Clinical History:
1.Chronic mixed bowel diarrhea (suspect small bowel is primary component) with severe weight loss (BCS 2/9)
2.Decreased cobalamin and folate levels
3.Pan-hypoproteinaemia
4.Mild non-regenerative anaemia
5. Appetite waxes and wanes. occasional haematochezia
6. No vomiting
Chemistry panel: T.P. 3.7, Alb 2.0, Glob 1.7 (low end normal), Creat 0.5, Mg 1.6, ALP 15
CBC: 13.50 WBC, RBC 4.47, 10.4 HGB, HCT 29.8, RDW 14.3, PP 4.8, Mono 2.160, Eosin 1.89, Baso 0.810, absolute retic 36,000
Cobalamin level decreased 194 ng/l, Folate level decreased 7 ug/l, cTLI- normal Vitamin b12 injections 500mg/ul once weekly
Past medications include 1. Multiple rounds of metronidazole 500mg q12h 2. Tylosin unknown dose. 3. Vitamn B12 injections 500mg/ul weekly injections. 4. Panacur 800mg q24 x 10 days for empiric deworming 5. Prednisone 6/8/15 20mg q12hr.