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Canine protein-losing enteropathy (PLE) is commonly considered to occur secondary to severe inflammatory bowel disease (IBD) and is associated with poor outcomes, with only about 50% of dogs surviving longer than 4 months.
The syndrome typically causes gastrointestinal signs, but also systemic manifestations due to hypoalbuminaemia, such as pleural effusion, ascites and peripheral oedema.
Some breeds were identified as predisposed to PLE secondary to IBD, including Yorkshire terriers, Border collies, German shepherds, and Rottweilers.
Regarding diagnosis, the approach to PLE is similar to the approach to chronic small intestine diarrhoea, with PLE often suspected in the presence of panhypoproteinaemia. Other causes of hypoalbuminaemia, such as Addison’s disease, protein-losing nephropathy and liver dysfunction should be ruled out.
Authors note that to reach a definitive diagnosis of the causes of PLE, which include intestinal lymphangiectasia, and crypt disease, histologic evaluation of intestinal biopsies is necessary. They also suggest that in severely debilitated and anorexic dogs, intestinal biopsies should be prioritised over treatment trials, preferably endoscopic ileal biopsies.
As ionised hypocalcaemia, vitamin D deficiency, cobalamin deficiency, hypercoagulability and thromboembolic complications, can occur as systemic complications, the authors suggest testing for these as well, as the results could help elaborate individualised treatment plans and could improve the odds for survival.
In Allenspach, K., & Iennarella-Servantez, C. (2020). Canine Protein Losing Enteropathies and Systemic Complications. Veterinary Clinics of North America: Small Animal Practice. doi:10.1016/j.cvsm.2020.09.010
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