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.

DX

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

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.

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.