Written by my buddy Jason Sigler, a dog trainer who experienced this first hand.
It’s Common But it’s not Normal.
Several years ago, I had a German Shepherd (GSD) that I adopted from a rescue. He was intelligent, strong, and a bit of a jerk, but he had all of the necessary drives I wanted in a demo dog as far as training was concerned. At the time I had never had a GSD, but had always wanted one. And now I did. He was two-years old when I adopted him and he seemed to be pretty slim. My immediate thought was that he’d be putting on weight soon as I use a lot of treats when training. Over the course of a few weeks I noticed that he had very soft, greasy looking bowel movements. I asked my mentor about it, and she told me that loose stool is completely normal in GSDs. Being a novice trainer and she being the resident subject matter expert on all things GSD I didn’t give it another thought.
So, three months later I was graduating from dog training school with Gibbs, my GSD. The adoption was finalized and he was now the newest addition to my family. Prior to traveling across country with him I decided to have my Veterinarian look at him for a full physical, just to make sure that he was physically healthy. The Doctor called me the following the day and informed me that Gibbs had Exocrine Pancreatic Insufficiency (EPI).
The doctor went on to tell me that the first tell-tail sign of EPI is loose, greasy stool. I told him that I was told loose stool like that of Gibbs’ was completely normal for GSDs. The doctor then laid some knowledge on me by saying, “loose stool like Gibbs’ is very common in GSDs but it’s not normal.”
So, what is EPI?
EPI is the inability of the acinar cells of the exocrine pancreas to produce and secrete enzymes necessary for the proper digestion of food. In other words, the pancreas stops producing the enzymes needed to absorb nutrients from the food they eat.
EPI is sometimes referred to as Pancreatic Hypoplasia or Pancreatic Acinar Atrophy (PAA). EPI can also be the secondary condition of a chronic illness, such as chronic pancreatitis. Without these enzymes, the digestive tract is unable to absorb nutrients from the food, which causes further health complications if not managed appropriately. Because the food is not being fully digested and nutrients aren’t getting absorbed despite eating copious amounts of food; the dog is constantly hungry, malnourished and can literally starve to death. Without proper treatment, dogs with EPI can die a painful death from malnourishment, starvation and in severe cases multiple organ failure.
Due to EPI; organ, immune, nervous and all other body systems become compromised to one degree or another. A lack of nutrients often results in temperament changes which may present themselves as one or more variations of aggression (in Gibbs’ case it was resource guarding and predatory aggression). It is an overwhelming, maddening disease that is misdiagnosed more often than not. What makes this disease so difficult to diagnose is that symptoms don’t usually show until 80% and 95% of the exocrine pancreas acinar cells are destroyed. And, not all dogs display any or all of the symptoms at all. Any breed can have EPI, but the most common are GSDs.
What does EPI look like?
EPI can manifest anytime in a dog’s life, from a young pup to an elderly dog, with the severity and symptoms of the disease varying from dog to dog.
Common symptoms include but not limited to:
Stools are very soft (loose) and appear greasy.
The amount of stool passed will appear to be the same as the amount of food consumed.
Increased rumbling sounds from the abdomen.
Increased amounts of flatulence.
Gradual wasting away despite a voracious appetite.
Some display a personality change.
So, if I suspect it, how do I test for it?
The only way to positively confirm EPI is with a TLI (Trypsin-Like Immunoreactivity) blood test.
Because GSDs and their crossbreeds make up the majority of diagnosed EPI cases, anytime a gastrointestinal upset persist with a GSD, it is strongly recommended that you have them tested for EPI.
What is the treatment for EPI?
Every dog is different and will require a different treatment protocols for effective management. Be prepared for a long stressful road to stabilization. Be aware too that this road will not only put a strain on your emotions, but will also place considerable tension on finances as well.
Most, but not all, dogs with EPI require a grain-free food with mild protein that is easier for the body to digest with what little digestive enzymes they have naturally.
A dog with EPI will require enzyme replacements in EVERY meal. I had the best results with Pancrezyme. However, it was very expensive. At the time depending on the Veterinary clinic you purchased it from it cost $110.00 - $130.00 per jar and one jar lasted about three weeks. It worked out to around $4,500 a year in just the replacement enzymes alone. Raw fresh beef, pork or lamb pancreas can be used as a natural enzyme replacement, but depending on your geographic location it can be near impossible to find a meat market that carries it.
Having a dog with EPI is an absolute nightmare. That doesn’t mean it’s impossible to live with. It can be managed. If the dog is positive for EPI don’t let anyone fool you into believing that simply feeding your dog probiotics will solve the problem because it won’t. Remember that the root problem with EPI is that your dog lacks the digestive enzymes necessary to properly absorb nutrients from the food they eat. Therefore, if you give the them probiotics they still won’t get any benefits from them if they cannot absorb them. They go in probiotics – they come out probiotics. The key to management is in the Enzyme replacement.
Sure, it’s very common for GSDs to have large, greasy, soft stools…. But it is not normal.
In the immortal lyrics of Andy Williams, “It’s the most wonderful time of the year.” Now, be that as it may, to continue the tithings if good cheer and prevent a possible trip to the veterinary emergency room we’ve got some precautions for you. These are especially important if you are considering a puppy as a gift for a loved one, or have recently adopted/rescued a dog and this will be the first holiday season you’ve had with the dog.
1. Keep the candy dish out of reach of your four-legged family members. Just incase you missed the memo, chocolate is toxic to dogs. Well, no… Not really. There’s a little more to it than that. Let’s get sciencey. Chocolate contains substances known as methylxanthines (specifically caffeine and theobromine), which dogs are far more sensitive to than people. Different types of chocolate contain varying amounts of methylxanthines. So technically, chocolate isn’t toxic to dogs, however, the theobromine in chocolate is. In general, though, the darker and more bitter the chocolate the greater the danger.
For example, Vincent (my 50 lb German Shepherd) could ingest 8 ounces (227g) of milk chocolate before getting sick, but can be poisoned by as little as 1oz (28g) of Baker's chocolate. The first signs of theobromine poisoning are nausea, vomiting, diarrhea, and increased urination. These can progress to cardiac arrhythmias, epileptic seizures, internal bleeding, heart attacks, and eventually death.
I’ve talked to several people in the past who have bragged that they’ve given their dog chocolate and that Fido is just fine. Well, personally I’m not willing to take that chance. Need I go over the complications brought on by theobromine poisoning again? The afore mentioned are horrible ways to die. Do your dog a favor and just keep the human candy out of reach.
2. That Christmas tree sure does look nice there in the corner of the Livingroom. Keep an eye on your dog around it though. There are a few dangers herein that you may not be aware of.
Needles: Don’t let him chew or swallow fallen Christmas tree needles. They are not digestible and can be mildly toxic depending upon your dog’s size and how much he ingests. The pine tree oils can irritate your dog’s mouth and stomach and cause him to vomit or drool excessively. Tree needles can also cause a small bowel obstruction or perforation. It’s important to point out that both of these conditions will require surgical corrective intervention.
Water: Pine water can poison your dog. Preservatives, pesticides, fertilizers and other agents, such as aspirin, are commonly added to tree water to keep the tree fresh. Treated water can be harmful to a thirsty dog, so use a covered tree water dish to be safe.
Lights: Don’t string the bottom of your tree with lights unless your dog is conditioned to leave the lights alone; some types can get very hot and burn the dog. Firmly tape cords to the wall or floor and check them frequently for chew marks or punctures. Dogs who gnaw on electrical cords and lights could end up with serious electrical burns. An electrical burn cause by chewing on wire also can cause pulmonary edema (fluid in the lungs) which can be fatal.
Ornaments: If you decorate the tree with glass ornaments, your dog (especially puppies) may knock over the tree trying to get to one, or injure itself trying to play with a broken one. Swallowing an ornament also can cause a gastrointestinal blockage. Some ornaments may be lethal depending upon the materials or chemicals used to create them.
Hooks: Use ribbon, yarn or lightweight twine to hang your ornaments avoid use of traditional wire hooks which can snag an ear or wagging tail. If swallowed, they can lodge in your dog’s throat or intestines.
Tinsel: If you trim your tree with tinsel beware that your dog may be attracted to it due to its shiny and reflective nature. If they can get it into their mouth it can become an air way obstruction, or a blockage of the GI tract. Surgery is often necessary to remove the tinsel from the GI system. In the unfortunate event that your dog is choking on the tinsel and you see it hanging out of their mouth, DO NOT try to pull it out. Because you don’t know what’s on the other end of the tinsel pulling it out could make the injury far worse. The same goes if the dog is defecating and you see tinsel hanging from the rectum.
It may seem like a lot, but rest assured it really isn’t. Some basic obedience training for the dog will mitigate many of the holiday risks prevalent around the winter holidays. Otherwise, just keep an eye on the dog(s) when they’re in the living room with the tree and when you cannot realistically watch the dog, crate him until you can.
Written by: Jason Sigler. Canine Training and Behavior Specialist, and blog contributor.
If you have a dog and subscribe to the importance of interactive toys for the mental stimulation of your four-legged family member(s) or have to hide medication in cheese or peanut butter the following information may be of interest to you. For a long time, it’s been pretty commonplace for peanut butter or cheese to use in interactive toys and treats. However, there’s an ingredient that has slowly become more and more common in the production of consumption products that is toxic to dogs. I’m talking about Xylitol. If your dog consumes enough of it; it can kill your dog D.E.D dead.
So, what is Xylitol? In laymen’s terms it’s a sweetener used as a substitute for sugar. Technically speaking, it’s sugar-alcohol found in various vegetation. It’s been around for decades but wasn’t widely used until recently.
Why has it gotten to be so popular? It’s about as sweet as table sugar but at only 2/3 the calories. Which means this sugar substitute is lower on the glycemic index. In other words, it’s better for your blood sugar. This makes it more appealing to diabetics and anyone else on a low carbohydrate diet. The most common products Xylitol is used is in gum, candies, medications, sports supplements, toothpaste and peanut butter.
Is Xylitol safe? Well, it is for human consumption, however, it is extremely toxic for dogs. Even in small amounts xylitol is capable of causing hypoglycemia (low blood sugar), seizures, liver failure and death in dogs.
But why is it toxic to dogs? I’m going to give you a little bit of biology here… The level of blood sugar is regulated by the release of insulin from the pancreas. When dogs ingest something containing xylitol it’s quickly absorbed into the bloodstream which causes the pancreas to release excessive amounts of insulin. The sudden release of insulin causes the blood sugar levels to plummet resulting in hypoglycemia. Untreated you can expect death to occur within sixty minutes of initial ingestion of the Xylitol if a lethal quantity has been ingested. This begs the question; how much will it take to kill my dog? Hypoglycemia will be induced by a dose as small as about 50mg per pound of the dog or for all of you metric types, 100mg per kg. It goes without saying that the more ingested the greater the risk of organ damage and death. The most specific I can get regarding lethal doses are: 225 mg/lb or 500 mg/kg body weight.
If my dog eats something with xylitol, what should I do? Your best bet is to contact your veterinarian or the ASPCA Animal Poison Control Center (888) 426-4435. A $65 consultation fee may be applied to your credit card however. Unless directed to do so by poison control or a veterinarian, do not induce vomiting or give anything orally. If your dog is already hypoglycemic from xylitol ingestion, vomiting can make it worse.
What does xylitol poisoning look like? You have to be observant because the signs and symptoms come on very quickly, usually within about fifteen minutes of ingestion.
Symptoms of xylitol poisoning develop rapidly, usually within 15-30 minutes of consumption. Signs of hypoglycemia may include any or all of the following: Vomiting, Listlessness, Lack of coordination or difficulty walking or standing (kinda looks like alcohol inebriation), Lethargy, Tremors, and Coma. In acute cases, the dog may develop seizures or liver failure.
Is there an antidote for xylitol toxicity? No. There is no antidote for xylitol poisoning, although treatment with sugar supplementation, IV fluids, and liver protective drugs are beneficial.
If there is no antidote, how is xylitol poisoning treated? Fast and aggressive treatment by your veterinarian is essential to effectively reverse any toxic effects and prevent the development of severe problems. If your dog has just eaten xylitol but has not yet developed any clinical signs, your veterinarian may induce vomiting to prevent further absorption, depending on what your dog's blood glucose level is. If clinical signs have developed, treatment will be based on the symptoms that are being shown. Since xylitol toxicity can cause both low blood glucose and low potassium levels, your veterinarian will perform blood work to determine whether these problems need to be treated. In all cases, your dog will require hospitalization for blood sugar monitoring, dextrose administration, intravenous fluids, liver protectants, and any other supportive care that may be needed. Blood work should be monitored frequently to make sure that blood sugar and liver function remain normal.
What is the prognosis for recovery from xylitol poisoning? The prognosis is good for dogs that are treated before clinical signs develop, or for dogs that develop uncomplicated hypoglycemia that is quickly reversed. If liver failure or a bleeding disorder develops, the prognosis is generally poor. If the dog lapses into a coma, the prognosis is very poor.
How can I prevent this problem? The short of the long is avoid giving your dog anything with xylitol in it’s ingredients. According the AMVA the leading cause of xylitol poisoning is sugar free gum. Remember that dogs perceive the world with their nose. If there is chewed gum on the ground in the path of your morning walk with Fido, don’t let your dog investigate it. If you’re using peanut butter or cheese to reward your dog or to load their toys check the labels to make sure it doesn’t contain xylitol. It’s that simple.
Jason Sigler is a dog training instructor and a PSA (Protection Sports Association) enthusiast. He's a certified Pet Tech Canine first Aid and CPR instructor as well as a certified Canine Training and Behavior Specialist.
Please check out his Facebook page Isoshikai Karate