Mei - doubtful EPI diagnosis (?)
Posted: 04 Jun 2019, 11:50
Hi everyone! I’m so glad this forum exists, because I’m at the end of my wits, and I think my vet is, too. At this stage, I’m not even sure anymore if my dog, Mei, has EPI at all.
Let me tell you a little bit about Mei first. She’s just turned two, roundabout in April or May. When she was about 4 months old, her and her brother were thrown over the fence of the animal rescue from where we adopted her when she was about a year and half. She was and still is (although much less now) an incredibly fearful dog, and in the rescue she would hardly eat because of this. Everybody thought that this was why she was so skinny. However, from the first day with us, she had an insatiable appetite and she would wolf every meal down within seconds - she still does that despite all the methods we use trying to slow her down. In the beginning we got her high energy food, which we noticed didn’t help at all with her weight and she kept having diarrhoea. So we had her checked up at the vet. The vet did several tests and was able to eliminate many potential causes (e.g. parasites, illnesses like Leishmaniasis, Heartworm etc.). After a bloodtest, the vet told us the diagnosis EPI. Also, Mei’s vitamin B12 was way too low.
So this was 3 months ago. Mei has been on enzymes (PancreaPharma first, then Lypex), probiotics (Enterovital) and on weekly vitamin B12 injections. Her poo has been absolutely normal for at least 2 months, she’s full of energy and still has this huge appetite. She would sometimes pick up things on walks, like leaves, certain kinds of poop (especially rabbit poo) but she never ate her own poo or any inorganic things. Recently, the vet advised not to let her off the lead too much or at all, so her body has a chance to put on weight instead of burning it all off running. I personally believe she gets way too much food to be burned off by a bit of running. But of course we’re trying everything. However, in all this time she has not put on any weight at all and her vitamin B12 level is still super low. Last week here faeces was sent to the lab to see if she eliminates fats, proteins etc. instead of absorbing it into the body. There was nothing! Everything very normal and as it should be (she also was again tested for parasites, this was negative too).
I do think that to a certain extent her scrawniness could be attributed to her breed and nature - although we don’t know her breed exactly, she might have some Podenco in her. But even so, she is painfully thin. And then there is the issue with the vitamin B12, which worries me. Her body just doesn’t seem able to absorb it, even after weeks and weeks of weekly injections. She has no other symptoms, no flatulence, no rumbling sounds and no diarrhoea in months. We even changed from one enzyme to another (now on 3 Lypex/day), because we thought the enzyme wasn’t working.
The full blood test in January revealed slightly elevated MCV (73.3 fl)and MCH (24.7 pg) and also Bilirubin (0.6 mg/dl).
Early March Mei’s TLI was 9.6 ng/ml and vitamin B12 level 206 pg/ml.
The repeat test about 10 weeks later was taken after fasting her for 7 hours, it revealed TLI 6.6 ng/ml and vitamin B12 level 202 pg/ml - after 10 weeks of weekly injections!
Does this sound familiar at all to anybody here? Does this sound like EPI at all? I’m really starting to doubt this and I’m losing confidence in my vet as well. I wonder are we giving her meds (specifically enzymes) that aren’t really necessary, but I don’t dare discontinuing them. Before I change vet and start from scratch with another one, I’d rather get the opinion from other experienced dog/cat-parents.
Sorry for writing a whole "book“ and thank you in advance for your suggestions, opinions and advice.
Anja and Mei
Let me tell you a little bit about Mei first. She’s just turned two, roundabout in April or May. When she was about 4 months old, her and her brother were thrown over the fence of the animal rescue from where we adopted her when she was about a year and half. She was and still is (although much less now) an incredibly fearful dog, and in the rescue she would hardly eat because of this. Everybody thought that this was why she was so skinny. However, from the first day with us, she had an insatiable appetite and she would wolf every meal down within seconds - she still does that despite all the methods we use trying to slow her down. In the beginning we got her high energy food, which we noticed didn’t help at all with her weight and she kept having diarrhoea. So we had her checked up at the vet. The vet did several tests and was able to eliminate many potential causes (e.g. parasites, illnesses like Leishmaniasis, Heartworm etc.). After a bloodtest, the vet told us the diagnosis EPI. Also, Mei’s vitamin B12 was way too low.
So this was 3 months ago. Mei has been on enzymes (PancreaPharma first, then Lypex), probiotics (Enterovital) and on weekly vitamin B12 injections. Her poo has been absolutely normal for at least 2 months, she’s full of energy and still has this huge appetite. She would sometimes pick up things on walks, like leaves, certain kinds of poop (especially rabbit poo) but she never ate her own poo or any inorganic things. Recently, the vet advised not to let her off the lead too much or at all, so her body has a chance to put on weight instead of burning it all off running. I personally believe she gets way too much food to be burned off by a bit of running. But of course we’re trying everything. However, in all this time she has not put on any weight at all and her vitamin B12 level is still super low. Last week here faeces was sent to the lab to see if she eliminates fats, proteins etc. instead of absorbing it into the body. There was nothing! Everything very normal and as it should be (she also was again tested for parasites, this was negative too).
I do think that to a certain extent her scrawniness could be attributed to her breed and nature - although we don’t know her breed exactly, she might have some Podenco in her. But even so, she is painfully thin. And then there is the issue with the vitamin B12, which worries me. Her body just doesn’t seem able to absorb it, even after weeks and weeks of weekly injections. She has no other symptoms, no flatulence, no rumbling sounds and no diarrhoea in months. We even changed from one enzyme to another (now on 3 Lypex/day), because we thought the enzyme wasn’t working.
The full blood test in January revealed slightly elevated MCV (73.3 fl)and MCH (24.7 pg) and also Bilirubin (0.6 mg/dl).
Early March Mei’s TLI was 9.6 ng/ml and vitamin B12 level 206 pg/ml.
The repeat test about 10 weeks later was taken after fasting her for 7 hours, it revealed TLI 6.6 ng/ml and vitamin B12 level 202 pg/ml - after 10 weeks of weekly injections!
Does this sound familiar at all to anybody here? Does this sound like EPI at all? I’m really starting to doubt this and I’m losing confidence in my vet as well. I wonder are we giving her meds (specifically enzymes) that aren’t really necessary, but I don’t dare discontinuing them. Before I change vet and start from scratch with another one, I’d rather get the opinion from other experienced dog/cat-parents.
Sorry for writing a whole "book“ and thank you in advance for your suggestions, opinions and advice.
Anja and Mei