Protein Losing Enteropathy - Revision history

TestStudent at 23:22, 9 September 2015

2015-09-09T23:22:07Z

Bara at 12:36, 9 August 2012

2012-08-09T12:36:47Z

Bara at 14:46, 26 October 2011

2011-10-26T14:46:06Z

HelenD at 09:33, 28 September 2011

2011-09-28T09:33:51Z

Bara: /* References */

2011-04-29T22:35:42Z

References

Bara at 22:34, 29 April 2011

2011-04-29T22:34:42Z

Show changes

Kthompson at 14:43, 30 March 2011

2011-03-30T14:43:20Z

Show changes

Kthompson at 14:08, 30 March 2011

2011-03-30T14:08:08Z

Bara at 12:14, 7 March 2011

2011-03-07T12:14:43Z

Bara: Text replace - "[[Haemorrhage - Pathology" to "[[Haemorrhage"

2011-02-14T14:55:30Z

Text replace - "[[Haemorrhage - Pathology" to "[[Haemorrhage"

@@ Line 88: / Line 88: @@
 {{Learning
 |flashcards = [[Small Animal Abdominal and Metabolic Disorders Q&A 01]]
 |literature search = [http://www.cabdirect.org/search.html?q=%28%28title%3A%28PLE%29+AND+sc%3A%22ve%22%29%29+OR+%28%28title%3A%28%22Protein+Losing+Enteropathy%22%29%29%29 Protein Losing Enteropathy publications]

@@ Line 1: / Line 1: @@
 == Introduction ==
 '''Protein-losing enteropathy (PLE)''' refers to the loss of plasma proteins into the gastro-intestinal (GI) tract, exceeding the absorptive capacity of the intestines. PLE can be caused by disruption to the intestinal wall due to [[Inflammation - Pathology|inflammation]] or infiltrative disease or by venous congestion of the GI tract and GI [[Haemorrhage|haemorrhage]].
@@ Line 104: / Line 105: @@
 {{review}}
 [[Category:Intestine_-_Inflammatory_Pathology]]
 [[Category:Intestinal Diseases - Cat]]
 [[Category:Intestinal Diseases - Dog]][[Category:Alimentary_Disorders]]
 [[Category:Expert Review - Small Animal]]

@@ Line 88: / Line 88: @@
 {{Learning
 |flashcards = [[Small Animal Abdominal and Metabolic Disorders Q&A 01]]
 }}
 ==References==

@@ Line 85: / Line 85: @@
 ==Prognosis==
 This depends on the underlying cause but Soft-coated Wheaten terriers are known to have a median survival time of five months after diagnosis of PLE and of two months if they suffer from concurrent protein-losing nephropathy.
 ==Literature Search==

@@ Line 110: / Line 110: @@
 [[Category:Intestinal Diseases - Cat]]
 [[Category:Intestinal Diseases - Dog]][[Category:Alimentary_Disorders]]
-[[Category:Expert Review Small Animal]]
+[[Category:Expert Review - Small Animal]]

@@ Line 1: / Line 1: @@
-==Introduction==
+== Introduction ==
-'''Protein-losing enteropathy (PLE)''' refers to the loss of plasma proteins into the gastro-intestinal (GI) tract, exceeding the absorptive capacity of the intestines.   PLE can be caused by:
+'''Protein-losing enteropathy (PLE)''' refers to the loss of plasma proteins into the gastro-intestinal (GI) tract, exceeding the absorptive capacity of the intestines.   PLE can be caused by disruption to the intestinal wall due to [[Inflammation - Pathology|inflammation]] or infiltrative disease or by venous congestion of the GI tract and GI [[Haemorrhage|haemorrhage]].
-*Disruption to the intestinal wall due to [[Inflammation - Pathology|inflammation]] or infiltrative disease
+<br>
-*Venous congestion of the GI tract
+Hence, there are numerous causes of PLE in cats and dogs, including:
-*GI [[Haemorrhage|haemorrhage]]
+<br>
 '''Inflammation'''
@@ Line 15: / Line 13: @@
 *Chronic [[Intussusception|intussusception]] in juvenile animals
 '''[[Lymphangiectasia]]'''
 '''Infiltrative disease'''
 *Alimentary lymphoma
 '''Venous congestion'''
@@ Line 23: / Line 23: @@
 *Posterior caval syndrome
 **[[Heart Failure - Pathophysiology|Right-sided congestive heart failure]]
 '''GI haemorrhage'''
 *This may occur with hypoadrenocorticism or with other causes of GI ulceration
-Rare causes of PLE include:
+Rare causes of PLE include [[Antibiotic Responsive Diarrhoea|Small intestinal bacterial overgrowth (SIBO)]], [[Hypoalbuminaemia]] causing intestinal mural oedema, increased activation of tissue plasminogen activator, systemic lupus erythematosis (SLE) and chemotherapy or radiotherapy.
-* [[Antibiotic Responsive Diarrhoea|Small intestinal bacterial overgrowth (SIBO)]]
+<br>
-==Signalment==
+Normally, dietary protein and protein from shed enterocytes is almost completely absorbed. In PLE there is excess loss of protein into the gut lumen of particularly non-selective i.e. albumin and globulin. This causes panhypoproteinaemia and hypocholesterolaemia. If this is severe, oedema and weight loss may result.
 Inflammatory bowel disease and lymphoma are the most common causes of PLE in both cats and dogs but lymphangiectasia occurs much more commonly in dogs than in cats.  Chronic intussuscepta (usually occurring secondary to acute enteritis) and endoparasite infection are the most common causes of PLE in juvenile cats and dogs.
 '''Basenjis''', '''Norwegian Lundehunds''', '''Soft-coated Wheaten terriers''' (SCWT), '''Yorkshire terriers''' and '''Shar peis''' all show breed predispositions for PLE. related to secretory enteropathy
 Basenjis develop PLE as a result of secretory enteropathy, a type of inflammatory bowel disease.  Soft-coated Wheaten Terriers often suffer from concurrent protein-losing nephropathy and most affected animals of this breed have a common ancestor who is thought to have lived in the USA.  Females of this breed are more commonly affected than males
-==Diagnosis==
+<br>
-===Clinical Signs===
-*'''Weight loss''' is the most evident sign.
+== Clinical Signs ==
-*'''Diarrhoea''' occurs due to the loss of protein into the GI tract and subsequent osmotic movement of fluid.  Melaena may occur with GI haemorrhage.
+'''Weight loss''' is the most evident sign, with '''Diarrhoea''' occuring due to the loss of protein into the GI tract and subsequent osmotic movement of fluid.  Melaena may occur with GI haemorrhage. [[Oedema|'''Oedema''']], '''ascites''' and '''pleural effusion''' due to reduced plasma oncotic pressure are notable clinical signs. The animal will also usually have vomiting and anorexia and will be depressed and lethargic. '''Thickened intestines''' may be detectable on abdominal palpation and this finding may be related to the primary pathological process. [[Thromboembolism|'''Thromboembolic]] disease''' due to the loss of plasma anticoagulants such as antithrombin III may also occur.
 *'''Hypocalcaemic tetany''' due to a reduced ability to absorb calcium and the fat soluble vitamin D.  Apparent hypocalcaemia may also develop as the protein-bound portion of the blood total calcium concentration is reduced.
@@ Line 106: / Line 122: @@
 ==Prognosis==
 This depends on the underlying cause but Soft-coated Wheaten terriers are known to have a median survival time of five months after diagnosis of PLE and of two months if they suffer from concurrent protein-losing nephropathy.