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What are Intestinal Protein Loss?

Animals absorb essential nutrients such as protein through their intestines, especially the small intestine. The small intestine is creased and folded with projections called villi that increase the available surface area for absorption. A healthy animal should be able to absorb most or all of the useful components of their food. Sometimes, a food allergy or anything causing inflammation of the gut can flatten these villi and/or impair the complete absorption of nutrition. This can cause vomiting, diarrhea, and electrolyte imbalance. Contact and schedule an appointment with a veterinarian immediately if you notice your dog has vomited, passed irregularly soft stool, or seems to be losing weight. Intestinal disorders often come on very gradually, and treating them before they become more severe is the best course of action.

Protein-losing enteropathy (PLE), sometimes referred to as intestinal protein loss, is a failure to absorb sufficient protein present in the animal’s diet. Thus, it is “lost” during waste excretion. Malabsorptive disorders such as PLE can indicate inflammatory bowl disease (IBD), food allergy, intestinal cancer, intestinal infections/parasites, heart conditions or rarely in conjunction with a pulmonary thromboembolism. Many malabsorption disorders are idiopathic and can only be managed rather than fully treated.

Intestinal Protein Loss Average Cost

From 68 quotes ranging from $500 - $3,000

Average Cost

$1,400

Symptoms of Intestinal Protein Loss in Dogs

  • Weight loss
  • Weakness
  • Bloated uncomfortable abdomen (fluid in the abdomen)
  • Difficult breathing (fluid in the chest) (Heart problem)
  • Decrease in muscle mass
  • Chronic diarrhea
  • Vomiting
  • Tremors and abnormal behavior (resulting from low blood calcium)
  • Excessive urination
  • Uncharacteristic lack of energy
  • Fluid buildup in tissues (edema) - you will notice this in your dog's legs and feet

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Causes of Intestinal Protein Loss in Dogs

  • Food allergy
  • Infection in the intestines, this can arise in many shapes and forms including:
    • Salmonella - Bacterial

    • Fungal
    • Viral (Parvo)
  • Inflammatory bowel disease (IBD)
  • Parasitic infection - hookworms, whipworms

  • Ulcers in the stomach or intestines
  • Lymphangiectasia
  • Pulmonary thromboembolism (rare)
  • Intestinal Neoplasia - lymphoma, adenocarcinoma

  • Congestive herat failure
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Diagnosis of Intestinal Protein Loss in Dogs

Take your pet to the veterinarian’s office for any gastrointestinal upset that does not resolve by the next meal given. Be prepared to give a detailed medical history of your pet, including any medications, recent surgeries or dietary changes. If you make your pet’s food at home, yourself, or are attempting to feed your dog a vegetarian diet, share this with the veterinarian as well. In all likelihood, the veterinarian will request a stool sample for gastrointestinal complaints, so it can speed up the diagnosis to collect one prior to visiting the veterinarian.

The veterinarian’s main goal will be to differentiate protein-losing enteropathy (PLE) from numerous other conditions that present with similar symptoms. Many times, PLE presents as a symptom of a broader gastrointestinal ailment. First, a physical examination of your dog may reveal loss of muscle mass and fluid accumulation in body cavities (abdomen/chest). The veterinarian will feel for abnormalities in your dog’s abdomen. Blood tests will show if the blood protein (albumin and globulin) is low, as well as if the calcium and cholesterol is low. An analysis of the dog’s urine can rule out protein-losing kidney disease. An ultrasound the abdomen if often recommended. An ultrasound is a helpful noninvasive tool for viewing the inside of the body without bulky or expensive equipment. The veterinarian will be able to spot bowel inflammation and identify if any abnormalities can be biopsied with an endoscope. An endoscope is a long, flexible tube with surgical instruments and/or a camera on the end. This can be used to take a tissue sample for examination in the lab. Sometimes a laparotomy (abdominal exploratory) is required to get full thickness biopsies of the intestine and biopsies of the lymph nodes to get a diagnosis.

Examination of the pet’s stool can determine whether small or large intestine-based diarrhea is occurring, and the presence of parasites. Small intestine-based diarrhea can indicate PLE. Blood tests can rule out infection or implicate parasites, and an analysis of the dog’s urine can rule out protein-losing kidney disease.

Another helpful clue can be low calcium, a side effect of PLE, and causes tremors, abnormal behavior, and elevated heart rate. Finally, administering an IV radiotracer of 51CrCl3 can identify PLE by measuring how long it takes the radioactive marker (which binds to protein) to be excreted.

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Treatment of Intestinal Protein Loss in Dogs

PLE is best managed by treating the underlying condition if any. Parasitic infections are treated with antiparasitic drugs, IBD with immune system suppressants, surgery and/or chemotherapy for cancer of the bowel, antibiotics for intestinal infections, appropriate medications for congestive heart failure, low-fat diet for lymphangectasia, and in the rare event of a pulmonary thromboembolism, removal of the clot and administration of blood thinners. Idiopathic PLE (not arising from any identifiable cause) is treated in two ways, the first of which is supplementing the animal’s diet with high-quality, easily digestible foods rich in protein and unsaturated fatty acids. Second, an elimination diet can be given to see if a food allergen or component of the animal’s diet is irritating the bowel. This involves systematically replacing certain food items with others and monitoring the animal’s response for improvement.

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Recovery of Intestinal Protein Loss in Dogs

If an underlying cause is not found, idiopathic PLE is a lifelong but manageable condition. Proper supplementation of the dog’s diet with formulas approved by the veterinarian is often successful in providing your pet with a good quality of life, as long as irritating or hard-to-digest foods are avoided. Follow-up appointments should be made every few months to monitor nutrition uptake, weight gain, and blood chemistry (albumin and globulin). Test different exercise schedules for your dog. You may need to adjust the length, time, and difficulty of common walking routes. If your dog is undergoing a new prescription or medication for treatment, be sure to allow your dog a personal space to rest. It's critically important to give your dog time and space to heal away from distractions, especially other pets.

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Intestinal Protein Loss Average Cost

From 68 quotes ranging from $500 - $3,000

Average Cost

$1,400

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Intestinal Protein Loss Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Chloe

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Siberian Husky

dog-age-icon

9 Years

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Serious severity

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pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Serious severity

Has Symptoms

Ple

Hi, my poor baby, Chloe, was diagnosed with PLE 2 weeks ago. She swole up to 3-4 times her size in a matter of hours so we rushed her to a vet hospital where we got this diagnosis. She had her abdomen drained via catheters. She was back to her normal size and was acting back to normal the next day. Day 5 after her catheter drainage, she swole back up to 4 times her typical size. Now she has a hard time breathing. And she can’t stand up. Her back legs have pretty much given out. She isn’t herself and she looks so tired. We don’t know if it’s her age or if it’s the 20 pounds she’s gained and her legs can’t handle that much weight. She is on a bland low fat high protein diet. I make her rice and chicken every day and interchange it with the low fat high protein wet dog food the ER vet told us to get. And she’s on a bunch of medications, Omeprazole, Proin, Amoxicillin, Medoprazole, Dexamethasone, and anti nausea medicine. She takes them as prescribed. We just don’t know if this turn for the worse is normal with a PLE diagnosis, if it will get better, if we drain her again will this do the same thing or will she get better, is this life threatening to her, how much life should we expect from her, and what portion of the projected life will be quality life. We love our baby girl and we don’t like seeing her in pain. We don’t want her to suffer for the rest of her either. We just want our happy Chloe back and we don’t know what the best route is. Our vets Keep going back and forth with what to do next and we just feel like a paycheck to their system at this point. Thank you for your help!

May 11, 2018

Chloe's Owner

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3320 Recommendations

Cases of protein losing enteropathy can be difficult to manage and has many different underlying cause with treatment being tied to the specific underlying cause along with management. The use of diuretics may be used to try and increase renal clearance of fluid, spironolactone or furosemide may be used; any other treatment would depend on the primary cause of the intestinal protein loss. Regards Dr Callum Turner DVM http://veterinarycalendar.dvm360.com/care-dogs-with-protein-losing-enteropathy-proceedings

May 11, 2018

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Cookie

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Olde English Bulldogge

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4 Years

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Serious severity

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Serious severity

Has Symptoms

No New Symptons As Of Now

My dog was on the verge of death being misdiagnosed by our Exvet. Needless to say she has an an extremely long road to recovery spending many days in the hospital on Ivs and so on . She is on cyclosporine metronidazole omeprazole clopdigrel prednisone calcitriol ans b12 shots once a week. One of her proteins is still in the low range and she’s not gaining much more weight , We got the ok for her to try fresh fruits and vegggies again I’m just wondering which ones world be the best for her ? What’s something high in protein low in fat and easy on the belly ? Egg whites ? Pumpkin ? Strawberries? Acidic Better for absorption or worse for sensitive bellies ? Thanks !

March 11, 2018

Cookie's Owner

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Dr. Michele K. DVM

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1611 Recommendations

Thank you for your email. Without knowing what diagnosis your veterinarian has decided for Cookie, I can't comment on what foods are appropriate for her - it would be best to follow up with your veterinarian, as they are aware of her situation and condition. They'll be able to responsibly recommend diet changes. I hope that she continues to recover well.

March 11, 2018

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Koby

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Golden Retriever

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8 Years

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Serious severity

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Serious severity

Has Symptoms

Diarrhea
Lethargy
Weakness
Low Albumin
Edema In Legs

My just about 9 year old Golden was diagnosed with very low albumin levels about two weeks ago after severe diarrhea, lethargy, and lack of appetite. Since then he had bloodwork, his urine checked, a fecal test, x-rays and two ultrasounds as well as fluids obtained from his abdomen sent off for evaluation. All were clear, though there were some spots of "thickening" in the intestine. He was put on metronidazole, and is on a bland diet. His albumin was 1.1 two weeks ago, and is now 1.6, which the internal medicine doctor said isn't statistically significant. He had a lot of fluid in his abdomen at first, but that seems to be gone (he was weighing 10 pounds more than usual), though he does have swelling in his legs, making it hard for him to get up. Yesterday's ultrasound looked the same as the one last week, with just those thickened areas and speckling. Layering looked normal, and lymph nodes, liver and spleen all looked normal. They said the only way to determine definitively the cause (Inflammatory Bowel or Lymphoma) is a surgical biopsy, because of his size. But they also said that it would be risky for both the anesthesia and the wound healing - especially the internal healing of the intestine, which could cause sepsis - because of the low protein levels. And, I've also read, and she confirmed, that chemo would not be as effective in this type of lymphoma, if it's found to be lymphoma. Maybe 9 months. I'm leaning towards treating it as Inflammatory Bowel and hoping, hoping, hoping, it is. My worst fear would be for something to happen and he die on the operating table, or afterwards, just to find out it wasn't even lymphoma. Thoughts?

Feb. 20, 2018

Koby's Owner


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3320 Recommendations

It is difficult to recommend a way forward since one path results in risk of surgery which includes death and the other path leaves the diagnosis being a presumptive one. I haven’t examined Koby but an intestinal biopsy would be the next step forward in the diagnostic process if all other tests have been performed already (mentioned in your question). I would recommend going forward with the biopsy if your Veterinarian is comfortable with performing the biopsy, but my decision is based on making a diagnosis and I haven’t assessed Koby’s current state of health. The decision is one to be made between you and your Veterinarian. Regards Dr Callum Turner DVM

Feb. 20, 2018

Even if the biopsy would need to be surgical, because of both his size and the fact that there are changes distributed within his intestinal tract, and as you put it - the risk of surgery "which includes death"? Plus, from what I've read, chemo is not nearly as effective in intestinal lymphoma. Not sure I could forgive myself if he died during a biopsy, and it turned out to be inflammatory bowel after all.

Feb. 20, 2018

Koby's Owner

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Maverick

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Boston Terrier

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9 Years

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Moderate severity

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Moderate severity

Has Symptoms

Diarrhea

Are there any other treatments to help with a diagnosis of inflamed intestinal tract other then steroids? I see talk of probiotics on here but that may be for a different issue. my dog is going in for a biopsy on Tuesday and this is likely course of action of the specialist. A bit of background -his proteins levels are 26%, calcium is very low and has liquid in his stomach. Parasites have been ruled out. Also curious as to what types of foods are high protein and low fat, I normally feed my dog a raw diet that consists of a balance of organ, bone, meat, pulped fruit and veg. Does this mean i have to put him on kibble?

Feb. 2, 2018

Maverick's Owner


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Dr. Michele K. DVM

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1611 Recommendations

Thank you for your email. Without knowing more about Maverick and his test results, I can't really comment on possible treatments or dietary changes for him. Depending on the cause of the inflamation, steroids are a very common treatment for some causes of intestinal inflamation. Others are treated with antibiotics or chemotherapeutic drugs, or Metronidazole, depending on the cause os the inflamation. Cottage cheese and yogurt are some foods that are safe for dogs, and high in protein. You should know more information once you get the biopsy results back and your veterinarian will be able to determine the best treatment and any diet changes that might need to be given.

Feb. 3, 2018

hello again, i received a diagonals, from the scope/biopsy, for Maverick! He as has lymphoplasmacytic and is currently being treated with 5mg of steroids a day. He is currently consuming Hills Prescription ID. He goes for follow up blood work in 2 weeks to check that his protein levels have increased from 13% (at the time of the initial blood work 3 weeks ago) and the vet will re assess if the steroid does will be lowered. Hopefully this info better helps you answer this question! With my vets approval, I would like to transition him off the canned Hills food to a bland cooked diet (eventually adding in prebotics and balancing supplements), my concern is what are safe bland foods to transition him to and what are the amounts to be given (his ideal weight is 15-16lbs). Ive read that boilded chicken, over cooked oats/rice and sweet potato are good start. However, I have concern about the chicken being a possible allergen - could i do beef or turkey? Do those foods need to be low in fat and fiber? And what is the time to slow transition him - 2 weeks? Any additional info that you have would be greatly appreciated. The Hills food has really helped in stabilizing him and getting his weight / energy back up but at !0 dollars a day it doesn't fit in to my long term budget. The last thing i want is to upset his GI tract with the switch. thanks!

Feb. 12, 2018

Maverick's Owner

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Charlie

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Mutt

dog-age-icon

10 Years

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Serious severity

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Approximately 4 years ago my (now 10 year old) dog was diagnosed with ITP due to a low platelet count. The underlying cause was never found, the vet and specialist - after much testing - put her on prednisone and immuran to manage it. After about a year of weaning her off - and safe platelet rangers on all blood tests - she was taken off the pred and immuran. About 6 months later, while in remission and not on any immunosuppressants she started developing respiratory difficulties. She would often wheeze or throw up bile, especially when playing ball (her favourite activity). She also developed a lack of appetite (very unusual for her). Again, we returned to the specialist who did several X-rays and ultrasounds. Her blood levels were all fine (slightly decreased protein level but within the normal range) but it appeared she had some masses around her lymph nodes. We feared lymphoma, but biopsies revealed the masses were not cancerous. The specialist ended up doing some trial and error treatment as he could not find the underlying cause. She began taking Flovent twice daily which shrunk the masses and she was fine. About 6 months later her ITP resurfaced. This time she was put back on prednisone but no immuran. She started at 50 mg/day. Because she went back in the prednisone we discontinued the Flovent as it is a steroid. She responded great to prednisone. Platelet count went up, masses on lymph nodes did not return nor any respiratory problems. After significant time, the vet began weaning her off the prednisone (due to excessive panting, hair loss, frequent ruination) and her platelets stayed (and still are) within the healthy ranged. As we decreased her down to 2 mg/day we once again introduced the Flovent into her routine. She has now been completely off of prednisone for approximately 2 months and has been getting biweekly blood tests. Two weeks ago her blood tests revealed a very low platelet count (19). We checked her urine for protein loss (negative), did an abdominal ultrasound (completely unremarkable), and she is likely to do the 3 day fecal screens next week. My questions are: 1. The prednisone appears to be moderating any illness she may have. It masked any respiratory problems, corrected her low platelet count, and maintained her protein level within a normal (albeit low) range. Is there any true advantage to finding the source of the protein loss (and the associated costs) rather than just moderating the affects through a lifelong prednisone routine (her liver functioning is fine)? 2. Can you think of any diagnoses of an underlying issue that could include respiratory, platelet, and protein problems. I do think that the three symptoms needs to be linked, however we (specialists included) are unable to come up with a common cause. 3. Could intestinal protein loss and villi distraction be in anyway related to a celiac disorder, like in humans. She we switch her diet to a gluten free diet? She is currently on a protein rich food which, based on her stool, appears to be fine and not hard on her stomach. Thanks so much!

Jan. 20, 2018

Charlie's Owner

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3320 Recommendations

Sometimes it is not possible to determine an underlying cause, but it is good practice to attempt to make a diagnosis so that the condition may be better understood and treatment directed effectively; I would push to diagnose the condition but limitations may prevent that from occurring. I am unable to think of any single condition which would explain the symptoms which Charlie is being affected by. Gluten intolerance is rare in animals and grain free diets are more of a fad than anything else, if Charlie is on a high quality protein food it will be low in grains anyway. Checking faeces for protein loss would be a good next step if the urine is free of protein and continue to treat according to your Veterinarian’s recommendations. Regards Dr Callum Turner DVM

Jan. 20, 2018

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Chaga

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Lab, pit, chow, shepard

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5 Years

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Serious severity

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Serious severity

Has Symptoms

Swollen Abdomen
Swollen Joints
Swollen Jowels
Appetite Low
Weight Gain/Loss,
Fluid In Abdomen
Muscle Loss

My dog was recently diagnosed with severely low albumin levels. The vet determined he was loosing the protein through his intestinal track. He has been given a 5 day de-wormer that should kill anything foreign residing in his intestines and is on a steroid for inflammation for a minimum 6 weeks. His energy level is somewhat down however the scariest thing is he looks like he is dying in front of us. He is loosing muscle mass daily and every time we look at him he has a new bone showing. From the top he looks like an emancipated pup. From the side he looks crazy. His undercarriage is swollen with fluid. Sometimes the fluid resides on his chest and looks like lipomas. Sometimes it is all in his groin making a massive mass. Sometimes it hangs evenly off his underside from the chin to his groin. His jewels are huge and sag. He has a hanging sack under his chin. When we walk him it seems to help however the last couple days he has been breathing much heavier and louder on our walks. We had the vet check for fluid in his lungs, twice, and said he was ok, however can the fluid move into and out of my dogs lungs at will? And if this is so, should I stop walking him? Walking seems to get the fluid moving and not build up so bad but I am scared if the fluid can move into his lungs. I would also love to know how to effectively help my dog build his muscle mass back and keep him from wasting away. Up until this point in life he has been an athletic, active, well stimulated dog. Also, up until this point he has been very independent, not very needy from humans, dog. These last two months he hasn’t left my side, he even insisted sleeping with me in bed which I couldn’t get him to do no matter how hard I tried before. I am very much hoping it is a parasite. We spend a lot of time in the Cascade mountains and I feel this all started when we came home from a 2 week trip in late October. I just need to know how to help my dog daily while we work our way through this and keep him as healthy as we can. My young, hardworking, athletic, high energy dog looks like we just pulled him out of a sewer. I should also mention, when he was checked by the vet he had a hole in his mouth that the vet also prescribed antibiotics for. Not sure where that was from, maybe the woods, a stick culprit perhaps, not sure how long it had been there. Was way far back, could only see when my dog was under. Don’t know if that getting infected could be the culprit for the intestinal protein loss?

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Winston

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Jack Russell Terrier

dog-age-icon

Seven Years

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Fair severity

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Fair severity

Has Symptoms

Excessive Drinking

My dog Winston is a 7 year old male Jack Russell Terrier who is in impecable shape. Extremely lean and muscular. He had some bloodwork done which came back with low protein and cholesterhol levels. It was determined that it is not Addison's Disease. Ultrasound came back normal. Normal bowel movements. Next step is more bloodwork and stool sample. then if the bloodwork comes back again as abnomal the specialist wants to do an intestinal scope. Is there a way to try to treat this withoout putting him through the scope and the cost? In addition he is acting completely normal. Normal energy levels, eating and sleeping well. Nothing out of the ordinary.

Intestinal Protein Loss Average Cost

From 68 quotes ranging from $500 - $3,000

Average Cost

$1,400