Reference Ranges

[Mariew]

Hi everyone, so happy I found this forum. My 3 month old retriever has been suffering from almost hourly liquid poop since coming home 6 weeks ago. We've done 2 rounds of dewormer (he had a heavy load of roundworms)with the vet and 1 x 7 day round of Flagyl. Of course his stomach cleared on Flagyl but the relief was short lived. I suspected his food may be playing a role due to it being an issue since 8 weeks old. After starting to switch his food last Thursday he's started having poops that are normal in consistency and frequency. His cLTI test has come back on the low end of normal. The vet referenced a normal range of 3.5 - 7 and Frank is a 4. We will test again if his diarrhea returns or in another month to be on the safe side. I pre-emptively ordered from enzymediane so we could start that immediately once his tests came back. My question is - did many of your dogs start to show symptoms that were improved with a new kibble but got worse down the road? I'm so happy he's going to the bathroom normally but I'm so worried about him going backwards again.

[jilbert57]

Hi Marie, was your pup food fasted at least 8 hrs before the Tli test? Here is a link to some new information:

viewtopic.php?t=1898

What food did you switch to?

Here is a link to information that will help plus a link to Canadian Epi site:

https://epi4dogs.com/epi-quick-guides-outside-usa/

There are 4 cornerstones to managing Epi.
1) Enzymes. Porcine enzymes must be used with all food and treats from here on out. 1 teaspoon enzyme per 1 cup kibble. Add a little room temperature water to food and enzymes and stir and let set 20 minutes. Stir before serving.
2) Diet. Grain free food with low or no peas, lentils, legumes is best and fiber is 4% or less.
Not sure what you have in Canada.
3) Antibiotic. Most dogs have SID/SIBO when diagnosed. It is an overgrowth of bad bacteria in the gut. Did the vet put Frank on a pro/prebiotic to help maintain a gut balance when he used Metro?
4) B12. All Epi animals need to have their level up around 600 and higher.

Since Franks Tli is under the norm I am not sure what your vets plan is.

Jill

[Mariew]

Hi Jill,

Thanks so much for your reply and this great info.

His test was fasted (14 hours). It came back on the low end of normal but my gut tells me this could just be the start of EPI for him. Something has been off with his stomach since he came home. I chalked most of it up to being a puppy not realizing he should have been having firm poops. One morning I noticed his poop was streaked with blood. That could have been the roundworm but hard to tell exactly.

I've ordered the Enzymes (hope to receive them within the week).
I switched him to Hills large breed puppy out of desperation. I've having such a hard time finding any grain free large breed formulas. Will continue to scour the internet and will likely end up making my own for the time being.
He sees the vet again next week for vaccines. If his loose poops return she's going to set him on a course of Tylan. He did the special poop sample for SIBO last week which came back with 'alphatoxin(S)?' but the vet said the number was so low she doesn't think it would cause anything noticeable. I forgot to ask about his B12 results so will ask for those next week also.

He is taking a daily probiotic from the vet that goes on his evening meal and I'm giving him a tbsp of fresh pumpkin in the mornings.

It's so nice reading all the stories of dogs improving. What a scary prognosis without all this amazing information.

Thank you!

[jilbert57]

There should be others from Canada who can give you direction on products available there. Here are some grsin free dog food options

https://epi4dogs.com/dog-food-options/

I would leave the diet as is right now. If after implementing the full Epi routine addressing Enzymes, Antibiotic and B12 the poop still doesn't come together I would look at the diet. Some dogs do ok on some grain.
There are also those who want to switch to grain free with other Epi outine.

Jill

[Eddiespaghetti]

I feel like your vet is using older references.

2.6 to 7.5 µg/L Subnormal cTLI concentration, highly suggestive of EPI. Assess response to pancreatic enzyme replacement therapy to confirm diagnosis

These are the new ranges for a cTLI of 4. On this forum there is a link for the updated ranges. It should be pinned. It was the very top post for me.
https://vetmed.tamu.edu/gilab/service/assays/tli/

For my personal opinion, treat with enzymes and retest in a few months (3-4). After he stabilizes, and once he grows just a little.

Try to stay away from Metronidazole going forward. Tylosin is the recommended treatment nowadays.

[Barb]

Hello, welcome to you and your pup. The beginning stage is the hardest while you are trying to get everything balanced and you are worrying about your pup. Try not to get too overwhelmed. It will get better.

One thing that really helped us was keeping a daily journal/log of everything we gave our pup, the amounts and the resulting poos, This helped us to see what was working and what needed to be adjusted.. It also helped us to keep our sanity (almost). Let us know how he does.

Barb

[Tuckaboo Pam]

WELCOME, Frank & Marie!

Sounds like you're on the right track. The flagyll may have left your pup with an unhappy gut. Next time, ask for Tylan, if you need an antibiotic. If I were you, I'd order some Proviable, open a capsule, and sprinkle just a little on her food once a day, to start balancing her flora.

Feed her several small meals, if you can.

Poor little girl, to already be feeling this way, but good for her that you adopted her. Take Care---Pam & Tucker

[Mariew]

Hi everyone,

I wanted to update everyone after all of the amazing information you shared with us. Frank repeated his fasted TLI test and shockingly - improved. The vet consulted many of her colleagues and Frank was put on a weekly dewormer 3 weeks ago - it would seem that everything he had been experiencing was from worms that were virtually impossible to get rid of (the vet described this as worm burn and excessive inflammation). He has been off Tylosin for 1.5 weeks and is pooping normally (frequency and consistency).

So I wanted to thank this group for chatting with me when I was quite stressed about this guy. And, I have a sample bag of Enzyme Diane (50 gram 8 X USP Powder). I realize it's not very much but I'd love to send it to someone that could use it. Is there somewhere in the forum you could point me to?

Thank you again - this bulk of information was really calming when nothing else was working!

[Eddiespaghetti]

Puppies are tough. Any issues can go away by time they reach maturity. They can also subside and return after they reach maturity. I am glad Frank is healthy and everything is going well.
One of the staff will probably be along shortly and reach out to you about the enzymes.
Most of us will be around if you ever need more help.

[Olesia711]

HI Marie... and what a GREAT update!!!!! Sorry that poor Frank was struggling with way too many worms (poor pup) BUT so so SO glad that that is what the problem is and that it is a "fixable" thing....

worm-burn... who would have thought that that could cause so many of these symptoms!

REgarding the enzymes.... if you want to donate them....and since it is a small batch, you can send them back to Diane.... she keeps donated enzymes separate and doles them out to folks that are struggling financially to help give them a hand up.

I will privately email you with the correct mailing address when sending her enzymes for donation.


Agan, thanks for the GREAT update!