TLI level decreased despite being on enzymes

[Dan_L]

First off I want to say I have been standing back in the corner listening to many of the conversations and I’m blown away at the level of expertise, wisdom, and compassion found here.

My German Shepherd began losing weight going from 73.6 pounds on September 25th 2023 to 60 pounds on December 4th 2023 despite eating and drinking quite well. One morning he was quite lethargic so we took him to a veterinary hospital who referred us to an internal specialist clinic. Once the blood work came back he was diagnosed with EPI based on a TLi level of 3.8 ug/L. We were instructed to start him on 2 cups of Purina EN Fiber Balance 3 times a day, Propectalin for 7 days, Fortiflora for 14 days, a “pinch” of Tylan powder with each meal, and 1 teaspoon of Panzquin with each meal.

Once the Panzquin ran out I switched him over to the Enzyme-Diane Pancreatin 6X maintaining the same amount per cup of food as what the doctor prescribed using Panzquin. I did however look at the Lipase, Protease, and Amytase levels listed on the Panzquin and compared that against the Enzyme-Diane Pancreatin to calculate how much I would need to add to his food to approximate the same levels as he was getting with Panzquin.

I also did a week long transition from the prescription fiber balance food to Hills Science Diet Chicken and Barley once I was comfortable he did not have any type of reaction to changing enzymes.

His normal stools are pretty much a consistent 2-3 using the Purina fecal scoring chart. He would occasionally have loose stools that are a 4 and borderline 5 side so to try and help him have some consistency with his stools we started adding 3/4 of a teaspoon of psyllium husk with each meal. This seems to have helped in that regard but I’m concerned about adding fiber to his diet since I have read fiber can reduce the efficacy of the enzymes.

I had another blood test performed last week and received the results this morning. This blood test shows his TLi dropped from 3.8 to 1.9 ug/L.

He has been putting the weight back on since starting the enzyme regiment and is quite active. His weight on February 8th was 75.2 pounds which is a 15 pound weight gain since December but I’m scratching my head as to why everything appears to be going in the right direction yet his TLi level has dropped.

So I’m hoping this body of experts can help me to understand what I seem to be doing wrong so I can make adjustments to get his TLi levels back up.

Thank you all in advance,
Dan

[Eddiespaghetti]

It is super common for the TLI to keep dropping. Whatever caused the lower TLI, most common is pancreas atrophy, will continue until there is nothing left.
The enzymes do not heal the pancreas. They replace the enzymes the pancreas used to make. It's probably why most dogs will need extra enzymes after a couple years.
If they are gaining weight and poos are good, it means you are doing everything correctly. It's also why most of us don't recommend running a cTLI again, outside of certain situations.
You are doing a great job, but once the pancreas starts to be damaged there is very little we can do to heal it

[Dan_L]

It is super common for the TLI to keep dropping. Whatever caused the lower TLI, most common is pancreas atrophy, will continue until there is nothing left.
The enzymes do not heal the pancreas. They replace the enzymes the pancreas used to make. It's probably why most dogs will need extra enzymes after a couple years.
If they are gaining weight and poos are good, it means you are doing everything correctly. It's also why most of us don't recommend running a cTLI again, outside of certain situations.
You are doing a great job, but once the pancreas starts to be damaged there is very little we can do to heal it

I may not want to know but with him only being 4 years old what would be the expected prognosis if it is indeed pancreatic atrophy?

[Eddiespaghetti]

As long as you give the enzymes along with any supplements they may need. They will live a long life.
EPI is a life long condition. It is 100 percent treatable and shouldn't lower their life expectancy.

[Dan_L]

As long as you give the enzymes along with any supplements they may need. They will live a long life.
EPI is a life long condition. It is 100 percent treatable and shouldn't lower their life expectancy.

Thank you!

[Eddiespaghetti]

https://www.vetspecialists.com/vet-blog ... eir%20life.
Wanted to give at least one source. They all basically say the same thing. With proper treatment they will live a full life