Bloody diarrhea - for 3 weeks now

Talk about diets, exercise, and disease.
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Bloody diarrhea - for 3 weeks now

Postby Melody » Wed May 28, 2008 8:17 am

To start off...yes, we've been to the vet - many times. Multiple fecal tests, parvo tests, etc...all came back negative. This dog has been dewormed, been on metronidazole, clavamox (for an URI), had this beneficial bacteria stuff from what looks like a horse wormer tube (I cant remember the name), chicken and rice doesn't help.

Little background on the dog: Laura, approx. 1 yr old American Bulldog, rescued from Miami Dade Animal Services 3 weeks ago. She was VERY underweight and from day one has had extremely runny, and always bloody diarrhea. She's NOT ONCE had a formed, solid poo.

I have been doing some research on what could be causing this, and I am almost positive that it's IBD - Irritable Bowel Disease. Does this sound right? Has anyone dealt with this before? I am going today to pick up some Duck & Potato food, and start the long process of an elimination diet, to see if this is causing her problem.

Here are some pictures to show what it looks like...we are going back to the vet again this Saturday for more tests and hopefully an answer. I know there's a lot of knowledgeable people here, and hopefully someone can help me.

Image
Image
Image

This is from about 20 minutes ago. You can see the bright red blood and absolutely no formation to the stool at all. :frown:

This is the dog:
Image

msvette2u

Postby msvette2u » Wed May 28, 2008 8:20 am

Fiber helps IBD in humans. Have you tried that?
Is there something the vet is missing? We've had some nasty illnesses coming from an area particularly rampant with feral dogs and tons of strays, intestinal illnesses I have not even heard of. The treatment was 4 diff. antibiotics for 10 days after the dog came here.

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Postby Maryellen » Wed May 28, 2008 9:03 am

has the vet checked her for SIBO or EPI?? the EPI test is a 12 hour fast blood test.. its worth it to have both tests done to see if she has either, as both have symptoms that mimic each other..


here is some info on SIBO and EPI, which i have noticed alot of dogs have.. symptoms include ravenous appetite, LARGE poops numerous times during the day, vomiting, and diarrhea, and excessive weight loss..

DOGS THAT TAKE THE PANCREATIC ENZYMES WILL DRINK MORE WATER, AND SOME DOGS WILL BECOME INCONTINENCE FROM THE ENZYMES.

there is one test that can determine if its EPI, that is the TLI test, which the dog must fast for 12 hours prior to the test..

Epi can strike at any time but the dog is usually very young when symptoms occur, indeed puppies can be born with this condition but not show any signs until they reach the juvenile stage. Epi is also beginning to show up in the middle aged dog.
Symptoms include loss of weight/failure to gain weight, constant hunger, loose rancid stools, frequent visits to the toilet, watery diarrhoea, excessive flatulence (wind), noisy tummy and in some cases vomiting.
They can develop a nervous, highly-strung character as well as being hyper active as these dogs have never ending energy and don't know when to stop!

As you can see, most of these symptoms can also be put down to normal doggie ailments so if in doubt, please contact your vet for further investigations i.e. a clinical examination which may include blood and faeces tests in order to establish if there is indeed anything to worry about.

Treatment

Along with the relevant medication, a good quality low fat, low protein, low fibre easily digestible diet is a must i.e. chicken & rice, lamb & rice kibble. It is essential that you stick to the diet rigidly especially in the early days until your dog is stabilized. Understandably, this is a bland diet but hopefully you'll be able to find something appetising to sprinkle in with the food that's low fat/protein etc.
We sprinkle liver cake in Freya's food as both the smell of the liver and garlic add that extra *taste* factor.
If your dog is used to treats, why not give him bits of his dried food or small bits of carrot as he'll be none the wiser.

It is important to try and cut down on the amount of air he swallows whilst eating his food in order to combat the flatulence (wind).
If your dog is greedy and rushes his food why not put clean, scrubbed stones in his dish so he has to move them about in order to eat his meal, thus slowing him down and minimizing gulping.

(make sure the stones are too big for him to swallow)

Raising his food and water dish may also help.
What we do is feed Freya some of her dried food in an activity ball, that way she has to manipulate the ball in order to tease the food out. The rest we put in a dish, sprinkle her medication in to it, add water and let it soak.
Doing this cuts down on the flatulence to a great extent.
You may find that your vet may want you to give twice the amounts of food in order to get the weight on the dog depending how under-weight he is. The best way to do this is to feed him 4 feeds a day in order to avoid overloading his stomach.
The dog, indeed any dog must not be exercised for at least two hours after any feed.

Through time, once the dog is stabilized, you'll be able to slip in the odd treat here and there so long as it's low in fat/protein and fibre. Should the dog take a downward turn you just up the medication for a couple of days and remember not to feed him that particular treat again.

Exercise

Your vet may advice you to cut back on the exercise to begin with in order to keep the calories in and get the weight on but it doesn't mean you can't have fun with your dog.
When out play mind games, hide a favourite toy in the grass and get him to search for it or do some training as both these activities stimulate the mind leaving your dog exhausted and ready for a good sleep when he gets in. You can also play these games indoors.
You can still let your dog run about and play but just limit the amount as these dogs could run all day, and night.

Prognosis

Well your vets the best person to answer this but with the right diet, medication and exercise there is no reason why your dog can't live a long, healthy, incident free life span.
Epi/Ped or Pi is not the end of the world, even with complications that doesn't mean your dog is doomed because he's not, he's just a dog with a medical condition although I have to stress yet again that some dogs do not respond to treatment as well as they should.
Looking after such a dog is very easy once you get into a routine, it's second nature believe me and within weeks your dog could be like any other dog in the street, toilet and all so it's not the end of the world although the treatment is life long.

Observations

Through time you'll just "know" when your dogs feeling a bit off colour, it doesn't mean there's anything to worry about, just limit his exercise and give him a little peace and quiet, just like you'd want if you were having an off day.

Epi dogs are no different to "normal" dogs as they can still pick up stomach bugs etc, in some cases they may be more susceptible so do be prepared for the odd relapse as it would be fool-hardy to think they'll always be perfect.
Should this happen please do consult your vet in order to get the infection treated as the Epi dog can drastically loose weight virtually overnight!


The main thing to remember is do keep communicating with your vet as it is all too easy for the relationship to break down (I should know as ours was tested to the limit). Always remember that your vet is on your side and there's a good chance that they too feel very despondent when things aren't going to plan, there's an even bigger chance that once they
get home they'll be reading up on all the latest information available regarding the treatment of these dogs so please do be patient and be guided by your vet.

The "ill Dog" Syndrome

Another thing to remember is don't fall into this trap
(especially with a young dog) of either cutting back or stopping your training, the ill dog syndrome, as you'll have a whole load of catching up to do when your dog is stabilized as well as him being a totally unruly dog (I should know as that's exactly what I did).

Advice

As an Auto Immune Disorder, it is advised that an Epi dog should not be re-vaccinated due to the risks involved. What more enlightened vets are now offering is what they call a Titres test.
This is a simple blood test that measures the antibody levels of each disease covered by vaccinations. Should your dog need any boosters, you can opt for a single vaccine dedicated to that particular disease.
It is also advisable to have your dogs Vitamin B12 levels checked at the same time, that way should they be low on B12, they can receive a B12 injection.

Please do enjoy your dog as the quicker you start to enjoy him again, the quicker everything will fall into place.

Articles discussing EPI and the genetic inheritance of this (or general) diseases:

http://www.upei.ca/~cidd/howare.htm#Top���� This article explains how genetic diseases are passed along from generation to generation. �

http://www.upei.ca/~cidd/Diseases/GI%20 ... m��� This article provides an easily read explanation on EPI, it's diagnosis and treatment recommendations.� It does not address diet specifically, however. �

http://www.gsdhelpline.com/genetic2.htm��� This article is just one of many on this websight.� It is based in the UK and is available for anyone to read.� This is another article that talks about autosomal recessive genetics and how two apparently normal parents can produce offspring with a debilitating or deadly disease.� It does not talk about EPI specifically, however. �

http://www.gsdhelpline.com/boweldis.htm��� This article discusses EPI in general terms and recommends an easily digestible, moderately fat restricted diet.� No references are given for the dietary recommendation.� It also talks about SIBO and other common Pancreatic and Intestinal diseases in the GSD.

(Thanks to Penny, fn117@aol.com for these references.)

Research article: Am J Vet Res. 2002 Oct;63(10):1429-34.

Inheritance of pancreatic acinar atrophy in German Shepherd Dogs.
Moeller EM, Steiner JM, Clark LA, Murphy KE, Famula TR, Williams DA, Stankovics ME, Vose AS.

Division of Small Animal Surgery and Orthopedics, Faculty of Veterinary Medicine, University of Bern, Switzerland.

OBJECTIVE: To assess the heritability of pancreatic acinar atrophy (PAA) in German Shepherd Dogs (GSDs) in the United States. ANIMALS: 135 GSDs belonging to 2 multigenerational pedigrees. PROCEDURE: Two multigenerational pedigrees of GSDs with family members with PAA were identified. The clinical history of each GSD enrolled in the study was recorded, and serum samples for canine trypsin-like immunoreactivity (cTLI) analysis were collected from 102 dogs. Dogs with a serum cTLI concentration < or = 2.0 microg/L were considered to have exocrine pancreatic insufficiency (EPI) and were assumed to have PAA. RESULTS: Pedigree I consisted of 59 dogs and pedigree II of 76 dogs. Serum cTLI concentrations were measured in 48 dogs from pedigree I and 54 dogs from pedigree II. A total of 19 dogs (14.1%) were determined to have EPI, 9 in pedigree I (15.3%) and 10 in pedigree II (13.6%). Of the 19 dogs with EPI, 8 were male and 11 were female. CONCLUSIONS AND CLINICAL RELEVANCE: Evaluation of data by complex segregation analysis is strongly suggestive of an autosomal recessive mode of inheritance for EPI in GSDs in the United States.

PMID: 12371772 [PubMed - indexed for MEDLINE]



If you have additions for this document, please contact Nancy Roberts at nancyr @ cc.usu.edu.

What is EPI?
Info from UPEI (University of Prince Edward Island)

Info from Vetcentric

Info from Regalwise

Info from Provet

Info from the White Shepherd Genetics page, ignore the part on testing with corn oil.


The Canine Gastrointestinal Tract: Exocrine Pancreas This article has diet information in it (towards the end) and discusses the need for a low fat diet and the role of fiber. This is from Waltham (a feed manufacturer) and discusses both pancreatitis and EPI.

How the Pancreas SHOULD work
Exocrine Secretions of the Pancreas
SIBO, Small intestine bacterial overgrowth:
Info from Provet

WSAVA Conference proceedings

Info from UPEI

Info from Purina research

Article on Clostridium Perfringens Enterotoxin another cause of GI upset in dogs.
Info on TLI testing:
Info from Texas A&M

info from DPC

Info from Antech Labs covers TLI, Cobalamin, Folate. NOTE THAT THIS ARTICLE INCORRECTLY STATES THAT ENZYMES NEED TO BE WITHDRAWN BEFORE TESTING!
Info on Cobalamin/Folate testing:
Info from Texas A&M


Vitamin B-12 (cobalamin) supplementation:
Info from Texas A&M

Vitamin B-12 minimum daily requirements chart: (found in files section of epi list).
Study on EPI from Helsinki, Finland:
Dissertation results


Digestive disorders in dogs:
Info from siriusdog

http://www.upei.ca/~cidd/Diseases/GI%20 ... ciency.htm

http://www.vetcentric.com/reference/enc ... &MODE=full

http://www.provet.co.uk/health/diseases/git-epi.htm

http://www.wsgenetics.org/articles/epi.html

http://www.walthamusa.com/articles/cgiexopanc.pdf

http://arbl.cvmbs.colostate.edu/hbooks/ ... crine.html

SIBO info

http://www.provet.co.uk/health/diseases/git-bo.htm

http://www.vin.com/proceedings/Proceedi ... tegory=414

http://www.upei.ca/~cidd/Diseases/GI%20 ... growth.htm

http://www.purina.com/images/articles/p ... growth.pdf

http://www.cah.com/dr_library/clost.html

info on TLI testing
http://www.cvm.tamu.edu/gilab/TLI.shtml

http://www.dpcweb.com/documents/news&vi ... ypsin.html

http://www.antechdiagnostics.com/client ... 9/5-99.htm

http://siriusdog.com/digestive-tract-disorders.htm

What is small intestinal bacterial overgrowth?
In this condition, there is a dramatic increase in the number of bacteria in the small intestine, and this interferes with normal absorption of nutrients. The result is chronic intermittent diarrhea, and weight loss or failure to gain weight.
In the German shepherd, this condition is thought to be related to a deficiency of immunoglobulin A (IgA) , the primary immune defense in the small intestine.
Small intestinal bacterial overgrowth (SIBO) may develop in association with exocrine pancreatic insufficiency. It may also be seen with inflammatory bowel disease, although it can't always be determined which came first.
How is small intestinal bacterial overgrowthinherited?
unknown
What breeds are affected by small intestinal bacterial overgrowth?
German shepherd; the condition is seen in other breeds as well.
For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.
What does small intestinal bacterial overgrowthmean to your dog & you?
The condition is usually seen in young dogs, who develop chronic intermittent diarrhea which gradually gets worse, and lose weight or fail to gain weight normally. Some dogs may only show weight loss and in others there may be vomiting.
How is small intestinal bacterial overgrowthdiagnosed?
There is no straightforward test to diagnose SIBO. Because the condition may develop as a complication of many intestinal diseases, it is important to search for any possible underlying cause. Your veterinarian will do tests for parasites, bacterial infections, partial obstruction, and other causes of diarrhea such as exocrine pancreatic insufficiency. Besides these baseline blood and fecal tests, there are several other tests that can be done to support the diagnosis of SIBO.
For the veterinarian: Bacterial overgrowth in the proximal small bowel is increasingly recognized as an important cause of chronic intermittent small bowel diarrhea +/- weight loss in many breeds. There is overgrowth of anaerobic bacteria, which have a greater potential for damaging the intestinal mucosa and causing malabsorption. Anaerobes are also the major cause of bile salt deconjugation, the results of which are fat malabsorption and steatorrhea.
There is no straightforward test to diagnose SIBO. Increased serum folate or reduced cobalamin provide indirect support for the diagnosis, once pancreatic insufficiency has been ruled out. Other helpful tests include absorption and permeability tests and hydrogen breath testing (available in some specialty centres). The diagnosis can be confirmed by microbiologic culture of duodenal juices (obtained endoscopically or by laparotomy) although this is expensive and technically complicated, and may miss some cases of SIBO.

How is small intestinal bacterial overgrowthtreated?
Antibiotics are used at the same time as any underlying cause is treated. Often, no underlying cause can be found and it becomes a question of long term management. The disorder can usually be controlled with long courses of antibiotics, repeated occasionally if there is a relapse, and dietary management using a therapeutic diet low in carbohydrates and fats.
For the veterinarian: Four weeks of treatment with oxytetracyline is usually successful. Some dogs with SIBO relapse soon after antibiotics are discontinued. This may mean there is an unidentified underlying cause, or there has been permanent functional mucosal damage. Antibiotics, gradually reduced to the lowest dose that will control the diarrhea, may need to be continued for extended periods.

Breeding advice
Affected dogs should not be bred, and until more is known about inheritance of this disorder, it is prudent to avoid breeding their parents and siblings as well.
FOR MORE INFORMATION ABOUT THIS DISORDER, PLEASE SEE YOUR VETERINARIAN.
Resources
Rutgers, H.C. 1998. Diagnosis and long-term management of bacterial overgrowth in the dog. ACVIM-Proceedings of the 16th Annual Vet. Med. Forum. pp. 482-484.
Burrows, C.F., Batt, R.M., Sherding, R.G. 1995. Diseases of the small intestine. In E.J. Ettinger and E.C. Feldman (eds.) Textbook of Veterinary Internal Medicine, pp. 1169-1232. W.B. Saunders Co., Toronto.

Copyright © 1998 Canine Inherited Disorders Database. All rights reserved.
Revised: April 27, 2001.
This database is a joint initiative of the Sir James Dunn Animal Welfare Centre at the Atlantic Veterinary College, University of Prince Edward Island, and the Canadian Veterinary Medical Association.

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Postby Maryellen » Wed May 28, 2008 9:04 am

has the vet checked her for SIBO or EPI?? the EPI test is a 12 hour fast blood test.. its worth it to have both tests done to see if she has either, as both have symptoms that mimic each other..


here is some info on SIBO and EPI, which i have noticed alot of dogs have.. symptoms include ravenous appetite, LARGE poops numerous times during the day, vomiting, and diarrhea, and excessive weight loss..

DOGS THAT TAKE THE PANCREATIC ENZYMES WILL DRINK MORE WATER, AND SOME DOGS WILL BECOME INCONTINENCE FROM THE ENZYMES.

there is one test that can determine if its EPI, that is the TLI test, which the dog must fast for 12 hours prior to the test..

Epi can strike at any time but the dog is usually very young when symptoms occur, indeed puppies can be born with this condition but not show any signs until they reach the juvenile stage. Epi is also beginning to show up in the middle aged dog.
Symptoms include loss of weight/failure to gain weight, constant hunger, loose rancid stools, frequent visits to the toilet, watery diarrhoea, excessive flatulence (wind), noisy tummy and in some cases vomiting.
They can develop a nervous, highly-strung character as well as being hyper active as these dogs have never ending energy and don't know when to stop!

As you can see, most of these symptoms can also be put down to normal doggie ailments so if in doubt, please contact your vet for further investigations i.e. a clinical examination which may include blood and faeces tests in order to establish if there is indeed anything to worry about.

Treatment

Along with the relevant medication, a good quality low fat, low protein, low fibre easily digestible diet is a must i.e. chicken & rice, lamb & rice kibble. It is essential that you stick to the diet rigidly especially in the early days until your dog is stabilized. Understandably, this is a bland diet but hopefully you'll be able to find something appetising to sprinkle in with the food that's low fat/protein etc.
We sprinkle liver cake in Freya's food as both the smell of the liver and garlic add that extra *taste* factor.
If your dog is used to treats, why not give him bits of his dried food or small bits of carrot as he'll be none the wiser.

It is important to try and cut down on the amount of air he swallows whilst eating his food in order to combat the flatulence (wind).
If your dog is greedy and rushes his food why not put clean, scrubbed stones in his dish so he has to move them about in order to eat his meal, thus slowing him down and minimizing gulping.

(make sure the stones are too big for him to swallow)

Raising his food and water dish may also help.
What we do is feed Freya some of her dried food in an activity ball, that way she has to manipulate the ball in order to tease the food out. The rest we put in a dish, sprinkle her medication in to it, add water and let it soak.
Doing this cuts down on the flatulence to a great extent.
You may find that your vet may want you to give twice the amounts of food in order to get the weight on the dog depending how under-weight he is. The best way to do this is to feed him 4 feeds a day in order to avoid overloading his stomach.
The dog, indeed any dog must not be exercised for at least two hours after any feed.

Through time, once the dog is stabilized, you'll be able to slip in the odd treat here and there so long as it's low in fat/protein and fibre. Should the dog take a downward turn you just up the medication for a couple of days and remember not to feed him that particular treat again.

Exercise

Your vet may advice you to cut back on the exercise to begin with in order to keep the calories in and get the weight on but it doesn't mean you can't have fun with your dog.
When out play mind games, hide a favourite toy in the grass and get him to search for it or do some training as both these activities stimulate the mind leaving your dog exhausted and ready for a good sleep when he gets in. You can also play these games indoors.
You can still let your dog run about and play but just limit the amount as these dogs could run all day, and night.

Prognosis

Well your vets the best person to answer this but with the right diet, medication and exercise there is no reason why your dog can't live a long, healthy, incident free life span.
Epi/Ped or Pi is not the end of the world, even with complications that doesn't mean your dog is doomed because he's not, he's just a dog with a medical condition although I have to stress yet again that some dogs do not respond to treatment as well as they should.
Looking after such a dog is very easy once you get into a routine, it's second nature believe me and within weeks your dog could be like any other dog in the street, toilet and all so it's not the end of the world although the treatment is life long.

Observations

Through time you'll just "know" when your dogs feeling a bit off colour, it doesn't mean there's anything to worry about, just limit his exercise and give him a little peace and quiet, just like you'd want if you were having an off day.

Epi dogs are no different to "normal" dogs as they can still pick up stomach bugs etc, in some cases they may be more susceptible so do be prepared for the odd relapse as it would be fool-hardy to think they'll always be perfect.
Should this happen please do consult your vet in order to get the infection treated as the Epi dog can drastically loose weight virtually overnight!


The main thing to remember is do keep communicating with your vet as it is all too easy for the relationship to break down (I should know as ours was tested to the limit). Always remember that your vet is on your side and there's a good chance that they too feel very despondent when things aren't going to plan, there's an even bigger chance that once they
get home they'll be reading up on all the latest information available regarding the treatment of these dogs so please do be patient and be guided by your vet.

The "ill Dog" Syndrome

Another thing to remember is don't fall into this trap
(especially with a young dog) of either cutting back or stopping your training, the ill dog syndrome, as you'll have a whole load of catching up to do when your dog is stabilized as well as him being a totally unruly dog (I should know as that's exactly what I did).

Advice

As an Auto Immune Disorder, it is advised that an Epi dog should not be re-vaccinated due to the risks involved. What more enlightened vets are now offering is what they call a Titres test.
This is a simple blood test that measures the antibody levels of each disease covered by vaccinations. Should your dog need any boosters, you can opt for a single vaccine dedicated to that particular disease.
It is also advisable to have your dogs Vitamin B12 levels checked at the same time, that way should they be low on B12, they can receive a B12 injection.

Please do enjoy your dog as the quicker you start to enjoy him again, the quicker everything will fall into place.

Articles discussing EPI and the genetic inheritance of this (or general) diseases:

http://www.upei.ca/~cidd/howare.htm#Top&#65533;��� This article explains how genetic diseases are passed along from generation to generation. �

http://www.upei.ca/~cidd/Diseases/GI%20 ... m&#65533;&#65533;� This article provides an easily read explanation on EPI, it's diagnosis and treatment recommendations.� It does not address diet specifically, however. �

http://www.gsdhelpline.com/genetic2.htm&#65533;&#65533;� This article is just one of many on this websight.� It is based in the UK and is available for anyone to read.� This is another article that talks about autosomal recessive genetics and how two apparently normal parents can produce offspring with a debilitating or deadly disease.� It does not talk about EPI specifically, however. �

http://www.gsdhelpline.com/boweldis.htm&#65533;&#65533;� This article discusses EPI in general terms and recommends an easily digestible, moderately fat restricted diet.� No references are given for the dietary recommendation.� It also talks about SIBO and other common Pancreatic and Intestinal diseases in the GSD.

(Thanks to Penny, fn117@aol.com for these references.)

Research article: Am J Vet Res. 2002 Oct;63(10):1429-34.

Inheritance of pancreatic acinar atrophy in German Shepherd Dogs.
Moeller EM, Steiner JM, Clark LA, Murphy KE, Famula TR, Williams DA, Stankovics ME, Vose AS.

Division of Small Animal Surgery and Orthopedics, Faculty of Veterinary Medicine, University of Bern, Switzerland.

OBJECTIVE: To assess the heritability of pancreatic acinar atrophy (PAA) in German Shepherd Dogs (GSDs) in the United States. ANIMALS: 135 GSDs belonging to 2 multigenerational pedigrees. PROCEDURE: Two multigenerational pedigrees of GSDs with family members with PAA were identified. The clinical history of each GSD enrolled in the study was recorded, and serum samples for canine trypsin-like immunoreactivity (cTLI) analysis were collected from 102 dogs. Dogs with a serum cTLI concentration < or = 2.0 microg/L were considered to have exocrine pancreatic insufficiency (EPI) and were assumed to have PAA. RESULTS: Pedigree I consisted of 59 dogs and pedigree II of 76 dogs. Serum cTLI concentrations were measured in 48 dogs from pedigree I and 54 dogs from pedigree II. A total of 19 dogs (14.1%) were determined to have EPI, 9 in pedigree I (15.3%) and 10 in pedigree II (13.6%). Of the 19 dogs with EPI, 8 were male and 11 were female. CONCLUSIONS AND CLINICAL RELEVANCE: Evaluation of data by complex segregation analysis is strongly suggestive of an autosomal recessive mode of inheritance for EPI in GSDs in the United States.

PMID: 12371772 [PubMed - indexed for MEDLINE]



If you have additions for this document, please contact Nancy Roberts at nancyr @ cc.usu.edu.

What is EPI?
Info from UPEI (University of Prince Edward Island)

Info from Vetcentric

Info from Regalwise

Info from Provet

Info from the White Shepherd Genetics page, ignore the part on testing with corn oil.


The Canine Gastrointestinal Tract: Exocrine Pancreas This article has diet information in it (towards the end) and discusses the need for a low fat diet and the role of fiber. This is from Waltham (a feed manufacturer) and discusses both pancreatitis and EPI.

How the Pancreas SHOULD work
Exocrine Secretions of the Pancreas
SIBO, Small intestine bacterial overgrowth:
Info from Provet

WSAVA Conference proceedings

Info from UPEI

Info from Purina research

Article on Clostridium Perfringens Enterotoxin another cause of GI upset in dogs.
Info on TLI testing:
Info from Texas A&M

info from DPC

Info from Antech Labs covers TLI, Cobalamin, Folate. NOTE THAT THIS ARTICLE INCORRECTLY STATES THAT ENZYMES NEED TO BE WITHDRAWN BEFORE TESTING!
Info on Cobalamin/Folate testing:
Info from Texas A&M


Vitamin B-12 (cobalamin) supplementation:
Info from Texas A&M

Vitamin B-12 minimum daily requirements chart: (found in files section of epi list).
Study on EPI from Helsinki, Finland:
Dissertation results


Digestive disorders in dogs:
Info from siriusdog

http://www.upei.ca/~cidd/Diseases/GI%20 ... ciency.htm

http://www.vetcentric.com/reference/enc ... &MODE=full

http://www.provet.co.uk/health/diseases/git-epi.htm

http://www.wsgenetics.org/articles/epi.html

http://www.walthamusa.com/articles/cgiexopanc.pdf

http://arbl.cvmbs.colostate.edu/hbooks/ ... crine.html

SIBO info

http://www.provet.co.uk/health/diseases/git-bo.htm

http://www.vin.com/proceedings/Proceedi ... tegory=414

http://www.upei.ca/~cidd/Diseases/GI%20 ... growth.htm

http://www.purina.com/images/articles/p ... growth.pdf

http://www.cah.com/dr_library/clost.html

info on TLI testing
http://www.cvm.tamu.edu/gilab/TLI.shtml

http://www.dpcweb.com/documents/news&vi ... ypsin.html

http://www.antechdiagnostics.com/client ... 9/5-99.htm

http://siriusdog.com/digestive-tract-disorders.htm

What is small intestinal bacterial overgrowth?
In this condition, there is a dramatic increase in the number of bacteria in the small intestine, and this interferes with normal absorption of nutrients. The result is chronic intermittent diarrhea, and weight loss or failure to gain weight.
In the German shepherd, this condition is thought to be related to a deficiency of immunoglobulin A (IgA) , the primary immune defense in the small intestine.
Small intestinal bacterial overgrowth (SIBO) may develop in association with exocrine pancreatic insufficiency. It may also be seen with inflammatory bowel disease, although it can't always be determined which came first.
How is small intestinal bacterial overgrowthinherited?
unknown
What breeds are affected by small intestinal bacterial overgrowth?
German shepherd; the condition is seen in other breeds as well.
For many breeds and many disorders, the studies to determine the mode of inheritance or the frequency in the breed have not been carried out, or are inconclusive. We have listed breeds for which there is a consensus among those investigating in this field and among veterinary practitioners, that the condition is significant in this breed.
What does small intestinal bacterial overgrowthmean to your dog & you?
The condition is usually seen in young dogs, who develop chronic intermittent diarrhea which gradually gets worse, and lose weight or fail to gain weight normally. Some dogs may only show weight loss and in others there may be vomiting.
How is small intestinal bacterial overgrowthdiagnosed?
There is no straightforward test to diagnose SIBO. Because the condition may develop as a complication of many intestinal diseases, it is important to search for any possible underlying cause. Your veterinarian will do tests for parasites, bacterial infections, partial obstruction, and other causes of diarrhea such as exocrine pancreatic insufficiency. Besides these baseline blood and fecal tests, there are several other tests that can be done to support the diagnosis of SIBO.
For the veterinarian: Bacterial overgrowth in the proximal small bowel is increasingly recognized as an important cause of chronic intermittent small bowel diarrhea +/- weight loss in many breeds. There is overgrowth of anaerobic bacteria, which have a greater potential for damaging the intestinal mucosa and causing malabsorption. Anaerobes are also the major cause of bile salt deconjugation, the results of which are fat malabsorption and steatorrhea.
There is no straightforward test to diagnose SIBO. Increased serum folate or reduced cobalamin provide indirect support for the diagnosis, once pancreatic insufficiency has been ruled out. Other helpful tests include absorption and permeability tests and hydrogen breath testing (available in some specialty centres). The diagnosis can be confirmed by microbiologic culture of duodenal juices (obtained endoscopically or by laparotomy) although this is expensive and technically complicated, and may miss some cases of SIBO.

How is small intestinal bacterial overgrowthtreated?
Antibiotics are used at the same time as any underlying cause is treated. Often, no underlying cause can be found and it becomes a question of long term management. The disorder can usually be controlled with long courses of antibiotics, repeated occasionally if there is a relapse, and dietary management using a therapeutic diet low in carbohydrates and fats.
For the veterinarian: Four weeks of treatment with oxytetracyline is usually successful. Some dogs with SIBO relapse soon after antibiotics are discontinued. This may mean there is an unidentified underlying cause, or there has been permanent functional mucosal damage. Antibiotics, gradually reduced to the lowest dose that will control the diarrhea, may need to be continued for extended periods.

Breeding advice
Affected dogs should not be bred, and until more is known about inheritance of this disorder, it is prudent to avoid breeding their parents and siblings as well.
FOR MORE INFORMATION ABOUT THIS DISORDER, PLEASE SEE YOUR VETERINARIAN.
Resources
Rutgers, H.C. 1998. Diagnosis and long-term management of bacterial overgrowth in the dog. ACVIM-Proceedings of the 16th Annual Vet. Med. Forum. pp. 482-484.
Burrows, C.F., Batt, R.M., Sherding, R.G. 1995. Diseases of the small intestine. In E.J. Ettinger and E.C. Feldman (eds.) Textbook of Veterinary Internal Medicine, pp. 1169-1232. W.B. Saunders Co., Toronto.

Copyright © 1998 Canine Inherited Disorders Database. All rights reserved.
Revised: April 27, 2001.
This database is a joint initiative of the Sir James Dunn Animal Welfare Centre at the Atlantic Veterinary College, University of Prince Edward Island, and the Canadian Veterinary Medical Association.

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Loca
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Postby Loca » Wed May 28, 2008 12:38 pm

That is worrisome for sure! Alonza's has the exact same looking bloody diarrhea. They gave her metradozole too. I hope it helps. So far Alonza hasn't pooped since she's been on the antibiotic for 2 and a half days, but the vet said she won't poop for a while. When she does poop I'll be interested to see if there's still blood or not. Good luck with your dog, I hope you can find out what's wrong.

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Postby Misskiwi67 » Wed May 28, 2008 12:58 pm

What foods are you trying for the elimination diet? Did metronidazole help at all? Your best shot is to look for IBD first, if your vet has endoscopy I would recommend getting biopsies as well.

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You can add some metamucil Apple Wafers to her diet..

Postby Doggiehotel » Wed May 28, 2008 1:31 pm

The Metamucil wafer ( apple fiber wafers) - can be added to offer some bulk to her diet... You get 2 wafers in a packet. Give her at last 2 wafers per day, or more. It won't hurt and will help a bunch.


Yes, it sounds like this kid has been thru hell. She is so lucky that you adopted her . You are a wonderful person to do this for her!!!


I hope you find out what is going on. Yes, irritable bowel could end up being the diagnosis. You seem to be on the right track.

Good luck and hang in there!






Marie of The Doggie Chalet in Wasilla AK
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Postby Siberian » Wed May 28, 2008 1:34 pm

My neighbors white boxer had the same problem for months. Bloody and runny poops. Tests, special foods, none of that helped. Few months ago he went on The Honest Kitchen dehydrated raw food, and the problem disappeared.

msvette2u

Re: You can add some metamucil Apple Wafers to her diet..

Postby msvette2u » Wed May 28, 2008 2:14 pm

Doggiehotel wrote:The Metamucil wafer ( apple fiber wafers) - can be added to offer some bulk to her diet... You get 2 wafers in a packet. Give her at last 2 wafers per day, or more. It won't hurt and will help a bunch.


Yes, it sounds like this kid has been thru hell. She is so lucky that you adopted her . You are a wonderful person to do this for her!!!


I hope you find out what is going on. Yes, irritable bowel could end up being the diagnosis. You seem to be on the right track.

Good luck and hang in there!






Marie of The Doggie Chalet in Wasilla AK
NuVET Plus - the best Pit Bull vitamin in the USA

http://www.apluspetcare.com/untitled4.html


I give my Dachshund Benefiber wafers, to help "fill him up" as he's the worst food thief in history!!

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Postby Sirian » Wed May 28, 2008 3:27 pm

Have whip worms been considered?

Long story short I had something similar happen about a year ago. My dog developed bloody diarrhea and lost about 15 pounds in the matter of a couple weeks. The bloody stool lasted about 6 weeks straight. He was an emaciated skeleton and his skin and coat were awful, at his worst I really expected to find him dead in his crate every morning.

We saw 2 different vets and spent a lot of money trying to figure out what was wrong with him but no one knew for sure. His breeder was certain it was whip worms as she had a dog with very similar symptoms years ago that had whips and once treated she was as good as new.

The first vet totally blew off that idea and the second considered it and gave us some panacur and flagyl but felt it was IBD or allergies and wanted to run some very expensive tests. So we switched food and gave him the flagyl and panacur which helped to some degree. He would have flare ups every 3-4 weeks of bloody diarrhea and never got back to a normal healthy weight and his skin and coat were still bad.

His breeder kept telling us it has to be whip worms and after this went on for months she wanted to get to the bottom of it as much as we did. She took him to treat him the way her vet (who has a PhD in parasitology) treated whip worms. He started to improve quickly, no more bloody diarrhea, he gained weight and kept it on, his skin and coat are great and he is back to his old self. He still needs to finish out treatment but we will be getting him back in a couple of weeks. If the first vet had listened to us/Boys breeder, Boy would have been better almost a year ago and we could have saved hundreds of dollars.

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Postby pitgrrl » Wed May 28, 2008 5:36 pm

msvette2u wrote:Fiber helps IBD in humans. Have you tried that?


Added fiber, when coming from grains, can sometimes makes things way worse. I mention this only because it's kind of a common suggestion which helps some dogs, but the possibility of having the opposite effect is not always mentioned.

SugarFox03, if no cause is discovered and you have the ability, I would just try feeding raw. I'm certainly not pushing the idea that raw feeding is the miracle cure to everything, but it was the only thing that made a significant and sustained impact on Streets' chronic colitis or IBD or whatever one wants to call it. I really wish I hadn't wasted years, time and money looking for that "right" kibble that obviously just doesn't exist.

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Postby Chili Peppers » Wed May 28, 2008 6:37 pm

Sirian wrote:Have whip worms been considered?

Long story short I had something similar happen about a year ago. My dog developed bloody diarrhea and lost about 15 pounds in the matter of a couple weeks. The bloody stool lasted about 6 weeks straight. He was an emaciated skeleton and his skin and coat were awful, at his worst I really expected to find him dead in his crate every morning.

We saw 2 different vets and spent a lot of money trying to figure out what was wrong with him but no one knew for sure. His breeder was certain it was whip worms as she had a dog with very similar symptoms years ago that had whips and once treated she was as good as new.

The first vet totally blew off that idea and the second considered it and gave us some panacur and flagyl but felt it was IBD or allergies and wanted to run some very expensive tests. So we switched food and gave him the flagyl and panacur which helped to some degree. He would have flare ups every 3-4 weeks of bloody diarrhea and never got back to a normal healthy weight and his skin and coat were still bad.

His breeder kept telling us it has to be whip worms and after this went on for months she wanted to get to the bottom of it as much as we did. She took him to treat him the way her vet (who has a PhD in parasitology) treated whip worms. He started to improve quickly, no more bloody diarrhea, he gained weight and kept it on, his skin and coat are great and he is back to his old self. He still needs to finish out treatment but we will be getting him back in a couple of weeks. If the first vet had listened to us/Boys breeder, Boy would have been better almost a year ago and we could have saved hundreds of dollars.


Agreed. Whipworms are not covered by regular dewormers. I would treat for that first, if it hasn't been done.

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Postby Melody » Wed May 28, 2008 8:11 pm

WOW...thanks for all the info everyone.

I started her today on Dick Van Patton's Natural Balance, Vegetarian Diet, a half can of pumpkin and plain yogurt. I am about to order some Slippery Elm Bark powder as I heard this works wonders on diarrhea dogs.

Question: She's had multiple fecals - all came back negative. Would the whip worms be seen in the fecal? They did both in house and sent it away to a lab - both with the same result.

I forgot to mention earlier that we also did a round of Panacur - 3 days of white powder in her food. I think this would have gotten rid of the whipworms? She's had so much stuff, I can't keep track. It's been over a week since we've finished the Panacur with absolutely no change. Her stools have not changed one bit since I brought her home (will be 3 weeks on Friday.) The metronidazole did not help at all (misskiwi)

I will ask the vet about the endoscopy/biopsy - as I read thats the only way to diagnose IBD.

I want to give this pumpkin/veggie diet a try, and if not change in a few weeks I will see if I can do raw. I just know it's extremely expensive. I have no place around here that sells it cheap (whether it be premade or store bought people food) as I tried it with my own dogs awhile back. This girl is a rescue, and will be up for adoption as soon as this is all figured about and she's 100% healthy. I am not sure if I would be able to find an owner willing to feed raw. I have someone who's very interested in her, but has a young child in the home, and I am not sure she would feel comfortable with that.

Do you think it would be too much at once to try the fiber wafers too, on her new diet? Should I continue to put in boiled rice?

Thanks again for the info. I really appreciate it! This has been so nerve wracking!!

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Postby Misskiwi67 » Wed May 28, 2008 8:27 pm

If the vegetarian diet does not work, try a novel protein diet, like the Natural balance duck and potato. Treat the dog like he's got food allergies, read a food allergies thread if you don't know what this means (chosen food and NOTHING else, not even flavored meds like heartguard).

Adding fiber helps for some, but low fiber low residue diets work for others, Eukanuba low residue prescription has been a miracle cure for some.

It may be a long road of trial and error, but most mild cases of IBD can be controlled by diet (at least in my experience) while others will need to have prednisone +/- metronidazole to control the symptoms.

If the dog begins to lose condition or becomes lethargic, its time to find a vet with an endoscope or take him to a referral clinic or teaching hospital for in-depth diagnostics. I don't want to scare you, but nasties like GI lymphoma can also cause these symptoms.

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Postby pitgrrl » Wed May 28, 2008 8:31 pm

Assuming it's not whipworms or anything else like that, I would tend to try and keep things as simple as possible. Don't throw too many things at her at once as that alone, regardless of whether each individual thing is problematic or not, can cause problems.

Slippery elm rocks. Marshmallow root can also be helpful.


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