Ruger - New Case Trying to Stabilize

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
SallieS
Member
Posts: 17
Country: United States
State: North Carolina
Pet name: Ruger
My name: Sallie

Re: Ruger - New Case Trying to Stabilize

Post by SallieS » 17 Aug 2022, 09:02

Good Morning Everyone,
I hope you all are having a good week. Ruger had his blood test and ultrasound yesterday. Lol, he’s rocking his new haircut where they shaved his sides. ;)
At this point I can let you know what I have been told, but I have no written results yet. Our vet called me and said the ultrasound showed nothing abnormal. She said there was no thickening or anything else that would indicate IBD.
As for the blood work, she said all looked good but her machine was not acting completely right so she was sending it out to a lab to verify her results. She was waiting for a service call on the machine, but the tech was not able to get to her office yesterday. I’ll post the written report as soon as I can. I’m hopeful they will have the report back from the lab by Thursday or Friday.
After a couple of discussions I believe our vet truly feels we are dealing with EPI although I’m not committed to that diagnosis. I started the food change process on Monday (after getting the ok from the vet) so I’m going to give that a chance but we may be seeking a second opinion soon.
Thank you all for listening and helping. As soon as I can get my hands on the blood test results I will post them.

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Olesia711
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Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
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Re: Ruger - New Case Trying to Stabilize

Post by Olesia711 » 17 Aug 2022, 09:49

thanks for keeping us apprised.

When you get the CBC blood panel.. please do share the results here, cuz even if nothing is blatantly out of whack ..i'd like to see if any values are "trending" in certain directions.

Based on the TLI blood test, Ruger does not have EPI, but as myself and others explained... sometimes values that come back in the teens and are clinically NOT EPI or even SEPI (sub-clinical EPI)... if all the symptoms persist.. definitely re-do the TLI test in the future (3 months or 6 months) to see if the TLI results are trending downwards ... to SEPI and then possibly EPI. We have seen this happen in the past. HOWEVER... just a FYI... although the research is not published yet, what i can share with you from the study we did is that approximately 50% of SEPI dogs go on to develop EPI, but the other 50% don't.... it is rather bizarre.

I am VERY relieved for you that there is no indication of IBD.... as that can be a real bear to manage.....

I am assuming since the vet is convinced this is EPI... you probably did not ask about trying Slippery Elm and Marshmallow Root powder first?
Or if you have tried it... what are the results?

Very much looking forward to seeing the CBC panel results.......... before we can try and really help guide you in what direction to lean towards........
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.........

SallieS
Member
Posts: 17
Country: United States
State: North Carolina
Pet name: Ruger
My name: Sallie

Re: Ruger - New Case Trying to Stabilize

Post by SallieS » 17 Aug 2022, 11:09

Thank you so much Olesia. After the conversations I have had with the vet, I thought I would give the food change a chance first before mentioning the Slippery Elm. I’m definitely willing to give Slippery Elm a try, but trying to manage myself and make 1 change at the time.

The vet just called a couple of minutes ago and said she has the results back from the lab. She told me that Ruger is mildly anemic, but that she was not surprised given the diarrhea and length of time we have had it. She said, thankfully the ultrasound showed no thickening or anything else that would indicate IBD, so we know that is not the cause of the level. She said she was not concerned, but we will watch it.

I’ll pick up a copy of the results tomorrow and post them.

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Olesia711
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Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Ruger - New Case Trying to Stabilize

Post by Olesia711 » 17 Aug 2022, 11:14

she is correct about the reason for the slightly anemic results.... but please post the CBC results when you get them..... i'd like to see if anything gives me pause....

and thank you for letting me know that you are going to try a food change first.... good to know and absolutely PERFECT that you will be trying things one at a time!. thank you so much for doing this. i know (Personally!!) how trying things one at a time can be a real pain in the butt... but it really does help!!!!!!!!!!!
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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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Ruger - New Case Trying to Stabilize

Post by Jean » 17 Aug 2022, 11:18

hey you are doing all you can, and a question not asked is an opportunity lost

let us know, but that result is not EPI so ask why the vet wants to treat as if it is, costing potentially unnecesssary cost , however as Olesia has said peoples dogs and cats have tested negative to only on retest became positive

i would be tempted to get a food with a protein prrviously not tried maybe rabbit or Kangaroo,

we tried all kinds of foods and ended up with lamb, no grain, no rice no chicken My friend had a Newfoundland that was very worst for wear and had lost lots of weight and wa losing his coat he was about have Bear PTS but tried grain free, chicken and rice free, and he survived,, on a walk I pesuaded him Thankfully, sometimes you just ghave to to basics
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Ruger - New Case Trying to Stabilize

Post by Jean » 17 Aug 2022, 11:23

has the vet done a stool analysis to see if there is any issues, and to see if there is undigested food , we had to do a three day stool test and put into test containers for the vets

came back undigested food , no giardia etc no worms,, we got the positve EPI result the same day

keep your chin up
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

SallieS
Member
Posts: 17
Country: United States
State: North Carolina
Pet name: Ruger
My name: Sallie

Re: Ruger - New Case Trying to Stabilize

Post by SallieS » 17 Aug 2022, 14:11

Hi Jean,
Thank you for your suggestions. We have not done a stool analysis. We’ve done several regular fecal tests and have dewormed twice. Once when we first brought Ruger home and once recently just in case he may have whipworms. I can certainly ask for the stool analysis, but the vet says she doesn’t see anything of concern in the regular test.

I am changing Ruger’s food from Hill’s Science Diet Large Breed Puppy Chicken and Oats to the Lamb and Brown Rice version (same brand). I’ve started looking for the next option, in case this one doesn’t work, but trying to find something in a puppy version is a little frustrating. I think I may try the Royal Canin Puppy Gastrointestinal food next. That one is a prescription food. I’ve seen the SportMix brand recommended several times, so I’ll look at those options also. I’m really hoping the lamb and brown rice will work since it is readily available. Fingers crossed. I started the transition Monday at lunch. I put a few pieces of carrot in his lunch today just to see the time frame involved for his system.

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Jean
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Posts: 1707
Location: South Liverpool
Country: United Kingdom - England
Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Ruger - New Case Trying to Stabilize

Post by Jean » 19 Aug 2022, 09:02

if there is no undigested food then it would seem not to be EPI as this is the biggie in looking at EPI

but life throws curved balls at us all of the time

jxxx
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

SallieS
Member
Posts: 17
Country: United States
State: North Carolina
Pet name: Ruger
My name: Sallie

Re: Ruger - New Case Trying to Stabilize

Post by SallieS » 19 Aug 2022, 12:16

Good Morning,
I was able to talk to our vet more yesterday and pick up the blood test results. The vet is supposed to make some calls today to get some additional information on food choices for Ruger in the event the lamb and brown rice does not work. She also prescribed a short term dose of Flagyl (7 days) in case we have some SIBO going on and a short term dose of Trazadone (she was thinking outside the box, for just in case this could have something to do with stress). I asked about Slippery Elm and she is all for it along with any other natural supplements, but doesn’t want to start that yet since we are changing food and the prescriptions. One thing at a time.

We take Ruger to day boarding at the vet’s office on Tuesday and Thursday because we can’t get him into doggie daycare and he needs interaction with other dogs. They have playtime during the day. Ruger was an only puppy (no siblings) so he needs to learn how to deal with other dogs. Lol, he didn’t even know to sniff butts. The stress thought came about because he does not poop there. The vet thought it would not hurt to try the med to see if it helps anything as could be a result of stress at home or there. I don’t think it’s stress as he seems to love going there and the trainer says he doesn’t see signs of stress at home, but we’ll see since it’s a short dose.

I know it’s too soon to say and I’m hoping I don’t jinx anything, but last night and this morning his poops were shaped and firmer and only in 1 place (not 2 or 3 places all over the yard). I think the Flagyl is helping. I’m still working on transitioning the food. We were on half and half, but today I increase again. Fingers crossed.

I’m attaching the blood test results. I’m hoping you don’t see any cause for concern but I SO VERY MUCH appreciate you reviewing these as we need to know if there is a concern.
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Olesia711
Founder & Research Director
Posts: 3857
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: Ruger - New Case Trying to Stabilize

Post by Olesia711 » 19 Aug 2022, 15:02

Hi Sallie,

Has Ruger been tested for tick disease recently? Or did he have Parvo as a pup, or has he had Coccidiosis, hook worms, fleas, an allergy to fleas? etc because when i see "LOW" RBC, HCT, Hemoglobin, Reticulocyte and i see that the MCHC is on the very low side of normal.... this "suggests" to me that one possibility is anemia or anemia starting.... but coupled with those weird stools and weight loss... it kind of jumps out at me that you probably should investigate further....

DId the vet mention anything about these low values?

Also...for SID, especially if in the future this segues into EPI, TYlan is given for SID, they are now recommending NOT to give Flagyl,
HOWEVER... that being said, different infections / toxins require different antibiotics......
I am glad that Flagyl is working.... but that also makes me lean towards maybe this is not SID but something else going on.......................
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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