# Poop Overload - Sibo vs EPI?



## marylou (Apr 21, 2006)

I am having a brain melt-down. Can someone please explain the difference between SIBO and EPI?

Chaos was at the vet again this morning; he's had ongoing runny/soft poops. We've treated for giardia, changed foods, tried pumpkin and yogurt (worse). He gets the runs from peanut butter and cheese, and if DH gives him a bite of his bacon, forget it.

The vet is running a CBC panel on him, and if it shows low protien counts, will send it off to Texas for an EPI test. I was trying to remember what I had heard about digestive enzimes here, but could not remember what the symptoms of dogs who needed them were. Our vet says he looks and sounds healthy, lean but not skinny; his coat is shinny, he has good energy. His only problem is soft/runny poops! 

Ideas? Think I need the dancing poop banana.....


----------



## BowWowMeow (May 7, 2007)

Based on the peanut butter, cheese, bacon connection I'd say he has trouble metabolizing fat. What is he currently eating? 

Jen has possession of the dancing poop banana but I did steal it recently so I'll see if I can find it.

Btw, Rafi has the same problem. I feed him reduced fat food and he absolutely cannot handle much kibble so I make him homemade food.


----------



## marylou (Apr 21, 2006)

He is eating Nutro Lamb and Rice; I've tried the Chicken/Rice and they have a sensitive stomach Chicken/Oatmeal that I've also tried. None has made a difference.

I'm not sold on Nutro; but DH balks at spending more than 40.00 on a bag of food. We don't have alot of choice (am in a small Montana town, and like to buy locally at the feed store) but can go to the Petsmart 50 miles away.


----------



## WiscTiger (Sep 25, 2002)

marylou, sounds like fat content is a major problem. It may or May not be EPI or it might be Pancreatitis. Lakota has that and can not have fats or he gets the runny poops and has a Pancretitis flare up. 

For the EPI test are you suppose to fast before the test? I can't remember.

Val


----------



## BowWowMeow (May 7, 2007)

Hmmm, that's not very high fat. I'm not a big Nutro fan though and I know there are lots of folks on here who have had trouble with it in the past. What other foods have you tried?

Do you have him on digestive enzymes or probiotics? That might help. 

You could also try feeding raw--I think you could do that for the same amount of money. Rafi's homemade food costs about $40/month but I do use the Primal raw grinds as the meat source.


----------



## marylou (Apr 21, 2006)

Val, yes he had to fast for 12 hours before hand.

He does not take any digestive enzymes or probiotics; that was the main reason for the blood taken today (the vet took enough to do the CBC's and to send off if needed). We were actually talking about a patient of his that ground up pig pancreas for about 6 months - then decided it was easier to just give the enzime.

Can you tell me the difference between a "digestive" enzime and a "pancreatic" enzime? Do they do the same thing? If Chaos is having problems with fat content, will a digestive one help?

I would like to stay with a Kibble; do you know of one off hand that would be better but comparable in price to Nutro that is realative low in fat content?


----------



## BlackGSD (Jan 4, 2005)

Keeping in mind that I know NOTHING about either EPI or SIBO. The Nutro products are 12% fat (min.). (And someone mentioned he may not be able to handle much fat.)

Natural Balance Sweet Potato and Fish, Potato and Duck, and Sweet Potato and Venison are 10%(min) fat. Not that these are the only ones by any stretch, but they might be something that is available at the feed store OR they could probably order it for you. (At least they will here.) 

They are most likely a bit over $40 a bag, but it would be cheaper to spend more than $40 a bag and get it locally, than having to drive 50 miles (I assume 1 WAY) to Petco to get something cheaper. Unless you have a secret store of FREE fuel!










Again, I don't know if one of these foods might be an option with his "issue" or not.


----------



## BowWowMeow (May 7, 2007)

Very good suggestion on the Natural Balance fish food! Fish is a novel protein too and sweet potatoes are very healing for the gut. I would try that first.


----------



## roxy84 (Jun 23, 2007)

if the vet comes up empty, maybe you could persuade DH that spending a bit more on a different food may well pay for itself if it eliminates continued trips to the vet trying to solve a loose stool problem.


----------



## TNGSD (Feb 15, 2008)

We had the same problem with Radar off and on and the vet never did find anthing wrong.... we eventually did the EPI test and he came back normal. I know this goes against everything I read and what everyone else says but as long as I keep him on Science Diet and don't over feed him his poop is great! What can I say cheap corn fillers are easy for him to digest! I also use probiotics from our local feed store. I am hoping as he matures his system will toughen-up since medically everything is ok. Since I know Science Diet is not the best I am interested in going part raw. I would love to get more info on BowWowMeow's homemade diet! Is there already a thread about it? 

Good Luck! My biggest problem was being patient and not changing more than one thing at a time- like food, treats and suppliments so if he improved I would know what food ingredients helped.


----------



## Hilary (Apr 12, 2005)

SIBO is small intestinal bacterial overgrowth - an inbalance of good vs bad bacteria in the small intestines. Symptoms include diarrhea. Usually cleared up by giving metronidazole. You can give the dog a probiotic to help keep the appropriate balance. EPI is exocrine pancreatic insufficiency. In this case the dog's pancreas does not make the enzyme needed to digest the food. The TLI is the only way to test for it. If your dog has EPI (and mine does), s/he has to have enzymes (either the powder or raw panncreas) added to food. Without the enzyme, they get no benefit from the food (and they eat like pigs) - it just goes in and out of their system - hence cow patty type poops. They also need a low fat diet. EPI dogs are prone to SIBO. I have had good luck with Eukanuba's large breed weight control chow. When I've tried to change it - she's had problems. Hope this helps. Good luck.


----------



## marylou (Apr 21, 2006)

Thank you for the explanation Hillary! That really helps me understand these better.

I'll ask at the feed store about the Natural Balance Fish. The vet was talking about Science Diet sensitive something (I heard "Science Diet" and tuned out the rest of the sentence







)


----------



## BowWowMeow (May 7, 2007)

> Originally Posted By: TNGSD I would love to get more info on BowWowMeow's homemade diet! Is there already a thread about it?


The basics of it are here http://www.germanshepherds.com/forum/ubb...true#Post806448


----------



## JenM66 (Jul 28, 2005)

Gracie has SIBO and cannot handle more than 9% fat in her food. 

Here are some articles for you:

http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2002&PID=2580&Category=414

http://www.upei.ca/cidd/Diseases/GI%20disorders/small%20intestinal%20bacterial%20overgrowth.htm

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


----------



## marksteven (Aug 2, 2008)

Hmm, not to steal anyones thread but maybe my dog with borderline #s for EPI doesnt have EPI but SIBO. is there a test i can request for SIBO? the pancreatin worked great for two weeks, solid stools but no weight gain at all. feeding him canidae chicken and rice 1 1/2 cups twice with a tabelspoon of pancreatin6X. shpuld i try a fish based low protein recipe?


----------



## Cassidy's Mom (Mar 30, 2003)

> Originally Posted By: markstevenHmm, not to steal anyones thread but maybe my dog with borderline #s for EPI doesnt have EPI but SIBO. is there a test i can request for SIBO?


Yes, ask for a cobalamin(B-12)/folate test. The treatment is at least 4 weeks of antibiotics, usually either Tylan or Tetracycline, and sometimes weekly B-12 shots. Some vets will prescribe Metronidazole instead, but there are some neurological concerns about long-term use, so while I've given it for a week or 10 days to treat giardia, I wouldn't use it for SIBO. 

Look at Jen's first two links, they will tell you all about it. It seems that SIBO can either be chronic, requiring long term food changes and possibly meds too, or it can be a one-time occurrence. Keefer had giardia, and also tested positive for SIBO, but once he finished treatment, over two years ago, he can now eat anything and doesn't need meds or digestive enzymes or anything else. I'm guessing that his was caused by the giardia.


----------



## TNGSD (Feb 15, 2008)

> Originally Posted By: BowWowMeow
> 
> 
> > Originally Posted By: TNGSD I would love to get more info on BowWowMeow's homemade diet! Is there already a thread about it?
> ...




Thanks! A store near me just started selling Primal frozen foods. (Nashville Pet Products) If you don't mind my asking, how did you come up with your recipie? I'm looking for sources to read. It's all so confusing!


----------



## DancingCavy (Feb 19, 2001)

The TLI will test for EPI and the B12/Cobalamin will test for SIBO. I think most vets test for both at the same time with the GI panel that goes to Texas A & M. Risa has had this blood test twice and has been diagnosed with SIBO each time. (Ris' SIBO doesn't seem to be chronic--more like seasonal.)

I know too much peanut butter and dairy will send Ris into yucky poops so I avoid giving it to her. She's raw-fed and I gave her some duck a week ago (even skinned most of it and removed all visible fat) and it went right through her.







Yuck.


----------



## LisaT (Feb 7, 2005)

marksteven -- there is one thought that EPI values decrease over time in some of these dogs, so I would still treat your dog for EPI, you just might not need as much enzymes as other dogs.

***every*** dog with EPI should be tested for SIBO, or at least treated for it if not tested. Personally, I would just treat -- if the dog gets better, then you know it was a problem. I am not completely sold on the tests, primarily because there are so many borderline results, and many vets dismiss those, which I think is a mistake.

marlou -- I have never heard of a low protein count being associated with EPI. Anyone else???? I don't follow that logic. Young GSDs *I think* can seem awfully lean -- ours was -- he tested negative for both EPI and SIBO, but he responds to SIBO treatment.

Digestive enzymes versus pancreatic enzymes -- in addition to the description above, some use these terms to distinguish the types of enzymes that are given. There are enzymes from plants, and those that are derived from the pancreas from an animal, usually pork (porcine). Neither of my dogs are EPI dogs, but they both require enzymes. I give Indy both kinds at each meal, and Max has to have a plant based one because he is allergic to pork and all the others seem to be pork-based. Tula has a similar situation with her dog. I think that they do different things. Because the problem in EPI is directly with the pancreas, the pancreatic enzymes are typically used. I'm a big believer in trying different products until you find the one(s) that work for your dog.


----------



## marylou (Apr 21, 2006)

> Originally Posted By: LisaTmarksteven -- there is one thought that EPI values decrease over time in some of these dogs, so I would still treat your dog for EPI, you just might not need as much enzymes as other dogs.
> 
> ***every*** dog with EPI should be tested for SIBO, or at least treated for it if not tested. Personally, I would just treat -- if the dog gets better, then you know it was a problem. I am not completely sold on the tests, primarily because there are so many borderline results, and many vets dismiss those, which I think is a mistake.
> 
> ...


Lisa, what is the other enzime you give? The vet called yesterday, and said Chaos' blood looks "normal" but he sent some off to Texas for his EPI test anyway. We discussed the possibility of treating for SIBO before, then redrawing blood but I told him to send it off first and we will go from there. Should I have him on an antibiotic now, before his test comes back? I'm hoping he is like your guy; just really lean (just turned 1) and will fill out as he gets older.


----------



## marylou (Apr 21, 2006)

> Originally Posted By: Cassidys Mom...Yes, ask for a cobalamin(B-12)/folate test. The treatment is at least 4 weeks of antibiotics, usually either Tylan or Tetracycline, and sometimes weekly B-12 shots. Some vets will prescribe Metronidazole instead, but there are some neurological concerns about long-term use...


My vet mentioned Amoxicillan or the Metronidazole - have you heard of amoxicillan being used for SIBO?


----------



## Cassidy's Mom (Mar 30, 2003)

Marylou, _I_ haven't, but that doesn't mean it's not a valid treatment. Maybe google amoxi and SIBO and see if you can find anything? I would definitely resist using metro for that long. 

The first link that Jen posted is the one I printed out and took with me to the vet's office. We went with tetracycline because he carries it in stock and would have had to order tylan. I don't know that either is any better than the other, I'd be comfortable with both.

Edited to add: Be sure that you get at least 4 weeks of antibiotics. Some vets who are not familiar with SIBO may prescribe them for shorter periods, which is standard for practically everything else, but not sufficient for SIBO. Insist if necessary.


----------



## DancingCavy (Feb 19, 2001)

Some dogs will test negative for SIBO but actually have it and some dogs who test positive really don't have it. It's a tricky condition. None of the tests for it are 100% accurate.


----------



## LisaT (Feb 7, 2005)

> Originally Posted By: marylou.....My vet mentioned Amoxicillan or the Metronidazole - have you heard of amoxicillan being used for SIBO?


The amoxi isn't the standard treatment. However, it helps with my mixed breed's digestive problems -- firms her stool right up. But I typically have to follow that up with something like panacur. The typical treatment is the metronidazole, or sometimes tetracycline/doxycycline.


----------



## LisaT (Feb 7, 2005)

> Originally Posted By: marylouLisa, what is the other enzime you give? The vet called yesterday, and said Chaos' blood looks "normal" but he sent some off to Texas for his EPI test anyway. We discussed the possibility of treating for SIBO before, then redrawing blood but I told him to send it off first and we will go from there. Should I have him on an antibiotic now, before his test comes back? I'm hoping he is like your guy; just really lean (just turned 1) and will fill out as he gets older.


Did you fast you dog before the blood test? I think for the EPI test, it's a 12 hour fast? You might be able to get away with a shorter time....

I would start on the SIBO treatment right now. If he responds, that's an answer. He may still come back with EPI, but it's better if you can start the treatments at different times anyone, just to get an idea of what is causing what, if that makes sense.

These are the pancreatic enzymes I have used for Indy for years:
http://www.vitacost.com/Jarrow-Formulas-Zymes-Plus

These are the plant based enzymes that I use for both dogs:
http://www.ritecare.com/prodsheets/asp/ITI-74230.asp

Max the GSD gets one similase at each meal.


----------



## marylou (Apr 21, 2006)

Thank you for the links, Lisa ~

Yes, Chaos fasted for 12 hours (he thought I was starving him that morning







) And, I have a call in to my vet about starting treatment now for SIBO.

Thank you all for some great information!


----------



## LisaT (Feb 7, 2005)

Good luck, keep us posted!


----------



## marylou (Apr 21, 2006)

Well, good news: Chaos came back negative on EPI. So....I guess now it is digestive enzimes and no/low fat stuff?

My vet said again "I talked to you about Science Diet sensitive stomach, right?" and I just "yep and no, I would rather not use it..." He also gave him amoxicillan for a week.

Do you think he might outgrow this? Maybe his digestive system will mature enough to be able to handle fats? He started on the enzimes yesterday so don't know the results of those yet.


----------



## DancingCavy (Feb 19, 2001)

It's possible he could outgrow it. Some dogs just get it once (like Keefer) whereas some have a chronic condition (Gracie). Risa gets it seasonally (every late winter/early spring). SIBO can be an autoimmune thing so some dogs never get over it.


----------



## JenM66 (Jul 28, 2005)

> Originally Posted By: LisaTI have never heard of a low protein count being associated with EPI. Anyone else????


My "TYPE A" personality is searching the forum for info on EPI....just in case. Lisa, the vet today is checking her protein count, thinking that if she is losing protein, that there is a problem with the pancreas. If it comes back low, she will do some more investigating - not hanging her hat on that one test alone. I'll let you know what she says tomorrow.


----------



## LisaT (Feb 7, 2005)

Jen, where did you find this old post?? Did I just enter the twilight zone?


----------

