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Forum Home > General Discussion > crypt abscesses -- EPI/SID or only Lymphangiestacia?

Sandy
Member
Posts: 5

Hello -- I am new to the forum and only recently discovered my dog Sandy has a chronic GI issue. I am heartbroken and still reeling, as I think over-vaccinations during 2016 kicked her (undiscovered) auto-immune condition into high gear. In January she got CIV/Lepto vaccinations, not knowing at the time that her blood work that day would come back to show that her albumin already was dropping -- 2.5 on the day if the vaccinations. Well, at the re-check a month later, it had dropped to 1.8.  In the interim, she'd has a diarrhea blow out, and then a couple days of vomiting bile in the AM, which has happened only about 3 times since I adopted her in 2014 (another time a week or so after the same vaccinations, as I've now pieced together). I'm providing this context because I don't understand exactly what's going on with Sandy, and what vets are telling me isn't quite adding up. I now find myself thrust down a rabbit hole not knowing to what extent I can trust my vets to have a complete and accurate picture (have now visited a handful of them) and not knowing how to parse the avalanche of information of advice, a lot of it conflicting and highly dependent on her precise diagnosis.

When her albumin result was 1.8, we immediately did an ultrasound (all clear) and then an endoscopy/biopsy, which came back showing mild IBD (both cell types) affecting her small intestine and stomach. no inflammation anywhere else, no fluid, no neoplasia, colon fine.  BUT, she has crypt abscesses in her small intestine; villi and lacteals within normal limits, and no sign of lymphagienctascia (which normally is cause of abscesses). Analysis is that the crypt abscess is the more aggressive disease process -- but cause of the abscesses is unknown. So, Sandy was immediately put on prednsisone, metronidazole, and enrofloxacin (Zeniquin) to treat the abscesses, fear being they could lead to fibrosis (no current evidence of fibrosis).  A week later, her albumin was back up to 3.4; we dropped the prednisone dose.  She is now fully transitioned to royal canin hydrolyzed protein diet, will stay on her med cocktail for at least 6 weeks, then take stock.

I want to get on a positive track of diet/supplements for her immune/digestive system -- but I can't understand what's going on and therefore, where to start! And after what seems like a cascade of mistakes (e.g., too many vaccines, missing auto-immune issue), I am terrified to do further harm. Today it was suggested that she may in fact have lymphangienctasia (because common with crypt abscesses), and that although not spotted on the biopsy, a biopsy of the full thickness of her intestinal wall would have been necessary for a definitive diagnosis. No recommendation for another biopsy at this point, but her specialist and vet are proceeding as if Lymphangiectasia. I appreciate erring on side of caution -- my issue is it doesn't seem quite right and I feel like we should be looking toward SID/EPI dynamic to explain the abscesses (and the localization of the IBD in SI/stomach). She doesn't seem to have symptoms consistent with Lymphangiectasia -- no notable weight loss (57 lbs to lowest 52.5 during diarrhea/bland diet, but quickly back to 54 -- and she had been considered overweight at 57); no fluid build up; no loss of appetite -- in fact, she is ALWAYS hungry no matter what. Last week I asked for a coalbamin/folate test -- sure enough, low B12, high B9.  That is consistent with both SID and L-tasia I guess; but inexplicably, not once did a doctor order tests for pancreatic enzyme functions or TLI. I finally put those pieces and together and asked for the test -- so happened today. To my mind, her clinical symptoms seem far more consistent with a SID/EPI process, possibly even not that severe, but spiked by the recent vacc reaction. The holistic vet we tried was reputable, but beyond useless (brushed aside my suggestions for focusing on enzymes, pre-biotics, probiotics, repairing intestinal walls, etc., and applied a poorly explained and seemingly half-baked TCM analysis, handed me a Chinese herb with no explanation why or what for, and sent me on my way -- never even read the biopsy or asked about her stool). All these visits happen so fast, it's a whirlwind and I leave telling myself "it's a process" but still with the intuition that no one's really paying attention.

I just feel desperate. I want to get started on a single protein diet and GI treatment regime with a doctor willing to slow down and take a look at all this with me. But I don't know where to turn.  Hopefully next blood test will provide more clarity on pancreatic enzyme dynamic.

Has anyone had experience with crypt abscesses? Is it possible they could be an infection from an underlying condition of small intestine bacterial overgrowth (whether or not chronic/pathology)? Is there a risk in proceeding with a "leaky gut" regime from a reputable holistic apothacary without more information (I'm looking at multi-step program from Adored Beast -- anti-vaccisnosis, liver detox, enzymes, pre-biotics, probiotics, intestinal mucosa repair, herbal anti-inflammatories)? my worry is that a probiotic strand might not agree with her, or she'll have a reaction to the ox enzyme .... but then I think, I have to start somewhere, and I can monitor and adjust as warranted.  I just wish I had trusted guidance.  

Would be grateful for any insight from the forum. Thanks in advance.

March 15, 2017 at 5:16 PM Flag Quote & Reply

Donna
Member
Posts: 927

Hello, 

Im so sorry to hear you are dealing with such hurdles... We are not vets here, and I personally don't like to play an arm chair vet... Please let us know what the last test results say. I know your head is spinning, and while you want answers (I understand), none of us here are qualified to answer them.  We are a support group and that's all we are able to offer... 

Do let us know what the last test reveal.

Donna

March 15, 2017 at 6:48 PM Flag Quote & Reply

Patsy
Member
Posts: 953

Hello, you are way over my head medically, but in describing the state of the gut ,  it doesn't give a cause.   It's quite bewildering!   What is the poop like, in colour and consistency?  I hope the Epi cTLI test gives a useful result, even to only eliminate it.  The problem with Epi symptoms are that they can be mistaken for other conditions, for example ,my dog showed signs of protein loss,abdominal bloating,manic thirst , and near organ shutdown.  My vet , with my agreement,,said he would treat her most life threatening symptoms first,  giving her steroids.  She was losing weight rapidly when he thought of Epi. Almost unheard of, especially in spaniels, presumably because they all died before diagnosis.  Then enzyme treatment had a magical effect.  All the other problems very gradually eased over time.     If you get an Epi diagnosis ,  you will be relieved because it's treatable.    But now, your B12 needs a injection regime.   Have they talked about tylan instead of metro,which is sometimes a problem?  I hope someone more knowledgable can come on here  re the other conditions.   It is  heartbreaking seeing pets suffer,  as everyone here knows.

--

Marti  Springer Spaniel, owned by Patsy, Sheffield, England.  She died age 12yrs 6mths  on 27/11/14 from heart failure. Diagnosed after three months, when she was 4 years old,she dropped from 24 kilos to 17 kg.  initially she also had protein losing enteropathy, treated with steroids, ,raw sores on back, obsessive thirst, bursting bowels and biadder, then stable after 2 years.   Developed another autoimmune problem with muscular myositis on head ( muscles wasted away, leaving gaunt hollows.)  She also suffered sometimes from  bottom end thrush, anal  gland infections, and recurrent SIBO treated with 4 weeks of oxytetracycline each time. 

Enzymes: Panzym caused mouth problems, resulting in tooth removal , as I didn't know at the time how caustic it was. I changed to one Lypex  then used VetUk Pancreatic Nutrient tablets, and one Chemeyes because it is half the strength, and I didn't need to use two vet uk ones. Then 3 Chemeyes or  2 pancreatic Nutrient  per meal. 

B12 injection monthly.  Trinfac B12 + intrinsic factor capsules from Chemeyes daily. Metacam for knee joints.  Also used Yumpro Bio pre/probiotics.

Food: picky eater,tinned  Chappie saved her life  till she would eat kibble again.  Eden Holistic, Millies Wolfheart and Lily's Kitchen all good,chicken and grain free.

Vets, one caring learner, who had  nervous breakdown, replaced by obnoxious vet , so I rang round  interviewing them to find someone I trusted and would work with us. Since losing Marti and Bob, I have changed again since the good vet us retired.

RIP Bobby the cocker , from PLN.  Present pet, Tinker the fluffy little grey Greek rescue dog. New addition, Jack ,  a neglected rescue terrier, looks like a fox cub and so happy to to be healthy and loved.

 


March 15, 2017 at 6:48 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 17063

Ah Geez... you head must be spinning and your heart breaking.  What you are describing in short sounds like PLE. Protein Losing Enteropathy. With PLE there are a few variations (primary and secondary) and the condition can happen in varying degrees. 

 

What also sounds like you are specifically describing is a PLE flare up (abcesses) ... the way i think of it is like usually means the flareup has subsided, but your dog still has PLE.   


With this SID also appens, loose stools, tummy gurgling, etc and i cannot begin to tell you how many times people have joined the forum describing signs that sure sound like EPI... and then the share a CBC blood panel  and there it is ...."low albumin". The folks go back and forth to the vets, they test for this and that and in the end... with that darn low albumin, the dog finally gets the diagnosis " PLE" .


Honestly with PLE i do not think the enzymes will help unless there is EPI going on too.... althou I have been told that EPI +PLE do not happen together, I am not so sure if I was given absolute correct info.... HOWEVER.... if you do need an antibiotic to clear up the SID, have your vet try Tylan... it often works better than Metronidazole.


Usually with PLE, pred is the first line of defense.... and then diet is key in keeping PLE under control..... you are lucky that your vet put your dog on a hydrolyzed diet and that it ids working.  Hydrolyzed is the way to go, but sometimes even with hydrolyzed it takes a lot of trial and error.  There are also other drugs, like azithromycin that they use to treat PLE with.   


In regards to how to treat,  for now i would keep it simple, start of with simple SLippery Elm powder (not capsules) as a gentle mucilage to help coat (soothe) the intestinal lining that will help the body better heal itself.  Give this a few weeks BEFORE introducing any multi-faceted product.


Also..... please read this material on PLE(Lymphangiestacia).... i have been running this website for 9 years, and to date this is the best comprehensive and still layman understandable piece that i ahve come across on PLE.

http://www.epi4dogs.com/plelymphangiectasia.htm


BTW... please know that you did nothing wrong... with immune-compromised dogs, we often don't know there is something wrong until AFTER the fact .... *sigh*.....

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

March 15, 2017 at 7:09 PM Flag Quote & Reply

Patsy
Member
Posts: 953

Ok , I've googled crypt abscess and it says it's part of ulcerative colitis.   many people have soothed this condition by using slippery elm powder, a harmless , well researched product. It helps to mke the gut coat itself with a mucous, which protects the sore areas so that they can heal quickly.  I recommend it too.

--

Marti  Springer Spaniel, owned by Patsy, Sheffield, England.  She died age 12yrs 6mths  on 27/11/14 from heart failure. Diagnosed after three months, when she was 4 years old,she dropped from 24 kilos to 17 kg.  initially she also had protein losing enteropathy, treated with steroids, ,raw sores on back, obsessive thirst, bursting bowels and biadder, then stable after 2 years.   Developed another autoimmune problem with muscular myositis on head ( muscles wasted away, leaving gaunt hollows.)  She also suffered sometimes from  bottom end thrush, anal  gland infections, and recurrent SIBO treated with 4 weeks of oxytetracycline each time. 

Enzymes: Panzym caused mouth problems, resulting in tooth removal , as I didn't know at the time how caustic it was. I changed to one Lypex  then used VetUk Pancreatic Nutrient tablets, and one Chemeyes because it is half the strength, and I didn't need to use two vet uk ones. Then 3 Chemeyes or  2 pancreatic Nutrient  per meal. 

B12 injection monthly.  Trinfac B12 + intrinsic factor capsules from Chemeyes daily. Metacam for knee joints.  Also used Yumpro Bio pre/probiotics.

Food: picky eater,tinned  Chappie saved her life  till she would eat kibble again.  Eden Holistic, Millies Wolfheart and Lily's Kitchen all good,chicken and grain free.

Vets, one caring learner, who had  nervous breakdown, replaced by obnoxious vet , so I rang round  interviewing them to find someone I trusted and would work with us. Since losing Marti and Bob, I have changed again since the good vet us retired.

RIP Bobby the cocker , from PLN.  Present pet, Tinker the fluffy little grey Greek rescue dog. New addition, Jack ,  a neglected rescue terrier, looks like a fox cub and so happy to to be healthy and loved.

 


March 15, 2017 at 7:23 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 17063

thanks Patsy for researching Slippery Elm and it's recommendation for the crypt abcess...... :)

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

March 15, 2017 at 7:59 PM Flag Quote & Reply

Sandy
Member
Posts: 5

I will respond in more detail tonight, but wanted quickly to say THANK YOU!! for the thoughtful responses and support. I did just speak with our vet again and feeling more on the same page (vet looked at her file in more detail and no longer suspects lymphangiectasia). Do not have TLI result yet, but do have a bit more info.  Will write again tonight, and until then again my sincere thank you.  

March 16, 2017 at 2:58 PM Flag Quote & Reply

Donna
Member
Posts: 927

Glad to hear you have more insight! Looking forward to your report.

Donna

March 16, 2017 at 6:31 PM Flag Quote & Reply

Barb
Member
Posts: 3898

Welcome.  So glad you have more information.  Hopefully, you will get more as the tests come back and you and your vet work together.  

Waiting isn't easy.   Let us know what you find out.  It's so hard to see our pets not feeling well.


Barb

--


March 16, 2017 at 8:18 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 17063

do keep us posted!

--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

March 18, 2017 at 11:29 AM Flag Quote & Reply

Sandy
Member
Posts: 5

Hello -- thank you again for the interest and support. So the headline -- TLI is 21.2. At this point, this is both a relief, of sorts, but also ominous, as at least that would have provided clarity on what to address in terms of her absorption.

Here's our story: Sandy is a 6.5 yr old pit bull mix (strong bull dog look and personality, e.g. stubborn and snoring). Not a lot of details on her early life -- adopted her in July 2014 from rescue group, she'd been in a shelter for almost a year, called the shelter and they remembered her (from the snoring and her affinity for mealtime!), said she was picked up from the street.

I already summarized my concern about her vaccinations but here's a bit more detail: Our whole nightmare started because I took her for her wellness exam several months early, nervous after losing my 16-yr-old cat (and her friend) in Christmas, asked for a blood panel just for good measure.  She got vaccinated for canine influenza and Lepto that day.  (As noted, we learned the next day that her albumin already was low at that visit -- 2.5.) A year earlier I had moved, and so was seeing 2 vets -- my old longtime vet and a new local one.  Well turns out their record-sharing wasn't as responsible as I expected (and reminded them) and Sandy got 4 non-core vaccinations in 10 months: 2 bordetella, and 2 canine influenza/Lepto.  And I had thought vaccinations were just good "maintenance" ... all upside.

If I knew then what I know now.  I now keep complete files, and have consolidated everything into timelines. And titers from here on out.

By late February, Sandy's albumin had dropped to 1.8. Prior to our wellness exam, it had never been below 3.1. When it hit 1.8 and I googled what that meant, I kicked into gear: ignored another "let's wait..." and got an ultrasound, which was all clear (no fluids, no visible inflammation, all organs looked fine). So internal medicine specialist suspected IBD (all other tests came up clear) and recommended biopsy of her intestine. Other option would be trial and error with diets and I wanted the info, so did the endoscopy, which I'm glad for because it revealed the crypt abscesses.  So: mild IBD affecting small intestine/stomach and crypt abscesses.

Medications: -- Prednisone at immunosuppressive dose for first 5 days (40mg/day); followed by 1 week at 20mg/day; and now almost at 2 weeks at 10mg/day, low-end of anti-inflammatory dose (reduced when labs showed albumin back to 3.4).

-- metronidazole 250mg 2X/day

-- Zeniquin 100 mg 2X/day

-- Diet: fully transitioned as of about 2 weeks to Royal Canin hydrolyzed protein.

-- Supplements: Proviable probiotic (seems to work well at least as measured in stool texture); 1/4 to 1/2 dose of Dr. Goodpet plant enzymes; slippery elm powder; dandelion powder; dandelion & milk thistle "liver defense" tincture (burn off the alcohol); colostrum.

-- Vets: Internal medicine specialist + plus new conventional GP who has a lot of experience with IBD and so far very thoughtful and detail-oriented. Trying new holistic vet next week who I had good connection with in long phone conversation and she knows the other vets.

She's had two blood panels since the 1.8 result, albumin was 3.4 and as of Wednesday 3.0.   

I think my issue at this point is that I haven't yet found a vet whose asssessment and approach fully makes sense, and therefore I'm not fully trusting the approach. And I'm generally being received as either trying to "cure" my dog or do too much at once -- and I don't want to piss off everyone trying to help us, but the truth is I have been consuming everything I can learn for 3 weeks straight, and feel now that I have a sense of what's going on and frankly am trusting my own judgment first (e.g., the lymphangientasia didn't make any sense, but had I said that outright, I'd have been dismissed or lectured at, just as they belatedly acknowledged vaccines as contributing factor).

Sandy's labs show that the prednisone is spiking her liver values (liver working too hard); docs aren't worried on temporary basis, I'm tentatively OK with that, if she needs it, but at this point seems like we should be further tapering the prednisone.  Otherwise -- what I see is that all of her mineral, vitamin, enzyme levels have been trending down, a few into "Low" territory, others on the brink.  This is across the board. This is why I wanted the EPI test (had to ask for B12 too, which was low). Her PrecisionPSL has jumped from the low end to the high end (i.e., pancreas being taxed), and her T4 similarly has gone from low end to inching very close to registering as hyothyroid. I get the sense her doctors aren't looking at trends and only look at what hits "high" or "low" -- i.e., registering things once it's too late, at which point, prescribe more meds and counsel more caution on diet, supplements.

I feel like she's being treated as presenting severe IBD -- heavy meds, digestible diet (and extreme caution about trying any diet changes), probiotics OK but anything else (enzymes, slippery elm, dandelion) and I'm cautioned as if *these* are the things that might aggravate her system, treated as if I'm just throwing things at her impatiently, but nevermind that a processed kibble diet is likely making her organs work harder. It seems to me we should be treating her for mild IBD, with an absorption problem localized in SI/stomach. Having ruled out EPI, would seem her stomach/intestine are the source of the absorption problem. My priority: support/heal her gut, which means a set of carefully selected treatments alongside the antibiotics.

As of now, vets want to stay on the Zeniquin for a full 6 weeks, and in meantime keep her on hydro diet, keep current dose of prednisone, increase metronidazole dose, start an ant-acid.  All these things are addressing her symptoms and staying steady from one perspective is the conservative thing to do .... but they also have downsides, especially if her most aggressive problem is absorption in her small intestine.

The crypt abscesses need the strong antibiotic, and I see rationale for 6 weeks (last thing we want is to stop short); and the metronidazole helps with inflammation and abscesses and is a targetted antibiotic, so no problem there either.  It's the prednisone, the diet, and the finger-wagging I get over supplements.  

Very hopeful for our visit to holistic vet on Tuesday. At minimum hope to have plan for a novel protein diet that's aimed at small intestine bacteria overgrowth and anti-inflammatory; will push my case for tapering the prednisone and using other gut-healers.

From everything I've read, whether you want to call it "holistic" or whatever, these sorts of digestive/inflammatory conditions seem to create negative feedback loops among different organ processes ... if I'm impatient, I think it's because I don't trust that conventional medicine necessarily accords the best/most wise treatment for the big picture, and after my vaccination experience, I can't bear to stand by while a treatment that might be helping one thing makes other things worse, or other dyfunctions more likely. I keep being told to expect that Sandy might be on antibiotics and/or steroids for the rest of her life .... maybe so, and maybe this was genetic and inevitable. But it fills me with rage and sadness, because until her last unnecessary vaccination in January -- again conventional medicine always assuming it knows best -- Sandy didn't seem to be in this crisis situation, whatever her underlying predisposition. I'm determined to do everything I can to avoid the fate these docs seem to be consigning her to.

Thanks for listening ... appreciate this forum, even though it turns out Sandy does not have EPI.



March 19, 2017 at 12:02 PM Flag Quote & Reply

Sandy
Member
Posts: 5

Quick addendum:  when I say I lost my 16-yr-old cat "and her friend" I mean that my cat was Sandy's friend. (realize that might be read as losing two cats, so wanted to clear that up)

March 19, 2017 at 12:04 PM Flag Quote & Reply

Donna
Member
Posts: 927

Wow, Sandy... You have really been thru it with this pup, who, BTW, is VERY lucky to have you in his corner!

You know, you may be onto something with the over vaccination starting the whole ball rolling... After swearing off GSDs after loosing two to DM (one had EPI as well), I found my current girl and I swore my two Bridge kids sent her to me... She was found roaming the streets, had basically no hair and what she did have was very crunchy, and she was very, painfully thin... She was not a young dog either as she was estimated to be between 5-6. With her age and looks, I figured she chance at adoption was slim to none, so I agreed to take her.  I'm very careful about vaccinations and usually titre, but of course with her coming her from rescue, she was hit with them all at once. I picked her up in July of last year and started to attempt the healing process... I started giving her a high quality kibble, but anything I put into her came back out pretty ugly. So off to the vet for a chem 24 and T3/T4. Thyroid came back ok, but slightly elevated WBC count, so antibiotics it was. Changed food a few times, and no change in the output. Tried raw at the insistence of her rescuer, but poop went from bad to worse. ran a cTLI and B12, she didn't have EPI, but B12 was very low. figuring it was probably IBD, also started a short course of pred, but it didn't help. I had to put her on a hydrolized diet while I waited and saved for the endoscopy. When I had that done, there were no findings.... Since the beginning, I was also using L-Glutamine and Slippery Elm. I really, really think this has been the answer... I've since switched her from the Z/D to Merrick LID Duck and potatoe and for e first time since I got her, her stool is formed! Sometimes softer than others, but always formed! She's going back to the vet tomorrow for full bloods, including B12, so am anxious to hear how she's doing.  She's now of normal weight, her fur has all grown back. The fly bitten off ears are the only scars that she carries from her days on the street...

Donna

March 19, 2017 at 4:40 PM Flag Quote & Reply

Donna
Member
Posts: 927

Oh, and I forgot about the 45 days of Tylan while doing the B12 supplements.

Donna

March 19, 2017 at 4:49 PM Flag Quote & Reply

Patsy
Member
Posts: 953

So not EPI,   Very frustrating. . We know from Epi that digestion affects absolutely everything,so  knowing where to start is a problem.    So pred is the first all rounder for  inflammations. 

what did they say regarding the likelihood of pancreatitis?  Does that fit in with any of your hypotheses? There seem to be similarities to me. 

--

Marti  Springer Spaniel, owned by Patsy, Sheffield, England.  She died age 12yrs 6mths  on 27/11/14 from heart failure. Diagnosed after three months, when she was 4 years old,she dropped from 24 kilos to 17 kg.  initially she also had protein losing enteropathy, treated with steroids, ,raw sores on back, obsessive thirst, bursting bowels and biadder, then stable after 2 years.   Developed another autoimmune problem with muscular myositis on head ( muscles wasted away, leaving gaunt hollows.)  She also suffered sometimes from  bottom end thrush, anal  gland infections, and recurrent SIBO treated with 4 weeks of oxytetracycline each time. 

Enzymes: Panzym caused mouth problems, resulting in tooth removal , as I didn't know at the time how caustic it was. I changed to one Lypex  then used VetUk Pancreatic Nutrient tablets, and one Chemeyes because it is half the strength, and I didn't need to use two vet uk ones. Then 3 Chemeyes or  2 pancreatic Nutrient  per meal. 

B12 injection monthly.  Trinfac B12 + intrinsic factor capsules from Chemeyes daily. Metacam for knee joints.  Also used Yumpro Bio pre/probiotics.

Food: picky eater,tinned  Chappie saved her life  till she would eat kibble again.  Eden Holistic, Millies Wolfheart and Lily's Kitchen all good,chicken and grain free.

Vets, one caring learner, who had  nervous breakdown, replaced by obnoxious vet , so I rang round  interviewing them to find someone I trusted and would work with us. Since losing Marti and Bob, I have changed again since the good vet us retired.

RIP Bobby the cocker , from PLN.  Present pet, Tinker the fluffy little grey Greek rescue dog. New addition, Jack ,  a neglected rescue terrier, looks like a fox cub and so happy to to be healthy and loved.

 


March 19, 2017 at 5:05 PM Flag Quote & Reply

Donna
Member
Posts: 927

You know Patsy, with that score I was wondering too, but I think Pancreatits is usually a higher score than that... I seem to remember reading 50's.

Donna

March 19, 2017 at 5:29 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 2968
Sandy - I just wanted to say you're an awesome mom and that I one lucky dog to have you!! I hope you find answers soon. Even though your dog doesn't have EPI, you are always welcome here. I do find the over vaccinating and on-set of this interesting. I knew nothing about vaccinations and titer testing until my boy was diagnosed with EPI. Sending hugs and prayers and donplease keep us posted! Madelon
--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


March 19, 2017 at 5:39 PM Flag Quote & Reply

Doc's Mom
Administrator
Posts: 2968
Sandy - I just wanted to say you're an awesome mom and that I one lucky dog to have you!! I hope you find answers soon. Even though your dog doesn't have EPI, you are always welcome here. I do find the over vaccinating and on-set of this interesting. I knew nothing about vaccinations and titer testing until my boy was diagnosed with EPI. Sending hugs and prayers and donplease keep us posted! Madelon
--

MADELON and DOC aka "BUBBY WUBBY"

Nashville, Tennessee

DOB: 4/3/2014 - Diagnosed EPI and SIBO: 5/22/2015
EPI Test Results: 1st test 7/2014 = TLI 16.5, B12 894, Folate > 24; 
2nd test 5/2015 = TLI < .4, B12 406; Folate >24; 3rd test 10/2015   TLI < .4; B12 >1000; Folate 14.4

Weight: 95 (highest 1/2015) - 76 (lowest 5/2015) - goal met 100lb (7/23/15) - 101.8LBS 12/3/15 - CHUNKY MONKEY

History prior to DX:  May/June 2014 (2mos old) - DX coccidia and bladder infection; July 2014 (3mos old) 1st EPI test = TLI 16.5, B12 894, Folate >24 - Diagnosed SIBO not EPI; Feb 2015 thru May 2015 - weight loss only; May  2015 vomitted several times, diarrhea and eating poop.

History since DX: has maintained weight between 95-101lbs since July 2015; extreme yeast and rod infection in ears; yeast infection paws (ongoing); bacterial eye infection; bacterial skin infection on legs; poops LIVE fly larvae; diagnosed with mild, focal superficial pyoderma (bacterial infection) - rare lesions on inner thighs; bacterial and yeast overgrowth lip folds; yeast overgrowth feet and left ear; metacarpal/metatarsal draining tracts/fistulae (infection and/or immune mediated disease; probable underlying allergy (food vs. environmental ); staphylococcus pseudintermedius infection in sores on paws; recurring metatarsal fistula - all issues resolved after NutriScan Food Sensitivity Test and switching foods.

NUTRISCAN Food Sensitivity Test (12/2015): reactive to chicken, turkey, white fish, wheat, white potato (mild), venison, soy (mild), pork (mild), duck (mild), corn - switching food based on test resolved all skin issues.

Serum Allergy Test (5/2016): Too many to mention

CURRENTLY :  6 cups Forza10 Legend Skin - Diane 6x 1tsp per cup; 1 WonderLab PetFactor B12 2x day; 2 scoops TotalBiotics 1x day; 600mg vitamin E; 1 Zyrtec 10mg 2x day; Milk Thistle during heartworm/flea/tick meds

I am not a vet.  All of my suggestions are based on my personal experiences, information gleaned from EPI research and information from other EPI owners.  Please always share anything and everything recommended on this forum with your vet

SO THANKfUL FOR OUR EPI4DOGS GUARDIAN ANGELS!!!!!!!!

YOUR PAWS LEFT PRINTS ON MY HEART (in loving memory of Bugsy aka Boo Boo - Boston Terrier 14yrs - not EPI but medically challenging and totally worth it)


March 19, 2017 at 5:40 PM Flag Quote & Reply

Epi4Dogs
Site Owner
Posts: 17063

hi Sandy's mom,

i 2nd what Madelon said.... you certainly are an awesome mom!!

Hmmmm...... It is kind of bitter sweet that this is not EPI... good that  Sandy doesn't have EPI, but then again, now you still do't have answers :(.  But also good that the vets now think it is not Lymphangienctasia (and not PLE) but something is affecting the gastro system.  With the low Albumin and all the other low numbers (vitamins/minerals) and since EPI and PLE now ruled out., and i am assuming cancer is ruled out.... did the vet consider looking into possible kidney/lver issues?   Other than that the only thing i can think of is the same that i think you re alluding too... too many vaccines lumped too close together????  Maybe this did cause gastrointestinal damage  *sigh*... and now... how to fix...


I too get frustrated when vets look at you funny when supplements are mentioned.  I can understand the concern because they are not closely regulated... but on the flip side... if you trust the source, many holistic treatments (and often in combination with western med) does wonders.  I am a BIG proponent of Slippery Elm.... to the point now where i am collaborating with one of the vet schools gastro lab that is going to test slippery elm to find out why itoften works on SID!  


When it comes to the gut, i really lean towards SLipppery Em because it has a lot of Butyrate in it, which is a SCFA that actually fights small intestinal dysbiosis, is a great mucilage/allowing the body to better heal itself, is loaded with B vitamins, etc....... BUT.... there is another alternative med called  Larch arabinogalactan that is a prebiotic, and also known for greatly reducing inflammation,  a great source of Butyrate... so maybe this is something you might want to look into and assess... see if you think it might be helpful to include in Sandy;'s regimen??  

http://intelegen.com/ImmuneSystem/larch_arabinogalactan_unique_nat.htm



--

Olesia, owned by Izzy, a 35lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable 9+ yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil one day and 1 tsp salmon oil next day, and also give canned sardines packed without salt or canned herring for extra omega oils.... until she developed Diabetes and now cannot tolerate higher fat foods.

In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. We also discovered that now, at 8+ years old, she not only has EPI, but also Diabetes, Low Thyroid and High Cholesterol.  Izzy was able to receive excellent care because of the kindness of so many here on epi4dogs and  is currently  doing extra-ordinarily well. If anyone could spend a day with Izzy, they would never guess that she has any health problems!  Because of Izzy's concurrent conditions of Diabetes and High Cholesterol we had to make changes to our daily EPI routine. We had to alter the fiber, type of fiber and the fat content her diet. She is now on an all home-made diet which she does best on and has even been able to reduce the insuline (Vetsulin:pork-based insulin) . Because of the diet change to all home-made i no longer worry about hypoglycemia or hyperglycemia- -she is much more even-keeled with a diet of sweet potato, a lean meat/fish, sometimes a free range egg, cottage cheese,  fish oil+vitamins and bone meal. We tried Novolin N a human synthetic RNA insulin.... but Izzy did not do well on it. aside from all of Izzy's health issues.... she continues to wake up every day full of joy and a great sense of humor!

I am not a vet.  All of my suggestions/recommendations are based on personal expereinces, observations, information gleaned from EPI research, and information shared with me by EPI researchers....that hopefully may help others. Please always share anything and everything recommended on this forum with your vet.

March 19, 2017 at 9:03 PM Flag Quote & Reply

Sandy
Member
Posts: 5

Donna, Patsy, Epi4Dogs, Barb, Doc's mom -- thanks. She's my best friend. She had it rough, and I promised her when I adopted her, that she was safe now. I just weep at the thought of letting her down.  But we don't know things until we know and I'm doing the best I can. 

And you know -- this stuff is EXPENSIVE, and I think, gosh, where I am right now, I can do it and I NEED to do it, but wow.  It's so tough.  My heart goes out.   

March 19, 2017 at 11:40 PM Flag Quote & Reply

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