EPI * Exocrine Pancreatic Insufficiency
managing EPI
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Member Posts: 33 |
Trixie just had a setback. She finished her round of metronidazole at the end of last week. Today she had liquid poop (once in her cage when I was at work, and another when I got home and took her out). Would SIBO cause this rapid of a change? | |
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-- Trixie: 2 year old corgi/terrier/lab mix. Dropped 10 pounds over 4 months, finally diagnosed with EPI June 20th. Lowest weight: 15lbs. Goal: 25lbs. Currently: 23lbs Had a 6 week treatment of B12 injections and metronidazole. Eating 1/2 cup a food 3x a day of Wellness Complete Health Super5Mix Limited Ingredients Whitefish & Sweet Potato Recipe. Her Lab results were: TLI 0.4ug/L, B12 150pg/mL, Folate 15.3 ng/mL -Phil
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Member Posts: 4512 |
Sorry to hear you had a setback. I am not familiar with your history but It could...We used Tylan and for us we saw an improvement in the poop in 24 hrs. Every dog is different but you may not have entirely kicked SIBO. How long was she on the Metro for? I copied the below statement from the SIBO page: "The preferred antibiotic of choice is now Tylosin (Tylan) twice a day, 30-45 days depending on the patient. The other drug that was commonly used is Metronidazole (Flagyl)." | |
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-- Michele http://gardensoftranquility.com/ Jackie - Diagnosed at 9 mos (09/09) - TLI 0.3 and low end of B12. Pancreatin 8x dosing 3/4tsp per cup. Natures Domain, Trinfac-B Intrinsic Factor daily, probiotics and Duralactin in the am. Mega-E: cisapride and metoclopramide. Stable and happy 122lbs - thanks to all the beautiful souls on this forum, we could not have done it without YOU. Dexter - Diagnosed 11/10 approx 3 yrs of age. We failed fostering and now he has his forever home
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Member Posts: 296 |
Possibly. But looking at your info, I see two things that could be the cause......... #1 the food you are feeding is not grain free. The 2nd ingrediant is BARLEY, 3rd ingrediant is RYE FLOUR and 5th is MORE BARLEY! Whitefish, Ground Barley (de-hulled), Rye Flour, Menhaden Fish Meal, Ground Pearled Barley, Sweet Potatoes, Canola Oil #2 You are on a 6 week of B12 injecitons. I would recomment you also suppliment those with 1 cap daily of Trinfac-B with Intristic Factor from Wonder Labs. It is cheap and it cannot hurt in any way. If (and it's a big IF) she gets too much B-12, she will just pee it out. It makes a BIG difference in these EPI dogs to be in the UPPER area of B-12 levels (not just "normal" or "high-normal"). I suggest you Get the B-12 caps I mentioned above and get them started ASAP. I also suggest you get her on a good single protein grain free food such as: #1 Earthborn Holistic Coastal Catch Grain Free formula Herring Meal, Potatoes, Peas, Canola Oil (preservedwith mixed tocopherols, a source of Vitamin E), Pea Protein, Tapioca, PeaFiber, Dried Egg Product, Sweet Potatoes, Salmon Meal, Whitefish Meal, #2 Pinnacle Salmon & Potato Grain Free Dry DogFormula Salmon,Salmon Meal, Potatoes, Peas, Canola Oil (Preserved With Mixed Tocopherols -Source of Vitamin E), Tomato Pomace (Source of Lycopene), Pumpkin, You would have to transition to the grain free over about a 7 day period. Follow instructions on the bag. Normally we only do one change of anything at a time. But, I see no reason to hold out the additional B-12 while changing foods as it can only help and not hurt anything at all. Good luck and let us know how it goes. | |
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-- Alan & Brandy Brandy, whelped 5/16/10. Purebred GSD (DDR) Sable Female (Spayed). Diagnosed EPI March 2012 at <50lbs. Went thru the SIBO routine and got it cleared up with a Tylan (Tylosin) 40 day regime. Feeding: Earthborn Holistic Grain Free Primitave Natural or Coastal Catch, 3x day - 1.5cup each. EnzymeDiane's 6x - 1/2 tsp each feeding. TRINFAC-B Intrinsic Factor - 1 cap daily. Occasionally, as a topper, I add a couple spoons of Solid Gold Canned Green Tripe or Sardines in water or Tunafish. She loves it! As of July 2012 she is doing GREAT and over 60lbs. **Started feeding without incubation on Jul 17th with no problems.** **Reduced feeding to twice daily on Aug 14th (as she was near her optimal weight).** ** Sep 4th, weighed in at 73 pounds (optimal weight for her size) & accepted into the coveted Chunky Monkey Club!** **Oct 24th, weight now 80 pounds (on a diet) LOL** Thanks to Olesia for this wonderful Site and the folks that participate in it. You ALL saved my Brandy. Also a BIG THANKS to Diane & Sarge (RIP).
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Member Posts: 654 | Seems a bit of a coincidence to me that after you finished the antibiotic therapy this has happened. How long was the course of Metro she was put on? | |
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-- Kobe - 5yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily, 2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6. Blood results April 2013 - B12: 596, Folate: >20. Read Kobe's journal that was started the day he was diagnosed here.
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Member Posts: 296 |
BTW......I am NOT A VET. My recommendations above are only based on what has worked for me. And I agree that if it does turn out to be SIBO still (assuming the Met only slowed it down and did not fix it) I agree that you should do 40-45 days on Tylosin (Brand name Tylan). EDIT: I tried Met too and it did not work for me on SIBO. Tylosin knocked it out good. You will see a difference in the poop within 1 or 2 days, but you MUST complete the 40-45 days to be sure. The Tylosin, Grain Free Food and supplimental B-12 (with Intristic Factor) should get her back to good health and gaining weight rapidly. | |
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-- Alan & Brandy Brandy, whelped 5/16/10. Purebred GSD (DDR) Sable Female (Spayed). Diagnosed EPI March 2012 at <50lbs. Went thru the SIBO routine and got it cleared up with a Tylan (Tylosin) 40 day regime. Feeding: Earthborn Holistic Grain Free Primitave Natural or Coastal Catch, 3x day - 1.5cup each. EnzymeDiane's 6x - 1/2 tsp each feeding. TRINFAC-B Intrinsic Factor - 1 cap daily. Occasionally, as a topper, I add a couple spoons of Solid Gold Canned Green Tripe or Sardines in water or Tunafish. She loves it! As of July 2012 she is doing GREAT and over 60lbs. **Started feeding without incubation on Jul 17th with no problems.** **Reduced feeding to twice daily on Aug 14th (as she was near her optimal weight).** ** Sep 4th, weighed in at 73 pounds (optimal weight for her size) & accepted into the coveted Chunky Monkey Club!** **Oct 24th, weight now 80 pounds (on a diet) LOL** Thanks to Olesia for this wonderful Site and the folks that participate in it. You ALL saved my Brandy. Also a BIG THANKS to Diane & Sarge (RIP).
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Member Posts: 296 |
Looking at your other thread (2 week update) it sounds to me like you tried the Met for only a week? Regardless, Met does not work well in very many dogs (mine included) and can have some strange alter effects as well. If she were mine, I would be getting her on Tylosin as quickly as possible. | |
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-- Alan & Brandy Brandy, whelped 5/16/10. Purebred GSD (DDR) Sable Female (Spayed). Diagnosed EPI March 2012 at <50lbs. Went thru the SIBO routine and got it cleared up with a Tylan (Tylosin) 40 day regime. Feeding: Earthborn Holistic Grain Free Primitave Natural or Coastal Catch, 3x day - 1.5cup each. EnzymeDiane's 6x - 1/2 tsp each feeding. TRINFAC-B Intrinsic Factor - 1 cap daily. Occasionally, as a topper, I add a couple spoons of Solid Gold Canned Green Tripe or Sardines in water or Tunafish. She loves it! As of July 2012 she is doing GREAT and over 60lbs. **Started feeding without incubation on Jul 17th with no problems.** **Reduced feeding to twice daily on Aug 14th (as she was near her optimal weight).** ** Sep 4th, weighed in at 73 pounds (optimal weight for her size) & accepted into the coveted Chunky Monkey Club!** **Oct 24th, weight now 80 pounds (on a diet) LOL** Thanks to Olesia for this wonderful Site and the folks that participate in it. You ALL saved my Brandy. Also a BIG THANKS to Diane & Sarge (RIP).
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Member Posts: 654 |
Kobe has never responded to Metro either, however in saying that Trixie did respond to it very well from the looks of things (And has been able to gain weight while on it). I'd suggest you discuss it with your vet, and keep in mind she has responded to it so well, you could try a longer course of it. Each dog is different, so with this in mind find the balance of antibiotics that works for Trixie and run with that. | |
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-- Kobe - 5yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily, 2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6. Blood results April 2013 - B12: 596, Folate: >20. Read Kobe's journal that was started the day he was diagnosed here.
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Member Posts: 33 | Trix was on metro for 2 weeks. I haven't read enough to want to switch trix to grain free. She is on food recommended by this site and enzymediane's. I plan to put her on a longer dose of antibiotics. I don't know if my vet has tylan or if I should just leave her on metro. | |
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-- Trixie: 2 year old corgi/terrier/lab mix. Dropped 10 pounds over 4 months, finally diagnosed with EPI June 20th. Lowest weight: 15lbs. Goal: 25lbs. Currently: 23lbs Had a 6 week treatment of B12 injections and metronidazole. Eating 1/2 cup a food 3x a day of Wellness Complete Health Super5Mix Limited Ingredients Whitefish & Sweet Potato Recipe. Her Lab results were: TLI 0.4ug/L, B12 150pg/mL, Folate 15.3 ng/mL -Phil
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Member Posts: 1328 |
I agree she may need a longer dose of antibiotics. In terms of the food: most epi pups do better on grain free food. Wellness has a line of food that is grain free so you could stay with Wellness and just switch over to the grain free if you do not see an improvement. She has been gaining weight and may be one of the pups who does fine with some grain. I'm not sure if it was an error listing a food that has grain or it's listed for those whose pups need some grain. It's always a balance of enzymes, food, B12 and antibiotics (if needed). If getting B12 that is taken care of...getting enzymes so that is taken care of (though sometimes a tweak up or down is needed) so that leaves the food and the antiobiotics. If she had "tootsie roll" poops, was gaining weight and doing better on a food with grain and was getting antibiotics..and then the antibiotics stop and the poops go south, my first inclination is the antibiotics...but once back on them if you do not see an improvement in about a week then I would switch foods. Tylan is a "milder" antibiotic and if a pup needs a very long course of it (some pups here have to be on it indefinitely) than Tylan is the better choice....again if the poops and everything were "perfect" than you may want to stick with the metro...but if not quite right then maybe switch to the Tylan. You might want to print out the info about SIBO treatment for your vet to share with him/her and see what his/her call is about it. | |
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-- Terry Mom of two EPI Shiloh Shepherds: Pharaoh born Nov. 2007 and dx with epi December 2009. Pharaoh weighed 62.4 lbs. (15 lb. weight loss) when diagnosed in 12/2009. Weight 10/31/11 his weight was 76.6. 85lbs on 9/22/12. Received six weeks of B12 shots Jan-Feb 2010 but his B12 on 8/10/2010 was only 232. So started weekly shots at home, which we continue to give. His older half sister is Taiko born Sept. 2006 and was dx with epi June 2010. Since she has severe bilateral hip dysplasia she had always been on the thin side. Taiko's weight was 70.7 lbs. in June 2010 (time of diagnosis; about a 10 lb. weight loss. Weight on 10/31/11 was 80.4 and on 9/22/12 was 82.4 lbs. B12 was 211 in June 2010 so started six weeks of shots and was only 293 on 8/10/10. She receive B12 shots weekly at home. Both are fed twice a day and we use either Costco grain free brand or Merrick BG brand:2 1/2 cups kibble in the morning and 4 oz cooked meat (usually steak) with 4 crushed tablets and in the evening 2 cups kibble with 4 oz cooked meat with 4 crushed tablets.
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Member Posts: 654 |
My opinion would be to stick with what you know works - Metro. Consult your vet and ask to be given a 30 day prescription of it. If after 7-10 days, things still stay bad, then look at switching to Tylan if its needed and things point that way.
Obviously the regime you had was working - weight gain and perfect poo, so I would get back on that track and perhaps as Terry suggested, look at grain free as a future option of switching over. Kobe did fine on a grain filled kibble, until this year. So while it may be the answer now.. and as many things with EPI, it may be the answer now, but not in the future. But it's a trial and error game. | |
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-- Kobe - 5yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily, 2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6. Blood results April 2013 - B12: 596, Folate: >20. Read Kobe's journal that was started the day he was diagnosed here.
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Member Posts: 2118 |
Just wondering if she has managed to eat someting as they say that wasnt on the menu ???? How are her poops today sometimes 24 -48 hours can sort this out. If the metro was agreeing with her i would be inclined to go back to this for another 14 days. Ann | |
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-- ANN (UK)
Maddie DOB 01-10-2007 she is now 5 DX 04/11 .B12 140 now 644 TLI <1.00 Folate 14.2. B12 RETESTED 0N 21-05-2013 Value 902 after 15 months of daily piils Yipheeee Weight was 22.3kg now 33.2kg (04-05-12) she is a small GSDbut she gained .(24lbs) Feed a mixture of foods she does better on fibre 3% and below she has b12 tablets daily (imported from the USAhttp://www.wonderlabs.com/itemleft.php?itemnum=6881) now changing to the uk version from http://www.chemeyes.co.uk/ Also omega3 and Vitamin E daily. Use Panzym 1/4 a tsp per 200 grams of food .Got SIBO under control after antibiotics ( stormormgyl) used synbotic by protexin. a pre-probotic
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Member Posts: 33 |
She had to go out around 3am for another bought of liquid poop. I cut back her feeding last night and this morning until I can get her back on metro. She really was doing great up until yesterday, so hopefully all she needs is to be back on antibiotics. | |
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-- Trixie: 2 year old corgi/terrier/lab mix. Dropped 10 pounds over 4 months, finally diagnosed with EPI June 20th. Lowest weight: 15lbs. Goal: 25lbs. Currently: 23lbs Had a 6 week treatment of B12 injections and metronidazole. Eating 1/2 cup a food 3x a day of Wellness Complete Health Super5Mix Limited Ingredients Whitefish & Sweet Potato Recipe. Her Lab results were: TLI 0.4ug/L, B12 150pg/mL, Folate 15.3 ng/mL -Phil
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Member Posts: 654 | Hang in there.. Getting more will hopefully be the answer for her. Unless she's joined Kobe's clan and decided to eat jumpers, or something else that's upset her belly. | |
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-- Kobe - 5yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily, 2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6. Blood results April 2013 - B12: 596, Folate: >20. Read Kobe's journal that was started the day he was diagnosed here.
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Member Posts: 2057 | While grain, in and of itself, is not a bad thing, as Olesia learned in her recent research, too much fiber is. Generally, EPI dogs do better on foods with less than 4% fiber. Your current food has 5% fiber (which doesn't seem like much but can make a big difference). Food is often the most difficult variable to zero in for our dogs. Since you are restarting the metro, you will have time to do your research on food and fiber. Be sure to read the new section on fiber at the top of the web page. I'm sure Trixie will get back to normal quickly once she's back on the antis. Good luck! And keep us posted. | |
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-- Paula and Maya (bday 12/21/06) (diagnosed 10/26/10 TLi 1.5, B12 659 (ref:249-733), weight 52 lbs. After 30 days, retested B12/folate - B12 plummeted to 200, which greatly affected her personality. After following B12 protocol, currently giving weekly B12 shots at home. Weight in July 2012: 75 lbs - the picture of health.
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Site Owner Posts: 10217 |
Hi.... i too agree, talk to your vet about continuing antibiotics ..... since you did see improvement with the MEtro, talk to your vet about continuing them until you meet a full course of 30 days... or talk to your vet about switching to Tylosin. (this is what we did and same as what the other mentioned here... we saw an immediate improvement.... but..... as you have probably gathered, although there are general guidelines for an EPI dog, within these guidelines many of us have to tweak things until we find the right balance for our dog. THe foods that are recommended on the Dog FOod Options page are food that have worked for various EPI dogs..... some foods do have fiber in them that will not agree with every EPI dog.... it all depends on the individual dog.... runny brown food is "usually" indicative of a food sensitivity.... but in Trixie's case, SIBO is mighty suspicious since you just stopped the Metro..... or, what could be going on is that the Metro WAS working but the food itself is not agreeing and a week of food that is not agreeing with her cranked up the SIBO again.... or it could be that the SIBO was never completely gotten rid of and it's baacckkkkkk with a vengence.... or.... it could be that she is not maintaining her B12 and needs more which can be supplemented via Wonderlabs "Trinfac". As you can see....It can be VERY confusing!!! Anyway... i would talk to your vet about putting her back on anti's as your first change AND i would consider changing the food to a lower fiber content as your 2nd change.....and keep an EPI LOG..... taking written notes - -noting every change and observing if the change you made is working or not...... iis the best tool we have in figuring out how to find the best balance of things for our individual EPI dog. I know this is a lot and very confusing, especially in the beginning... but once you find the balance for Trixie.... it is not hard at all to take care of an EPI dog...just in the beginning it can be very daunting. | |
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-- Olesia, owned by Izzy-45lb SWD, Diagnosed at 1.5 years old - TLI results 1.3, Stable almost 7 yrs! Once stable, was able to reduce enzymes to only 1/2 tsp of Enzymes with each meal, but after almost 4 years of stabilization... had to increase the amount of enzymes to 3/4 teaspoon with each meal. Feed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane. I give 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. 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 and Low Thyroid. 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!
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Member Posts: 33 |
I have good news to report. We started by cutting back food from 1/2 cup 3x a day to 1/4 3x a day and she has had a day's worth of metro (250mg/day). She had her last liquid poop around 5:30pm yesterday. This morning her poop was 3 small turds, no liquid, no waking up in the night. She still got only 1/4 cup this morning, and we are going to raise that back up to 1/2 cup this afternoon and tonight. Hopefully this keeps up. | |
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-- Trixie: 2 year old corgi/terrier/lab mix. Dropped 10 pounds over 4 months, finally diagnosed with EPI June 20th. Lowest weight: 15lbs. Goal: 25lbs. Currently: 23lbs Had a 6 week treatment of B12 injections and metronidazole. Eating 1/2 cup a food 3x a day of Wellness Complete Health Super5Mix Limited Ingredients Whitefish & Sweet Potato Recipe. Her Lab results were: TLI 0.4ug/L, B12 150pg/mL, Folate 15.3 ng/mL -Phil
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Member Posts: 654 |
That's great news. As I'm sure you will, keep a close eye on it and if things slip back to sloppy ways, get your hands on some more Metro. As Olesia said above, keeping a log of everything you do is key. For now and for the future, you have something to reference back to. I recently used mine that I hadn't looked at for two years and the info in it is priceless! | |
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-- Kobe - 5yo GSD diagnosed with EPI in October 2009 (19 months old). 2 cups of Canidae Bison & Lamb Grain Free, fed 3 times daily, 2 Creon 25,000 per meal. Weekly B12 injections at home & daily Wonderlab Trinfac-B in between. Inner Health Plus Probiotic once a week.. EPI weight 33.5kgs, current weight 40kgs. Original blood results - TLi: 1.2, B12: 306, Folate: 15.6. Blood results April 2013 - B12: 596, Folate: >20. Read Kobe's journal that was started the day he was diagnosed here.
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At initial testing - TLI 1.2 (range 5-35) B12 254 (range 249-733) folate 20.2 (range 6.5-11.5) Natures Domain, Pancreatin 8x dosing is 3/4 tsp per cup, Trinfac-B Intrinsic Factor daily, probiotics with each meal and glucosamine chondroitin in the am. Hypothyroidism: Soloxine. Stable and happy 97 lbs.
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