi4dogs.com/managing-epi/

Oh.... and when you schedule the TLI blood test, as mentioned in another post, be sure to food fast Sushi for at lest 12 hours..... BUT... also know that giving the enzymes will NOT skew the test results.

HOWEVER... if when you have the et run a Cobalamin (B12 & Folate test).... DO NOT give any B12 pill/capsule to the dog for 1 week prior to the test and/or... do not allow the vet give a B12 shot for 30 days prior to the blood being drawn for the Cobalamin test...

When you get the TLI blood test results (to confirm EPI) if you don't mind, please post them here.

Thanks Olesia.

I use Aventi GI probiotic-powder form.
[https://www.aventix.ca/aventi-gi-complete-1]

oh WOW! that looks like a top quality pre+probiotic !!!

there are a hundreds of different strains of Lactobaccillus (with various functions) and this product has multiple strains of it AND it also has the Saccharomyces bacteria AND what i am impressed with is that it includes B3. Of course there is no guarantee which pre+probiotic will best address which dog's SID (individual gut flora imbalance) but there are certain ingredients that appear to overall work better than others on "most" gut flora issues.

Lots and lots of attention has been given to SCFA's (short chain fatty acids) in which there are 3, but the one that is attributed with actually helping improve SID is "Butyrate".... and Butyrate is in SLippery elm. Although not clinically proven, we suspect that this is an additional benefit of Slippery Elm besides being a mucilage and why it usually helps!.

HOWEVER.... what they are also starting to research, but there has not been a lot of attention given to it yet... is that vitamin B3 (Niacin) may help reduce the mechanics of gut inflammation......

So.... i was impressed to see that it was included in this product too

If this product appears to help... i would continue with it for now...

Thanks for letting us know about it!

Thanks Olesia. Well-worth the $75(Canadian) the vet charged me I suppose. Of course, I found it on-line for $55. Will be ordering online from now on. :