TLI back to normal range!!!

[lylzzf3841]

I don't know how this happened, but long story short, Leo retested his TLI, B12 etc. on Monday, and the result just came back - now his TLI is 14.7, and B12 is 928. This, even based on the TAMU's updated intervals, is considered normal. So basically.. Leo doesn't have EPI!!!!!

Altho I have a very mixed feeling now - happy to know that he doesn't really need enzyme for the rest of his life, but then, we still don't have a diagnosis yet and are still trying to figure out what caused his chronic GI issue. Ultrasound also didn't reveal anything significant, so the specialist suggest we consult with a nutritionist and potentially start a diet trial.

But anyways, I'm going to start removing enzyme from the equation. Do you think we should go cold turkey or taper down? Since we're also on 6 weeks of Tylan mark, I'm wondering how to prioritize these 2 process.

[Eddiespaghetti]

Very awesome. It is rare, but it is possible. You are one of the lucky ones. It means there was probably some bad infection in or around the pancreas. The long term Tylosin helped clear it up.
You can stop the enzymes cold turkey and see how that goes. At 14, their pancreas should make enough enzymes. You will also find out pretty quickly if they are healed. The tylosin you will want to taper, give half the normal dose twice a day for two weeks , then half it again, then you can probably be done. It's a slow taper, but they might need Tylosin long term.

[jilbert57]

So glad to hear this news. Let us know how things work out.

Jill

[Olesia711]

great news!!!!!!!!!!!!

Since he started with a 6.7 and under the new guidelines.... they basically say to suspect EPI but re-test and watch which way the test results go...to really determine if this is or is not EPI...... and it looks like Leo is one of the very lucky ones..... the TLI value went up.... so not EPI

Regarding the diet.... i know you get the Viva (rabbit) and have been slightly cooking.... maybe look at the 1st pup loaf recipe on our website
https://epi4dogs.com/diet-raw-home-prepared-recipes/
and exchange the protein for something Leo can handle - - -check with your vet to decide if this might be a good thing to try with Leo...and maybe that will help...

Regarding the enzymes..... do not stop the enzymes all at once, but rather taper down..... jsut to see if the enzymes are still needed. I think i mentioned in the past, but if not, please share this with your vet...... that over the years we have had a handful of dogs who when tested did NOT have EPI, but instead had small distal proximal disease (kind of like IBD) and they did not do well unless they had a little enzymes.

ALthough i do not think this will be the case with Leo, cause if i remember correctly, in the beginning you gave enzymes and they didn't seem to help much at the onset. But still............ just in case.... i would slowly reduce the enzymes over the course of a week or two at the most.... and jsut see how things go.

I suspect your vet is correct and that this most likely is diet related..... BUT.. please also share the following with your vet.... not sure if i mentioned this too in the past or not, but i had another dog who the vet thought for sure had EPI (had all the symptoms) ... but when tested the TLI came back at 6.7 (this was before the assays were messed up), and the enzymes really didn't help either. It took my vet 2 years before they figured out it was A-Typical Cushings..... which displayed with none of the typical Cushing symptoms.... so.... just in case your vet doesn't have much luck figuring out what is going on.... please mention this story as a possibility. remote but still possible.

And last but not least... please know you are now part of the EPI family and you are welcome to continue to post about Leo

[lylzzf3841]

Thanks a lot for the suggestions! We’ll be working with nutritionist as well to figure out a home made diet plan for Leo. Meanwhile, currently chicken breast, white fish and rabbits seems to be the only proteins he can handle, so the doctor suggested we don’t change that for now.

Leo also tested cortisone level and it was in the normal range, so I guess it ruled out Cushings?

I’m currently only giving Leo 1/4 - 1/2 of his original enzyme dose, and he seems to be fine. His stool consistency and color remained unchanged. I’ll give it one more day before I stop it.

I will for sure keep posting updates here for Leo, especially during his enzyme and Tylan taper process. Just in case if anyone is in the similar situation, I wanted to share the experience.

[Olesia711]

if the chicken, white fish and rabbit is what works for Leo.... then i too think your vet is correct to keep him on the same proteins.... but share the pup loaf with your nutritionist.... since the pup loaf recipe allows for switching out the proteins... and "maybe" it could be something workable or not..... but guidance by a professional (nutritionist) will definitely be needed especially since Leo is not an EPI dog.

If Leo had the full ACTH test for CUshings and all values were in the normal range.... then yes, you can take "A-Typical Cushings" off the table. (thankfully!)

Regarding the 1/4 to 1/2 enzyme dose and things are still fine..... that is great that you are slowly reducing (just in case) and yes... i too think should be fine to stop in another day or two.

You are doing a great job with Leo.... many kudo's to you!!! and Yes, please do keep us posted!

[lylzzf3841]

Hi everyone, it’s been a while! So here’s a quick update for Leo for the whole enzyme and Tylan tapering process, in case anyone is experiencing a similar situation -

So after his retest for TLI back at the end of January, we were able to remove enzymes completely within about a week. Leo remained very stable during this so I guess it confirms that he doesn’t have EPI.

We then started tapering Tylan as instructed by our internist. We reduce only 1/4 dose at a time every 2 weeks. Leo again was doing great during this, didn’t have even one loose bowel movement. And we were able to completely stop Tylan in March.

However, 2 weeks after that, Leo had a bowel movement covered with mucus and some straining. I called the vet immediately and was told to put him back on Tylan again if it doesn’t resolve within 24 hours. Later that night, he had a watery diarrhea with lots mucus and some fresh blood in it.

I put him back initial dose of Tylan the next morning, diarrhea was immediately gone. And 2 days later, his bowel movement returned to normal-ish. I guess it’s true that they’ll always have relapse once tylan is stopped.

The other thing I noticed, couple of days before the flare up, he seems to be itchy all over. It seems very much like an allergy reaction but ended up with secondary bacterial/yeast infection. We’re still struggling with that right now.

His skin issue makes me wonder if he’s got a weakened immune system or some antibodies deficiency. I think he might be suffering from some chronic inflammation maybe cause by gut dysbiosis. I’m looking at adding some bovine colostrum into his diet since I heard it helps with gut and skin. Hopefully his system will tolerate that.

btw, he was also taking Visbiome and S. boulardii the entire time. I’m not sure how much they’ve helped, but certainly not enough to replace Tylan.

[jilbert57]

The Adored Beast Apothecary has a package called Yeasty Beast that is a great protocol for yeast.
https://adoredbeast.com/products/yeasty ... roduct-kit

Some dogs are lifers for the Tylan. Get to the smallest working dose.

Glad you don't have to use enzymes!

Jill

[Olesia711]

Another thing you can do is talk to your vet about trying "Spirulina" to reduce dysbiosis/inflammation.

I know this is a study on rats
"Spirulina platensis alleviates chronic inflammation with modulation of gut microbiota and intestinal permeability in rats fed a high‐fat diet"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7412692/
https://pubmed.ncbi.nlm.nih.gov/37213142/

... but i know that some dog owners long ago on the forum have used Spirulina on their dogs and claim that it really helps with SID/Dysbiosis...so it might be something to consider..... but PLEASE ask your vet first for their thoughts/opinion on this and if they agree, ask their recommendation for what amount to use.

You do have to be careful of the brand (quality)... here is a list of some reputable companies that are listed as reputable in producing Spirulina products:
Earthrise.com
Drlilys.com
Organicburst.com
Cyanotech.com
Australianspirulina.com/au