EPI * Exocrine Pancreatic Insufficiency

I agree with Karen that it does sound like there is more going on than just EPI and that seeking additional guidance from a vet teaching hospital or IMS might be the route to go to find the answers you need on how to best help Fleetwood.

Hi FLeetwood's  mom.... so glad to hear that Fleetwood is doing better.... but that sure doesn't sound like EPI if the enzymes were making him sicker, unless he has a severe allergy to pork..... but if he is doing beter without them.... then stick with what you are doing !!! Keep a journal as suggested and that will also help you see trends of what  might be helping or hurting....

Thank you SO much for posting his picture... he is absolutely ADORABLE!!!! I just love Beaucerons... they are such a cool dog..... looking forward to seeing more pictures of FLeetwood and i hope he continues to do well.... but if he has a set-back.... if possible, i think Karen's idea of having a veterinarian teaching hospital check him out might be a very good plan....

Ohhhhh shoot. When you'd mentioned Fleetwood's issues earlier this year on another forum, I knew it sounded a lot like EPI.

I have nothing to offer, unfortunately, since Revy does fine on porcine enzymes from EnzymeDiane.

Have you tried raw bovine pancreas?  My Pet Carnivore sells it, but it's kind of expensive.  I'm on a search for raw pancreas for Revy too.

Hey Leah! Funny meeting you here Revy's face caught my eye before your name, LOL!

I'm thinking that there's more going on than just EPI, however, it's the only thing we have proof of at this point. I'm thinking he was having a bad reaction to pork, so my vet is researching different options (bovine, plant-based, and other herbal remedies) tonight, and she should get back to me soon. We visited the clinic earlier today.

I may look into raw pancreas, too. Fleetwood has been doing better off of the porcine enzymes, and on the NaturVet enzymes + probiotics. However, he threw up last night, and has been ill-looking today. I imagine it's because he was swimming intensely yesterday, and ingested a lot of the river water. Otherwise, he hasn't gotten ANYTHING but his food and salmon oil.

I also got a copy of the EPI test results. They were done at Texas A&M University.

Cobalamin: 421 ng/L

Folate: 8.6 ug/L

Pancreatic Lipase Immunoreactivity 105 ug/L

TLI: 80.2 ug/L

So it appears that the only thing that was off was TLI. And it was high, not low....? What does that mean?

By the way, Should I start him on weekly B12 injections? My vet isn't pushing for them, but says she can do that if I feel I want to.

I don't understand this one bit. After reading this, it doesn't sound like EPI at all. More like Pancreatitis, except... It's not? He certainly isn't suffering renal failure. I read on the TLI page that malnourished dogs can have high TLI, and he was/is, but what's malnourishing him?

I am SO confused now. What does my vet see that I'm not??

Hi.  I would say there is def no EPI.  If you read the link I sent on IBD, it can raise the enzymes.  I would def get into an IMS.  I am guessing you live by my sister in S Rockwood or there abouts.  If you want to get into MSU and you want company, I will gladly go with you.  You are about 1.5 hours from there, if my guess of where you are at is right.  It may be worth the drive.  I did a search for IMS's and it looks like there or in the Southfield area, probably about the same distance.  I did not check the Toledo area.  If you want, you can check here http://www.acvim.org/websites/acvim/index.php?p=2  Go to search for a specialist, then under specialty, click small animal internal med specialists, then either OH or MI.  Good luck.  And let me know if you want to come out this way.

Yes it is confusing and sounds like specialist territory but (a question for all forumites) is the PLI test the same as the Spec cPL test also developed by Jorg Steiner? There's a bunch of detailed info here

Fleetwood's low score at 105 ug/L seems to indicate he's clear 

Doesn't look like EPI or Pancreatitis.  I hope you can arrange for him to see an IMS and get answers to your questions.

I hope you get to the bottom of Fleetwood's issues.   I think Karen's idea of getting to a teaching hospital is a very good one.

Please keep us posted on how Fleetwood is doing.

Barb

Thanks for the replies... I don't understand why my vet would say that it's EPI... She really is a very respectable and knowledgable doctor.

Anyway, I think that I will have to see a specialist next. I don't know if I mentioned, but before he was 'diagnosed', he had a very high lymphocyte count, and the cells were not well formed. He had other symptoms that I can't exactly remember. They thought it looked like leukemia (my vet's colleague is an oncologist) but the next time we did a blood panel, it looked better. So I definitely think there's something else going on.

Karen, thanks so much for the link! I appreciate the offer to help (I'm not going to say no quite yet!) and I live in Grosse Ile Pretty close to S Rockwood. I'm familiar with Michigan Veterinary Specialists, and they're not that far from me. That's where my dobe received radiation therapy for his Osteosarcoma years ago.

How much does a 'Specialist' or University typically cost in comparison to a regular Veterinarian? Cost is an issue, at some rate.

I am with the others on this you need to go and see a Specalist i am hoping somebody will give you an idea of the cost .

Ann

I think the costs of specialists is regional. Best to ask them, I'm afraid.