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Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 01 May 2019, 11:25
by Judith
Hi Bri

A cbc and chemistry panel will let you know if there is an infection, if she is anemic, kidney and liver function, pancreatitis, etc. It gives a overall a picture of what is going on and is usually the first step when a dog has had bloody diarrhea for a period of time. The medications your vet has given are basically acting as a bandaid, just covering up symptoms. Your vet is just throwing medicines at the issue in hopes that something works. Prednisone can be a cure all and unless dogs have a specific problem (Addison's, IBD, IMHA, cancer) should not be used for long periods of time. You need to get to the bottom of what is causing this. From what you are describing it could be IBD or Addison's. I would want to consult with an internal medicine vet since your vet has not been able to help the current issue

B12 injections are a good idea but you really need to find out what is wrong with Opal. Checking her B12 level is fine but I would do a cbc and chem panel first (it is usually between 100 -250 depending on what the vet wants). There is no need to repeat the cTLI, once a dog fails it they will always have EPI

Hope this helps and you figure out what is going on soon.

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 01 May 2019, 11:53
by Bri S
Thank you thank you thank you!!!!

That is such great insight. I just don't know what panels or tests to have done. I will certainly read right from your email to her vet and ask about having those done. I agree that at this point the meds are a bandaid that is just not working. We want to figure out what is really wrong with her.

THANK YOU for the great info!!!!

- Bri & Opal

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 02 May 2019, 22:01
by Madelon
Thank you Judith so much for chiming in .and offering your valuable insight!

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 03 May 2019, 11:12
by Bri S
Yes, Judith that was most helpful! I appreciate it so much - THANK YOU!!!!

A slight update, Opal had her cbc panel done on Monday and I talked to only the vet tech about her results yesterday as Opal's usual vet will call with detailed results today - but the vet tech said that there were no red flags or anything that we wouldn't expect to see on the panel. So that is somewhat good I think? Like I said waiting to hear the more detailed version from her vet today but the initial review sounds hopeful.

A Hill's food representative was in their vet clinic for a meeting yesterday and I was told that Opal's vet discussed Opal directly with the rep and the issues that we are having regarding getting her EPI managed. Opal has been eating Hill's Prescription Diet i/d Digestive Care Chicken Flavor Dry Dog Food - NOT the low fat version of their i/d food - she eats the regular i/d food. Opal lost so much weight while trying to diagnose her EPI that the vet encouraged her to be on the regular i/d to gain weight; opposed to the low fat i/d so that's what we have stayed with. The representative from Hill's told our vet to switch her to low fat i/d immediately in hopes that it would work better for her to process..... That perhaps now her tummy has decided it can't handle the regular dry i/d food.

It looks like the main difference in ingredient analysis is that the low fat i/d has 6% min-9% max crude fat while the regular i/d has 10% minimum. So perhaps the regular i/d food got to be too much fat for her to process? Protein is the same at 20% on both foods and fiber is slightly higher in the low fat i/d at 5% max opposed to regular i/d which is 3.5% max. Hopefully that isn't too much fiber for her, that worries me slightly! The vet said we could switch her right over since we are moving from the same brand of i/d to low fat i/d but Opal has SUCH a sensitive tummy that I am doing 50/50 for a few days to try and transition her a bit but asap if the low fat i/d will make her feel better. Just don't want to do too much at once!

I started the 50/50 last night for her dinner and bed time snack as well as breakfast this morning and Opal has definitely asked to go outside to potty more often..... but has almost been a bit constipated and when she does go it isn't a ton. So I think that is good? So hard to tell at this point lol. There is still a little blood in her stools, but I wouldn't expect this to fix things right away so we shall keep our fingers crossed. Opal was definitely not as active this morning as usual.... sleepier and more lazy than normal. Poor thing! I am sure she is tired and that her tummy doesn't feel great.

I am waiting to hear from her vet today for those detailed cbc results - and to see when we'll proceed with the B12 test as I'd like to get that done too to see where her levels are there. Try whatever we can to pin point what's wrong with our sweet little corgi!

Thanks Again,
- Bri & Opal

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 03 May 2019, 11:41
by Judith
Hi Bri

Please ask your vet to email you the results of the cbc. Did they do a chemistry panel. It is the chemistry panel that would look at kidney function, liver function, the pancreas and electrolytes.

It is always a good idea to get a copy of any blood work and results so if you are ever have an emergency you have a copy of Opal's records. I keep both a file on the laptop and a paper file with Nate's results. It has come in handy many times

Hope you get some answers. I don't think the difference in fat between the Hill's ID regular and low fat would be the reason for all the issues she is having.

Good luck

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 03 May 2019, 12:04
by Bri S
Another great idea, I will definitely ask for it to be emailed so I have a digital copy. I have every single vet record and print out at home in a file folder for Opal but certainly doesn't hurt to have it digital too.

Hoping to get some answers soon once I talk to the vet more in depth about the panel and in regards to doing a B12.

Thanks again, I really appreciate the insight!!!

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 03 May 2019, 16:49
by Patsy
Good advice from Judith.
Talking to a dog food rep won’t get you anywhere. Like drug reps, they don’t require specialist knowledge, just a persuasive manner to get orders= commission.
At one time my son was a used car salesman, he could sell anything to anyone. A tiny bit of conscience prevented him selling them to nice, old people.
Our members are the experts on dog food, we see the results.

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 03 May 2019, 23:30
by Riley's Mom
I agree with Patsy, and not to make your head spin, but feeding low fat for EPI is actually old school thinking. Most (but not all.....they are all so different) EPI dogs do just fine on regular fat content food.
See how she does with the switch, keep careful notes so you can track her response.

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 05 May 2019, 13:15
by Madelon
I have to agree with Patsy as well. Food reps typically are not going to be knowledgeable about specific dog conditions, let alone one that is not seen that often like EPI.

This may have already been addressed before, but is there a reason for feeding the Hills i/d? The ingredients may be the issue as it contains rice, corn, pea protein, etc. We recommend grain free as the grains can interfere with the efficacy of the enzymes. If it's because of the possible kidney issue then maybe try another prescription food?

I hope you can get some answers soon.

Re: Newly Diagnosed Corgi w/EPI - Suggestions?

Posted: 06 May 2019, 12:14
by Bri S
Thanks for the recommendations and words of warning, everyone.

I certainly understand that a food rep is not someone with a doctorate and mainly a sales person who wants to push their product, but I do think that trying to feed her the low fat i/d Hills is worth a shot - mostly because Opal had done SO WELL on the Hill's regular i/d in the past. She started eating Hilll's at the point of EPI diagnosis last year because she was eating blue buffalo prior to finding that she had EPI and her vet recommended Hill's. I do want to get her onto a grain free diet at some point but right now goal #1 is getting her tummy settled down and the blood out of her stools.

We had a GREAT day on Saturday and Sunday this weekend. We added in 1/2 of a pill 2x a day of metronidazole on Saturday for lunch and Opal is no longer frantically running around the yard to potty and her stools have improved.... still a tan/orange color and soft but there is no longer blood in them. It appears that she is finally starting to process the food better. Blood had been in her stools for the past few weeks while we've tried tweaking things so this is promising that we are on the right track by adding in the metronidazole.

Opal is eating a mixture of 60% low fat i/d to 40% regular i/d Hill's food right now. I know that metronidazole is not a long term solution but it is clearly helping. She slept thru the night for the first time in a month to a month and a half last night without asking to be let outside. It was heavenly for all of us! Has anyone had their dogs on metronidazole for extended periods of time? Opal has been consistently on Tylan and hasn't been able to get off of it - so I am now curious if we can swap metronidazole out for Tylan. Have any of you heard of long term side effects or dangers with prolonged use of metronidazole? I'll talk to Opal's vet about that. However for now, it is definitely working.

I have a call into her vet this morning to discuss how she is doing currently and to schedule a blood draw for the B12 level testing - hopefully tomorrow or Wednesday morning. Her cbc panel came back totally normal - no pancreatitis or kidney failure.... which I was worried about. PHEW! Her vet said that sure she was a little high or low in a few areas but it showed nothing to be worried about and that she was very pleased with her results. She said if she didn't know it were Opal's cbc results she would deem the dog healthy - however we know Opal isn't doing too great right now. This weekend was a glimmer of hope, fingers crossed that it continues to improve.

Thanks!
Bri & Opal