[Ellie May]

I am very sorry to hear about Libby.

It is so difficult to know what to do in an emergency like this. Everybody has different ideas and it is confusing. Not everyone will agree with what is decided and that's ok. People here just really want Libby to get better.

I love my vet to death and trust her with the kids, but she isn't right 100% of the time because she is human. That's where specialists come in. It is never wrong to get a second opinion. If you are comfortable without doing that, it is ok. She is your girl and you need to do what you think is best. However, standard of care for this is different than what is being done. Her best chance of getting through this is to make sure all the right meds and food are being given. As said above, that is really impossible without a diagnosis. I'm not sure why a bile acids test and urine culture haven't been done to at least help rule out a couple things. It wouldn't be a bad idea. I agree that a full thickness intestinal biopsy could be too much on her. Thankfully specialty hospitals have endoscopy available which may work for her.

Low fat is good, but more goes into diet than that. Please have her protein checked often. Some vets would admit and start hetastarch at the level it is now. Her extreme lethargy at home would concern me very much.

Also, PLE can be secondary to some things including heart disease. An echocardiogram may (or may not) be recommended.