Liver enzymes ALT level of 1500

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
Barb
Staff
Posts: 918
Country: United States
State: New Jersey

Re: Liver enzymes ALT level of 1500

Post by Barb » 22 Oct 2021, 16:44

Hello Elizabeth, I am just catching up with your thread. You are in great hands with Olesia and it sounds like you have a good plan. Your pup is lucky to have you. And you are right. We are constantly trying our best to figure out what is best for our dogs. It isn't always easy. Your love for Whiskey is evident.

Olesia is right about the vets who are willing to learn. When Kolby was diagnosed, our vet at the time read everything I gave him. He had had only one other EPI case in 30 years, so he knew that he didn't have a lot of experience with it, but he was willing to learn and took good care of Kolby.

Let us know what your vet says. Try not to be too anxious.....not easy, I know.

Barb

User avatar
Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Liver enzymes ALT level of 1500

Post by Olesia711 » 22 Oct 2021, 17:22

Hi Elizabeth... no do not stop the Metro antibiotic..... wait until you speak with your vet and have her swap it out for Tylan.
Regarding the slippery elm... sure.... try some and see if that helps... with a prebiotic you do not have to worry if the Metronidazole or any other antibiotic will killl it cause a prebiotic is just food for the bacteria... it's the probiotic that you cannot give with most antibiotics cause the antibiotic just destroy it. That is why they say always give probiotic at least 2 hours away from an antibiotic. BUT since slippery elm is a prebiotic (i know, it can be confusing, eh?!) you can give it in food along with the Metro...and hopefully the vet will swap out the metro and give Whiskey some tylan instead.

Just be sure to add a tablespoon or so of water/liquid when you add slippery elm powder to the food, since it thickens everything. And if you can see what kind of poo output happens after you administer slippery elm. Use the SLippery Elm dosing guide on this page: https://epi4dogs.com/slippery-elm/.

usually the enzyme to food ratio is 1 tsp per 1 cup of food..... some dogs, after they settle out can use less enzymes, but some dogs need more. So i think giving 2 tsp of enzymes per 2 cups of food is a smart move... actually since you are also giving 1/4 cup of soft food too... it wouldn't hurt to give 2 tsps plus 1/8 tsp of enzymes for the amount of food that you are feeding....

Regarding what type of food...for now i would stick to what you are doing since you are (a) giving more enzymes (b) going to try some slippery elm- -this you should see an almost immediate improvement or nothing at all or if an immediate worst poo output, then stop the slippery elm. What you don't want to do is make too many changes at once.
After you assess the increased enzymes o see if that is helping... and assess if the slippery elm is helping or not.... hopefully by then it's the beginning of next week and you can speak with your vet about Tylan vs. Metro... and THEN if that doesn't help... then you will need to see if some food ingredient is perpetuating this uncontrolled SID.... if this is what is going on and not something else.

With EPI you always want to try things one at a time...........

Hope this helps.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
nessmuk@ntcnet.com
Member
Posts: 49
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 23 Oct 2021, 10:39

Thank you again! My vet just emailed me and she read the research, agrees with your medicine suggestions and will have them ready for me on Monday! Yay! I hope they work and that we are on the road of complete recovery and even better health for Whiskey. Should I continue giving him the denamarin?
Another question. In the past I noticed when I tried to increase his enzymes a little he sometimes would spit up a little bile almost like a burp up of fluid. Not often just once in awhile. Back then when I ask my vet they said I could give him a famotidine pill. I was excited to see that this time when I increased his enzymes he didn't do it until yesterday he did. Is this normal for EPI dogs to do? Does it make sense that it was related to the enzymes or it might have been something else, it is hard to tell.
Thanks again for answering all of my incessant questions. I am just so excited to have some help with managing his health and understand his condition!
Take care and have a wonderful weekend!
Elizabeth

User avatar
nessmuk@ntcnet.com
Member
Posts: 49
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 23 Oct 2021, 10:40

Thanks Barb for your support and encouragement! Much appreciated!

User avatar
Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Liver enzymes ALT level of 1500

Post by Olesia711 » 23 Oct 2021, 20:26

hi Elizabeth, sorry that it has taken me all day to respond... we were traveling today, so i wasn't online.

I am so pleased that your vet had time to read the research and will be swapping out the metro for the tylan on Monday! we basically follow the TAMU protocol for EPI.

Regarding the Denamarin... YES! Please do continue giving this as instructed by your vet.
And the spit up/acid reflux, regurg, etc .... all that is very common with EPI dog. EPI dogs have a malfunction with their secondary bile acid working properly. with some of the dogs, you don't notice any symptoms, with others...you do.. and that is when an acid reflux med is given. Try it on a temporary basis... see if that is enough to help the situation. So yes, go ahead and give Whiskey the famotidine. If it doesn't help, then tell your vet that what they next recommend is Omeprazole....

Please keep us posted!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
nessmuk@ntcnet.com
Member
Posts: 49
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 24 Oct 2021, 00:01

As always, thank you so very much for your response and no need to apologize for the lateness I am just over the top happy that I have you guiding me! You are angel sent from heaven to me!!! But I am sure you hear it all the time as you have helped so many people and our fur babies! I don't have children and my dogs are my kids, I would do anything for them. I too was very happy with my vets follow up on a non working Saturday and sending a private email to me. She is very busy and short staffed at a small rural vets office so I am so glad she got right back to me. I am sure this will help her treat other EPI dogs in the future. Poop update, I just followed Whiskey around in our woods in the dark to catch him pooping. I am attaching a photo. FYI, it is 36 degrees here in the Adirondacks and I didn't think to take the photo right away. As you can see it was first very soupy yellow pile but finished with slightly formed light brownish soft serve. I will take the improvement in color as a good thing...small steps.
Take good care and again thank you for caring and giving so much to the world! I pray you and all those you love are blessed beyond measure!
Elizabeth
PS I am also attaching a photo of my sweet Whiskey! He is in the back seat of our truck and trying to look cute at us in the front seat!
Attachments
Whiskey thank you!
Whiskey thank you!
InkedIMG_20210911_141157759 (1)_LI.jpg (2.12 MiB) Viewed 1430 times
Whiskey poop 10/23/21 11:00 pm
Whiskey poop 10/23/21 11:00 pm
IMG_20211023_231035157.jpg (702.24 KiB) Viewed 1430 times

User avatar
nessmuk@ntcnet.com
Member
Posts: 49
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 25 Oct 2021, 15:03

I have a dosing question on the antibiotic tylan. You mentioned the following "Once you start the tylan (45 days regimen/twice a day)" but my vets directions on the Tylan soluble powder 100am=(8tsp)packet said give 1/8 tsp once a day on food. He is 75 lbs. Your thougths? Thanks!

User avatar
Jean
Forum Director
Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Liver enzymes ALT level of 1500

Post by Jean » 25 Oct 2021, 15:32

My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

User avatar
Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Liver enzymes ALT level of 1500

Post by Olesia711 » 25 Oct 2021, 15:43

Ahh Whiskey sure is looking very "zen" :)
But that poo... that sure looks like typical SID poo....
SOoooo glad you got the Tylan, the dose for an EPI dog at 75 lbs is 1/4 tsp (with food) twice a day with (before during or after) breakfast and dinner.

Give this dose of Tylan for 45 days.
about half way thru the 45 days... talk to your vet about introducing a pre+probiotic. We suggest either Visbiome or Proviable. Mention this to your vet and see what she prefers/suggests.

After the 45th day... do not stop the Tylan completely but rather slowly ween WHiskey off of it.... although this "weening" suggestion is not part of TAMU's protocol, but rather Epi4Dogs protocol it is based on years of repeated positive observation. This weening technique appears to benefit a lot of EPI dogs coming off Tylan and appears to help them avoid a relapse (Tylosin TRD ).

I actually spoke to Dr. Jan Suchdolski about this during one of our conference calls about the EPI gut flora and he said that probably the reason why we noticed weening off the Tylan works better is because it actually makes a lot more sense then just stopping completely at the 45th day. At the very least, it won't hurt anything..... SOOOOOOOOOoo please do try weening off vs. stopping cold turkey after 45 days.

And per usual, be sure to share with your vet what we are suggesting to you :)

Please keep us posted on Whiskey!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
nessmuk@ntcnet.com
Member
Posts: 49
Location: Upstate NY
Country: United States
State: New York
Pet name: Whiskey
My name: Elizabeth

Re: Liver enzymes ALT level of 1500

Post by nessmuk@ntcnet.com » 25 Oct 2021, 20:06

I emailed my vet your prior post with the dosage suggestions plus the link to your website page that Jean sent to me but she hasn't written back yet. I gave Whiskey 1/8 of a tsp his food this afternoon because I hadn't received your email until after he ate but tomorrow I will up it to 1/4 tsp like you suggest. Hopefully she agrees with your recommendation as I will quickly run out of the amount she gave me. She also gave me proviable-forte M/L to give him later on.
Thanks again, ...glad you liked my Zen Whiskey boy!

Post Reply

Who is online

Users browsing this forum: No registered users and 241 guests