Atypical case? Possible EPI but Vet not sure

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Olesia711
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Re: Atypical case? Possible EPI but Vet not sure

Post by Olesia711 » 27 Mar 2023, 11:33

Hi Rob, i did want to clarify one other point..... if this was confirmed EPI..... (2.5 or less) or even confirmed possible SEPI (below 5.75) if #3 didn't work with the forti flora, i would have suggested that your vet try Visbiome or Proviable (probiotic)and if these were also a bust THEN i would have suggested talking to your vet about trying Tylan antibiotic (Tylosin Tartrate soluble powder antibiotic) HOWEVER................. we now save Tylan antibiotic as a lost resort if possible.

HOpe this all helps and PLEASE do keep us posted!
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.........

Wedge
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State: Pennsylvania
Pet name: Franklin
My name: Rob

Re: Atypical case? Possible EPI but Vet not sure

Post by Wedge » 18 Apr 2023, 10:40

Ok, so I wanted to post an update since you all have been so helpful.

As a reminder, part of our history with Franklin's stools was unknown because we were observing loose stool on walks, which was very consistently loose and at times very watery. Although we hadn't been noticing his stools as much in our yard and he was not a frequent pooper...so unlike some of you that observe diarrhea multiple times a day we were seeing it every day, but always on walks. As we started to pay attention, we noticed that virtually all of his stools in the yard were 100% normal, but his poops on walks continued to be loose (like a big pile of pudding)

After treatment with enzymes for at least a month now (when was my first post?? ha), we have noticed no change. The reason we went down the enzyme path was EPI level was 6.5, which our vet felt was low enough that this was the possible problem. We have also now changed his food from Hills chicken & rice to Taste of the Wild Salmon. We noticed no change to his stool pattern with the food change. And we discontinued enzymes a few days ago and so far have continued to notice no change to his stools. In the yard, they are always normal.

However, we have seen one change with Franklin which started for us shortly after this loose stools on walks started. He won't go on walks around the neighborhood. When we put on his lease, he is often so hesitant he won't leave the house through the front door...and if he does that, often times he won't leave our driveway. The view of our trainer and our vet is that he's suffering from anxiety and now he's been put on Prozac to try and address this issue and calm him down. He's been on it for ~3 weeks and while he is more calm and a bit sleepy in the house, he still wont go on walks...although Prozac can take 4-6 weeks to fully kick in from what I've been told & read.

Franklin is willing to go on walks at our local parks. And when we do this, his stools are often loose, pudding piles, but not crazy watery. So my best guess, and the reason we've switched the food and transitioned away from enzymes for now to see what happens, is that he's got some type of anxiety related reaction to being on a leash, walking in general, walking in our neighborhood, etc., which is causing the loose stools but he's otherwise a normal pup with normal stools at home. Our vet said it would be unusual to have anxiety induced diarrhea like this, but not impossible.

We've also moved to the salmon food away from chicken, just to rule that out. We're continuing with the pro-biotic supplement since it probably can't hurt. And we're going to wait and see. If everything stays exactly as it has been, normal poops at home, loose any time he's on a leash, and no change based on changing food/enzymes, then I think we can probably rule out EPI. Our vet also said we could re-test for EPI eventually and see if his levels have gone back up just to further rule it out.

One aspect that is frustrating is that Franklin isn't gaining weight, and lost about 1 to 1.5 pounds over the past month. He eats a decent amount, in total about 5 cups of dry food a day plus 2/3-1 can of wet for a 70lb dog, which is generally about 1-1.5 cups more than recommended for a dog his size. Although this could also be related to the Prozac, but he's been continuing to eat his entire food bowl daily, it's not like his appetite has decreased as being responsible for his slight weight loss.

Hopefully the Prozac calms him down. He gets over this anxiety related to being on leash/walks, and everything normalizes. That's my best guess for now.

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jilbert57
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Re: Atypical case? Possible EPI but Vet not sure

Post by jilbert57 » 18 Apr 2023, 10:47

Thank you for that update on Franklin. I am hoping the Prozac helps.
Is Franklins B12 level up in the high range? Low B12 can cause fearfulness.
Keep up the good work!

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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Olesia711
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Location: North Carolina
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Re: Atypical case? Possible EPI but Vet not sure

Post by Olesia711 » 18 Apr 2023, 11:43

hmm............... this sure is a strange case.

First, Jill made a very important point.... make sure his B12 is at a medium high level.

Next.... for the weight gain....... try adding real meat (protein) to his meals and see if that helps with the weight gain. Something like cooked Hamberger (90/10, or 93/7 ratio ) i personally try to avoid 80/20 burger meat. Or add pieces of baked chicken.

Regarding the anxiety with the leash/going for walks. I understand the use of Prozac, but.... i am also wondering, if while on Prozac if you might consider calling in a dog trainer/behaviorist to help you desensitize Franklin's fear that sounds like it started with the loose stools on walks only, and then hesitancy to go on walks which then sounds like it progressed to not wanting the leash on in anxious anticipation of going on a walk.... it just all sounds like a progression that while he is calmer/less fearful on Prozac, you might want to work on altering this fearfulness. Sounds like something set him off initially and it just got worse and worse. HOWEVER.... all this being said does not explain the weight loss unless anxiousness has contributed to the weight loss........

If you are interested in a behaviorist... look into APDT dog trainers in your area.
https://apdt.com/

I wish i had an answer or even just better solutions to this, but this has me stumped.... The ONLY thing i can think of is that there is an underlying health condition and sometimes when they are not feeling 100% they start acting weird.... and this sure qualifies.... DId you vet run any cortisol tests? Like ACTH for A-typical Cushings? Just wondering............
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.........

Wedge
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Posts: 8
Country: United States
State: Pennsylvania
Pet name: Franklin
My name: Rob

Re: Atypical case? Possible EPI but Vet not sure

Post by Wedge » 18 Apr 2023, 12:49

Cobalamin level was at 797 when tested, which according to my report is the high end of normal.

I'll ask about coritsol and atypical Cushings. Pretty sure we haven't tested for that.

And I definitely agree on the behavior therapy. It's strange in that it's not so much putting on the leash, or anything leash specific, but it's really about leaving our house and our yard and walking around the neighborhood. He's also hesitant to go up our stairs (even though we put in a runner and he's never had any physical issue with them in the past). Hopefully once the Prozac takes full effect we'll have some better opportunities to work with him and get him over whatever is making him nervous.

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Olesia711
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Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Atypical case? Possible EPI but Vet not sure

Post by Olesia711 » 18 Apr 2023, 15:30

maybe talk to the vet about testing cortisol levels for possible A-Typical Cushings and or Addisons..... the reason why i am suggesting this is because my non-EPI dog had similar TLI test results .....and my vet he was heading into EPI too.... had the yellow cow patty poo.... tried enzymes, Tylan... no improvement... and the weird thing was that his personality changed ....and there was a little bit of weight loss if i remember correctly. Finally out of desperation, the vet tested for Cushings even though he didn't have the typical Cushing symptoms... and sure enough, he had A-Typical Cushings.....you could have knocked me & the vet over with a feather, we were bother surprised! so... just saying..... might be worth having a conversation with the vet if he thinks this "might" be an A-Typical adrenal situation??? and if it would be warranted running some tests or not............

In the meantime... yea.... if you can, maybe take advantage of the prozac with some behavior/desensitization therapy and see if this helps??? ALso... while i am thinking of it....if he is too sleepy inside the house....maybe ask the vet if the dose should be modified somewhat ... i know it can be kind of tricky getting the dose right.
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.........

Wedge
Member
Posts: 8
Country: United States
State: Pennsylvania
Pet name: Franklin
My name: Rob

Re: Atypical case? Possible EPI but Vet not sure

Post by Wedge » 18 Apr 2023, 19:16

I’ll definitely ask when I’m at the Vet tomorrow. Thanks for the suggestion.

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