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Molly's blood test are in confusing
Posted: 13 May 2019, 15:04
by Mom of a Tibetan
I got Molly's blood tests back. Please share any feedback and or experiences you have with this!
I'm working with a new holistic vet who isn't that versed with EPI. She did consult with an internist on Molly's blood work.
TLI was normal 24.7 says the range is 5-35.
Pancreatic Lipase immuno is 50 in 0-200 range.
***Cobalamin is low 196 normal range is 249-733!
Folate is 7.77 normal is 6.5-11.5 range
This is some what confusing situation....her symptoms were and some what now with the low B12 in line with EPI. She has two symptoms of IBS mucus in stools and diarreaha. I wonder if her pancreas has responded to the fecal transplants and enzymes?! 3 years ago before I gave her the fecal transplants she had chronic problems 6-8 months of cow pie foule smelling stools, loosing weight on any and all the raw foods. She stabalized with low fat meats after the fecal transplants. I'd had testing done for bugs in her gut back then and there weren't any.
She has responded with normal stools on the enzymes so I'll keep her on them.
I'm going to get the intrinsic factor B12 tablets. I've read that the intrinsic factor is critical with low B12 test results. The new holistic vet suggests the holistic route with a vit B complex, I may add that in.
I wonder has anyone had TLI fluctuate in 2 dif blood tests? ie normal on first blood test to find that it drops down to abnormal in a later blood test?
Anyone have any ideas and or experiences with this?
Re: Molly's blood test are in confusing
Posted: 13 May 2019, 16:30
by jilbert57
So definitely not EPI. Yes the cobalamin needs to be brought up, however since the pancreas is functioning not sure you have to have the B12 with the intrinsic factor added in. I am wondering if you have ever tried plant enzymes( ex. Totalzymes, Prozyme) as you probably don't want to use pancreatic replacement enzymes when EPI or pancreatitis is present. Just a thought.
Re: Molly's blood test are in confusing
Posted: 13 May 2019, 16:50
by Olesia711
Hi ... sorry for all the confusion, sometimes interpreting blood test is part science (objective) regarding the actual test values....and part intuition based on past experiences (subjective) regarding putting the whole picture together and getting a proper diagnosis.
And YES... the TLI test values can fluctuate... usually within range though.... you can read about TLI fluctuations on the TLI page.
HOWEVER...with the other kind of fluctuation.... where the TLI numbers vary dramatically.... that can be due to errors in the lab, blood sitting around longer (too long for one of the tests) or equipment fluctuation.
AND..... another situation that i have observed, that has not been clinically proven, but from reading multiple blood test results posted on the forum for 11 years and then reading a 2nd test results with totally different values.... and recently from helping the vet researchers with the EPI Metabolomic & Microbiotic Study where we saw the initial TLI blood test report of true EPI dogs and of SEPI dogs (not yet clinically EPI but showing a lot of the symptoms)... and of dogs that were definitely not EPI, not SEPI but still displayed some of the symptoms..... and then a few years later when re-tested yet again.... one of two things seemed to be most prevalent:
1. Many of the "initially" non-EPI dogs who displayed EPI symptoms went on to develop clinical EPI a few years later.
2.Some of the "initially" non-EPI dogs who displayed EPI symptoms went on to never develop EPI.... (many of these dogs were dealing with IBD)
So there is no set answer, but if the enzymes help... continue to use them BUT.... also continue to work with your vet to see if this might be IBD, IBS or some thing else... and DO re-test via TLI in another 6 months to a year.
Regarding the low B12 and it is indeed very low.....although over 80% of all EPI dogs have issues with their B12, low B12 is not just for EPI dogs, dogs with any gastrointestinal condition are at risk for low B12.
Please reconsider the double high dose of B12 you are planning to give...your vet is on the right path with more vitamin.... but instead of over dosing with B12....( give the B12 with the intrinsic factor (to cover all your bases ) ) but instead talk to your vet about also giving a good all around doggie vitamin....
Re: Molly's blood test are in confusing
Posted: 13 May 2019, 18:17
by Mom of a Tibetan
Hi Olesia,
Thanks for the feedback and suggestions. I will take your suggestion and retest down the road!
I don't know for sure if Molly needs the intrinsic factor (I feel like she does).
The vet leans toward a more holistic approach vs isolating the B12. She suggested Cataplex B, it does not have any B12 in it. It has Niacin, Thiamine and B 6 and glandular in it. Since Molly has such low B12 I don't know if she can produce B12 from a supplement. I have a call back request to the vet to discuss this.
The loose stools panting burping etc gets worse for Molly with higher fat content in her food...any thing with above 6% fat. So that is why I was planning to continue giving her the EPI enzymes with the raw diet and lower fat meals.
Thanks!
Olesia711 wrote: ↑13 May 2019, 16:50
Hi ... sorry for all the confusion, sometimes interpreting blood test is part science (objective) regarding the actual test values....and part intuition based on past experiences (subjective) regarding putting the whole picture together and getting a proper diagnosis.
And YES... the TLI test values can fluctuate... usually within range though.... you can read about TLI fluctuations on the TLI page.
HOWEVER...with the other kind of fluctuation.... where the TLI numbers vary dramatically.... that can be due to errors in the lab, blood sitting around longer (too long for one of the tests) or equipment fluctuation.
AND..... another situation that i have observed, that has not been clinically proven, but from reading multiple blood test results posted on the forum for 11 years and then reading a 2nd test results with totally different values.... and recently from helping the vet researchers with the EPI Metabolomic & Microbiotic Study where we saw the initial TLI blood test report of true EPI dogs and of SEPI dogs (not yet clinically EPI but showing a lot of the symptoms)... and of dogs that were definitely not EPI, not SEPI but still displayed some of the symptoms..... and then a few years later when re-tested yet again.... one of two things seemed to be most prevalent:
1. Many of the "initially" non-EPI dogs who displayed EPI symptoms went on to develop clinical EPI a few years later.
2.Some of the "initially" non-EPI dogs who displayed EPI symptoms went on to never develop EPI.... (many of these dogs were dealing with IBD)
So there is no set answer, but if the enzymes help... continue to use them BUT.... also continue to work with your vet to see if this might be IBD, IBS or some thing else... and DO re-test via TLI in another 6 months to a year.
Regarding the low B12 and it is indeed very low.....although over 80% of all EPI dogs have issues with their B12, low B12 is not just for EPI dogs, dogs with any gastrointestinal condition are at risk for low B12.
Please reconsider the double high dose of B12 you are planning to give...your vet is on the right path with more vitamin.... but instead of over dosing with B12....( give the B12 with the intrinsic factor (to cover all your bases ) ) but instead talk to your vet about also giving a good all around doggie vitamin....
Re: Molly's blood test are in confusing
Posted: 13 May 2019, 18:50
by Mom of a Tibetan
Hi Jill,
I think it was you who mentioned on my first post it didn't seem like Molly has EPI?!
As for the enzymes I have not heard of the plant enzymes you listed. I researched the two you listed and they may be an option! I'll run it by the vet too.
I've tied capsules from health food store with mainly Lipase, Protease and Amylase enzymes because she has the challenge with higher than 6% fat in meat meals. They weren't strong enough and didn't help. I also tried enzymes for dogs from Mercola and they didn't help her loose stools, panting, burping and gas.
As for the Pancrease enzymes the vet suggested I keep her on the 6x Enzyme Diane enzymes because they are helping and the pancrease won't hurt her, she suggested glandulars which are made from the organs. Hm Molly's Pancreatic Lipase Immuno # was at 50 of 0-200. The enzymes have made a huge difference creating stool constancy and she has little to no panting, burping and flatulence on them. Since being on the enzymes Molly has not had to go for a walk to defecate in the wee hours of the night!! Which she was doing off and on when not on the enzymes!
Thanks!
jilbert57 wrote: ↑13 May 2019, 16:30
So definitely not EPI. Yes the cobalamin needs to be brought up, however since the pancreas is functioning not sure you have to have the B12 with the intrinsic factor added in. I am wondering if you have ever tried plant enzymes( ex. Totalzymes, Prozyme) as you probably don't want to use pancreatic replacement enzymes when EPI or pancreatitis is present. Just a thought.