Case Study

Protein Losing Enteropathy in an 8 Year Old FS Yorkshire Terrier dog

An 8 year old FS Yorkshire Terrier dog with a history of protein losing enteropathy (PLE) was presented for ascites, which was confirmed on physical examination. The dog has been treated with Atopica. Abdominocentesis yielded 265 mls of fluid. CBC and blood work showed leukocytosis, lymphopenia, neutrophilia, thrombocytosis, hypoproteinemia, hypoalbuminemia, and hypocalcemia.

An 8 year old FS Yorkshire Terrier dog with a history of protein losing enteropathy (PLE) was presented for ascites, which was confirmed on physical examination. The dog has been treated with Atopica. Abdominocentesis yielded 265 mls of fluid. CBC and blood work showed leukocytosis, lymphopenia, neutrophilia, thrombocytosis, hypoproteinemia, hypoalbuminemia, and hypocalcemia.

DX

Protein losing enteropathy

Sonographic Differential Diagnosis

Protein losing enteropathy. Chronic inflammatory bowel disease with probable lymphangectasia. Potential emerging intestinal lymphoma, not overtly suspected. Chronic glomerulonephritis pattern.

Image Interpretation

The abdomen in this patient presented a moderate amount of anechoic ascites with diffuse gastrointestinal thickening with mucosal striations and some loss of mural detail. Echogenic omentum was also noted. The kidneys presented thickened cortices consistent with a chronic glomerulonephritis. Protein losing nephropathy could also be a contributing factor.

Outcome

Blood pressure assessment and assessment of proteinuria in this patient was recommended. The patient was treated with a plasma transfusion, fed an easily digestible diet with added MCT oil, prednisone and Atopica. The patient was presented one week later for progressive abdominal distension. The patient was treated with I.V. fluids, hetastarch, ampicillin, Atopica, prednisone, and vitamin B and discharged the following day with metronidazole. Within a month the current treatments were no longer keeping the patient`s condition under control. Recheck blood chemistry showed worsening hypoalbuminemia. The patient was referred to a specialist for a second opinion, but due to poor quality of life and a grave prognosis was humanely euthanized.