Hello All,
I hope everyone had a nice Thanksgiving. I have Neko's test results.
B12-854ng\L
Folate-4.9ug\L
TLI- 50ug\L
My vet has advised me to give her 200 mg of folate once a day for 4 weeks and then retest to see if it's gone up. She said we should look into diseases that affect the top part of the small intestine. Right now her stools are still a 2 and she is eating well and has finally put on a pound(i think I put on 4 yesterday alone)
She will stay on the proviable as well. As always any feedback is welcome.
Waiting for test results
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Olesia711
- Founder & Research Director
- Posts: 3929
- Location: North Carolina
- Country: United States
- State: North Carolina
- Pet name: Izzy
- My name: olesia
Re: Waiting for test results
Hi Linda,
Thank you so much for posting the test results.... No wonder why Neko is having such issues..... notice the Folate value.... "Folate-4.9ug\L".... any test result below 7.7 means the dog has proximal small distal disease....
This is kind of a catch all phrase for, like your vet indicated, small intestinal issues. Very often (although not every single time) this indicates that there are food sensitivities as a result of this.
If you look on our B12 tab, under B12 protocol..... we have a layman explanation for Proximal Small Distal Disease"(explanation of proximal small distal disease : “Low serum folate concentrations particularly draw attention to the possibility of dietary hypersensitivity since the proximal small intestine is exposed to the highest concentrations of food antigens. A hypersensitivity reaction causing mucosal damage is therefore most likely to result in folate malabsorption”. http://www.revmedvet.com/2000/RMV151_559_563.pdf
simply put… A food intolerance could cause the low folate:
“Decreased serum folate can therefore be suggestive of damage to the proximal small intestine, as this is the main site for the absorption of dietary folate. There may be many causes of damage at this site, including dietary sensitivity which particularly affects the proximal small intestine where intraluminal dietary antigens are at their highest concentration e.g. gluten enteropathy in Irish setters. Alternative possible causes of proximal intestinal damage include idiopathic “inflammatory bowel disease” and lymphoma”. http://www.ivis.org/journals/vetfocus/19_1/en/2.pdf )
The normal range for Folate is 7.7 – 24.4 µg/L … high folate levels are an indication of SIBO (small bacterial intestinal overgrowth). Values above the normal range are consistent with bacterial overgrowth in the upper small intestine.
With this you kind of have to try things to see what works best... and you judge by "gut" reactions. How the poo is (loose/frequent or normal), how the tummy responds (gurgling, gas), weight gain/loss, etc.
If Neko is doing a #2 poo on the poo scale... that is GOOD!!!! then i would stick with the current food regimen you are giving. If the weight loss is continuing, then i would up the food BUT do not feed bigger portions but rather increase the food intake via by giving another meal.
If the poo starts to go downhill, these are some of the things that have been known to help some dogs: Just be sure when trying thing to only try a new item one-at-a-time so you can assess if that item is helping or hurting.
1. If you need to make a food switch... and if you want to try a different hydrolyzed food.... i would first and foremost try Royal Canine "ULTAMINO" hydrolyzed food..... this food seems to work much better on a wider population that we have dealt with than other lines of hydrolyzed foods. HOwever.... if what you are using right now is working. stick with it.
2. if the poos go south and/or if the tummy starts grumbling, i would absolutely "try" some slippery elm powder as this may help tremendously, or it may not agree at all with Neko's situation but well worth trying IF things go south.... especially since this very well could be a permeability problem in the small intestine.... slippery elm would / should help. (SLippery Elm is known for helping a lot of dogs (and people too!) with IBD or leaky gut syndrome)
3. Again, if the poos go south,, i would definitely "try" adding enzymes to the meal... i have no idea why this works in this case, but we have had other proximal small distal disease cases and some did not do well at all unless pancreatic enzymes were included in their food - -but then again, these were cases where they had loose, mushy stools and nothing else helped until enzymes were added to the meals .
4.Also for consideration especially now that it is known that there is a small intestinal issues....is that i would not use Metronidazole but rather 'IF" your vet or you feel that Neko needs an antibiotic for this i would definitely request Tylan (Tylosin Tartrate) over Metronidazole.
5. Also... with this DEFINTELY continue with the Proviable. WHat i did not mention before though is do not give any antibiotics at the same time you are giving Metronidazole... cause the Metro kills all the good bacteria.... you have to wait at least 2 hrs to give antibiotics and probiotics away from one another. EXCEPT with Tylan.... Tylan does NOT kill all the bacteria, but rather just inhibits the bacterial reproduction... So even though "technically" it is okay to give tylan antibiotic with a probiotic... i am still kind of old school and like to suggest to give even this combo 2 hrs away from each other.
6. And lastly, i am going to go out on a limb here with this suggestion, ... and.please don't think i am crazy, but IMHO... i would also give consideration to possibly doing CHinese herbal supplements ( maybe do your research into what type of medicinal herbs or mushrooms would best benefit Neko with an immune/gastrointestinal issue. IN addition to what your regular vet is recommending. Just from what you have mentioned, it sounds like your regular vet is on top of things (except for using Metronidazole- -but the new recommendations on this just came out this fall time... so it is very new) Anyway......if chinese herbal supplements would be something you might consider, Check with the American Holistic Veterinary Medical Association [url]https://www.ahvma .org/[/url] to find a holistic vet near you that maybe can help you with this possibility. someone that is fully certified and understands eastern medicine. As you can tell, i firmly believe in science and western medicine/ research etc.... but over the years, i have also seen/read/experienced holistic treatments/supplements that were poo-poo'd by the medical community and then a few years later, after traditional science did their own studies, all of a sudden, such and such plant/herb etc has been proven to have effective healing results after all. So, it might be worth looking into to see if there is anything in addition to regular treatments, that might be helpful to Neko's small intestinal issue.
Thank you so much for posting the test results.... No wonder why Neko is having such issues..... notice the Folate value.... "Folate-4.9ug\L".... any test result below 7.7 means the dog has proximal small distal disease....
This is kind of a catch all phrase for, like your vet indicated, small intestinal issues. Very often (although not every single time) this indicates that there are food sensitivities as a result of this.
If you look on our B12 tab, under B12 protocol..... we have a layman explanation for Proximal Small Distal Disease"(explanation of proximal small distal disease : “Low serum folate concentrations particularly draw attention to the possibility of dietary hypersensitivity since the proximal small intestine is exposed to the highest concentrations of food antigens. A hypersensitivity reaction causing mucosal damage is therefore most likely to result in folate malabsorption”. http://www.revmedvet.com/2000/RMV151_559_563.pdf
simply put… A food intolerance could cause the low folate:
“Decreased serum folate can therefore be suggestive of damage to the proximal small intestine, as this is the main site for the absorption of dietary folate. There may be many causes of damage at this site, including dietary sensitivity which particularly affects the proximal small intestine where intraluminal dietary antigens are at their highest concentration e.g. gluten enteropathy in Irish setters. Alternative possible causes of proximal intestinal damage include idiopathic “inflammatory bowel disease” and lymphoma”. http://www.ivis.org/journals/vetfocus/19_1/en/2.pdf )
The normal range for Folate is 7.7 – 24.4 µg/L … high folate levels are an indication of SIBO (small bacterial intestinal overgrowth). Values above the normal range are consistent with bacterial overgrowth in the upper small intestine.
With this you kind of have to try things to see what works best... and you judge by "gut" reactions. How the poo is (loose/frequent or normal), how the tummy responds (gurgling, gas), weight gain/loss, etc.
If Neko is doing a #2 poo on the poo scale... that is GOOD!!!! then i would stick with the current food regimen you are giving. If the weight loss is continuing, then i would up the food BUT do not feed bigger portions but rather increase the food intake via by giving another meal.
If the poo starts to go downhill, these are some of the things that have been known to help some dogs: Just be sure when trying thing to only try a new item one-at-a-time so you can assess if that item is helping or hurting.
1. If you need to make a food switch... and if you want to try a different hydrolyzed food.... i would first and foremost try Royal Canine "ULTAMINO" hydrolyzed food..... this food seems to work much better on a wider population that we have dealt with than other lines of hydrolyzed foods. HOwever.... if what you are using right now is working. stick with it.
2. if the poos go south and/or if the tummy starts grumbling, i would absolutely "try" some slippery elm powder as this may help tremendously, or it may not agree at all with Neko's situation but well worth trying IF things go south.... especially since this very well could be a permeability problem in the small intestine.... slippery elm would / should help. (SLippery Elm is known for helping a lot of dogs (and people too!) with IBD or leaky gut syndrome)
3. Again, if the poos go south,, i would definitely "try" adding enzymes to the meal... i have no idea why this works in this case, but we have had other proximal small distal disease cases and some did not do well at all unless pancreatic enzymes were included in their food - -but then again, these were cases where they had loose, mushy stools and nothing else helped until enzymes were added to the meals .
4.Also for consideration especially now that it is known that there is a small intestinal issues....is that i would not use Metronidazole but rather 'IF" your vet or you feel that Neko needs an antibiotic for this i would definitely request Tylan (Tylosin Tartrate) over Metronidazole.
5. Also... with this DEFINTELY continue with the Proviable. WHat i did not mention before though is do not give any antibiotics at the same time you are giving Metronidazole... cause the Metro kills all the good bacteria.... you have to wait at least 2 hrs to give antibiotics and probiotics away from one another. EXCEPT with Tylan.... Tylan does NOT kill all the bacteria, but rather just inhibits the bacterial reproduction... So even though "technically" it is okay to give tylan antibiotic with a probiotic... i am still kind of old school and like to suggest to give even this combo 2 hrs away from each other.
6. And lastly, i am going to go out on a limb here with this suggestion, ... and.please don't think i am crazy, but IMHO... i would also give consideration to possibly doing CHinese herbal supplements ( maybe do your research into what type of medicinal herbs or mushrooms would best benefit Neko with an immune/gastrointestinal issue. IN addition to what your regular vet is recommending. Just from what you have mentioned, it sounds like your regular vet is on top of things (except for using Metronidazole- -but the new recommendations on this just came out this fall time... so it is very new) Anyway......if chinese herbal supplements would be something you might consider, Check with the American Holistic Veterinary Medical Association [url]https://www.ahvma .org/[/url] to find a holistic vet near you that maybe can help you with this possibility. someone that is fully certified and understands eastern medicine. As you can tell, i firmly believe in science and western medicine/ research etc.... but over the years, i have also seen/read/experienced holistic treatments/supplements that were poo-poo'd by the medical community and then a few years later, after traditional science did their own studies, all of a sudden, such and such plant/herb etc has been proven to have effective healing results after all. So, it might be worth looking into to see if there is anything in addition to regular treatments, that might be helpful to Neko's small intestinal issue.
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.........
Re: Waiting for test results
Olesia, many thanx for all your insight on what's going on with Neko. Truly this site has been much more informative than what I can get from talking to my vet in my car because of covid....I will definitely keep in touch as we move forward.
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Olesia711
- Founder & Research Director
- Posts: 3929
- Location: North Carolina
- Country: United States
- State: North Carolina
- Pet name: Izzy
- My name: olesia
Re: Waiting for test results
You are more than welcome. Because of this damn virus it is very hard nowadays to have a good chat with any vet.....such a disservice to vets and their practice and a disservice to clients and their pets. Can;t wait until this virus subsides and life can go back to semi-normal!
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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Madelon
- Staff
- Posts: 1317
- Location: Nashville, TN
- Country: United States
- State: Tennessee
- Pet name: Doc
Re: Waiting for test results
Hi Linda - just wanted to check in on Neko and see how things are going.
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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