Atypical case? Possible EPI but Vet not sure
Posted: 25 Mar 2023, 15:05
Full story: We adopted Franklin from a rescue at 8 weeks, the mother gave birth in the rescue to the litter. According to his DNA test his 3 leading breeds are lab, rottweiler, and GSD (with small amounts of boxer, Belgian Malinois and Great Pyrenees). He has always been thin, but the couple vets he's seen have always said he's just at the low end of normal for weight.
When we got him he had diarrhea. Seems the vet the rescue used knew that he was positive for coccidia and had put him on a couple rounds of metro but after we got him we took him to our Vet and he was diagnosed with both coccidia and giardia. Anti-parasitic medications (non-metro) were prescribed for both and his condition cleared up and follow up tests showed no more parasites.
Overall he's been a happy, normal pup. Grew to around 72 pounds by 9 months. At that point we noticed a little bit of change in his eating habits. Whereas before he would gobble down his kibble (Purina pro plan puppy, large breed, chicken & rice), he started eating more slowly. Sometimes he would eat some breakfast and save the rest till after lunch time. Other times he started not eating all his food, although he normally always ate his dinner. We never noticed any change in his activity level. But otherwise there was nothing that stuck out to us that required attention from the vet.
As he reached roughly 11-12 months, we noticed that his poops were getting looser. Typically he's out in the back yard and goes in the weeds & ground cover, not the grass, so this was most noticeable to us when we'd take him for walks (like 30 minutes, around the block type walks). When we took him in for his vaccine boosters, his weight was exactly where it was at 9 mos (72lbs). The vet was somewhat concerned by the diarrhea so we didn't give any vaccines and he recommended Hills prescription GI Biome food, chicken & vegetable. Unfortunately Franklin's taste for dry kibble hadn't really improved and when we took him back to the vet 2 weeks later he had lost 2 pounds. Dr recommended adding in some of the canned/wet version of the HIlls Biome food which we did, and Franklin seems to enjoy that and gobbles eats all of his breakfast and dinner. We're giving him 2.5 cups of dry and roughly 1/2 a can of wet at each meal (2 meals a day).
On the Hills Biome I feel like we saw a little improvement. The wet diarrhea had turned to more of a thick pudding, and at night, before bed, I would notice him take completely normal poops (2/3 on the scale). But his poops on walks were always stills like a 5, more of a mound with no definition. And if he had 2 poops on a walk the 2nd was pretty watery.
The Vet, at the first time we brough him in at 12 months also prescribed a one week treatment of metro (which I now know is not what is recommended here...but I didn't know that then). All the blood work and fecal tests came back normal.
After a month on Hills Biome the Vet ran the GI panel to test for pancreatic function and the like. Cobalamin and folate levels are normal (797 and 16.2, respectively), but TLI was 6.5 and PLI was 61. The Vet said that since TLI was normal, but at the very low end of normal, he suspected EPI and recommended we start enzymes.
I also brought Franklin in yesterday to get the vaccines that had been delayed. At this time he weighed 71lbs, so he seems to have gained back 1 pound over past few weeks.
So as of yesterday we started with enzymes, 1 Tbsp, twice a day in his food. Continuing with the Hills GI Biome food.
Franklin's poops up until this point have still been inconsistent. This morning I went out with him when he woke up and his poop was a total 2/3, completely normal. I just got back on a walk and his first poop was like 25% a 3, but then 75% a 5. 2nd poop was all 5 or worse. I figure we're probably a little early to see if Enzymes fully working or not since he's only had 2 meals with them so far.
So what do you think? Maybe his gut was just rocked by his early treatments for coccidia and giardia? He definitely has some good poops, but it's not consistent at all (although it was consistently fine for a long time before things started acting up around 12 months). Had a little weight loss, but maybe that was just because he didn't like 100% dry kibble and with adding wet he's eating full meals. His energy level has always been high and he's always been thin (but supposedly normal thin). His TLI is technically normal, but at the lower end. And we've never changed his diet away from a chicken based food to try and rule that out (it's been in the back of my head that we should just move him to a salmon based food or something like that and away from chicken).
I'm definitely willing to go the enzyme route since this is what the Vet is recommending...and it's too early to see if it's working. But this stuff is expensive, and I'm not sure if his pet insurance is going to cover it because TLI is technically normal (which seems like an easy way for them to reject the vet suggestion...or at least not be willing to pay for it).
Any ideas or suggestions are much appreciated.
When we got him he had diarrhea. Seems the vet the rescue used knew that he was positive for coccidia and had put him on a couple rounds of metro but after we got him we took him to our Vet and he was diagnosed with both coccidia and giardia. Anti-parasitic medications (non-metro) were prescribed for both and his condition cleared up and follow up tests showed no more parasites.
Overall he's been a happy, normal pup. Grew to around 72 pounds by 9 months. At that point we noticed a little bit of change in his eating habits. Whereas before he would gobble down his kibble (Purina pro plan puppy, large breed, chicken & rice), he started eating more slowly. Sometimes he would eat some breakfast and save the rest till after lunch time. Other times he started not eating all his food, although he normally always ate his dinner. We never noticed any change in his activity level. But otherwise there was nothing that stuck out to us that required attention from the vet.
As he reached roughly 11-12 months, we noticed that his poops were getting looser. Typically he's out in the back yard and goes in the weeds & ground cover, not the grass, so this was most noticeable to us when we'd take him for walks (like 30 minutes, around the block type walks). When we took him in for his vaccine boosters, his weight was exactly where it was at 9 mos (72lbs). The vet was somewhat concerned by the diarrhea so we didn't give any vaccines and he recommended Hills prescription GI Biome food, chicken & vegetable. Unfortunately Franklin's taste for dry kibble hadn't really improved and when we took him back to the vet 2 weeks later he had lost 2 pounds. Dr recommended adding in some of the canned/wet version of the HIlls Biome food which we did, and Franklin seems to enjoy that and gobbles eats all of his breakfast and dinner. We're giving him 2.5 cups of dry and roughly 1/2 a can of wet at each meal (2 meals a day).
On the Hills Biome I feel like we saw a little improvement. The wet diarrhea had turned to more of a thick pudding, and at night, before bed, I would notice him take completely normal poops (2/3 on the scale). But his poops on walks were always stills like a 5, more of a mound with no definition. And if he had 2 poops on a walk the 2nd was pretty watery.
The Vet, at the first time we brough him in at 12 months also prescribed a one week treatment of metro (which I now know is not what is recommended here...but I didn't know that then). All the blood work and fecal tests came back normal.
After a month on Hills Biome the Vet ran the GI panel to test for pancreatic function and the like. Cobalamin and folate levels are normal (797 and 16.2, respectively), but TLI was 6.5 and PLI was 61. The Vet said that since TLI was normal, but at the very low end of normal, he suspected EPI and recommended we start enzymes.
I also brought Franklin in yesterday to get the vaccines that had been delayed. At this time he weighed 71lbs, so he seems to have gained back 1 pound over past few weeks.
So as of yesterday we started with enzymes, 1 Tbsp, twice a day in his food. Continuing with the Hills GI Biome food.
Franklin's poops up until this point have still been inconsistent. This morning I went out with him when he woke up and his poop was a total 2/3, completely normal. I just got back on a walk and his first poop was like 25% a 3, but then 75% a 5. 2nd poop was all 5 or worse. I figure we're probably a little early to see if Enzymes fully working or not since he's only had 2 meals with them so far.
So what do you think? Maybe his gut was just rocked by his early treatments for coccidia and giardia? He definitely has some good poops, but it's not consistent at all (although it was consistently fine for a long time before things started acting up around 12 months). Had a little weight loss, but maybe that was just because he didn't like 100% dry kibble and with adding wet he's eating full meals. His energy level has always been high and he's always been thin (but supposedly normal thin). His TLI is technically normal, but at the lower end. And we've never changed his diet away from a chicken based food to try and rule that out (it's been in the back of my head that we should just move him to a salmon based food or something like that and away from chicken).
I'm definitely willing to go the enzyme route since this is what the Vet is recommending...and it's too early to see if it's working. But this stuff is expensive, and I'm not sure if his pet insurance is going to cover it because TLI is technically normal (which seems like an easy way for them to reject the vet suggestion...or at least not be willing to pay for it).
Any ideas or suggestions are much appreciated.