Razzie 14 year old

[jilbert57]

Welcome to the forum. Well it is not pancreatitis with a score of 110. Is it fair to say your vet is not open to suggestions you bring to the table? Getting the SID under control might also help other issues.
This is from the TAMU vet site:

"Serum TLI values above 50.0 µg/L (dogs) and 100.0 µg/L (cats) may be associated with either acute or chronic pancreatitis or decreased renal excretion due to severe renal insufficiency, although our experience suggests that serum TLI is often minimally increased even in severe renal failure. Elevated serum TLI concentrations are also seen in some malnourished patients (dogs usually) without evidence of pancreatitis, and in some cats with patchy pancreatic hypertrophy/atrophy (generally considered to be a benign age-related change). Because increased serum TLI concentrations are not specific for pancreatitis it is important to perform a PLI test before concluding a patient has pancreatitis. Serum TLI is increased in only approximately 30-40% of cats and dogs with pancreatitis; normal test results do not rule out the possibility of pancreatic inflammation. If pancreatitis is suspected, a PLI test should be performed. In cats increased serum TLI is often also observed with small intestinal disease. In these cases serum concentrations of cobalamin and folate should be determined for evaluation of the small intestine."

So you have elevated Tli and normal cPl and it says renal issues and/or malnourish. I would tend to this also. Don't know about the use of enzymes when neither EPI nor pancreatitis is present. Have they had your pup on a renal diet?

[Olesia711]

Hi and thank you so much for those test values. As suggested... this isn't EPI... and it doesn't look like Pancreatitis.

The elevated liver enzymes ALT is (my guess) most likely due to SID and with such a high Folate score, although not to be used as a diagnostic tool.... is high which also "indicates" SID...... did anyone explain this to you? Did anyone suggest or give Tylan antibiotics for SID. SID can happen with any gastro condition like IBD, IBS, etc.... and not just EPI.

Next the fact that the AST level went back to normal AFTER you reduced those medications "indicate" that it was the medications elevating the AST... (which is a HUGE relief, as this is another liver enzyme- -and when out of whack then you have something to worry about)

Okay that GGT.... that can either be something to worry about or... it could be nothing to worry about cause it can also be triggered by drugs.... here is an explanation of GGT that may help you better understand the possibilities of what might be going on: "Various types of liver damage will raise GGT levels in your pet’s blood. GGT levels tend to rise significantly any time bile flow within your pet's liver is blocked (cholestasis). Bile duct obstructions (by gall stones or duct inflammation), liver tumors or secondary to pancreatic inflammation can all cause high GGT levels.

Corticosteroid medications can also raise GGT levels, as can drugs given to control epilepsy (phenobarbital), biliary tract hyperplasia or biliary tract inflammation (cholangiohepatitis)."

So.... as you can see... the GGT level might be raised because there is a problem with the liver... OR... it might be raised simply because of the meds your dog is on.

I have to agree with your vet, in that i wouldn't want to do a scope at your dog's age either.....to positively see if this is IBD either... Although it sure sounds like it could be a possibility since EPI has been ruled out, which BTW, i commend whoever made the decision to test for EPI first ... smart move and the most logical next step.


The only other thing i can think of is to ask your vet if you can try a true "HYDROLYZED" dog food.... there are only 5 on the market, the latest being by Blue (but i personally am not impressed with their ingredients) Many of us have had the best luck with Royal Canin "Ultamino" hydrolyzed food. Hydrolyzed food is processed in such a manner that that body will not recognize protein ingredients therefor eliminating ANY possible offending food sensitivity with IBD..... so... you might want to try this instead of the EN... although EN is a very good food for those battling most unknown gastro issues.........

The only thing i will warn you is that Royal Canin "Ultamino" or any of the Hydrolyzed foods are expensive and you never know which brand out of the 5 are going to work best for your dog (if this is IBD or IBS) so... if you decide to try this, my thought is to ask the vet (since this is a prescription food) to get you the smallest bag possible... just in case it doesn't work.

Not sure if any of this is helpful.... but i hope so.

[Jean]

as far as Royal Canin is concerned, they have a returns policy which can be used once over here in UK

This is way out of my knowledge

Jean

[Madelon]

Hi there. Glad Olesia chimed in. I too was going to suggest Tylan for SID as that could definitely be going on as well as the Royal Canin Ultamino food. It's so hard and frustrating when you don't know for certain what is going on. Please keep us posted - your pup is lucky to have you!