Re: Complicated EPI Case
Posted: 17 Mar 2023, 11:07
Hi Miranda,
Because my current dog had high consistently eosinophils and terrible appetite when she presented with EPI, her internal medicine vet was concerned that it might be concurrent IBD, so I tried very hard to get her to eat only hypoallergenic food while I was stabilizing her (with logic that if there was concurrent IBD, it would be clinically very helpful, and it would do no harm if it was only EPI). She was so food averse that I just couldn't do it. So I truly understand what you are going through, we can't sit by and watch our dogs waste away.
The general protocol I used for getting Mina eating again was to cook her some meat and white rice (she likes beef more than chicken). I bought low-fat ground beef and boiled it in quite a lot of water to make "broth". I would feed her about 1/3 meat to 2/3 rice, with plenty of "broth" on the rice to make it very flavorful. Because this is not very nutritionally balanced, I would add a very small amount (like a tablespoon) of some kind of canned dog food. I tried things like canned Z/D and Evangers vegetarian (which at least seemed less likely to add more potential protein allergies if I was dealing with IBD). She liked to eat this while warm, but not too hot. It stinks more when slightly warm. As she started feeling better, I first slowly increased the amount of canned dog food (first up to a quarter cup per meal, then up to 1/3 cup per meal, etc.), then started also adding very small amounts of kibble, ie a teaspoon, I would slowly reduce the amounts of meat and rice so the amount off calories per meal stayed about the same. It took me about a month to get her eating dog food again. I would feed her three or four times a day.
It is important to note that if I had not gotten the SIBO under control, this would not have worked. Given that all new-onset EPI dogs probably have SIBO, and that tylosin is very good for both SIBO and dog IBD, that seems like a very good thing to discuss with vet.
If Mina had ended up having IBD and I had not been able to use beef for that process, I would have either tried harder to get her to eat hypoallergenics, or used novel proteins, as if a dog has never eaten a protein like deer or rabbit or kangaroo before, it will not react to it. Happy to discuss that more if it's something you end up wanting to try.
I am so, so happy that you have an internal medicine vet to help you manage this. I could not have managed my IBD dog without one.
Because my current dog had high consistently eosinophils and terrible appetite when she presented with EPI, her internal medicine vet was concerned that it might be concurrent IBD, so I tried very hard to get her to eat only hypoallergenic food while I was stabilizing her (with logic that if there was concurrent IBD, it would be clinically very helpful, and it would do no harm if it was only EPI). She was so food averse that I just couldn't do it. So I truly understand what you are going through, we can't sit by and watch our dogs waste away.
The general protocol I used for getting Mina eating again was to cook her some meat and white rice (she likes beef more than chicken). I bought low-fat ground beef and boiled it in quite a lot of water to make "broth". I would feed her about 1/3 meat to 2/3 rice, with plenty of "broth" on the rice to make it very flavorful. Because this is not very nutritionally balanced, I would add a very small amount (like a tablespoon) of some kind of canned dog food. I tried things like canned Z/D and Evangers vegetarian (which at least seemed less likely to add more potential protein allergies if I was dealing with IBD). She liked to eat this while warm, but not too hot. It stinks more when slightly warm. As she started feeling better, I first slowly increased the amount of canned dog food (first up to a quarter cup per meal, then up to 1/3 cup per meal, etc.), then started also adding very small amounts of kibble, ie a teaspoon, I would slowly reduce the amounts of meat and rice so the amount off calories per meal stayed about the same. It took me about a month to get her eating dog food again. I would feed her three or four times a day.
It is important to note that if I had not gotten the SIBO under control, this would not have worked. Given that all new-onset EPI dogs probably have SIBO, and that tylosin is very good for both SIBO and dog IBD, that seems like a very good thing to discuss with vet.
If Mina had ended up having IBD and I had not been able to use beef for that process, I would have either tried harder to get her to eat hypoallergenics, or used novel proteins, as if a dog has never eaten a protein like deer or rabbit or kangaroo before, it will not react to it. Happy to discuss that more if it's something you end up wanting to try.
I am so, so happy that you have an internal medicine vet to help you manage this. I could not have managed my IBD dog without one.