Low Lipase?

[Guest BooBooMama]

Deeni my 5 year old female greyhound has always had a sensitive stomach. Since I adopted a year ago in May, I tried hundreds of dog foods and finally gave up and fed her raw frozen. That seemed to work but from time to time she would have bouts of stomach upset- soft stool with mucus. Unfortunately she also came from the track with hookworm, so each bout of diarrhea we attributed to the infestation, teated it and things got better.

 

Back in May she had soft stool that had a lot of mucus in it but this time the mucus was pink with blood. We tested her and found a tapeworm segment (she had eaten a dead bird she found in the yard before I could get it away from her a week earlier) so we treated her for tapeworm. Now the beginning of July the bloody mucus was back. Once again we tested her for worms- negative. The vet thought colitis and put her on Metronidazole for a week. Three days after the Metronidazole ran out the pink mucus was back. So we tested again for worms- still negative. We send a culture of her stool to the lab to be tested for cryptosporidium and Giardia- negative. So we ran blood work- the only thing abnormal is her pancreatic enzyme, lipase is low. Normally in pancreatic cancer the enzymes are high. Blood pressure good, blood sugar levels normal, kidneys good. Currently she is on her second dose of Metronidazole but still has mucus from time to time- not as much as before the meds but I still see pink from time to time.

 

She doesn’t act ill- fairly peppy considering the intense heat here in the Midwest, good appetite, drinks water but not excessively. Now she seems to be losing weight (1 pound since May) but I have also cut out all her treats thinking they could be the culprit so I am uncertain if the diet change caused the weight loss or this illness. Now we are waiting for the results of another lipase level specific blood test to come in- takes 4 days. What could it be? Has anyone else experienced this?

[Guest Stripeyfan]

Kelly has IBD as a result of a heavy worm infestation. A fecal revealed rounds, but we think he had hooks too because he's been left with extensive damage to his GI tract that means he can't eat anything except chicken and rice (plus a vit/mineral supplement). Hooks bite the intestinal lining and can cause all the symptoms you list above… AND they don't always show up on fecals. So even though Deeni's testing negative for them, it doesn't mean they aren't there - just that they're not laying eggs.

 

Low lipase levels could mean her pancreas is affected somehow - do you know what the actual numbers were? If there's a problem there the vet can prescribe enzymes to add to the food which make up for the body not being able to produce them by itself. We tried these for Kelly (although his pancreas was normal) to try to get him off his antibiotics but they didn't make any difference, so we stopped them.

 

If the colitis improves when Deeni has flagyl, and once everything else is ruled out, I'd suspect some form of IBD, possibly caused by the worms. Kelly has had to stay on his antibiotic (not flagyl but oxytetractycline) at a very low dose as it controls the inflammation in his GI tract - we found the right dose by slowly weaning it down. Could that be an option for Deeni if she can't come off the flagyl altogether? I know there are several people on here that have dogs on low, long-term doses of Tylan or flagyl for IBD and they do just fine.

 

Hope you get this sorted out soon.

[Guest BooBooMama]

Kelly has IBD as a result of a heavy worm infestation. A fecal revealed rounds, but we think he had hooks too because he's been left with extensive damage to his GI tract that means he can't eat anything except chicken and rice (plus a vit/mineral supplement). Hooks bite the intestinal lining and can cause all the symptoms you list above… AND they don't always show up on fecals. So even though Deeni's testing negative for them, it doesn't mean they aren't there - just that they're not laying eggs.

 

Low lipase levels could mean her pancreas is affected somehow - do you know what the actual numbers were? If there's a problem there the vet can prescribe enzymes to add to the food which make up for the body not being able to produce them by itself. We tried these for Kelly (although his pancreas was normal) to try to get him off his antibiotics but they didn't make any difference, so we stopped them.

 

If the colitis improves when Deeni has flagyl, and once everything else is ruled out, I'd suspect some form of IBD, possibly caused by the worms. Kelly has had to stay on his antibiotic (not flagyl but oxytetractycline) at a very low dose as it controls the inflammation in his GI tract - we found the right dose by slowly weaning it down. Could that be an option for Deeni if she can't come off the flagyl altogether? I know there are several people on here that have dogs on low, long-term doses of Tylan or flagyl for IBD and they do just fine.

 

Hope you get this sorted out soon.

 

 

Dear Stripeyfan,

How did you determine that there is "extensive damage to his GI tract"? Did you do an ultra sound or do you say that because of his chronic IBD? The flagyl doesn't really get stop the symptoms- just lessens them- still bloody mucus just not as much and the stools are not as soft. Now I am uncertain if we should we try Panacur again to combat a possible infestation. But that being said, how would worms affect the pancreas?

[Guest Stripeyfan]

Hi BooBooMama,

 

We didn't scope because by the time we got round to talking about it with the vet (after leaving another vet who completely failed to diagnose Kelly's IBD and made him so sick he lost over 20lbs), he was starting to pull round and put weight back on - I didn't want to set him back by putting him through major surgery, which our vet said could possibly kill him and might not even give any answers (as it doesn't always tell the vet anything). Our vet also decided not to do ultrasound as by then we'd found a food and meds combo which worked, which would have been the ultimate aim even if we had done those tests.

 

However, blood tests back in March 2010 found malabsorption in his intestines which is an indicator of damage to the intestinal wall - it's no longer able to absorb certain nutrients as efficiently, and the levels of these nutrients (I forget which ones but hopefully Greyhead will post soon and remind me!) show up as wonky in the tests.

 

18 months after the illness started, Kelly still can't eat dog food - even prescription foods for IBD give him the big D within 24 hours, and dog toothpaste has the same effect. So the conclusion our vet has come to is that he has permanent scarring and damage to his GI tract which makes his GI tract ultra-sensitive. She also suspects he may have had HGE at some point before we got him which caused damage, which then made him susceptible to worms, which made the damage worse, and so on...

 

As for the pancreas, I have no idea how worms would affect it - sorry. It was just that the lipase levels being out made me wonder if there might be something going on there. Has your vet suggested testing for Exocrine Pancreatic Insufficiency? Might be a good idea, just to rule it out - that was the pancreas test Kelly had, as EPI can be another cause of chronic big D.

 

Sorry, that's a bit of a rambling answer, but I hope it makes sense.

[Guest BooBooMama]

Hi BooBooMama,

 

We didn't scope because by the time we got round to talking about it with the vet (after leaving another vet who completely failed to diagnose Kelly's IBD and made him so sick he lost over 20lbs), he was starting to pull round and put weight back on - I didn't want to set him back by putting him through major surgery, which our vet said could possibly kill him and might not even give any answers (as it doesn't always tell the vet anything). Our vet also decided not to do ultrasound as by then we'd found a food and meds combo which worked, which would have been the ultimate aim even if we had done those tests.

 

However, blood tests back in March 2010 found malabsorption in his intestines which is an indicator of damage to the intestinal wall - it's no longer able to absorb certain nutrients as efficiently, and the levels of these nutrients (I forget which ones but hopefully Greyhead will post soon and remind me!) show up as wonky in the tests.

 

18 months after the illness started, Kelly still can't eat dog food - even prescription foods for IBD give him the big D within 24 hours, and dog toothpaste has the same effect. So the conclusion our vet has come to is that he has permanent scarring and damage to his GI tract which makes his GI tract ultra-sensitive. She also suspects he may have had HGE at some point before we got him which caused damage, which then made him susceptible to worms, which made the damage worse, and so on...

 

As for the pancreas, I have no idea how worms would affect it - sorry. It was just that the lipase levels being out made me wonder if there might be something going on there. Has your vet suggested testing for Exocrine Pancreatic Insufficiency? Might be a good idea, just to rule it out - that was the pancreas test Kelly had, as EPI can be another cause of chronic big D.

 

Sorry, that's a bit of a rambling answer, but I hope it makes sense.

 

Thank you, that did answer my questions. We are waiting for the results of a pancreatic enzyme test- which should be in by the end of the week. The vet suspects EPI but does not want to start the enzyme supplements until we get some confirmation. He also suggested an ultrasound. I guess I will wait for the final test results. If they are inconclusive, I will schedule her for an ultrasound. She just doesn't look as emaciated as EPI dogs look and her blood tests show no signs of malnutrition, so I am confused. Perhaps this is just the beginning of the condition and maybe she just isn't that sick yet. I hope we get to the root of the problem soon. I lost my job and money is running out but I can't allow her to go untreated. So many diagnostic tests and no real conclusion is draining my resources and not yet helping her.

 

Poor Kelly! He lost 20 lbs and he lived- what a will to survive! I wish you and Kelly the best. Thank you for your help.

[greyhead]

BooBooMama, our Spencer has a very similar history to Stripeyfan's Kelly. Kelly and Spencer have been IBD buds, so to speak, for the last 2-3 years. So if Stripeyfan is asleep on the other side of the pond, feel free to rattle my cage for any help I can give you. For now, I agree with everything she said. And I have to run out the door, so I can't add anything right now anyway. Hugs and scritches to you and your pup.

[Guest BooBooMama]

Deeni my 5 year old female greyhound has always had a sensitive stomach. Since I adopted a year ago in May, I tried hundreds of dog foods and finally gave up and fed her raw frozen. That seemed to work but from time to time she would have bouts of stomach upset- soft stool with mucus. Unfortunately she also came from the track with hookworm, so each bout of diarrhea we attributed to the infestation, teated it and things got better.

 

Back in May she had soft stool that had a lot of mucus in it but this time the mucus was pink with blood. We tested her and found a tapeworm segment (she had eaten a dead bird she found in the yard before I could get it away from her a week earlier) so we treated her for tapeworm. Now the beginning of July the bloody mucus was back. Once again we tested her for worms- negative. The vet thought colitis and put her on Metronidazole for a week. Three days after the Metronidazole ran out the pink mucus was back. So we tested again for worms- still negative. We send a culture of her stool to the lab to be tested for cryptosporidium and Giardia- negative. So we ran blood work- the only thing abnormal is her pancreatic enzyme, lipase is low. Normally in pancreatic cancer the enzymes are high. Blood pressure good, blood sugar levels normal, kidneys good. Currently she is on her second dose of Metronidazole but still has mucus from time to time- not as much as before the meds but I still see pink from time to time.

 

She doesn’t act ill- fairly peppy considering the intense heat here in the Midwest, good appetite, drinks water but not excessively. Now she seems to be losing weight (1 pound since May) but I have also cut out all her treats thinking they could be the culprit so I am uncertain if the diet change caused the weight loss or this illness. Now we are waiting for the results of another lipase level specific blood test to come in- takes 4 days. What could it be? Has anyone else experienced this?

 

 

 

UPDATE:

Results from the more extensive blood test shows that she does not have low lipase levels afterall. Her stools (after this second series of flagl) are beginning to look better. I have thought all along that this is hookworm even after 3 negative fecals so I am requesting Panacur. Maybe the worms are not the current cause and it IS IBS, but I want to cover all my bases. She sure doesn't act sick, so I am grateful.