Protein Losing Enteropathy (PLE) in Dogs

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.

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
• Diarrhea
• Mucus in the stool

• Inflammatory bowel disease
• Cancer in the intestinal tract
• Food allergies
• Hookworm
• Ulcers
• Bacterial infections
• Fungal infection

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.

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.

Parasitic Infections

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

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.

Allergies

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.  

Stomach Ulcers

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.

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.