Dear Specialist,:)
I need Your help. My patient is an old dog ( 15 years old) hungarian vizsla,female castrated .
She has chronic diarrhoe for 3-4 month, she lost 10 kg. Now she is kachectic. Her apetite is really good. Her body condition is poor, she has got a heart murmur of 5/6.
The fecal investigation (parasitology, bacteriology, and ctology) show nothing special, except dysbiosis.
Dear Specialist,:)
I need Your help. My patient is an old dog ( 15 years old) hungarian vizsla,female castrated .
She has chronic diarrhoe for 3-4 month, she lost 10 kg. Now she is kachectic. Her apetite is really good. Her body condition is poor, she has got a heart murmur of 5/6.
The fecal investigation (parasitology, bacteriology, and ctology) show nothing special, except dysbiosis.
The blood results show normal hepatic function ( normal GPT, GOT, ALKP), normal kidney function ( Urea, krea). She has a strong hypoalbuminaemia ( alb: 15-19, measured three times)
Urine analysis was normal (no protein)
Thorax x-ray normal (no tumor)
Abdominal ultrasound: sometimes i can see a mild ascites, but i can not find the reason of the protein loosing condition.
I’ve tried to treat her protein loosing enteropathy with hypoallergenic diet (wild and rice cooked), omeprazole, sucralfate, i have tried to give prednisolon ( 2,2 mg/kg) and antibiotics ( metronidazole) after 3 weeks no improvement of the albumin is noted.
The owner does not let us to do the endoscopy or biopsy according to the dog’s age and heart murmur. ( Ao/ LA RPS.SAX: 1/1,6)
How could i help more this dog?
Do You see anything abnormal on the pictures?
Thank You!
Rita Mietsch
small intestines
large intestine, liver
pancreas
Comments
There appear to be some
There appear to be some chronic pancreatic and hepatic changes suggestive for past episodes of inflammatory disease. The GI maintains curvilinear mural structure and no obvious neoplasia. It sounds like you have rteated empirically for the usual issues. If no PLN then its likely GI PLE which would entail full thickness bx. How is the TLI?
Any other potential for weight loiss like subtle CNS disease? The answers are not obvious on the image set provided as they are usual old dog changes with PLE. Addison’s is technically possible cause of low albumin as well but usually not that low and should have responded to pred.
There appear to be some
There appear to be some chronic pancreatic and hepatic changes suggestive for past episodes of inflammatory disease. The GI maintains curvilinear mural structure and no obvious neoplasia. It sounds like you have rteated empirically for the usual issues. If no PLN then its likely GI PLE which would entail full thickness bx. How is the TLI?
Any other potential for weight loiss like subtle CNS disease? The answers are not obvious on the image set provided as they are usual old dog changes with PLE. Addison’s is technically possible cause of low albumin as well but usually not that low and should have responded to pred.
Albumin would be low because
Albumin would be low because of decreased production (hepatic disease), protein being lost through the kidey (PLN) or bowel (PLE), or fluid shifts. Urine protein was negative making PLN less likely.
Consider a SBA (unlikely considering the liver enzymes are normal- but I have seen hepatic numbers drop when hepatic mass goes down. Does not appear that way on the images submitted).
Most of the time when I see the albumin get down to 1.5 the dogs have ascites.
I don’t know what- but something is being missed here.
Albumin would be low because
Albumin would be low because of decreased production (hepatic disease), protein being lost through the kidey (PLN) or bowel (PLE), or fluid shifts. Urine protein was negative making PLN less likely.
Consider a SBA (unlikely considering the liver enzymes are normal- but I have seen hepatic numbers drop when hepatic mass goes down. Does not appear that way on the images submitted).
Most of the time when I see the albumin get down to 1.5 the dogs have ascites.
I don’t know what- but something is being missed here.
i think also that i have
i think also that i have missed something.
I will check urine, liver, and TLI again.
Thank You!:)
i think also that i have
i think also that i have missed something.
I will check urine, liver, and TLI again.
Thank You!:)
Hi did you check the serum
Hi did you check the serum Cobalaminlevel in the blood as well?
Hi did you check the serum
Hi did you check the serum Cobalaminlevel in the blood as well?
No i did not. Do You think
No i did not. Do You think this could be small intestinal bacterial overgrowth?
I will check it, Thanks!
No i did not. Do You think
No i did not. Do You think this could be small intestinal bacterial overgrowth?
I will check it, Thanks!
Cobalamine levels would be
Cobalamine levels would be tested with a maldigestion panel but injections biweekly wont hurt anything. SIBO, panc insufficiency occult parasitism and occult neoplasia elsewhere are usually what does this.
Cobalamine levels would be
Cobalamine levels would be tested with a maldigestion panel but injections biweekly wont hurt anything. SIBO, panc insufficiency occult parasitism and occult neoplasia elsewhere are usually what does this.