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Very Low B12 but EPI Negative

Posted: 23 Mar 2023, 17:18
by JFinSF
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.

Re: Very Low B12 but EPI Negative

Posted: 24 Mar 2023, 06:49
by Jean
Good Morning from UK

what were the results of the tests taken

Re: Very Low B12 but EPI Negative

Posted: 24 Mar 2023, 10:01
by jilbert57
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

Re: Very Low B12 but EPI Negative

Posted: 27 Mar 2023, 16:42
by Olesia711
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.

Re: Very Low B12 but EPI Negative

Posted: 31 Mar 2023, 16:50
by JFinSF
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%)

Re: Very Low B12 but EPI Negative

Posted: 31 Mar 2023, 20:30
by Olesia711
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.