Very Low B12 but EPI Negative

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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JFinSF
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Country: United States
State: California
Pet name: Penny
My name: Jean-Francois

Very Low B12 but EPI Negative

Post by JFinSF » 23 Mar 2023, 17:18

Hello!
My Swiss Shepherd (~white GSD) Penny who is 9 months old has been showing all the symptoms usually associated with EPI. Voracious appetite combined with continued weight loss, cow-like poop (sometimes diarrhea' light color). She also tends to eat her own feces if we don't pick them up right away.
The vet ran an EPI test and a full blood panel. Just got off the phone.
Vet indicated B12 levels (and I think folate?) were extremely low but the EPI test came back negative. (We did fast the dog from 12pm to next day 8am time of the test so more than 12hrs).
Next step is a fecal test. (waiting for her to poop as I am typing this)
Is there a chance the test for EPI was a false negative? vet seems to think it's pretty accurate. I already have a bag on Pancreatin from Enzyme Diane but vet wants me to hold off on it.
Is there a risk of using the Enzyme solution if she does not have EPI?
Sorry for the newbie questions and thanks in advance! Love my puppy.

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Jean
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Pet name: Kara, lost 10th May 2019
My name: Jean

Re: Very Low B12 but EPI Negative

Post by Jean » 24 Mar 2023, 06:49

Good Morning from UK

what were the results of the tests taken
My name is Jean we live in Liverpool in Uk

I am the Forum Director which I am very proud of

My Kara born 21 July 2009 diagnosed with EPI by cTLI test August 2010 TLI = <1...folate 14 Cobalamin 408, shot down to 94, b12 injections every other day

Lowest weight 39 pounds

We used Panzym enzymes, Tylan and Chemeyes b12 capsules

Sadly, on 10th May 2019, we lost her to DM


Jeanx

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jilbert57
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Re: Very Low B12 but EPI Negative

Post by jilbert57 » 24 Mar 2023, 10:01

Yes as Jean says please post the test results of the bloods. Low B12 can be indicative of chronic small intestinal disease (SID), pernicious anemia, EPI and some other issues. Was your pup checked for pancreatitis?

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

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

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Olesia711
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Re: Very Low B12 but EPI Negative

Post by Olesia711 » 27 Mar 2023, 16:42

If the folate reading was 7.7 or below..... your pet most likely has small proximal distal disease.... although this is more or less a catch-all phrase..... when you see many of the same symptoms as you do in an EPI patient, but it is not EPI,,,,then is most often is, some sort of food sensitivity, IBD, etc.

With the fecal test.... maybe ask your vet to just contact Texas A&M Gastro lab and request a Dysbiosis index test.
https://vetmed.tamu.edu/gilab/service/assays/canine-microbiota-dysbiosis-index/

Here is the contact information or your vet:
Tel: 979.862.2861 | Fax: 979.862.2864
Email: gilab@cvm.tamu.edu | Web: vetmed.tamu.edu/gilab
Hours: Mon.-Fri. 8:00 AM to 5:00 PM (CT)

The Dysbiosis test will test 7 groups of bacterial strains and the results will help your vet better identify (by the over-abundance or lack there-of of certain bacterial groups) what is probably going on.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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JFinSF
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Country: United States
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Pet name: Penny
My name: Jean-Francois

Re: Very Low B12 but EPI Negative

Post by JFinSF » 31 Mar 2023, 16:50

Hello everyone! Sorry for the delay. Keep waiting for new test results ..
So far we did blood, urine and fecal tests. Probably Ultrasound next as it seems to be contained to small intestine (Mostly because my dog has solid poop in the morning that turns soft/liquid later in the day). Vet says EPI ruled out.
Urine Culture: Negative after 72 hours MS
pH 5.0 (normal 5.5 to 7)
Cobalamin 271 pg/ml
Folate >24.0 ng/ml
cTLI 30.3 mg/l
All fecal tests came back negative (bunch of parasite tests)
For blood test - reporting just out of range numbers
Neutrophils 54 (normal 60-77%)
Lymphocytes 39 (Normal 12-30%)
Eosinophils 1 (normal 2-10%)

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Olesia711
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Re: Very Low B12 but EPI Negative

Post by Olesia711 » 31 Mar 2023, 20:30

thanks for posting the results.... Glad to hear no EPI...but so sorry that you still have to try and figure out what is going on.
THat B12 score is quite low :(
And that high of a Folate level is indicative of something amiss.............ii don't think the Eosinophil is much to worry about at a level 1
but the low neutrophils and high lymphocytes are also indicative of something going on :(

With the stools fine in the morning.... and then sloppy/loose later....... ask the vet if they think it would be okay for you to try adding a little bit of a high fiber prescription diet kibble to the food mix you are giving now. (Royal Canin or Purina).... just get the smallest bag possible if your vet thinks it would be okay to try.

REason why i am suggesting this is because my young pup, at about 6 months old also started having "iffy" poos... and yellow too! it wasn't EPI, we checked for Addison's etc., i avoided anti's, tried a variety of probiotics.... and finally i noticed whenever i added brown rice to the mix with some cooked meat... his poos improved, but if i did not include rice or potato with the small portion of fresh cooked meat... his stools went sloppy. i detailed EVERYTHING he was eating... i finally asked the vet if i could try adding a high fiber food... OMG... that did it... he now gets 25% high fiber food, 25% regular kibble, 25% cooked rice or sweet potato and 25% some sort or protein(meat). Been working like a charm for over a year now :)

SO......... i am just throwing this out there as a possibility.

In the meantime, i sure hope the vets can figure this out soon.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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