Protein Losing Enteropathy

[Guest savvytwh]

I have a grey who has been diagnosed with PLE. Does anyone understand this

aliment? If so can you tell me alittle more about it. My dog has massive muscle

loss and went from 75 to 45 pounds. Right now he is eating Kangaroo & oat kibble

from Iams. Barely surviving, I take him Monday for more testing. He has had x-rays

and a barium swallow, of course blood and stool testing.

Any information or help would be greatly appreciated.

Thanks,

Carol & Matlock

[ahicks51]

Welcome to GT. Wish it were under better circumstances.

 

The short story: "Leaky gut," provided the diagnosis is correct. For whatever reason, the gut is unable to retain absorbed nutrients- in this case, proteins. See also:

 

http://www.petplace.com/dogs/protein-losing-enteropathy-in-dogs-ple/page1.aspx

 

If the cause is truly gastrointestinal, the MCT oil recommendation is a good one- as is feeding raw or cooked food (with as little vegetable matter as possible, with none coming from grains if it can possibly be helped).

 

As most people don't feed kangaroo without reason, can you explain the series of events that have transpired to get to this type of diet?

[brandimom]

I have no advice but I am putting your grey into my prayers and positive thoughts that you get to the bottom of this. Would you please keep us posted?

[Guest savvytwh]

Welcome to GT. Wish it were under better circumstances.

 

The short story: "Leaky gut," provided the diagnosis is correct. For whatever reason, the gut is unable to retain absorbed nutrients- in this case, proteins. See also:

 

http://www.petplace.com/dogs/protein-losing-enteropathy-in-dogs-ple/page1.aspx

 

If the cause is truly gastrointestinal, the MCT oil recommendation is a good one- as is feeding raw or cooked food (with as little vegetable matter as possible, with none coming from grains if it can possibly be helped).

 

As most people don't feed kangaroo without reason, can you explain the series of events that have transpired to get to this type of diet?

I had previously fed iams/eukanuba kibble, without problems. About 2 1/2 months ago my grey had vomitting & diarrhea. Very acidic. I original thought it

was something he ate on the yard. Unfortunately it didn't get better & I started to notice he was losing muscle mass. Took him to vet, they did blood & stool checks

thought it might have been gastritis-he was put on flagyl, probiotics and Science Diet-very bland mixed with the kibble. And a doggy probiotic daily for 30 days.

It appeared he was getting better, then suddenly the vomitting & diarrhea started again, with dramatic weight & muscle loss. Contacted friends & took him to a different vet.

 

This vet did abdominal x-rays, different blood & stool testing and a barium swallow test. The abd x-ray showed his stomach was full of food even though he had eaten 6 hours early.

The barium swallow showed extremely fast emptying of his stomach and delayed processing through the intestinal track.

The vet suggested changing the protien source to see if that would help with the vomiting & diarrhea. So far so good.

Monday I take him to a doggy Internist, so for I understand he'll be having an Ultrasound to see if the stomach and/or intestinal

wall thickening, which I understand will help with determining if he really has PLE.

 

Thanks for the education links.

Thanks for all the thoughts and wishes for his health.

 

Carol

[Trudy]

It sounds a lot like what was described to me for Tavarish before he was brought to the shelter in Kodiak. The local authorities were keeping him with them until he was officially surrendered to the shelter and could be brought here. After extensive testing and treatment, it was finally determined that he has Exocrine Pancreatic Insufficiency (EPI).

Here's some info on that:

http://www.marvistavet.com/html/body_exocrine_pancreatic_insufficie.html

 

If they haven't tested specifically for EPI, I'd have them check that as well as many of the symptoms overlap with what you'd see for PLE.

 

 

 

For protein absorption issues, studies go both ways for food high with protein or lower in protein. For Ryan, a higher protein food was not helping his issues and changing him to a lower (but not super low) protein and lower phosphate food seemed to work better. 2 years later, he's still peeing protein quicker than he can make it, but he's still around.

 

Good luck getting a definitive diagnosis and a treatment that helps.

[ahicks51]

OK. Any blood values out of whack? (Please list reference range with values if you have copies of his tests.)

 

Any other symptoms?

[Guest MZH]

Hi Carol,

 

Welcome to GT.

 

If you do a forum search on "protein losing enteropathy", you'll see what others have posted about this. Unfortunately, there's quite a bit of experience on the forum with this condition.

[Guest savvytwh]

OK. Any blood values out of whack? (Please list reference range with values if you have copies of his tests.)

 

Any other symptoms?

Started with vomitting & diarrhea, he started looseing muscle mass slowly. I had originally thought he had eaten some fermenting pears. After several days of vomitting & diarrhea, & trying several home remodies. Less food, wetting food to make mash, adding yogurt those types of home care. At times he seemed better. The vomit was mainly undigested food with alittle digested and fluid-very acidy smelling. The diarrhea was about the same. The 1st vet did CBC:

RBC-4.03 5.50-8.50;;;; HCT-31.1 37.0-55.0;;;; HGB 14.2 12.-16.;;; MVC-77.3 60.-77.;;;; MCH-35.36 18.5-30.;;; RDW-17.4 14.7-17.9 ;;;; WBC-4.40 5.5-16.9;;;;;NEU-2.77 2.0-12.;;;;LYM-0.82 0.50-4.9;;;;;MONO-0.59 0.3-2.0;;;;EOS-0.21 0.10-1.49;;;;BASO-0.01 0.0-0.10 ;;;;; PLT-452 175-500

MPV-9.2 no range;;; PDW-19.6 no range;;;; PCT-0.4 no range;;;; MCHC- out of reportable range

Comprehensive diagnostic-

ALB-2.9 2.5-4.4;;;; ALP-24 20-150;;;; ALT-58 10-118;;;; AMY-474 200-1200;;; TBIL-0.3 0.1-0.6;;;; BUN-16 7-25;;;;; CA-8.9 8.6-11.8;;;; PHOS-4.5 2.9-6.6;;;; CRE-0.9 0.3-1.4;;;; GLU-122 60-110;;;; NA+137 138-160;;;;; K+-4.7 3.7-5.8;;;;; TP-5.1 5.4-8.2;;;;; GLOB-2.2 2.3-5.2

These labs were done on 10/29 at 3pm he had not been fasting.

 

Most current dine on 12/12 non fasting:

Chem Panel:

ALT 119 5-107;;;;TOTAL PROTEIN 4.5 5.1-7.5;;;;;;BUN 19 7-27;;;;;CREAT 0.9 0.4-1.8;;;;GLU 113 60-125;;;;K+ 4.0 4.0-5.6;;;;;;NA 146 141-156

CBC w/ FECAL:

WBC-4.0 5.7-16.3;;;;RBC-8.83 5.5-8.5;;;;HGB-17.0 12-18;;;;HCT-48.6 37-55;;;;MCH 55 60-77;;;;MCH-19.3 19.5-26;;;;MCHC-35 32-36;;;NEUTROPHIL SEG-85 60-77

LYMPHOCYTES-8 12-30;;;;MONO-7 3-10;;;EOS-0 2-10;;;;BASO-0 0-1;;;AUTO PLATELET-456 164-519

FECAL:

ABSOLUTE NEUTROPHIIL SEG-3400 3000-11500

ABS LYMPH-320 1000-4800

ABS MONO-280 150-1350

ABS EOS-0 100-1250

ABS BASO-0 0-100

 

THYROID:

T4-1.8 0.9-3.9

 

URINE: No ranges done on 12-22

pH-6.5

LEU- neg

PRO-30

GLU- neg

KEY-15 (brown)

UBG-4

BIL-3

BLD-10 ery

S.G.- 1.042

Gross-concentrated, clear

 

 

Differential Diagnosis: Lymphangicotasia

Protien Losing Enteropathy

Gastritis Luten formation

Inflammatory Bowel Disease

 

 

No change in attitude, enthusiastic eater, still appears 'bright' no edema or ascites. Breath & heart sounds good.

 

Thanks again for all info and well thoughts.

Carol & Matlock

[MP_the4pack]

I hate to say it, but ask for another test. A liver FUNCTION test, not the liver enzymes that are part of a normal Chem profile. You'll know when this test is being done because there are two blood draws, one before food and one 2 hrs later after eating.

 

My Topaz had PLE and everyone was focusing on her gut. We went to U of Penn and found it to be her liver. It was shot. Nothing left of it even though there were normal enzyme values. We went down there for a second opinion. She never made it back. She was only five.

I sure hope it's something other than her liver or something that can be treated. Several things can cause PLE.

Good luck.

[Guest savvytwh]

I hate to say it, but ask for another test. A liver FUNCTION test, not the liver enzymes that are part of a normal Chem profile. You'll know when this test is being done because there are two blood draws, one before food and one 2 hrs later after eating.

 

My Topaz had PLE and everyone was focusing on her gut. We went to U of Penn and found it to be her liver. It was shot. Nothing left of it even though there were normal enzyme values. We went down there for a second opinion. She never made it back. She was only five.

I sure hope it's something other than her liver or something that can be treated. Several things can cause PLE.

Good luck.

I'm so sorry for your loss. Thanks for the heads up on the Liver Function test..I'll definitely request it.

Again thanks for all the info & thoughts for my grey.

 

Carol & Matlock

[ahicks51]

When was the first CBC? The RBC went from 4.03 (reference range 5.50-8.50) and HCT of 31.1 (37.0-55.0) to RBC of 8.83 (5.5-8.5) and HCT of 48.6 (reference range 37-55), which seems a bit odd to me.

 

If it's lymphangiectasia, you might see edema as well- abdominal distension, shortness of breath (from pleural effusion, where fluid backs up in the lining of the lungs), and fluid depositing in the legs.

 

Monday is a ways off; if you want to try something, MCT oil works with both lymphangiectasia and PLE. Coconut oil is a good source of MCT, and it might help get some calories into him. Good luck.

[Guest zoolaine]

Sunny (8 year old non-grey) was diagnosed with PLE about a year and a half ago. Luckily he never got real sick but rather his yearly bloodwork showed the low protein levels. He has had many tests: ultrasound, endoscopic biopsy, liver function, urinalysis, and bloodwork - usually every three weeks; all without any definitive diagnosis of what is causing the low protein levels. However, they still believe it is from a food intolerance. He is currently on Metronidazole 750mg per day, Budesonide 2mg/twice a day, and Azathioprine 50mg a day. When he was diagnosed they said he would be dead in 3 months, but thankfully he is doing relatively well. He started all of those medications when he was diagnosed and his protein numbers returned to a normal level so they began weaning him off the meds. He was down to one Azathioprine every 3 days when his numbers tanked again so he has returned to taking all three (it was kinda heartbreaking for me with him going from 1 pill every 3 days to 6 pills a day). They idea now is they will taper him off some since his numbers are improving but he will probably remain on the meds for the rest of his life. He is also on a limited diet. he is currently eating Natural Balance duck and potato, which he likes. He can also have the venison version. For extra treats he is only allowed: bison/buffalo, sweet potatoes and 100% rye crackers (I make him "cookies" using rye flour), and occasional fish.

I agree that he should be tested for EPI and liver function test. Oh, welcome to GT and to both you and your grey. I know how hard PLE can be. It is so frustrating to not be able to figure out what is going on and how to help them get better.

[Guest savvytwh]

When was the first CBC? The RBC went from 4.03 (reference range 5.50-8.50) and HCT of 31.1 (37.0-55.0) to RBC of 8.83 (5.5-8.5) and HCT of 48.6 (reference range 37-55), which seems a bit odd to me.

 

If it's lymphangiectasia, you might see edema as well- abdominal distension, shortness of breath (from pleural effusion, where fluid backs up in the lining of the lungs), and fluid depositing in the legs.

 

Monday is a ways off; if you want to try something, MCT oil works with both lymphangiectasia and PLE. Coconut oil is a good source of MCT, and it might help get some calories into him. Good luck.

 

The 1st lab was 10/29.

He has no edema, abdominal distention, SOB or fluid build in the legs.

Other than the massive muscle loss- nothing had changed, hair coat good, acts as normal as a dog cam with muscle loss.

Still has a light in his eyes, tries to play & run with the other dogs.

At this point he looks like a skeleton with a dog coat on.

 

Thanks,

Carol & Matlock

Edited January 2, 2010 by savvytwh

[Guest savvytwh]

When was the first CBC? The RBC went from 4.03 (reference range 5.50-8.50) and HCT of 31.1 (37.0-55.0) to RBC of 8.83 (5.5-8.5) and HCT of 48.6 (reference range 37-55), which seems a bit odd to me.

 

If it's lymphangiectasia, you might see edema as well- abdominal distension, shortness of breath (from pleural effusion, where fluid backs up in the lining of the lungs), and fluid depositing in the legs.

 

Monday is a ways off; if you want to try something, MCT oil works with both lymphangiectasia and PLE. Coconut oil is a good source of MCT, and it might help get some calories into him. Good luck.

 

The 1st lab was 10/29.

 

He has no edema, abdominal distention, SOB or fluid build in the legs.

Other than the massive muscle loss- nothing had changed, hair coat good, acts as normal as a dog cam with muscle loss.

Still has a light in his eyes, tries to play & run with the other dogs.

At this point he looks like a skeleton with a dog coat on.

 

I'll try an post a link with pics that I'll take tomorrow.

 

Thanks,

Carol & Matlock

[Charlies_Dad]

Sorry I don't have any good advice, just sending prayers for your pup. I hope a diagnosis can be confirmed and treatment follows soon.

Edited January 2, 2010 by Charlies_Dad

[Guest zoolaine]

Is he eating well? I read a good article awhile back about EPI and it basically said that the dogs eat and eat but continually lose weight because they can't absorb the nutrients properly.

[Guest savvytwh]

Is he eating well? I read a good article awhile back about EPI and it basically said that the dogs eat and eat but continually lose weight because they can't absorb the nutrients properly.

Yes he is eatting well with great enthusiasm.

 

Here is linklink for today's pictures:

 

http://smg.photobucket.com/albums/v468/savvytwh/Matlock/

 

 

If you don't want to see an extremly thin dog don't check the pics out.

[Guest zoolaine]

Is he eating well? I read a good article awhile back about EPI and it basically said that the dogs eat and eat but continually lose weight because they can't absorb the nutrients properly.

Yes he is eatting well with great enthusiasm.

 

Here is linklink for today's pictures:

 

http://smg.photobucket.com/albums/v468/savvytwh/Matlock/

 

 

If you don't want to see an extremly thin dog don't check the pics out.

 

 

Sounds like it could be EPI; but that is what is so hard - it could be a lot of things. Poor baby, please give him a hug for me.

[MandysMom]

I don't have any experience with PLE, but do know about EPI. Here is a good website with EPI info: EPI

 

EPI can be diagnosed with a TLI test. The most common symptoms are rapid weight loss and yellowish or gray greasy diarrhea.

EPI dogs usually are ravenous because they are not digesting food.

 

Sending prayers for your pup.

[Guest savvytwh]

I don't have any experience with PLE, but do know about EPI. Here is a good website with EPI info: EPI

 

EPI can be diagnosed with a TLI test. The most common symptoms are rapid weight loss and yellowish or gray greasy diarrhea.

EPI dogs usually are ravenous because they are not digesting food.

 

Sending prayers for your pup.

Thanks, he's never had yellowish or gray greasy diarrhea.

But I will ask about the TLI test.

 

Carol & Matlock

[Guest savvytwh]

We spent 3 hours at the specialist, very nice vet. Took time and really explained tests and possible diagnosises.

He had blood drawn, for comprehensive CBC and LFT.

Also had ultra sound to check for stomach & intestinal wall thickening, which he had slightly-each layer of the walls,

appeared normal. There was slight fluid in the abdominal cavity. The original abdominal x-rays did't show from the throat to the

diaphram, so a couple more xrays.

The vet prescribed antibiotics and panacur powder. He explained even though the fecal tests were neg. the dog could still

have worms.

Once the labs are back...there might be a chance for a diagnosis.

 

Carol & Matlock

[EllenEveBaz]

Sending good thoughts! Hang in there.

[Guest savvytwh]

Had a vm from the vet-pancreas is normal. So when we talk later w

we'll discuss other diagnostic tools.

Agains thanks to all for yor thoughts and prayers for my grey.

 

Carol & Matlock

[Guest jskelton]

I really think that aggressive medical treatment is required. My dog had chronic diarrhea and low albumin. My vet immediately recommended taking her to a specialist. So we went to the University of GA Veterinary Hospital where diagnostics would be more affordable. She too has fluid in her belly and also swollen lacteals. Her PLE was suspected to be due to IBD and possibly Lymphangiectasia and she was immediately put on Metranidazole, Azathioprine, and Prednisone. This treatment brought her protein levels back to normal and after six months she continues to do well and is taking prednisone and Azathioprine every third day.

 

With your dog's significant weight loss, time is critical. In researching PLE and Lymphangiectasia I learned that recovery becomes much more difficult when the dog is significantly under weight.

 

Good luck and God bless your baby.

[Guest jskelton]

Addressing one of the poster's questiosn about why Kangaroo...

Kangaroo is a unique protein source. So if the GI issues are related to an allergic reaction to a certain food, eliminating all previously fed food and grain from the diet and replacing with a never before eaten food may provide relief.