Case Study

Lymphangectasia presentation with likely protein-losing enteropathy (PLE) in a 4 year old M Rottweiler dog

A 4-year-old intact male Rottweiler that was recently adopted was presented for evaluation of anorexia, intermittent vomiting, diarrhea, and coughing. Physical examination showed poor condition and muscle wasting. Survey radiographs showed poor serosal detail and a AFAST scan revealed free fluid within the abdomen.

DX

lymphangectasia presentation, Likely PLE

Sonographic Differential Diagnosis

Diffuse mucosal fogging, lymphangectasia presentation. Free fluid is likley owing to poor oncotic pressures. Underlying intestinal lymphoma is a minor potential. If the clinical signs persist despite medical therapy then full thickness biopsies would be recommended. Fluid analysis is recommended to ensure that this is simple transudate without potential lymphoma cells given the breed predisposition. Serial evaluation for parasites would be warranted.

Image Interpretation

The stomach appeared normal. The intestinal tract revealed diffuse, mucosal striations and fogging. This is suggestive for protein losing enteropathy/lymphangectasia. There is some loss of mural detail noted in the intestinal tract. Minor reactive mesentery was noted. Free fluid was noted in the abdomen.

Clinical Differential Diagnosis

Ascites – hypoproteinemia, liver disease, peritonitis (bacterial, urine, bile), neoplasia, cardiac disease (cardiomyopathy, pericardial effusion), splenic torsion, liver lobe torsion