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| ==Prognosis== | | ==Prognosis== |
| This depends on the underlying cause. | | This depends on the underlying cause. |
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| + | =From Pathology= |
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| + | ==Protein-Losing Enteropathy (PLE)== |
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| + | * Affects soft coated wheaten terriers. |
| + | ** Common male ancestor for most of the dogs. |
| + | ** Bitches are affected more often than dogs. |
| + | ** Also affects Besenji, Lundehund. |
| + | * Normally, dietary protein and protein from shed enterocytes is almost completely absorbed. |
| + | ** In PLE there is excess loss of protein into the gut lumen. |
| + | *** The loss is non-selective i.e. albumin and globulin. |
| + | ** Causes panhypoproteinaemia and hypocholesterolaemia. |
| + | * If this is severe, oedema and weight loss may result. |
| + | * Enteropathy not due to gluten sensitivity. |
| + | * Can diagnose PLE on basis of finding α1-protease inhibitor in the faeces in dogs. |
| + | |
| + | ===Causes of PLE=== |
| + | |
| + | * Severe inflammatory disease. |
| + | ** Protein is lost in exudate. |
| + | * [[Intestines Inflammatory Bowel Disease And Related Conditions - Pathology#Lymphangiectasia|Lymphangiectasia]]. |
| + | ** Loss of protein-rich lymph due to obstruction of gut lymphatics. |
| + | * Increased mucosal permeability. |
| + | ** E.g. erosions, loss of tight junctions, lymphosarcoma. |
| + | * Increased loss of enterocytes (less important). |
| + | * Also: |
| + | ** Immunoproliferative enteropathy |
| + | ** Lymphocytic plasmacytic enteritis |
| + | ** Eosinophilic enteritis |
| + | ** GI ulceration/erosion |
| + | ** Giardiasis |
| + | ** Chronic intussusception |
| + | ** Small intestinal bacterial overgrowth |
| + | ** Neoplasia |
| + | ** Hypoalbunimaemia causing mural oedema |
| + | ** Increased activation of tissue plasminogen activator |
| + | ** Systemic lupus erythematosis (SLE) |
| + | ** Vascular lesion in the GI mucosa |
| + | ** Chemotherapy/radiotherapy. |
| + | |
| + | ===Pathology=== |
| + | |
| + | * Lesions include: |
| + | ** Inflammatory bowel disease |
| + | ** Dilated lymphatics |
| + | ** Lipogranulomatous lymphangitis. |
| + | * Intestinal crypts become dilated with mucus, sloughed epithelial cells with or without inflammatory cells. |
| + | * PLE is also associated with protein losing nephropathy (PLN). |
| + | ** PLN may be a chronic sequelae to the PLE. |
| + | ** Follows immune complex deposition in the glomerulus, causing glomerulonephritis or glomerulosclerosis. |
| + | ** PLN causes hypoalbunaemian and hypercholesterolaemia. |
| + | ** Similar PLN and PLE lesions seen in young Besenjis with immunoproliferative enteropathy and glomerulosclerosis. |
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