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Real quick also: what's your opinion on the low white blood cell count, considering Charlie's state?
This is from: http://www.bestfriendsvet.com/pdffiles/Chronic GI disease 2011.pdfOnce we have ruled out the diseases that are easy to test for the next step is usually a set of blood tests that look at the function of the pancreas and the small intestine. We refer to this set of tests as a gastrointestinal or GI panel.
There are four tests in the panel: PLI is an enzyme produced by the pancreas. An elevated PLI means the pancreas is inflamed and the pet has pancreatitis. Pancreatitis is treated with pain medication and special low-fat diets. The other pancreatic test is TLI. This one tells us whether the pancreas is making enough digestive enzymes to properly digest food. If not, we can add enzymes to the food to replace what the pancreas isn’t producing.
The intestinal tests are both looking for changes in vitamin levels. Low cobalamin and/ or high folate levels mean intestinal disease is present. When the intestine is thickened and not functioning properly vitamin B12, or cobalamin, is not absorbed well and the level of cobalamin in the bloodstream becomes too low. If your pet’s B12 level is low we will teach you how to give vitamin B12 injections at home to improve the blood level and also start treatment for intestinal disease. When bacteria overgrow in an unhealthy intestine they produce excess folate, which then shows up in the bloodstream. If this is the case we treat with antibiotics. Treatment may be needed anywhere from a few weeks to forever. Probiotic supplements may also be used to reintroduce healthy, good gut bacteria.
A GI panel costs about $165 and it takes 10-14 days to get results back from the lab.
Of course, I've had kitties with diarrhea and they've passed undigested food, and they don't have EPI. It IS possible this is a very inflamed GI system now further upset by a strong antibiotic.A veterinarian may suspect that your cat has EPI based on her medical history and symptoms, but a definitive diagnosis requires confirmatory testing. The trypsin-like immunoreactivity test (TLI) is the most common diagnostic tool used and requires only one sample of blood taken after a 12-18 hour fast. Fecal testing may also be appropriate under certain circumstances.