Wren's Results

[dmswartzfager]

For those of you who missed it in my original thread, nothing remarkable was found on Wren's ultrasound on Tuesday. They drew blood for cPL and B12/folate testing, and I just received the results via e-mail:

 

-------------------------------------------------------------

Diagnostic findings and information:

spec cPL: 202 mcg/L

cobalamin (B12): <150 ng/L

folate: 8.5 mcg/L

 

The spec cPL/B12/folate results were finalized and reviewed. The spec

cPL were very mildly elevated in the equivocal range for pancreatic

inflammation. The recommendation would be to recheck a spec cPL in two

to 3 weeks for any further progression or stronger evidence of

pancreatitis. However, Pancreatitis is not highly suspected in this

case.

The cobalamin level was markedly decreased suggesting underlying small

intestinal disease resulting in the low value. The recommendation would

be to begin supplementation with injectable cyanocobalamin and to

consider further diagnostics to evaluate for underlying small intestinal

disease.

The next step in diagnostics would be to consider an upper GI endoscopy

with gastrointestinal biopsies and/or abdominal exploratory surgery with

gastrointestinal biopsies. Wren would be a good candidate for an upper

GI endoscopy. The goal of upper GI endoscopy would be to evaluate the

stomach and proximal portion of the small intestines and to obtain

endoscopic biopsies of the stomach and small intestines. Endoscopy is

generally done on an outpatient basis and cost is approximately $1200.

 

Assessment:

1) Diarrhea

2) Anorexia

3) Decreased serum cobalamin level

-------------------------------------------------------------

Plans and/or communications:

1) Review the option of going forward with further diagnostics to

evaluate for primary small intestinal disease. If the decision is made

to go forward with an endoscopy procedure or surgery, call to make

arrangements.

 

2) Medication:

Recommend starting supplementation with cyanocobalamin:

-Cyanocobalamin 1000 mcg/mL: give 1.2 mL under the skin once a week

for six weeks, then one dose every two weeks for six weeks, then dose

monthly. Remeasure serum cobalamin concentrations one month after last

administration.

 

The cyanocobalamin injections can be performed by her primary

veterinarian or Dr. Gonzales.

 

3) Recommend a re-check fasted spec cPL in 2-3 weeks.

 

 

 

I'm not keen on the idea of a biopsy, particularly when she's otherwise fine - just loose, orange stool (I've started giving her metamucil wafers - I haven't gone out to clean the yard today, so not sure if that's working). I would be able to do the B12 injections myself - just need to see if Dr. Patty can get me a vial and syringes. I've forwarded the results to Dr. Patty and DH (he's out of town for a few days) - I need to talk to them first before we decide what to do.

[Burpdog]

You could try some enzymes and see if it straightens out. I remember when Shadow had one bout of pancreatitis, he was on enzymes for 3 months then was able to get off.

[dmswartzfager]

What kind/brand of enzymes?

 

And the metamucil seems to be working! Solid orange poop now!

Edited August 13, 2009 by dmswartzfager

[dmswartzfager]

E-mailed back and forth with Dr. Patty. She's ordering the B12 and syringes for me (less than $3 for the vial of B12). She's thinking possibly SIBO, and recommends we try the B12 and see how that goes before going the biopsy route, unless Wren gets worse. She's not thrilled with the idea of pancreatic enzymes, but if I want them, she'll order them for me. I think we'll hold off until the results of the repeat cPL in a few weeks.

 

I've started giving Wren probiotics, so we'll see if that also helps.

[2hounds]

I hope Wren feels better soon!

[ahicks51]

I know one vet who recommends Purina's "Fortiflora," but I can't advise intelligently as to its efficacy in SIBO specifically.

[greyhead]

Definitely test for SIBO! she said from sad experience. A C&S on a poop sample will do the trick. Just trying a course of tylosin isn't a great approach, but it's the course a lot of vets take initially. Trouble is, not all bacteria are susceptible to it. Meanwhile, time is marching on, and the bacteria are multiplying.

 

B12 injections are pretty easy, I find. Spencer gets one every two weeks. That's not the usual protocol, but it works for him. (He's been getting the B12 for several months.)

 

Good luck with this!

[dmswartzfager]

Definitely test for SIBO! she said from sad experience. A C&S on a poop sample will do the trick. Just trying a course of tylosin isn't a great approach, but it's the course a lot of vets take initially. Trouble is, not all bacteria are susceptible to it. Meanwhile, time is marching on, and the bacteria are multiplying.

 

B12 injections are pretty easy, I find. Spencer gets one every two weeks. That's not the usual protocol, but it works for him. (He's been getting the B12 for several months.)

 

Good luck with this!

 

We've done a full c&s - no growth.

[VinnieAndRexsMom]

We had two with orange poop after vetting. Chase had a multiple extraction during his dental and Jake had abdominal surgery. I have no idea why they went soft and orange. In a week or two I got them firmed up and back to their original color with kao-pec from the vet. It is not the stuff with the salicylate. It is kaolin and pectin. We have really god luck with it and have been using it for years.

We like this brand best: http://www.jefferspet.com/ssc/product.asp?...p;pf_id=0027459

 

Good luck with Wren

 

 

 

[Lilysmom]

continued prayers for Wren

[turbotaina]

What kind/brand of enzymes?

 

And the metamucil seems to be working! Solid orange poop now!

 

It's good stuff

 

Hope the injections further clear up the problem!

[Guest mandm]

When I adopted my 2 yr old greyhound in 2006, he had several health problems, including GI problems, that needed sorting out. He tested low cobalamin - 150. Plan was to change diet & retest in a few months. I supplemented with oral B12 just for the heck of it, even though it is not supposed to be well absorbed if given orally. I changed his diet to meat only, low fat, no carbs. A few months later, cobalamin showed a dramatic increase, but folate dropped, most likely due to change of diet, no plants. I added oral folic acid and folate increased, but slowly. Around the same time of his original folate/cobalamin test, he also tested low positive for babesia, and so we treated, since he was symptomatic.

 

I'm not sure if any of the above info is helpful. And I'm not sure if the diet change & oral supplements or TBD treatment caused the improvement in cobalamin. I think it was the diet change -- elimination of all carbs and drastic reduction in fat. During this time I also switched from cooked meat to raw meat. I read that raw animal fat is more easily digested than cooked or processed fats, and it seemed to hold true for my greyhound.

 

I would definitely have tried B12 injections, but held off after his TBD test came back positive. If the diet change & oral B12 had not worked, the next step would have been B12 shots.

 

My greyhound is absolutely fine, healthy and at good weight, as long as I continue to feed a raw, low-fat, high bone content diet. But his gut remains very sensitive, which leads me to believe that diet change, and not TBD treatment, fixed his GI troubles.

[Guest kydie]

My GSP had biospies done, with his EGD, was not a problem, I mean other than the cost, they were sent to Texas A&M.

[PrairieProf]

I know one vet who recommends Purina's "Fortiflora," but I can't advise intelligently as to its efficacy in SIBO specifically.

 

Fortiflora is probiotics; digestive enzymes are something different. Prozyme and TotalZymes are some brands I've seen online; I use something called Fresh Digest (same as Optagest) that's available at Petco (but not Petsmart). When you read about digestive enzymes as a supplement for kibble-fed dogs they sound pretty important to me; I've been using them daily for my girl.

 

[dmswartzfager]

When I adopted my 2 yr old greyhound in 2006, he had several health problems, including GI problems, that needed sorting out. He tested low cobalamin - 150. Plan was to change diet & retest in a few months. I supplemented with oral B12 just for the heck of it, even though it is not supposed to be well absorbed if given orally. I changed his diet to meat only, low fat, no carbs. A few months later, cobalamin showed a dramatic increase, but folate dropped, most likely due to change of diet, no plants. I added oral folic acid and folate increased, but slowly. Around the same time of his original folate/cobalamin test, he also tested low positive for babesia, and so we treated, since he was symptomatic.

 

I'm not sure if any of the above info is helpful. And I'm not sure if the diet change & oral supplements or TBD treatment caused the improvement in cobalamin. I think it was the diet change -- elimination of all carbs and drastic reduction in fat. During this time I also switched from cooked meat to raw meat. I read that raw animal fat is more easily digested than cooked or processed fats, and it seemed to hold true for my greyhound.

 

I would definitely have tried B12 injections, but held off after his TBD test came back positive. If the diet change & oral B12 had not worked, the next step would have been B12 shots.

 

My greyhound is absolutely fine, healthy and at good weight, as long as I continue to feed a raw, low-fat, high bone content diet. But his gut remains very sensitive, which leads me to believe that diet change, and not TBD treatment, fixed his GI troubles.

 

Thanks - but Wren has been raw-fed for six years now. Might look into TBD testing though.

 

My GSP had biospies done, with his EGD, was not a problem, I mean other than the cost, they were sent to Texas A&M.

 

I'm not worried about the biopsies themselves (though Blitz almost died after exploratory abdominal surgery with intestinal biopsies) - it's the cost. I've already spent one month's pay on this, and the endoscopy would be at least another month's worth of pay. So if we can get her straightened out without biopsy, that would be awesome.