Protein-Losing Enteropathy Syndrome Associated with Lymphangiectasia in Dogs
Introduction
Protein-losing enteropathy (PLE) is a complication of a variety of intestinal disorders characterized by an excessive loss of proteins into the gastrointestinal tract due to impaired integrity of the mucosa. In dogs, lymphangiectasia - the dilatation and rupture of the lymphatic vessels of the gastrointestinal tract - is often associated with PLE.
Objectives
To review the clinical signs, clinicopathologic abnormalities, and histopathologic findings associated with lymphangiectasia in dogs.
Methods
Nineteen cases were retrospectively studied; all dogs had hypoalbuminemia (serum albumin <2.7 g/dL) and lacteal dilatation on histopathologic evaluation. Renal or hepatic causes of protein loss were excluded.
Results
Twelve dogs were females. The median age was 7 years (range: 1–11 years). Yorkshire Terriers (n=5) and Maltese (n=3) dogs were the most common breeds. Diarrhea (n=15) and ascites (n=13) were the most observed clinical signs. The mean serum albumin was 1.6 g/dL (0.89–2.68). Hypocholesterolemia and lymphopenia were observed in 8 and 5 dogs, respectively. Ten dogs had moderate to marked intestinal inflammation, and 9 dogs had lymphangiectasia and minimal inflammation. All dogs were treated with low-fat diet and clopidogrel. Dogs with inflammation also received immunosuppressive drugs. Variable, but satisfactory, response occurred in all cases, but 3 dogs died - 2 of them because of thromboembolism - confirmed at necropsy.
Conclusions
In almost half of the dogs, evidence of mucosal damage, other than lacteal dilatation, or an underlying cause were detected. Further studies are necessary to access the risk of thromboembolism and its treatment in dogs with lymphangiectasia.