The fecal alpha-1-protease inhibitor activity test is a newly developed assay to assist in the diagnosis
of protein-losing enteropathies (such as IBD, intestinal lymphoma, lymphangiectasia, and histoplasmosis).
Alpha-1-protease inhibitor is a serum protein that leaks into the intestinal lumen of animals with protein-losing
enteropathies, and can be detected in the feces because it resists degradation by fecal proteases. This test is
very sensitive for detecting protein-losing enteropathies, and will detect disease before protein loss is severe
enough to cause hypoalbuminemia or panhypoproteinemia. The test is species-specific and is only available for
dogs at this time.
Interpretation of Serum TLI, Folate and Cobalamin Concentrations
TLI
Folate
Cobalamin
Interpretation
N
N
N
Normal TLI concentration rules out EPI. Normal folate and cobalamin concentrations do not
rule out small intestinal disease.
D
N or D
N or D
EPI ± SIBO
I
N or D
N or D
Pancreatitis ± small intestinal disease.
N
D
D
Diffuse small intestinal disease ± SIBO.
N
D
N
Disease of the proximal small intestine (duodenum and jejunum).
N
N
D
Disease of the distal small intestine (ileum) ± SIBO.
N
I
D
This pattern of results in dogs indicates SIBO. Disease of the distal part of the small intestine
may also be present.
N
I
N
SIBO, dietary folate supplementation, or sample hemolysis.
N
I
I
Dietary folate and cobalamin supplementation.
N = normal D = decreased I = increased
Sampling Information for Gastrointestinal Disease Function Testing
Test
Sample
Qty.
Test Code Number
East & Test Express / West
Comments
Canine TLI
Separated serum or spun SST
1 ml
717 / 4024
812 hour fast required.
Feline TLI
Separated serum or spun SST
1 ml
722 / 16800
812 hour fast required.
Folate & Cobalamin
Separated serum or spun SST
0.5 ml
959 / 16195
812 hour fast required. Avoid hemolysis. TLI should be requested
simultaneously.