Need Help With Diagnosis

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.
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jilbert57
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Re: Need Help With Diagnosis

Post by jilbert57 » 04 Sep 2018, 19:25

I see. I also see that you use a probiotic. Probiotics are not recommended for acute pancreatitis but their effect on chronic pancreatitis is unknown. It restricts blood flow. Just something to keep in mind. Here is a good article:

https://www.whole-dog-journal.com/news/ ... 579-1.html
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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Olesia711
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Re: Need Help With Diagnosis

Post by Olesia711 » 04 Sep 2018, 19:45

i have a little something to add...but only from the lens of dealing with simply EPI or Chronic Pancreatitis or IBD or IBS..... regarding the liver enzymes..... if a dog has SID (small intestinal dysbiosis) the ALT liver enzymes may be elevated... and this is nothing to really worry about because once the SID (also formerly called SIBO) gets under better control, the ALT liver enzymes values will calm down too.

HOWEVER... please know that i have no idea how liver enzymes are or can be affected with everything that Tyson is dealing with......glad you are meeting with the neuro doc this week and maybe this is something else you can have him/her explain to you....

Also... please mention to the neuro about the low folate score, as mentioned earlier, that often is indicative of small distal proximal disease (i swear, another "vague" label for when they aren't sure what is really going on.....) as it can be many things... but the most common thing is a food sensitivity or sorts.... AND, please share this also with the neuro vet.... we have had cases her on the forum where the signs/symptoms made one strongly suspect EPI.. but when TLI tested it wasn't EPI... but rather a low folate score showed up and the dog was diagnosed with small proximal intestinal disease. The really really strange thing is that some of these dogs improved once pancreatic replacement enzymes were added to their meals. When the enzymes were stopped the loose stools returned... so the went back to using pancreatic replacement enzymes. I have no idea why this happened ... i just know that it has happened a few times... so...maybe also share this piece odd but positive result of using enzymes the neuro vet too.... just in case it might be of some help to make Tyson more comfortable.......
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.........

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Olesia711
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Re: Need Help With Diagnosis

Post by Olesia711 » 04 Sep 2018, 22:50

Deb,

check out the Diabetic thread... Judith has a dog, Nate, and they are considering taking him off his seizure meds due to them causing hyperchloremic metabolic acidosis.... so..... i am wondering if this might be causing a similar problem with Tyson too.

Might be yet another thing to discuss with the vet when you meet Friday.............
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.........

Tyson

Re: Need Help With Diagnosis

Post by Tyson » 07 Sep 2018, 17:24

Well it looks like the jury is back. We saw Tyson's neurologist today and she immediately said EPI. She doesn't believe it is medication induced but is going to consult with their GI specialist there at the hospital.
I missed a handwritten cpl at the bottom of one of the lab sheets that was only 184 so that ruled out pancreatitis. I did ask her about SID and she said no she did not believe that was the cause.
She drew some labs and I'll have the results probably on Monday. We are going to continue to taper off the prednisone. She did agree that it possible that Tysons recent relapse with seizures may related to malabsorption of the meds that we need to watch for toxicity.
She was good with diet switch and she recommended Missing Link Vitamins but I haven't been able to locate those. Anyone know these vitamins? Those feeding homemade food, what kind of vitamins are you using? New vet and I discussed the
B12 injections.
Tyson himself is doing pretty good. Though he did lose 6 pounds over this last 2 weeks. I am kind of surprised as he has been on the enzymes now for a week but the GI food is low cal and he has been getting more active. I was amazed at him playing with my new vets dog. So good to see and a long time coming. So now we have 2 very expensive diagnoses....sigh but he will have the best even if hubby gets peanut butter and jelly for dinner!!!

Judith
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State: Delaware

Re: Need Help With Diagnosis

Post by Judith » 07 Sep 2018, 19:35

Hi

So sorry you are going through this. Is there any way your vet would consult with Dr Rebecka Hess? She specializes isn endocrine disorders and is the chief of Internal Medicine at the University of Pennsylvania's Vet School.

I see a couple of things about your dogs meds:
prednisone interferes with phenobarbital and they should not be given together
zonisamide has a rare side effect of causing hyperchloremic metabolic acidosis, Dr. Hess caught this right away with my dog Nate's blood work, he's Addisonian and has EPI.
Keppra has a 'honeymoon' effect with many dogs and stops controlling the seizures after about a year or so

It would be worth checking his electrolytes.

Hope things improve soon
Nate and Raymi's mom
Nate 4 year old Pembroke Welsh Corgi
EPI, typical Addison's disease and epilepsy
TLI 2.0 June 2016
Chemeyes enzyme capsules
Hydroxocobalamin injections weekly
0.5mg prednisolone daily for Addison's
Percorten-V/Zycortal injection every 28 days for Addison's
Zonisamide 2x for epilepsy

Raymi 6 year old Pembroke Welsh Corgi
Allergic to chicken and turkey

Eats Canine Caviar Venison kibble 3x

Nate and Raymi happily live in Bogotá, Colombia and Dover, Delaware.

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Madelon
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Re: Need Help With Diagnosis

Post by Madelon » 07 Sep 2018, 20:29

Sorry I am just now seeing these posts. This way way out of my realm of knowledge but you are in great hands with Olesia, Jill and Judy - I just wanted to say welcome to our family - we are all here for you when you need us!
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

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Olesia711
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Re: Need Help With Diagnosis

Post by Olesia711 » 08 Sep 2018, 11:29

Sorry about now having to most likely deal with EPI...... but..... I am assuming the vet drew blood for another TLI to confirm EPI???? Is that the test results you are waiting for? If so ... PLEASE be sure to share with us when you get the results.

Regarding MIssing Link..... here is the company and the products.... best to contact the vet and ask specifically which product she wants you to use:
https://missinglinkproducts.com/purchase/dog/
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.........

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Olesia711
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Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Need Help With Diagnosis

Post by Olesia711 » 17 Oct 2018, 10:39

Wondering.... how is Tyson doing?????

Also.... just wanted to share with you.... i just read about canine research with seizures (and or epilepsy) and what they are discovering is that a Ketogenic diet can substantially reduce seizure activity in dogs having seizures.... specifically idiopathic seizures. In some cases this diet was actually more effective than the canine seizure medications!

They have also found the same results in children with seizures..........

Here is the link to the research if you are interested in reading about it:
Epilepsy-Seizures & Diet.pdf
(1.09 MiB) Downloaded 242 times
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.........

Tyson

Re: Need Help With Diagnosis

Post by Tyson » 21 Oct 2018, 07:39

Knock on wood...Tyson has been doing very well. I updated my signature with current food/meds/enzymes. He has had #2 poos now for weeks. New vet is calling him PIA for Pancreatic Iatrogenic Atrophy as he feels this was induced by medications. Whatever you want to call it he is thriving on the current treatment and I am good with that. I took your advice on advice initial diet (Thank you!!) and those couple of weeks allowed my brain to slow down and figure out a plan. I settled on the Balance It supplement with additional daily B12 injections. He's been on this for almost 10 days and the improvement is dramatic!! Much more energy, running like a nut and playing again. He is losing a few pounds which seems contradictory with the PIA but for him it is good. The high dose of steroids caused weight gain earlier in the year so for his health we need to get him down a bit. We weigh weekly so we make sure he isn't losing too quickly.
Excellent study on the ketogenic diet. Seems very promising. I am slowly adding fats into his diet to get it balanced and we've been doing good so far for a week with the addition of coconut oil. I need to be careful because he does have some gall bladder sludge. Our next addition will be the corn oil that the diet calls for.
Seizure wise we went 8 weeks without and then he has had 2 about 12 days apart. Our phenobarb level dropped from 30 to 15 without a change in dosage so I am thinking absorbtion issue and am now making sure that he has enzymes with all meds. We are also weaning off the prednisone so that may be part of the cause for seizure but at this time I don't want to change what we're doing. Must get him off the pred. Hopefully the MCT will help. If they get to be a problem I plan to add the CBD oil before any meds. We repeat bloodwork in the beginning of December and I am really hoping the liver enzymes show more improvement.

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Olesia711
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Posts: 3857
Location: North Carolina
Country: United States
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Pet name: Izzy
My name: olesia

Re: Need Help With Diagnosis

Post by Olesia711 » 21 Oct 2018, 11:11

I am so so SOOOoooooo glad to hear that Tyson is doing better.... isn't it amazing how food change and B12 can make a difference?

Glad you read about the Ketagenic Diet research for dogs with seizures......really interesting, eh?!....... and although i know with EPI and enzymes administration... that fat actually aids in better nutrient absorption (with the enzymes)..... and i am guessing that this might 'also be the case with "Pancreatic Iatrogenic Atrophy" but please check with your vet to make sure that the Ketagenic Diet would be okay to try with Tyson ... especially with everything he has going on.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301368/
Even with people (2017) they are now citing that EPI patients on enzymes that consume fat have a much better success rate "Corey et al. [16] compared 1000 patients from CF clinics in Boston and Toronto and demonstrated that prolonged untreated EPI is associated with a worse long-term outcome and that patients maintained on a high fat diet (100 g per day) with higher doses of exogenous pancreatic enzymes did better than those on a low fat, lower pancreatic enzyme regimen."

HOWEVER.... Tyson is unique.... if you can check with the vet, that would be great and PLEASE let us know what he says about this Ketagenic research... as i'd be very interested in what his take is on it!
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.........

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