Quote:
Originally Posted by ally173  actually the blood work didnt include amylase nor lipase
he said he doesnt depend on those values
instead he did the TLI (trypsin like immunoreact) and it was 25 (range 5-35); so that shows normal exocrine pancreatic function
he tested spec cpl it was 166 (anything less than 200) that shows concentration is normal
he also tested her cobalamin b-12 and folate and they were normal
her blood work is mostly clean; except for these (anyone knows what they mean)
HGB and HCT was a bit high
lymphocytes was high 40% (range 12-30%) maybe she needed antibiotic after all
Eosinophil and neutrophil were low
absolute lymphocyte were normal 3360 (range 1000-4800)
absolute eosinophil is low 84 (range 100-1250)
her biopsy result states:
the endoscopic biopsies of the duodenal mucosa contain diffuse infiltrates of lymphocytes and plasma cells throughout the lamina propria of the intestinal villi. the villi are somewhat thicker than normal and blunted as a consequence of the inflammatory infiltrates. the surface epithelium of the villi is intact and there no evidence of erosion, ulceration or neoplasia. the microscopic findings in the small intestinal mucosa are consistent with a moderately severe, diffuse lypmhoplasmacytic enteritis, i.e.. a chronic, idiopathic, inflammatory bowel disease. |
it is too bad he did not run a full panel as the amylase and lipase can give you some indication and since this dog had no diarhea the tli was not ever a concern of mine as that is tied to epi which is different than pancreatitis and dogs with epi have diarhea not vomit. I would not do it now though as would be a waste since the endoscopy was done but dogs with elevated amylase and lipase can be an indication of ibd per our internal medicine specialist. I like that he did the cobalamin b-12 and folate as that is a test for sibo which is over bacteria in the digestive tract
EPI in Dogs
but again i think he was trying to rule out epi with the sibo and epi combo which those two diseases the dog always has diarrhea which she does not have. Due to cobalamin b-12 and folate tests being normal may be why he did not give antibiotics after all - did that test come back after he mentioned the metronidazole if so that may be why he did not prescribe it. My question would be why do those tests when she never had pancreatitis as epi is from getting pancreatitis over and over usually. He is being very thorough and someone with alot of money ok but i wish he would have tried to focus on the symptoms of dog and tried to minimize the cost as your dog showed no signs of epi
EPI in Dogs small intestinal bacterial overgrowth Exocrine Pancreatic Insufficiency in Dogs (EPI)