Molly's blood test are in confusing

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Mom of a Tibetan
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Posts: 23
Country: United States
State: Colorado
Dog name: Molly

Molly's blood test are in confusing

Post by Mom of a Tibetan » 13 May 2019, 15:04

I got Molly's blood tests back. Please share any feedback and or experiences you have with this!
I'm working with a new holistic vet who isn't that versed with EPI. She did consult with an internist on Molly's blood work.
TLI was normal 24.7 says the range is 5-35.
Pancreatic Lipase immuno is 50 in 0-200 range.
***Cobalamin is low 196 normal range is 249-733!
Folate is 7.77 normal is 6.5-11.5 range

This is some what confusing situation....her symptoms were and some what now with the low B12 in line with EPI. She has two symptoms of IBS mucus in stools and diarreaha. I wonder if her pancreas has responded to the fecal transplants and enzymes?! 3 years ago before I gave her the fecal transplants she had chronic problems 6-8 months of cow pie foule smelling stools, loosing weight on any and all the raw foods. She stabalized with low fat meats after the fecal transplants. I'd had testing done for bugs in her gut back then and there weren't any.

She has responded with normal stools on the enzymes so I'll keep her on them.
I'm going to get the intrinsic factor B12 tablets. I've read that the intrinsic factor is critical with low B12 test results. The new holistic vet suggests the holistic route with a vit B complex, I may add that in.

I wonder has anyone had TLI fluctuate in 2 dif blood tests? ie normal on first blood test to find that it drops down to abnormal in a later blood test?

Anyone have any ideas and or experiences with this?
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

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jilbert57
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Posts: 392
Country: United States
State: Washington

Re: Molly's blood test are in confusing

Post by jilbert57 » 13 May 2019, 16:30

So definitely not EPI. Yes the cobalamin needs to be brought up, however since the pancreas is functioning not sure you have to have the B12 with the intrinsic factor added in. I am wondering if you have ever tried plant enzymes( ex. Totalzymes, Prozyme) as you probably don't want to use pancreatic replacement enzymes when EPI or pancreatitis is present. Just a thought.
My name is Jill and I live on the Hood Canal in Washington State. I have two dogs: Kiya is an aussie/blue heeler and is 12 yrs young. TJ is a 3 year old Jack Russell. They keep me on my toes.
Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.
6/1999 - 8/2014

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Olesia711
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Location: North Carolina
Country: United States
State: North Carolina
Dog name: Izzy

Re: Molly's blood test are in confusing

Post by Olesia711 » 13 May 2019, 16:50

Hi ... sorry for all the confusion, sometimes interpreting blood test is part science (objective) regarding the actual test values....and part intuition based on past experiences (subjective) regarding putting the whole picture together and getting a proper diagnosis.

And YES... the TLI test values can fluctuate... usually within range though.... you can read about TLI fluctuations on the TLI page.

HOWEVER...with the other kind of fluctuation.... where the TLI numbers vary dramatically.... that can be due to errors in the lab, blood sitting around longer (too long for one of the tests) or equipment fluctuation.

AND..... another situation that i have observed, that has not been clinically proven, but from reading multiple blood test results posted on the forum for 11 years and then reading a 2nd test results with totally different values.... and recently from helping the vet researchers with the EPI Metabolomic & Microbiotic Study where we saw the initial TLI blood test report of true EPI dogs and of SEPI dogs (not yet clinically EPI but showing a lot of the symptoms)... and of dogs that were definitely not EPI, not SEPI but still displayed some of the symptoms..... and then a few years later when re-tested yet again.... one of two things seemed to be most prevalent:
1. Many of the "initially" non-EPI dogs who displayed EPI symptoms went on to develop clinical EPI a few years later.
2.Some of the "initially" non-EPI dogs who displayed EPI symptoms went on to never develop EPI.... (many of these dogs were dealing with IBD)

So there is no set answer, but if the enzymes help... continue to use them BUT.... also continue to work with your vet to see if this might be IBD, IBS or some thing else... and DO re-test via TLI in another 6 months to a year.

Regarding the low B12 and it is indeed very low.....although over 80% of all EPI dogs have issues with their B12, low B12 is not just for EPI dogs, dogs with any gastrointestinal condition are at risk for low B12.

Please reconsider the double high dose of B12 you are planning to give...your vet is on the right path with more vitamin.... but instead of over dosing with B12....( give the B12 with the intrinsic factor (to cover all your bases ) ) but instead talk to your vet about also giving a good all around doggie vitamin....
Olesia, owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.3, Doing great 12+ years later! Once stable at 3+ months, was able to reduce enzymes to only 1/2 tsp of Enzymes (use EnzymeDiane's 6x) with each cup of food, but as she aged- -had to go back 1 tsp enzymes per cup of food. Fed various grain-free kibble+real meat, 6x pancreatin enzymes from EnzymeDiane., gave 1 tsp of coconut oil / fish oil daily .... until she developed Diabetes and she now cannot tolerate higher fat foods. Currently feed an 80% home-made diet of sweet potato, a lean meat/fish, 1/3 of a raw egg, fat free cottage cheese, fish oil+vitamins and bone meal with 20% Annamaet Lean & Grain Free kibble. This combo has regulated her Diabetes (takes Vetsulin) and EPI and is very well managed. In Feb 2013, Izzy developed a very serious condition called IMHA which she (thankfully) beat and is now in remission. This is when we discovered that she also developed Diabetes & Low Thyroid. Izzy was able to receive excellent care because of the generosity of folks on Epi4dogs! Izzy continues to wake up every day full of joy. I am not a vet. All of my suggestions/recommendations are based on personal experiences, observations, information gleaned from EPI researchers & pet parents alike, and EPI research. Please share with your vet everything we suggest.

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Mom of a Tibetan
Member
Posts: 23
Country: United States
State: Colorado
Dog name: Molly

Re: Molly's blood test are in confusing

Post by Mom of a Tibetan » 13 May 2019, 18:17

Hi Olesia,
Thanks for the feedback and suggestions. I will take your suggestion and retest down the road!

I don't know for sure if Molly needs the intrinsic factor (I feel like she does).

The vet leans toward a more holistic approach vs isolating the B12. She suggested Cataplex B, it does not have any B12 in it. It has Niacin, Thiamine and B 6 and glandular in it. Since Molly has such low B12 I don't know if she can produce B12 from a supplement. I have a call back request to the vet to discuss this.

The loose stools panting burping etc gets worse for Molly with higher fat content in her food...any thing with above 6% fat. So that is why I was planning to continue giving her the EPI enzymes with the raw diet and lower fat meals.

Thanks!



Olesia711 wrote:
13 May 2019, 16:50
Hi ... sorry for all the confusion, sometimes interpreting blood test is part science (objective) regarding the actual test values....and part intuition based on past experiences (subjective) regarding putting the whole picture together and getting a proper diagnosis.

And YES... the TLI test values can fluctuate... usually within range though.... you can read about TLI fluctuations on the TLI page.

HOWEVER...with the other kind of fluctuation.... where the TLI numbers vary dramatically.... that can be due to errors in the lab, blood sitting around longer (too long for one of the tests) or equipment fluctuation.

AND..... another situation that i have observed, that has not been clinically proven, but from reading multiple blood test results posted on the forum for 11 years and then reading a 2nd test results with totally different values.... and recently from helping the vet researchers with the EPI Metabolomic & Microbiotic Study where we saw the initial TLI blood test report of true EPI dogs and of SEPI dogs (not yet clinically EPI but showing a lot of the symptoms)... and of dogs that were definitely not EPI, not SEPI but still displayed some of the symptoms..... and then a few years later when re-tested yet again.... one of two things seemed to be most prevalent:
1. Many of the "initially" non-EPI dogs who displayed EPI symptoms went on to develop clinical EPI a few years later.
2.Some of the "initially" non-EPI dogs who displayed EPI symptoms went on to never develop EPI.... (many of these dogs were dealing with IBD)

So there is no set answer, but if the enzymes help... continue to use them BUT.... also continue to work with your vet to see if this might be IBD, IBS or some thing else... and DO re-test via TLI in another 6 months to a year.

Regarding the low B12 and it is indeed very low.....although over 80% of all EPI dogs have issues with their B12, low B12 is not just for EPI dogs, dogs with any gastrointestinal condition are at risk for low B12.

Please reconsider the double high dose of B12 you are planning to give...your vet is on the right path with more vitamin.... but instead of over dosing with B12....( give the B12 with the intrinsic factor (to cover all your bases ) ) but instead talk to your vet about also giving a good all around doggie vitamin....
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

User avatar
Mom of a Tibetan
Member
Posts: 23
Country: United States
State: Colorado
Dog name: Molly

Re: Molly's blood test are in confusing

Post by Mom of a Tibetan » 13 May 2019, 18:50

Hi Jill,
I think it was you who mentioned on my first post it didn't seem like Molly has EPI?!

As for the enzymes I have not heard of the plant enzymes you listed. I researched the two you listed and they may be an option! I'll run it by the vet too.

I've tied capsules from health food store with mainly Lipase, Protease and Amylase enzymes because she has the challenge with higher than 6% fat in meat meals. They weren't strong enough and didn't help. I also tried enzymes for dogs from Mercola and they didn't help her loose stools, panting, burping and gas.

As for the Pancrease enzymes the vet suggested I keep her on the 6x Enzyme Diane enzymes because they are helping and the pancrease won't hurt her, she suggested glandulars which are made from the organs. Hm Molly's Pancreatic Lipase Immuno # was at 50 of 0-200. The enzymes have made a huge difference creating stool constancy and she has little to no panting, burping and flatulence on them. Since being on the enzymes Molly has not had to go for a walk to defecate in the wee hours of the night!! Which she was doing off and on when not on the enzymes!

Thanks!


jilbert57 wrote:
13 May 2019, 16:30
So definitely not EPI. Yes the cobalamin needs to be brought up, however since the pancreas is functioning not sure you have to have the B12 with the intrinsic factor added in. I am wondering if you have ever tried plant enzymes( ex. Totalzymes, Prozyme) as you probably don't want to use pancreatic replacement enzymes when EPI or pancreatitis is present. Just a thought.
Ann here mom of Molly a 5.5yr old Tibetan Terrier. A friend suggested Molly might have EPI. Approx a month ago I did the home test she tested positive. I have a vet appointment this week to do more in depth tests. For approx 30 days I have been giving her Enzyme Diane's 6x enzymes....her daily meal supplement regime is 1/2 tsp enzymes I let them sit approx 20-30 mins in her morning meal of raw meat or eggs and veggies and a calcium/mineral/vitamin supplement. I have been giving her 1/4 tsp slippery elm, probiotics and 1/4-1/2 tsp psylium powder.

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