Hello,
Mandy is a 11 years old S/F Min. Poodle that presented for diarheea and weight loss. She has severe hypoalbuminemia( 16)and hypoglobulinemia(14) and mild anemia. She has a heart murmur, X-rays chest revealed an enlarged heart but no signs of decompensation.
US revealed free fluid, thickened si with linear striations in the mucosa, especially in the duodenum. Pancreas was heteroechoic with hyperechoic fat surrounding it.
Hello,
Mandy is a 11 years old S/F Min. Poodle that presented for diarheea and weight loss. She has severe hypoalbuminemia( 16)and hypoglobulinemia(14) and mild anemia. She has a heart murmur, X-rays chest revealed an enlarged heart but no signs of decompensation.
US revealed free fluid, thickened si with linear striations in the mucosa, especially in the duodenum. Pancreas was heteroechoic with hyperechoic fat surrounding it.
To me it looks like Lymphangiectasia, would you agree? Due to concurent pancreatitis, beside low fat diet, vit B12, Metronidazole would you consider budesonide over prednisone or other ?
Thank you.
Comments
yes good example of mucosal
yes good example of mucosal striations or “mucosal fogging” (my personal term wont likely find it published anywhere) when they coaleasce in the second video.
Here is the protocol I recommend and you can adjust depending ont he level of low albumin and the response to tx.
PLE Therapy
OBJECTIVE: keep albumin levels > 2 g/dl, Avoid thromboembolism and cavitary effusions, monitor concurrent PLN (Wheaton Terrier PLE/PLN) and liver disease:
Plasma 10 mL / kilogram IV over 4 hours
Or Human albumin 2 ml/kg/h over 10 hours. Total daily volume 20.l/kg/day
And Colloids/Hetastarch
10 to 20 mL per kilogram per hour and dogs
10 to 15 mL per kilogram per hour cats
(Can bolus first 1/3 of dose over 15 minutes)
& maintain on LRS maintenance otherwise.
Metronidazole (10-20 mg/kg po bid)
Famoditine 1 mg/kg Iv Im po dc Sid /bid
Sucralfate 0.5-1 g po tid dogs, 0.5 g bid cats in slurry Or Misoprostol 1-5 ug/kg po tid
Diet: Highly digestible high quality protein, low fiber, low fat diet (< 15% of dry matter). Hydrolyzed protein or novel protein. Purina HA or Royal Canine HP or similar.
Prednisone or prednisolone 2 mg/kg bid x 3-5 days then 2 mg/kg sid. Chlorambucil in refractive severe IBD/alimentary lymphoma cases (monitor cbc for rare bone marrow suppression) 4 mg/m2 Q 24-48 hours.
Cobalamine (B12) 250-1500 ug/dog weekly x 6 weeks.
Calcium supplementation if necessary.
Aspirin 0.5-1 mg/kg/day or Clopidrel (Plavix) 1-5 mg/kg/day.
Thank you EL
Thank you EL