GSD Thor lives where its difficult to diagnose EPI and relies on your help

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
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Niusvil
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Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 08 Feb 2020, 10:28

Madelon wrote:
07 Feb 2020, 14:15
Hi Ana. See my post above - I think you are giving too little Tylan and gave you the amount you should be using. I"m sorry you're having such a difficult time with the food - I'm sure you will get it straightened out - your pup is lucky to have you.
Thank you Madelon, yes I saw your suggestion, and attempting to increase Tylosin slowly, as I am afraid to give too much as not sure about the strength of the powder. Thanks also for very useful info about Creon, so far I have not been able to establish what dose of Creon works best for my dog, and as we don't have TLI result yet, will continue with Creon until ordering Diane's enzymes which should be better hopeful.

I think probably made a mistake adding Tylosin, bone broth and Royal Canine HP kibbles on the same day and hence cant say which of them caused diarrhea, now cut back broth kibbles to see if Tylosin works. Does anyone have experience of having their dog on a mix of cooked meals and dry food?
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

Tuckaboo.
Member
Posts: 310
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Tuckaboo. » 08 Feb 2020, 13:02

Anna, I am not as knowlegeable as most on here, but I sometimes add a few bites of turkey to Tucker's food. I consider this when I measure the kibble. So, if he eats 1 1/2 cups of kibble at a regular meal, I cut back on the kibble so there is a total amount of 1 1/2 cups kibble + turkey. The turkey I use is a by product of the wing bone broth, and so he only gets cooked meat a few times each month. I do not notice a difference in his poo after he gets the meat. The broth and meat are somewhat lean. The kibble is sport dog elite, which has made a big difference. I don't know if it's available where you are, but I learned about it from the staff, and I highly recommend it if you can get it. You must really love your dog. ---Pam
Tucker is a shepherd/lab mix, adopted on craigslist; he has tested positive on the ScheBo test for EPI. Currently taking Diane's Enzymes 3 teaspoons/day, Wonderlab B12 capsules 1/day, and Tylan 1/5 teaspoon/day. Thriving on Sport Dog Food Elite/Herding Dog. No more coprophagia, his weight is steady, and he is a happy member of the family, if a bit of a bully with his four siblings from time to time. Tucker is my boyfriend, and my husband is OK with that.

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Niusvil
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Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 13 Feb 2020, 11:48

Our TLI result arrived (took thee weeks) and now I am confused as the range this doctor writes is different from what I've seen here.

Thor's result is 14.0 and the range is 15-50 the unit is ng/l ( if you convert it to µg/L its the same). Definitely its lower then norm but is it really very low? I do not have direct contact with the vet who did the test as intermediary lab was involved but I found the doc and dispatched the email asking to interpret according to US guidelines but not sure if he will :)


Image

Did anyone have the same experience with the normal TLI range 15-50?
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

Tuckaboo.
Member
Posts: 310
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Tuckaboo. » 13 Feb 2020, 18:09

I wonder if this just means he has started to decline, and that if retested later it would be worse?
Tucker is a shepherd/lab mix, adopted on craigslist; he has tested positive on the ScheBo test for EPI. Currently taking Diane's Enzymes 3 teaspoons/day, Wonderlab B12 capsules 1/day, and Tylan 1/5 teaspoon/day. Thriving on Sport Dog Food Elite/Herding Dog. No more coprophagia, his weight is steady, and he is a happy member of the family, if a bit of a bully with his four siblings from time to time. Tucker is my boyfriend, and my husband is OK with that.

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jilbert57
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Country: United States
State: Washington

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by jilbert57 » 13 Feb 2020, 21:55

The range for dogs Tli results from TAMU:

SERUM TRYPSIN-LIKE IMMUNOREACTIVITY (TLI)
REFERENCE INTERVALS
Canine 5.7 – 45.2 µg/L


INTERPRETATION
In dogs, values below 2.5 µg/L are diagnostic for EPI. Values between 3.5 and 5.7 µg/L are rarely if ever associated with signs of EPI but may reflect subclinical pancreatic disease such as subtotal pancreatic acinar cell destruction secondary to on-going immune-mediated lymphocytic pancreatitis. Progression of the disease in such patients may ultimately lead to EPI. Values between 2.5 and 3.5 µg/L are sometimes (but rarely) associated with clinical signs due to EPI. In these cases the TLI assay should be repeated after one month paying particular attention to ensuring that food is withheld for 12 to 15 hours before the blood sample is collected.


Jill
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 13, TJ is a 4 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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Niusvil
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Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 14 Feb 2020, 10:53

Tuckaboo. wrote:
13 Feb 2020, 18:09
I wonder if this just means he has started to decline, and that if retested later it would be worse?
This is also my thought. But the doctor in the Dutch laboratory replied and he wrote this:

"Many thanks for your email. The TLI result obtained via us showed a subnormal concentration. We use our own reference values and these are not directly comparable to the USA values. As such, the TLI result from your dog does not clearly indicate EPI (yet). Sometimes this subnormal concentration reverses to normal. Eventually it might be considered to repeat the assay in 1-2 months time.

In case of EPI one might expect increased faecal volume combined with pale, white faeces.

Your dog suffers from chronic diarrhoea. I presume bacteriology of the faeces has been assessed as well as the detection of Giardia parasite and worms.

I hope to have informed you sufficiently.

Sincerely Yours,
Han van der Kolk, DVM"

So 14.0 out of 15-50 is quite low, but he still thinks not clearly indicative of EPI (yet)!
My worry is whether or not to continue enzymes, I use Creon but was going to order Diane's enzymes, it takes time to arrive to Georgia (Europe), I think I will still order them. Can enzymes be bad in this situation?
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

Tuckaboo.
Member
Posts: 310
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Tuckaboo. » 14 Feb 2020, 16:57

I'm gonna send you a link in a private message. Watch for it!---Pam
Tucker is a shepherd/lab mix, adopted on craigslist; he has tested positive on the ScheBo test for EPI. Currently taking Diane's Enzymes 3 teaspoons/day, Wonderlab B12 capsules 1/day, and Tylan 1/5 teaspoon/day. Thriving on Sport Dog Food Elite/Herding Dog. No more coprophagia, his weight is steady, and he is a happy member of the family, if a bit of a bully with his four siblings from time to time. Tucker is my boyfriend, and my husband is OK with that.

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Niusvil
Member
Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 14 Feb 2020, 19:59

Tuckaboo. wrote:
14 Feb 2020, 16:57
I'm gonna send you a link in a private message. Watch for it!---Pam
Great link, thanks so much! My dog vomited today three times after being stable for weeks, and I realized I made a mistake described in this lecture - giving chunks of raw rabbit back with bone :cry: I thought he was ready because I've been giving him less and less cooked rabbit and chicken already for some time. But apparently he can only tolerate ground food. And diarrhea is back too :cry: What are general recommendations for giving the next meal when such indigestion happens? is it better to allow some time for fasting?
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

Tuckaboo.
Member
Posts: 310
Country: United States
State: Florida
Pet name: Tucker
My name: Pam H.

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Tuckaboo. » 14 Feb 2020, 20:37

Oh, Anna, I'm so sorry that happened. I'm not sure, but I would think going back to what was working would be the best plan. Poor Thor---Pam
Tucker is a shepherd/lab mix, adopted on craigslist; he has tested positive on the ScheBo test for EPI. Currently taking Diane's Enzymes 3 teaspoons/day, Wonderlab B12 capsules 1/day, and Tylan 1/5 teaspoon/day. Thriving on Sport Dog Food Elite/Herding Dog. No more coprophagia, his weight is steady, and he is a happy member of the family, if a bit of a bully with his four siblings from time to time. Tucker is my boyfriend, and my husband is OK with that.

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Niusvil
Member
Posts: 11
Country: Georgia
Pet name: Thor

Re: GSD Thor lives where its difficult to diagnose EPI and relies on your help

Post by Niusvil » 15 Feb 2020, 12:18

Still very frustrated as can't get hold on the diagnosis completely. As you remember, we sent Thor's blood to test TLI and the results came as 14.0 (normal range 15-50 apparently in dutch laboratories). I have asked the Dutch doctor who did TLI to provide his interpenetration, and the answer he wrote is very similar to a local vet's:

"many thanks for your email. Considering the TLI result from your dog EPI does not seem very likely to me. Usually the faecal color in case of EPI is most of cases gray. Good to hear that bacteriology and assessment of worms and Giardia are negative in your dog. Was food allergy/intolerance considered in your dog? If not, feeding only cooked rice and cooked chicken might be an option for 7-10 days. If Tylosin is given more than 7-10 days I would suggest to quit that. Hopefully these reflections might be of value."

I think there are several things wrong with his answer:

Why he thinks EPI is unlikely?
Why Tylosin can't be given for more than 7-10 days? I read here that some dogs are on Tylan for life.
Is faecal color in case of EPI is really mostly gray? I thought it was mostly yellow.
And is rice really good when dog has diarrhea? in my experience not, sweet potato or pumpkin is better.

I was almost ready to order Enzymes Diane and now I do not know what to do. If it's not EPI would he benefit from enzymes? I don't really have the vet here who can explain all of this as TLI is not administered in my country, so I have to rely on symptoms and experience :( I feel somehow that the dog EPI is not well researched outside of US, and even in US probably sites like this one and mobilizaiton of active dog owners make a huge difference.
I am Anna, my German Shepherd Thor is 2 y.o. we live in Eastern Europe. The TLI result came back from the Netherland laboratory as 14.0 but their normal range is 15-50. I still give Creon 25000 with every meal, started Pet Factor B-12. He has diarrhea often and started Tylosin 1/4 tsp.

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