The primary gastrointestinal causes for PLE can be divided into two broad categories; disorders that increase mucosal permeability and lymphatic disorders.
Increased mucosal permeability can be further divided into disorders of parasitism, mechanical obstruction, such as intussusception and chronic foreign body and inflammation, such as food allergies and inflammatory bowel disease.
Therefore, numerous causes of this disease in dogs, include:
- Intestinal parasites
- Ulcerative colitis
- Eosinophilic gastrointestinal masses
- Lymphocytic-plasmacytic enteritis
- Pancreatic exocrine insufficiency
- Intestinal lymphoma
- Intestinal lymphangiectasia.
The only way to definitively diagnose either of these conditions is histologically through collection of intestinal biopsies via endoscopy or laparotomy.
Laparotomy has the advantage of allowing visual evaluation of all of the abdominal organs, including the entire gastrointestinal tract and the gastrointestinal lymphatics. However, it is associated with a high occurrence of postsurgical complications, including death or dehiscence due to delayed wound healing associated with hypoalbuminemia.
Treatment is based on diagnosis of inciting cause and dietary change (usually low-allergenic and low-fat diet). Broad-spectrum anthelmintics are recommended to eliminate gastrointestinal parasites as these are frequently a compounding problem.
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