# 4 year old male too skinny ? Help



## FaithW (Jan 26, 2014)

Hi all , 

I'm having issues with my dogs weight gain. After several brand switches ( the breeder gave him Alpo Dry food which we don't have in NYC) I finally got him on Core Wellness that doesn't give him diarrhea when he gets near the bottom of the bag . The vet noticed he wasn't putting on much weight and suggested pumpkin to be included in his food but it made his stool a little more softer . 
When I took him to the vet recently the new vet said to stop . I also mentioned that if I gave him the amount on the bag it would come out like mush . 
So now he's dropped about 22 pounds in a year. He is not lethargic and never turns down food . He's really hyper . You can see his ribs and easily feel them . They did 4 blood test and have no idea what's wrong with him . He also was negative for parasites/worms . 

I'm following the directions from when he was boarding ( 2 -2 1/2 cups 2x a day ) & I added some wet food too and changed from the Orginal recipe to the one with fish . Any suggestions ??? He also is not neutered yet . Just hyper with a good appetite. He also went from 90 pounds to 68.5 


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## Mary Beth (Apr 17, 2010)

That is a big weight loss. Has your vet tested him for EPI?


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## Harry and Lola (Oct 26, 2013)

Demand your vet test him for EPI, if the vet tests him and comes back negative - get another opinion.

If he is eating lots and losing weight his pancreas may not be working and he can not digest his food - that is EPI, they eat and basically starve to death all at the same time if not treated.

If it is EPI, it is easy to manage and treat by giving replacement enzymes before each meal. I use Creon capusles. These act as a replacement pancreas and help his body digest the food. You will notice an increase in weight by the end of a week and within a couple of months, he will be at an appropriate and good weight.

Also look at SIBO as these EPI and SIBO usually go hand in hand, again easy to treat with a course of Tylan.

It is very important you test and either confirm or eliminate EPI.

EPI in Snapshots - EPI * Exocrine Pancreatic Insufficiency


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## FaithW (Jan 26, 2014)

Thank you all for the responses . From what I understand all the test came back negative . I'm actually removing him from that vet because they ran a while bunch of tests on him without my consent and knowledge . 

I'm actually not sure how much he weighed last year ; I realized they never updated the paper they gave me . I'm going to speak with the vet tomorrow and see what else they didn't find . 

Any other suggestions ?? 


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## Mary Beth (Apr 17, 2010)

If it isn't EPI and you may want to have the new vet retest for that, then I would suspect a food allergy either to a grain, or to chicken, or even to salmon because of the diarrhea. I would try a grain free, no chicken, and gluten free food unless the one he was on is like that. Solid Gold is one dog food company that makes them. I guess i would feed that, and also give a pre-biotic for digestion.


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## FaithW (Jan 26, 2014)

He's been tested for EPI & they did a full blood work up on him . I am not too sure what's going on. They just said the test came back negative . I ask going to take him to another vet for personal reasons as well 


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## Harry and Lola (Oct 26, 2013)

Absolutely take him to another vet and ask for the test to be done again, sometimes they do get it wrong and is better to get a second opinion.

My previous vet failed to diagnose Lola's thyroid problem, fortunately I found a vet experienced with the breed and have now ditched my local vet and travel almost an hour to new vet - worth it though.


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## FaithW (Jan 26, 2014)

Update : 
The vet thinks he might have an chronic intestine issue? But we have to do more blood work maybe even a biopsy . But he also gave me some suggestions on how to manipulate his diet as well. 
I'm stilly going to go to another vet . All his blood text came back negative . He's healthy otherwise .




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## Mary Beth (Apr 17, 2010)

I agree with you I would go to another vet. Hopefully the diet changes will make him feel better in the meantime.


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## Harry and Lola (Oct 26, 2013)

I wonder if you should give him replacement enzymes anyway?

Anyone agree with this?

If you give him enzymes (Creon, EnzymeDiane just to name a few) and he does have EPI, then you will notice weight gain by the end of first week. ENZYME - EPI * Exocrine Pancreatic Insufficiency

Otherwise to to EPI for dogs website Overview - EPI * Exocrine Pancreatic Insufficiency register and post your symptoms on their forum as their are some very experienced people there that may be able to better advise you.


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## FaithW (Jan 26, 2014)

Thank you for the EPI website I have been pouring over the information . I'm thankful my dog isn't as bad as some of the dogs. I'm just petrified of what could happen. 
It's my first dog and I thought he was just growing into his body . He had a few pretty bad bouts of diarrhea and vomiting . I should have know something was up when he ate pretty much all the newspaper in his crate . 
I'm hoping I can beef him up while I'm saving up for the specialist visit . 

Thanks again. 


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## FaithW (Jan 26, 2014)

these are pictures of my boy. I am so nervous now.


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## Mary Beth (Apr 17, 2010)

:wub: lovely black coat! I agree with Harry & Lola, I would give him the replacement enzymes anyway . It can't hurt to try them.


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## _Zero_ (Sep 1, 2013)

Hi there,

I'm really sorry to hear your boy is going through this. Your situation sounds very similar to my own with my 2.5 yo GSD x border collie. I posted about it in another thread. Basically we experienced similar issues-- lots of weight loss, frequent bouts of diarrhea, and regardless of what I fed him he wouldn't put on weight. After six months, thousands of dollars in vet bills, and trying several different foods and medications (two different kinds of steroids and two different kinds of antibiotics) we finally hit on a combination that works-- a limited ingredient, canned diet (chicken and rice--- although I cooked chicken and potato for him for a long time) and chlorambucil, a chemotherapy drug that also works as an immunosuppressent. The vet calls it idiopathic immune-mediated lymphoplasmocydic enteritis, which is more or less a fancy name for inflammatory bowel disease (IBD).

Initially I thought my dog likely had EPI as well. I know you said his bloodwork came back normal, but I'm just checking to make sure-- the blood test for EPI is different from a regular blood chem pannel. It is a cTLI test, and it's good to also have cobalamin and folate tested at the same time. You MUST fast the dog for a least 12 hours prior to blood being drawn. Usually dogs diagnosed with EPI recover very quickly once enzymes are added to their food. Most dogs also have to take antibiotics for a time because of small intestinal bacterial overgrowth (SIBO).

That being said, if you did have the TLI test run after fasting and the values are normal, there is a strong possibility that something else is going on in the gut. Unfortunately digestive issues are tricky and there are often no clear answers as to what's going wrong or why. If your vet rules out EPI and other common causes of GI inflammation (worms and parasites, tick-borne illnesses, common bacterial infections) then you'll likely have to go down an expensive road of tests to pinpoint the problem exactly. This will probably include an ultrasound and possibly endoscopy with intestinal biopsies.

A lot of vets will work to treat symptoms first instead of locating the underlying problem. This will save money, but will also take time. Some things that might be suggested to you are doing a feeding trial with a novel protein kibble or a hydrolyzed protein kibble, starting your dog on antibiotics such as metronidazole, Tylan, or doxycycline, and/or steroids like prednisone, prednisolone, or budesonide. Honestly I would hold off on starting steroids until you're sure you've exhausted other options or if you feel he's doing really poorly. Something like Tylan you can order online and begin giving now. It comes in a 100g powder and the dose is 1/4 tsp for a 75 pound dog twice daily. Tylan is relatively mild and very forgiving as an antibiotic, and often helps dogs with colitis issues. Tylan won't work as well for small bowel diarrhea or stomach inflammation.

For starters, I would make sure your vet ran the TLI/cobalamin/folate bloodwork after at least a 12 hour fast. In the interim, I agree with what others say here and suggest you try some enzymes right away. You can find 6x or 8x pancreatin at your local health food store, and the epi4dogs.com website should have the dosage info. You could see a turnaround within a week, but if it seems to make him worse, stop immediately! If EPI is not his issue he could react negatively to the enzymes. If you do/did do the EPI test and the results were negative, ask for a full fecal exam (for giardia, campylobacter, coccidia, etc.) and check for tick-borne disease. If all those come back negative you'll have to start looking into other options, like a feeding trial or antibiotics/steroids for inflammation.

There is a lot of information on the web about IBD, and a lot of it is conflicting. The important thing to remember about IBD is that it is not a disease in the common sense-- it is more a catch-all term for inflammation in the GI tract for which a cause cannot be identified. The tricky thing about IBD is that since it's not really a disease, per say, there is no standard protocol for treating it. Every dog will react differently, and finding something that works for your dog is trial and error. It can take months to find a combination of diet and meds that works, and the entire process can be extremely expensive and emotionally draining. Some folks have luck switching to raw food or novel-protein kibbles, some just adding fiber to the food, others with antibiotics alone, others with antibiotics and steroids, and still others with heavier-duty drugs, etc. If you search for info/help on IBD on the internet, EVERYONE will give you different suggestions, so it can be confusing as well.

PM me if you have any questions! I feel for you, and I really hope you can find out what's going on with your handsome guy. :hugs:


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## HOBY (Aug 12, 2013)

*Newspaper*

Are you still leaving newspaper in his crate? Did anyone suggest blockage? I would not leave anything in his crate for now until you know what's up.


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## FaithW (Jan 26, 2014)

Hello! 

Hoby: I haven't used newspaper in his crate since the day I realized he ate all of it ( I was in such disbelief ) . If I leave him out of his crate I usually leave plenty of Raw Hyde out so he can chew and not destroy my apartment . 

Zero , Marybeth , Harry & Lola 
I actually found some on Amazon as well & petaflora ( sp?) his old vet before doctor snippy pants got ahold of him had me use that and pumpkin so I might double back and do that 


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## GatorBytes (Jul 16, 2012)

STOP giving rawhide! This can cause intestinal problems, blockage, choking. Some are treated with formaldehyde.

As for enzymes - EPI or not, your dog could benefit from it...if your dog has "leaky" gut syndrome, then this will help hydrolize the food for better assimilation...

However, looking at the cause of leaky gut - could be a food intolerance, look into Dr. Jean Dodd's Nutriscan (google it). It could be giardia or coccidia. If either or both, the most effective treatment would be "Kocci Free". A natural non-toxic, no side effect solution to these elusive parasites that test after test can miss, but vet will treat with pharmaceuticals anyhow leading to a damaged GI tract, intestinal bacterial overload due to good bacteria being killed off and on and on you are circling around again and again, vet visit after vet visit, new drug, increased dose, steroids...

Biopsy? Seriously...is this the new vet med protocol to make up for lost revenues due to the NEW vaccine protocol. Every single thread I have read on here where this is preformed only determined "inflammation" in the intestines - really? 

Add a probiotic when you do the enzymes


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## FaithW (Jan 26, 2014)

I will take him off Raw Hide lol as soon as I find something durable to help him with boredom. Its the only thing he can chew on besides bully sticks when I am grooming him that doesnt run right through him. Bully sticks also make his stool soft too. I am open to other suggestions that are long lasting and can help him with chewing.

I got the chart back not necessarily the labs I didn't understand a word of it . I ahve included the pictures. The one thing they DID not tell me was "hey he bulked up part to the fact we gave him Tylon with his food" and gave me a sample or something. Nope they just sent him home. So now I have an idea about what could possibly be a solution . It helped him pack on the pounds while he was there. Anyone who wants to take a fander to decipher the Vet Speak from Dr. Snippy Pants would be helpful.


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## GatorBytes (Jul 16, 2012)

FaithW said:


> I will take him off Raw Hide lol as soon as I find something durable to help him with boredom. Its the only thing he can chew on besides bully sticks when I am grooming him that doesnt run right through him. Bully sticks also make his stool soft too. I am open to other suggestions that are long lasting and can help him with chewing.
> 
> .


 A nice RAW knuckle bone...last and last and will help bulk the stool, clean teeth and exercise a slew of muscle groups. Good source of minerals too.

When fed indoors I use a small throw to keep the mess off the floor/carpet


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## FaithW (Jan 26, 2014)

I'll look into it . His stomach is so ... Sensitive but thanks going to look into that tonight 


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## _Zero_ (Sep 1, 2013)

FaithW said:


> I will take him off Raw Hide lol as soon as I find something durable to help him with boredom. Its the only thing he can chew on besides bully sticks when I am grooming him that doesnt run right through him. Bully sticks also make his stool soft too. I am open to other suggestions that are long lasting and can help him with chewing.
> 
> I got the chart back not necessarily the labs I didn't understand a word of it . I ahve included the pictures. The one thing they DID not tell me was "hey he bulked up part to the fact we gave him Tylon with his food" and gave me a sample or something. Nope they just sent him home. So now I have an idea about what could possibly be a solution . It helped him pack on the pounds while he was there. Anyone who wants to take a fander to decipher the Vet Speak from Dr. Snippy Pants would be helpful.


There's nothing of any real use here. Unless you can get the values from the blood work, including the value for cTLI, cobalamin, and folate, there is no way for any of us here to help you understand the tests that were done or what they mean.

From the images you posted, it seems the doctor recommended ways you could alter his diet to help with his weight. In addition, the chart says that you could also try Panacur (a de-wormer), Tylan (an antibiotic), or flagyl (another antibiotic) to see if that helps with his diarrhea and weight before doing anymore tests. The second image is just detailing his behavior at the vet. The third is some baseline values for his heart rate, respiratory rate, etc. The working diagnosis is severe weight loss and cachexia (muscle loss, fatigue, wasting). The r/o is an abbreviation for "rule out" which means that they're not sure why he's losing so much weight, but they need to consider a host of things, including severe primary GI disease, underfeeding, malabsorption issues (something like IBD), maldigestion issues (something like EPI), infectious disease, etc.

I would recommend that you demand to see the lab results from the blood work that was completed, and if the cTLI test for EPI was not done (following a 12 hour fast), have it done as quickly as possible. In the interim, do not try to switch his food anymore or add things to his diet. This could worsen his digestive issues if EPI is not the cause. Rawhides are very hard on the GI tract, so I wouldn't give him any more of those. I would also avoid raw knucklebones, or raw bones of any kind. Raw CAN be great for dogs, but with a dog losing a lot of weight with an as yet unknown cause, giving a dog raw could be the worst thing for him. The fat from the marrow in the bone would stress the GI tract, and although dog's guts are normally very well equipped to deal with bacteria, adding bacteria to an inflamed GI tract in an already sick dog is asking for a bacterial infection. Elk antlers are one possible option for chewing. Just make sure you watch the dog carefully, and get antler that is as fresh as possible to prevent cracking.

If they did give him Tylan at the vet and that did help put weight on, you can do the same. You do not need a prescription for Tylan. You can likely find it at your local feed store or order it online for Amazon. This is what you need:Amazon.com: Elanco DC120 Tylan Soluble Powder, 100-Grams: Patio, Lawn & Garden

The dose is 1/4 tsp twice daily for a dog Cupcake's size.

Please keep us update on how he's doing.


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## FaithW (Jan 26, 2014)

Thank you so much Zero . That stuff could have been written in ancient Sumerian . He did speak to me in a very short time about it and sighed whenever I asked what he meant . From the other sheets I don't think they ever fasted him . 
I will try and call the specialist again to see if I can see what things they did or did not test him on. 

I hate talking to the vet even the receptionist are kind of the rude side now . DR. Snippy pants has been known to misdiagnose too . I actually just ordered the Tylan . And will continue his diet the way they did ( the only positive thing out of the ordeal ) and continue with the pumpkin . 


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## _Zero_ (Sep 1, 2013)

FaithW said:


> Thank you so much Zero . That stuff could have been written in ancient Sumerian . He did speak to me in a very short time about it and sighed whenever I asked what he meant . From the other sheets I don't think they ever fasted him .
> I will try and call the specialist again to see if I can see what things they did or did not test him on.
> 
> I hate talking to the vet even the receptionist are kind of the rude side now . DR. Snippy pants has been known to misdiagnose too . I actually just ordered the Tylan . And will continue his diet the way they did ( the only positive thing out of the ordeal ) and continue with the pumpkin .
> ...


That sounds like a good course of action for now. It can be hard to talk to vet practices sometimes, but remember that Cupcake is your dog, and they are serving you. Just call and ask to confirm that a TLI test was done to test for pancreatitis, and ask what the TLI value was. Also ask if he was fasted before the test was completed. You can also go in and talk to the receptionist in person, which may be more effective. While you're there, you can ask for copies of all of the lab work they did.

I know you mentioned earlier you were going to seek counsel from another vet. I would do this as quickly as possible, but make sure they fax the records over from your current practice so the new vet knows exactly which tests they did. Look on Yelp or talk to your friends with dogs to find a practice that has good reviews. If you post your general location here on the forum, there might be other folks in your area who can recommend a good vet. From the chart copies you posted, it seems this guy is pretty sick and needs help as soon as possible. The sooner he sees a vet you feel you can work with and you guys get him on a protocol for getting better, the happier you'll both be.


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## Harry and Lola (Oct 26, 2013)

Try Nylabones for his chewing desires (get one that has a flavour).

Also, to alleviate boredom throughout the day, put some of his kibble into a treat ball or puzzle toy so he has to work to get the food, even in the crate, he should have enough room to move the ball or toy. This way his brain is being engaged and he will tire himself out from trying to work out how to get the kibble.

I used to do this with my pups when I left the house, put their food in a treat ball and it gave them something to do.


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## FaithW (Jan 26, 2014)

Slight good news ... His poop is getting firmer ! 


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## Harry and Lola (Oct 26, 2013)

Great news on the poops.

What are you doing differently?


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## FaithW (Jan 26, 2014)

Hello everyone !

Poops no longer pudding but still soft taking a lil more shape . I think his stomach was reacting negatively to 1. Me being gone 2. Switching abruptly from my food to their food 3. Stress/anxiety . 
Once he was back on his regular feeding I did the same diet they did ( I only found out they were using Tylan after reading the details ; yet the vet made no mention when he was speaking to me & neither did the receptionist ) with 4 cups total. I broke down the final 2 cups into 2 separate feedings with PuppyCal . And he seems to be responding well . He still scarfs down his food like it's going out of style . 
The vet won't give me a hard copy of the blood test results due to the conflict of him not making me aware he was doing ( I would NEVER allow my dog to be tested while I'm away I want to be able to ask questions and etc). I think if the actual new vet calls them they will read him the results . But my plan is to get him retested and find out what else I can do for him . Right now I just am keeping him on the same food ( just more of it ). He seems to be gaining a little bit more weight . I also ordered the B12 pills , Tylan and Sundays Sundaes... Along with feeding him pumpkin . I scheduled his new annual wellness ( they never gave him the bordatella shot . ) 

But I will look into the Nyla Bones. I need something long and durable . He had a Kong toy and he quickly got tired of it . Thanks so much ! 


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