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Protein Losing Enteropathy in Cats (PLE)

By: Dr. Bari Spielman

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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

  • Intestinal lymphangiectasia, or blockage of the lymphatics of the gastrointestinal tract
  • Cancer
  • Congestive heart failure
  • Granuloma (a non-cancerous mass of tissue) of the small intestines or the tissue that attaches abdominal organs to the body wall

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

  • Lymphoplasmacytic enteritis, a type of inflammatory bowel disorder
  • Intestinal cancer
  • Intussusception, which is telescoping of one part of the bowel into an adjoining segment
  • Chronic intestinal foreign body
  • Ulcerative gastroenteritis
  • Histoplasmosis (fungal infection)
  • Intestinal parasitism
  • Immune-mediated diseases
  • Hemorrhagic gastroenteritis (HGE) is a disorder with no known cause. It has a predilection for small breed dogs, and it is not recognized in cats. HGE is characterized by the sudden onset of profuse bloody diarrhea and occasional vomiting

    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

  • Diarrhea
  • Anorexia
  • Lethargy
  • Weight loss
  • Ascities (fluid in the abdominal cavity)
  • Edema (abnormal fluid accumulation in any part of the body)
  • Respiratory difficulty secondary to fluid in the chest cavity

    Diagnosis

  • Complete blood cell count (CBC)
  • Biochemical profile
  • Urinalysis
  • Fecal examinations
  • Chest and abdominal X-rays
  • Abdominal ultrasound
  • Gastroduodenoscopy

    Treatment

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

  • Dietary management is often recommended and varies depending on the underlying cause.

  • MCT oil is a source of calories that is well tolerated by patients with PLE that may be indicated in patients who are severely emaciated.

  • Fluid therapy may be necessary in some patients with severe vomiting and diarrhea, and is directed toward correction of dehydration and acid-base derangements, replacement of electrolyte deficits and to provide for ongoing losses.

  • Diuretics that help remove excess fluid from the body may be indicated in some patients with PLE.

  • Oncotic agents help maintain normal fluid distribution in the body.

  • Antibiotic therapy, anti-inflammatory drugs, and/or antifungal agents may be indicated depending on the underlying cause of PLE.

    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.

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