Dogs can suffer from a variety of digestive issues. One of the most common is protein-losing enteropathy (PLE). Protein-losing enteropathy in dogs is characterized by the loss of proteins in the digestive tract. This leads to a lack of protein absorption which leads to malnutrition and a host of other problems. This blog article will look at the different causes of protein-losing enteropathy in dogs (PLE) and what the treatment options are.
What is and what causes protein losing enteropathy in dogs?
Protein-losing enteropathy in dogs (PLE) is a disorder in which protein is significantly lost through the gastrointestinal tract. Protein-losing enteropathy can be caused by any gastrointestinal disease, although the term is typically reserved for chronic diseases. The most common chronic conditions that can cause protein-losing enteropathy in dogs include:
- Inflammatory bowel disease
- Lymphangiectasia
- Intestinal fungal infections
- Intestinal cancer such as lymphoma
- Intestinal parasites (especially in younger dogs)
- Chronic intussusception
In dogs with protein losing enteropathy, the normal loss of proteins is increased because the proteins are leaked out of the intestine and not absorbed back in.
Multiple types of proteins are lost in PLE in dogs, such as albumin and globulin. The liver can respond to albumin loss by synthesizing more albumin, but eventually, the rate of albumin loss becomes greater than the rate of production. The lack of protein in the body causes cavitary effusions such as ascites (fluid in the abdomen) and peripheral edema to occur. Anti-coagulant proteins can also be lost in protein losing enteropathy. This can create a hypercoagulable state and increase the risk of thromboembolism. Other potential complications of protein losing enteropathy in dogs can include low calcium (hypocalcemia), low vitamin D (hypovitaminosis D) and low levels of vitamin B12 (hypocobalaminemia).
What are the symptoms of protein losing enteropathy in dogs?
The clinical symptoms of protein-losing enteropathy in dogs can vary depending on the underlying cause. However, most dogs with protein-losing enteropathy will have some combination of the following symptoms:
- Malnutrition or weight loss
- Anorexia (lack of appetite)
- Vomiting
- Diarrhea
- Abdominal distension due to ascites (fluid in the abdomen)
- Peripheral edema (fluid accumulation in the extremities)
- Weakness or lethargy
How is protein losing enteropathy in dogs diagnosed?
Protein losing enteropathy in dogs is typically diagnosed based on a combination of clinical signs and laboratory findings. The most common laboratory tests used to diagnose protein losing enteropathy in dogs include blood work assays to measure the serum protein levels, calcium, and vitamin B12 levels. A urinalysis should also be performed to rule out protein losing nephropathy which is protein loss through the kidneys. Protein-losing enteropathy (PLE) can be definitively diagnosed and the cause is determined by histopathology of intestinal biopsy samples. The biopsy can be done via exploratory surgery, laparoscopy or endoscopy.
What are the treatment options for protein losing enteropathy in dogs?
The treatment options for protein-losing enteropathy in dogs will vary depending on the underlying cause. However, some of the most common treatment options include:
Corticosteroids
Dogs with protein-losing enteropathy often respond well to corticosteroid therapy and will help reduce protein loss in cases of inflammatory bowel disease. The most common corticosteroids used to treat protein-losing enteropathy are prednisone and budesonide.
Dietary management
Dietary changes are an important part of the treatment for protein-losing enteropathy in dogs and some dogs can be managed with diet alone. Current recommendations include hydrolyzed diets in cases of inflammatory bowel disease or a fat-restricted diet. For PLE, highly digestible, calorie-dense, and low-fat (10-15%) diets are commonly used.
Vitamin B12 supplementation
Dogs with protein losing enteropathy can also be deficient in vitamin B12. Supplementation with oral or injectable forms of vitamin B12 is often recommended for these dogs.
What is the prognosis for dogs with protein losing enteropathy?
Depending on the specific diagnosis, the long-term prognosis varies. According to some references, the prognosis may be poor because the response to treatment may be unpredictable for any of the underlying conditions.
Protein Losing Enteropathy in dogs is a serious disease that can lead to protein loss from the intestine. The protein lost through protein-losing enteropathy (PLE) could be caused by inflammatory bowel disease, or it may develop due to other factors such as infection, inflammation, or intestinal obstructions. Some of the symptoms associated with PLE are malnutrition or weight loss, anorexia, vomiting, diarrhea, and abdominal distension. The disease is typically diagnosed by a combination of clinical signs and laboratory findings. Treatment options for protein-losing enteropathy vary depending on the underlying cause but may include corticosteroids and dietary management changes. The prognosis for protein-losing enteropathy varies depending on the specific diagnosis. If you have any further questions about protein-losing enteropathy in dogs, please reach out to your veterinarian.