What is Protein Losing Enteropathy (PLE)?
Protein losing enteropathy (PLE) causes too much plasma protein to enter the gastrointestinal tract. The gastrointestinal tract is then unable to absorb all the excess plasma protein. The excess plasma proteins within the gastrointestinal tract can then cause inflammation in the intestines and a gastrointestinal hemorrhage.
The breeds that are more predisposed to protein losing enteropathy are the Wheaten Terrier, Basenji, Yorkshire Terrier, Maltese Terrier, Norwegian Lundehund and Shar-Pei.
Protein losing enteropathy (PLE) is the excessive loss of plasma proteins into the gastrointestinal tract, which can affect the adequate absorption of nutrients and caloric intake in the body. The loss of plasma proteins may be associated with a variety of underlying diseases.
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Symptoms of Protein Losing Enteropathy (PLE) in Dogs
Symptoms may include one or more of the following symptoms:
- Decreased appetite
- Weight loss
- Leg edema
- Blood in the stool
- Swollen abdomen
- Swollen lymph nodes
- Respiratory difficulties
- Heart murmur
- Mucus in the stool
Causes of Protein Losing Enteropathy (PLE) in Dogs
- Inflammatory bowel disease
- Cancer in the intestinal tract
- Food allergies
- Bacterial infections
- Fungal infection
Diagnosis of Protein Losing Enteropathy (PLE) in Dogs
The veterinarian will go over your pet’s medical history. Let him know what visual symptoms you have observed in your pet and when they started. The veterinarian will then perform a physical exam on your pet that may include taking his temperature, listening to the lungs and heart with a stethoscope and palpitation of the abdomen and the lymph nodes. The veterinarian may recommend a complete blood count (CBC) which can determine the platelets, white, red blood cell count and if there is a bacterial infection. Other blood tests that may be recommended are a serum chemistry panel, ELISA test, and electrolyte panel. A urinalysis can determine if there is blood, crystals, or proteins in the urine. If your veterinarian suspects intestinal parasites he may also suggest a fecal exam. Additional diagnostic tests may include:
- X-rays of the abdomen and chest – Can show any masses, inflammations or fluids
- Ultrasound on the abdomen – Can give an image of the organs (stomach, liver, pancreas and the kidneys) and their size.
- Endoscopy can observe the internal organs and the surrounding tissue
- Surgical biopsies may be necessary to confirm lymphoma
- Intradermal skin testing - to confirm allergies and what are the allergens.
Your pet may need to be sedated or a given general anesthesia for some of these diagnostic tests.
Treatment of Protein Losing Enteropathy (PLE) in Dogs
If fluid was found in the chest or abdomen it will need to be aspirated using a needle. Further treatment will depend on the underlying cause of protein losing enteropathy.
Your dog will need to be dewormed. His bedding, crate, and toys will need to be cleaned. The yard should be cleaned of any feces and should be spray with an insecticide.
Inflammatory Bowel Disease
Sometimes a homemade diet, low in fat may be suggested. Medications may include corticosteroids and antibiotics. Dietary supplements may be suggested.
Cancer will require surgery, radiation and possibly chemotherapy. Pain management, antibiotics, and chemotherapy medications may be prescribed.
Bacterial and Fungal Infections
Bacterial infections are usually treated with antibiotics. Fungal infections are treated with antibiotics and antifungal medications.
The ELISA test and intradermal skin testing will identify the allergens that your dog is allergic too. He may need weekly allergy shots and a change of diet.
Surgery is sometimes required for severe stomach ulcers. The canine may be prescribed antacids and medications that help coat the stomach lining, such as sucralfate. A bland diet may also be suggested.
Recovery of Protein Losing Enteropathy (PLE) in Dogs
Follow up visits will be needed to check on the dog’s progress. Dogs that underwent surgery will have post-operative instructions. Your pet will need an Elizabethan collar (cone) so he does not lick or bite the incision. Sutures will need to be removed by the surgeon. Bloodwork, x-rays and ultrasound will need to be retaken to make sure there is no protein losing enteropathy re-occurring in your pet.
Prognosis will depend on the underlying cause of protein losing enteropathy. Dogs diagnosed with parasites, infections, or ulcers have a very good chance of full recovery. Dogs diagnosed with allergies or irritable bowel disease have a good prognosis but will need lifelong treatment and medications. Dogs with cancer may have a more guarded prognosis. If the cancer was diagnosed and surgically removed in the early stages, there may be a more positive outcome.
Protein Losing Enteropathy (PLE) Questions and Advice from Veterinary Professionals
Our 4-year old Newfoundland was diagnosed with PLE by Cornell Univ Vet Specialists in 2017 after a series of tests, including endoscopy and aspirations of samples from his upper colon. We uncovered the problem when he had a strong reaction to the Lyme disease vaccination. He was given antibiotics and a few other treatments, and we have had him on VSL3 (Visbiome) probiotic since. We believe his PLE is a result of IBD.
Other than asking his vet to run random albumin level tests on blood and urine, and monitoring his belly, stool, and energy level, is there anything else we can watch for or do for him to ensure we stay ahead of his condition and prevent him from feeling pretty darn lousy? He has had a soft stool since we got him (a rescue, mostly likely from a puppy mill), so we supplement his hypoallergenic food with a cup of pumpkin each day spread out over two meals.
I would be grateful for any feedback you might be able to provide for our beloved Newfie, Oscar. Thank you so much!
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Is there any diagnostic test to determine if a yorkshire terrier puppy be genetically predisposed to be afflicted with PLE or other gastrointestinal problems? I have had 2 yorkies (biologically unrelated) & both passed away as a result of gastrointestinal issues...although I realize that this breed is vulnerable to GI diseases, I have only had yorkies, & was wondering if there is a way to ascertain in advance if a new puppy has a predisposition to this heartbreaking problem.
Thank you so much for your attention to my question & concern..
I am so grateful to Dr. Turner for his kind & timely response to my concerns about yorkshire terriers regarding gastrointestinal issues and diseases. The link he sent was truly informative, and I gained a great deal of insight into the prevalence of my favorite breed's vulnerability, both genetic and environmental (nutrition, treats etc...) to these often life-threatening problems.
Again, thank you so very much for your wonderful website!
A forever animal ( & in particular, Yorkie ) lover!
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About a month ago we brought our dog to the vet for weight loss and vomitting and diarrhea. After all the ultra sounds and X-rays the dr cleared her of having cancer and She has been diagnosed with PLE. We put her on a simple bland diet. And she was doing great. After we sent her urine sample in she was put on a new food and put on vitamins B and prednisone.. Before medication she was a healthy weight and had become active and her self again.
But we have found that since being on medication she seems to be losing mass in her face her eyes seem sunken in and she doesn’t seem her self.
I also believe she may have kennel cough.
We called vet today but we won’t here back from her till Monday. Any insight would be great
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