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Lymphoplasmacytic, Transmural Enteritis in a 5 year old MN Yorkshire Terrier dog

Case Study

Lymphoplasmacytic, Transmural Enteritis in a 5 year old MN Yorkshire Terrier dog

This 5-year-old MN Yorkshire Terrier was presented for inappetence over a 2 day period. Physical exam of the dog revealed tacky mucous membranes, and focally painful abdomen. The CBC was normal. Blood chemistry analysis revealed mildly elevated BUN and mildly elevated amylase with moderate panhypoproteinemia and moderately low T4. The urinalysis revealed 3+ proteinuria and pyuria.

This 5-year-old MN Yorkshire Terrier was presented for inappetence over a 2 day period. Physical exam of the dog revealed tacky mucous membranes, and focally painful abdomen. The CBC was normal. Blood chemistry analysis revealed mildly elevated BUN and mildly elevated amylase with moderate panhypoproteinemia and moderately low T4. The urinalysis revealed 3+ proteinuria and pyuria.

Sonographic Differential Diagnosis

These findings support PLE with referred peritoneal inflammation and effusion. Potential causes are numerous, including parasites, dietary indiscretion, IBD, lymphangiectasia, infectious enteritis, ARE (antibiotic responsive enteropathy), and less likely neoplasia.

Image Interpretation

Image 1: Moderately thickened segment of small bowel. The most severely affected layer is the mucosal layer. The lumen is empty and contracted. Image 2: Moderately thickened segment of small bowel is bordered by a trace amount of anechoic peritoneal fluid and echogenic mesentery. Diffusely thickened small bowel with adjacent peritoneal inflammation and a trace amount of peritoneal effusion.

DX

Moderate, chronic active, lymphoplasmacytic, transmural enteritis with granulomatous lymphangitis

Outcome

Laparotomy revealed focal peritonitis associated with a perforated jejunum enveloped with omental adhesions. An intestinal resection was performed.The patient recovered uneventfully. However, the clinical status declined rapidly over the following 4 weeks inducing the owner to euthanize.

Comments

Yorkshire Terriers are predisposed to PLE and are often sited as having 10 times the incidence of PLE and associated syndromes of hypocalcemia and hypomagnesemia.

Clinical Differential Diagnosis

GI pathology – Protein losing enteropathy, IBD, Protein losing nephropathy, pancreatitis, GI obstruction, neoplasia, infectious, toxin ingestion.

Sampling

Histopath: Moderate, chronic active, lymphoplasmacytic, transmural enteritis with granulomatous lymphangitis.

Patient Information

Patient Name : Niedermyer P
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 04_00115

Clinical Signs

  • Anorexia

Exam Finding

  • Abdominal Pain
  • Dehydration

Images

Neidermyer_free_fluid_01232010041125Neidermyer_thick_mucosa_01232010041228

Blood Chemistry

  • Amylase, High
  • BUN high
  • Hypothyroidism
  • Total Protein, Low

Clinical Signs

  • Anorexia

Urinalysi

  • Bacteria Present
  • Protein Present