Enzyme dose not working? What should I try next?

[lylzzf3841]

Yeah I understand not to change much before he’s more stable. But it feels that I can never get him stabilized until I figure out the correct enzyme dose.

At this point I don’t even know if enzyme is helping him. His TLI wasn’t low enough for a definitive diagnosis, and he’s been on enzyme for more than a week. Even now with SID more under control I still can’t say his BM has improved much…

So this is the situation I’m battling everyday… I don’t know how much is “too much” enzyme. I don’t know if the loose stool is because he doesn’t not have enough enzyme, or because I’m overdosing him…

[Olesia711]

Also gage an enzyme product first by the Lipase content.....most enzymes have the Lipase USP units somewhere around 71,400 USP units, give or take 20,000. These are also called 6x.

The 8x are more potent and their Lipase USP units are more than the 6x.... as an example can be approximately 105,000 Lipase USP ... give or take.

As you can see there is much leeway with the powdered enzymes.... HOWEVER..... some dogs are more sensitive than others.... so if you have a very strong Lipase batch of enzymes.... maybe start with a little less then what is recommended and see how it goes.....
Other EPi dogs actually benefit from a stronger dose...

What i personally really like about EnzymeDiane's enzymes is that every bag is marked with exactly what that particular barrel of enzymes tested out as.....so you know the exact strength that you are getting.................................... where as all the other enzymes print a standard label stating Lipase 71,400 USP units.... which means their enzymes have to "meet" the 71,400 Lipase criteria.

[lylzzf3841]

Yeah I also like the fact that Enzyme Diane has the precise label for each batch. But since this is the very first one I got from them, I don't know if 93,800USP lipase counts as a "strong" batch...

Since too much enzyme can also cause loose stool, I can't decide if I wanted to try increasing or reducing the enzyme next... When my dog was on Metronidazole, he actually gained about 5lbs in that 5 days. So it means at least his pancreas is still producing some enzymes, correct? Does that mean I should start from really low and work the way up?

[Eddiespaghetti]

It's super tough knowing what to do next. I somewhat understand how you feel. As I said it is recommended to wait until they are stable, but you are the owner of the dog. You get to decide what to do next.
One thing to try is experiment in the morning, but not at night. Morning feeding give zero enzymes and see how that goes. If you see a lot of undigested food, youwill need to increase to 1/4th? So on and so fourth. I say experiment in the morning to make sure they get at least one good meal a day. Alternatively you can go the other way. Start at 2.5 teaspoons and work your way down until you see undigested food.
This isn't the typical process, but you and your pup aren't in a typical situation.

[Olesia711]

good suggestion Jeremy..... and i wholeheartedly agree with trying changes in the morning dose not the evening.

I even stick with "morning" when i give new meds or even something like the monthly tick and flea meds....

[Eddiespaghetti]

I say morning, but that is when it works for me. I really mean whatever feeding you do when you can watch them for the next 2-6 hours. Experimenting doesn't work if you can't see the results.

[Olesia711]

the reason i think when trying anything new... or doing changes ... and why i prefer doing these first with a morning dose is that just in case something goes wrong, or if there is a bad reaction, you can call the vet during regular hours .

Also... what i forgot to mention, is that many of us may have a preference for one brand of enzymes over another.... but in the end, if they are the right kind and potency, they work .... so often times it is a personal choice

[lylzzf3841]

Thanks Jeremy and Olesia for the great suggestions! Yes I think trying new things only with the morning meal definitely makes sense. I'll follow that!

A bit update for Leo today. His BM looks a bit better this morning (2 days in a row). Not score 2 yet but a combination of score 3 and 4, with more brown color. I went back to the log to see what changed for the past 2 days and noticed 2 things:
1. Visbiome
2. Pumpkin puree

My theory is that the probiotics and the little extra fiber helped regulate the transit time and the overall environment in colon, so we're seeing better water absorption there. But anyway, since he's now finally had a BM I think I'm okay with, I'll stick to what we're having now for at least 1 more week before making any new changes, unless his condition somehow got worse again.

Another question regarding B12 - he just got his 3rd weekly injection. But how often should I give him oral supplements in between those injections?

[Eddiespaghetti]

You don't have to give oral supplements while receiving the weekly B12 injections. The injections are typically enough for the most part. I gave Eddie his dose every 2-3 days though. It's the same regimen as now. I mostly wanted to get in the routine of giving it while I had padding from the injections. If their kidneys are healthy they will pass any extra B12 without any problem.

[Olesia711]

Very glad to hear that LEO's poops are improving.... this is great news .... and as you figured out..... improvement often doesn't happen over night ....except with some dogs when given Tylan ... but often takes a few days/weeks. After all, if this is EPI, it takes time for EPI to wreak havoc with the body, and consequently takes time for the body to heal and be maintained.

My guess is that the Visbiome probably is having the bigger effect simply because with these probiotics.....one can go thru a bunch of different brands and none really do much UNTIL you happen upon one the best agrees with your dog's individual gut flora... where you finally see improvement. And i am sure the pumpkin fiber is also helping

REgarding the B12.... Jeremy summed it up nicely,,,, but if you want to give extra B12 via WOnderlabs Pet Factor while the B12 shots are also be given weekly, then you can try giving 1 to 3 pills a week inbetween the shots... as any excess should be peed out and do no harm.... however, if the cyanocobalamin version of B12 in the shots are not as effective as expected in Leo's system ... then the methylcobalamin B12 version in the pills will really help bringing up his B2 levels....