I am going crazy ... is it EPI or NOT

[JR0579]

Roy [16-month old male GSD] was diagnosed with EPI back in March 2006. His TLI level was 8. He has had the clinical signs of EPI; chronic diarrhea and weight loss and because of that, his breed and age my vet. prescribed digestive enzymes mainly Viokase which somewhat controlled the diarrhea and the weight loss. I repeated the EPI,fecal and blood profile tests last week with a different vet and just received the results this afternoon [ Tuesday, July 26,2006 ]. I was shocked; his TLI came back 28.2 !!!! The normal range for TLI in a healthy dog is from 5 to 35. The fecal test came back negative to parasites. We're still waiting on the blood profile. Now my question is, does Roy have EPI or not ?
If yes, how can his TLI be 28.2 from 8 when it should deteriorating not improving. If no, then what is causing the voluminous soft stools and weight loss ?

The second vet. is suspecting Inflammatory Bowel Disease and maybe Giardia. Do IBD and EPI have the same clinical signs ?

 

[Citrus007]

I have no idea and this post will be of no help but good luck I hope you get everything figured out and Roy ends up ok.

 

[Buddy'sParents]

I am so sorry I don't know... but wishes of good luck sent your way!

Buddy sends a sloppy kiss!

 

[JR0579]

If I need anything now besides opinions .... it's prayers and wishes. So Citrus007 and Buddy's Parents .... Thanks so much .... keep me in your thoughts.

 

[Buddy'sParents]

keep me in your thoughts.

for sure!

 

[Jynx]

did Roy ever test positive for Giardia? Sorry I forget..if yes or even no, was he treated with metronadizole or Flagyl? and how long?

Giardia can stay in the system for YEARS, it can go into a dorment stage and then just rear it's ugly head.

Why the testing is coming out different, who knows? When my aussie was very sick, her ANA (systemic lupus) test was coming out REALLY high, if she had true SLE, she'd be dead by now. So when it comes to alot of testing, I can pretty skeptical, especially when testing comes out so differently.

Have you seen an internist with Roy? I would probably suggest, to find a good internist as in specialist vs a vet.

Things like this can be sooooooooo frustrating! There is a really good canine health forum I frequent who is moderated by a vet , here's the site, maybe he could give you some ideas

http://p069.ezboard.com/fhealthforumfordogsandcatsfrm14
Diane

 

[JR0579]

did Roy ever test positive for Giardia? Sorry I forget..if yes or even no, was he treated with metronadizole or Flagyl? and how long?

Giardia can stay in the system for YEARS, it can go into a dorment stage and then just rear it's ugly head.

Why the testing is coming out different, who knows? When my aussie was very sick, her ANA (systemic lupus) test was coming out REALLY high, if she had true SLE, she'd be dead by now. So when it comes to alot of testing, I can pretty skeptical, especially when testing comes out so differently.

Have you seen an internist with Roy? I would probably suggest, to find a good internist as in specialist vs a vet.

Things like this can be sooooooooo frustrating! There is a really good canine health forum I frequent who is moderated by a vet , here's the site, maybe he could give you some ideas

http://p069.ezboard.com/fhealthforumfordogsandcatsfrm14
Diane

Hey Diane,
Thanks for the help and to answer your questions :

1. Roy was treated with Tylosin and Metronidazole at least 3 times. Once with each vet. I have been to. Each time was about 3-4 weeks. He is actually on a Tylosin course right now and should be done in a week.

2. I had him tested for Giardia antigen and also Giardia DNA which is even more accurate, again, at least 3 times and each time he tested negative.

3. I have no idea what an internist for canine would be nor have I been told to be referred to one by any of the 4 vets. Yeah .... they are now 4. The last vet is the one who told me that Roy's TLI is 28.2

When I think about it, all 4 vets use the same lab. for their tests. So do you think I should call the lab. directly and ask about the discrepancy in the TLI with 5 months apart ?

 

[SummerRiot]

That acutally wouldn't be a bad idea about calling the lab.

Perhaps taking him to an entirely different clinic and have them test for the same thing and compare the answer. Get the name of the Lab that the vet uses from the first vets office and make sure that the second vet doesn't use the same lab.

Best wishes!!

 

[JR0579]

I forgot to add that I sent the results I received on Tuesday to my original vet. to hear what he thinks. My visit to the 2nd vet was for a 2nd opinion only. I also sent it to the breeder who is a vet and has a copy of the initial results. SummerRiot, I have already contacted a 5 clinic to have the EPI test redone in a month. I will make sure that they don't use the same lab. the other vets used.

 

[Buddy'sParents]

Hmm, what are all the abbreviations for? I'm lost... I mean, it sounds serious and I hope the best, but I'm still lost. *Feels blond* oh wait, I am! lol....

 

[Bucket]

Hi
Just a thought. I have a dog with EPI,Malabsorption and IBD. One thing we did find is that she cannot handle any Lactose. That included any food (Kibble)that has any dairy source. She also does better on one Carb source and one protein source.

 

[JR0579]

Hi
Just a thought. I have a dog with EPI,Malabsorption and IBD. One thing we did find is that she cannot handle any Lactose. That included any food (Kibble)that has any dairy source. She also does better on one Carb source and one protein source.

OK Bucket ... you are giving me a good lead. When you say "cannot handle any Lactose", what do you mean by that ? What happens if she eats yogurt for example ? The reason I ask is that I add yogurt to Roy's food and that doesn't seem to make any difference ?

 

[Bucket]

If I were to give her Yogurt her Tummy would start making some loud gurgling noises. Her bowel movement would then have lots of gas and very stinky. It was also very runny and would contain blood. Also not to be gross it also looked like she passed bloody guts with it. Scared the heck out of me. Sometimes her bowel movement would be both solid and then runny too. Or another description would be like a cow pod

 

[Jynx]

I to would try calling the lab, I know when I have testing done on my dogs, it goes to Antech labs,,they have a website, where you can also call and speek to a vet/technician in regards to test results performed by them.

An "internist" is a specialist, usually board certified, that deals in just that, "internal" *vbg*...

Did you see the "doc" responded to your post on the site I gave you? He had an idea for you to try, and thinks it could be more IBD, vs EPI, which I kinda think so to. irritable bowel can be a real pain to deal with,and i'm not sure which one I'd "rather" deal with..

Anyhow, the lactose thing is a thought to, I am lactose intolerant, and boy do I pay for it, IF i eat anything especially if it's not "non fat"..I really pay.

I don't think it's your "lab" your having probs with, I think it's the vet's lack of being able to really give you a definitive diagnosis, which again, been there done that.

I'd see if any of the vets could recommend an internist, hey what's one more perspective!!!
diane

 

[Bucket]

I do want to add that I also had to find enzymes for her that don"t contain Lactose.

 

[JR0579]

I to would try calling the lab, I know when I have testing done on my dogs, it goes to Antech labs,,they have a website, where you can also call and speek to a vet/technician in regards to test results performed by them.

An "internist" is a specialist, usually board certified, that deals in just that, "internal" *vbg*...

Did you see the "doc" responded to your post on the site I gave you? He had an idea for you to try, and thinks it could be more IBD, vs EPI, which I kinda think so to. irritable bowel can be a real pain to deal with,and i'm not sure which one I'd "rather" deal with..

Anyhow, the lactose thing is a thought to, I am lactose intolerant, and boy do I pay for it, IF i eat anything especially if it's not "non fat"..I really pay.

I don't think it's your "lab" your having probs with, I think it's the vet's lack of being able to really give you a definitive diagnosis, which again, been there done that.



I'd see if any of the vets could recommend an internist, hey what's one more perspective!!!
diane

Hey Diane,

Yes I did check the site you referred me to. Thanks so much. I did call the lab but they refused to let me talk to a pathologist or a tech. because they "are not allowed to talk directly to pet owners. Only my vet. can contact them"

I am just going ask the same questions I asked on the site that you referred me to :

1. If it's not EPI, why is he responding to the enzymes ?
2. If it's IBD, one of the symptoms is being in pain which he isn't.


I think that the lab and the vet. are having issues. The 2 tests were done at the same lab. with hugely different results. As for the vet. I have no confidence in any of them any more. I have been to 4 of them so far and all I am getting is "maybe", "let's try this and that" and "I am guessing". None of them seem to be really sure or confident of what they are saying.

 

[weylyn]

Have you considered SIBO?

As for the vet. I have no confidence in any of them any more. I have been to 4 of them so far and all I am getting is "maybe", "let's try this and that" and "I am guessing". None of them seem to be really sure or confident of what they are saying

I feel your pain, every ounce of it. I went through the exact same thing with my dog. I lost a good deal of confidence in my vets, although I know they're human and not perfect. So am I. Nevertheless, the process of diagnosing things is a long, hard, difficult road. It'll stress you to the max. Sadly, you can't just run a test and say "This is it, plain as day." Still, they did not provide me with much information and I had to literally harass any tidbit out of them. I had to look up symptoms and alternative treatments all on my own. I learned a few things from my experience, and that was to trust my gut. I switched my dog to a diet my vet did not recommend, and he improved. I switched my dog to digestive enzymes my vet refused to perscribe to me, and he improved. Granted, I did my researched and didn't do it on the fly.

I'm not saying to ignore your vet or don't run any tests (I ran many and, thankfully, a lot of things were ruled out), but do question what they tell you. You have every right to ask questions, and ask questions to other vets and other people who have delt with these issues.

 

[Jynx]

My sister's lab has IBD and isn't "in pain",,she just has a really touchy sensitive stomache..Give her anything other than her normal diet (she now feeds raw) and she is either vomiting or diarhea. Usually puts her on sulfasalazine(sp) for a week and clears it up.

I also feel your pain with vets not being able to get a definitive diagnosis and saying 'let's try this' let's try that,,it's like they use the dog for a guiena pig and if something happens to work GREAT..but getting there is a major pain as well as expense/frustration.

From what I know about the Enzymes they are good for your dog no matter what they may have..I have always had my dogs on Prozyme, since my gsd breeder has also and suggested I use it.

I honestly don't know what to say, have you ever thought of taking him off all food, and putting him on a completely raw diet? It definately takes some researching, but I know at the gsdboard, we belong to, Lisa T, has some really good ideas/background in dogs with health problems (she's suffered them all !) I like her suggestions and have used a few on my own dogs suffering from "whatever"..She is really "into" healthy feeding/supplementing.

Keep us updated!
Diane

 

[weylyn]

I honestly don't know what to say, have you ever thought of taking him off all food, and putting him on a completely raw diet?

This is what my pancreatic pup is on also.

 

[fillyone]

Was the TLI done after a 12 hour fast? Both of the TLIs that is?

Dante came back at 8.3 which is normal and I do not give him enzymes. Dante did have Giardia (found with the Antigen) and had to be treated with 2 different antibiotics before we got a clear test. After the Giardia was clear he went from "cowpie" to "Soft but pick-up-able". At that point I put him on a food with less than 15% fat and fiber of 4 or less (along the lines of an EPI diet). He remained at "soft but pick-up-able" (and there was a lot of it) until I moved him from 2x a day feedings to 3x a day feedings. At that point I was also able to reduce his food from 5 cups a day to 3.5 cups a day with no weight loss.
I think Dante just doesn't digest "well" and so lower fat, smaller meals seems to agree with him. I'm in the process right now of changing from Nature's Variety to Canidae. Just didn't like his coat on NV, but the food he did the best by far on was TimberWolf Organics Black Forrest.

Anyway, that's what worked for Dante