Protein-losing enteropathy

From Dog
Classic presentation of a Beagle with pot-bellied appearance associated with intestinal lymphangiectasia, resulting in a protein-losing enteropathy characteristic of inflammatory bowel disease[1]

Protein-losing enteropathies (PLE) are usually associated with inflammatory bowel disease and are characterized by protein-rich diarrhea[2].

The primary gastrointestinal causes for PLE can be divided into two broad categories; disorders that increase mucosal permeability and lymphatic disorders[3].

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.

Lymphatic disorders can be caused by intestinal lymphangiectasia and lymphosarcoma.

Therefore, numerous causes of this disease in dogs, include:

The only way to definitively diagnose either of these conditions is histologically through collection of intestinal biopsies via endoscopy or laparotomy[6].

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[7].

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.


  1. Brooks TA (2005) Case study in canine intestinal lymphangiectasia. Can Vet J 46(12):1138-1142
  2. Lecoindre P et al (2010) Protein-losing enteropathy of non neoplastic origin in the dog: a retrospective study of 34 cases. Schweiz Arch Tierheilkd 152(3):141-146
  3. Steiner JM (2004) Protein-losing enteropathy. In: Tilley LP, Smith FWK, eds. The 5-Minute Veterinary Consult Canine and Feline, 3rd ed. Philadelphia: Lippincott Williams & Wilkins. pp:1070–1071
  4. Lyles SE et al (2009) Idiopathic eosinophilic masses of the gastrointestinal tract in dogs. J Vet Intern Med 23(4):818-823
  5. Larson RN et al (2012) Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs. J Vet Intern Med 26(5):1087-1092
  6. Moore LE (2000) Protein-losing enteropathies. In: Bonagura JD, ed. Current Veterinary Therapy XIII. Philadelphia: WB Saunders. pp:641–643
  7. Kull PA & Hess RS (2001) Clinical, clinicopathologic, radiographic, and ultrasonographic characteristics of intestinal lymphangiectasia in dogs: 17 cases (1996–1998). Am Vet Med Assoc 219:197–202