Dr. Pankatz: “At first I thought it was my probe or settings but then I switched presets and also compared other loops of bowel which had a normal hypoechoic mucosal layer so I do believe this lesion is real – rest of scan was normal; no effusion or enlarged LN’s. So looks like a protein losing enteropathy [PLE] (pending normal pro:crea ratio). What are your thoughts of this bowel lesion? I am scheduled to perform intra-operative ultrasound on this as I think it may be difficult to determine where it is grossly. The plan is to identify the abnormal loop of bowel and biopsy or possibly resect.” Histopath Results: These intestinal biopsies are excellent, and are definitive for primary lymphangiectasia. The intestine is structurally normal and has no increase in leukocytes, but every villus lacteal is massively distended to the point of rupture, and the dilation of lymphatics continues within the submucosa and tunica muscularis. There is absolutely no evidence of neoplasia, and there is no evidence of previous inflammation or fibrosis that might explain the development of the lymphangiectasia. The vast majority of cases of lymphangiectasia that I see in dogs are primary and idiopathic like this.