Protein Losing Enteropathy in Cats (PLE)

Overview of Feline Protein Losing Enteropathy (PLE)

Protein losing enteropathy (PLE) is a nonspecific term referring to conditions associated with excessive loss of plasma proteins into the gastrointestinal tract.

There are numerous causes including:

Disorders of lymphatic system

Diseases associated with increased mucosal permeability, which is the passage of fluid through tissue

PLE is seen in both dogs and cats. PLE can be seen in any age animal and equally in both genders. Although PLE affects all breeds, dogs with familial predisposition to lymphangiectasia (the most common cause of PLE) include soft-coated Wheaten terriers, basenjis, Lundehunds and Yorkshire terriers.

Although some patients may be asymptomatic (have no clinical signs), some may have life threatening manifestations of PLE.

What to Watch For

Diagnosis of Protein Losing Enteropathy in Cats

Treatment of Protein Losing Enteropathy in Cats

Treatment of patients with PLE should be directed at the underlying cause. Most of these individuals can be treated as outpatients.

Home Care and Prevention

Administer all medication and dietary recommendations as directed by your veterinarian. Follow up as directed.

If your pet’s condition is not improving and is getting worse, seek veterinary attention at once. There is no preventative care for protein losing enteropathy.

In-depth Information on Protein Losing Enteropathy in Cats

The term protein losing enteropathy (PLE) refers to a variety of intestinal diseases that are associated with hypoproteinemia (low protein levels) caused by an excessive loss of protein into the gut. It is important to note that the initial step in the diagnosis is to exclude non-intestinal causes of hypoproteinemia, specifically related to the liver or kidneys.

Many different disease processes can cause or are associated with PLE. The clinical signs seen are quite varied, ranging from mild non-specific intermittent signs, to profound weight loss, emaciation, and in some cases, life-threatening respiratory difficulty secondary to fluid accumulation in the chest cavity.

Many disorders must be considered initially. These disorders may include:

Liver Disease

Severe hepatic disease must be ruled out as a contributing cause of hypoproteinemia. These include:

Kidney Disease

Protein losing kidney disorders need to be considered in hypoproteinemic patients. These include:

Lymphatic Diseases

Disorders of the lymphatic system need to be considered. These include:

Gastrointestinal Diseases

Diseases associated with increased permeability of mucosa commonly cause PLE. These include:

Miscellaneous

Diagnosis In-depth

Certain diagnostic tests must be performed to make a definitive diagnosis of the underlying disorder and to exclude other disease processes that may cause similar symptoms. A complete history, description of clinical signs, and thorough physical examination are all an important part of obtaining a diagnosis. In addition, the following tests are recommended to confirm a diagnosis:

Your veterinarian may require additional tests to insure optimal medical care. These are selected on a case by case basis:

Therapy In-depth

Appropriate therapy for protein losing enteropathy is largely dependent on the underlying cause, and varies according to the type and severity of clinical illness. Depending on the severity of clinical signs and/or stage of disease, hospitalization may or may not be recommended. Patients who have severe vomiting and/or diarrhea, dehydration, or hypoproteinemia and associated inappropriate fluid accumulation are hospitalized for aggressive treatment and stabilization. Stable patients can be treated as outpatients as long as they are monitored closely for response to therapy. With appropriate therapy, many patients do quite well. It is important that all recommendations by your veterinarian are followed very closely, and any questions or concerns that arise during treatment are addressed immediately.

Follow-up Care for Cats with Protein Losing Enteropathy

Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your pet does not rapidly improve. Administer all prescribed medication as directed. Alert your veterinarian if you are experiencing problems treating your pet.

Observe your pet’s general activity level, body weight, appetite and evidence of return of clinical signs such as the accumulation of fluid in the chest (pleural effusion), accumulation of fluid in the abdomen (ascities), and accumulation of fluid under the skin (edema). Follow serum protein level as directed by your veterinarian.