Changes

==Description==

==Introduction==

'''Lymphangiectasia''' is a disease of the [[Lymphatic Vessels - Anatomy & Physiology|lymphatic vessels]] that results in the leakage of protein-rich [[Lymph - Anatomy & Physiology|lymph]].  The term is usually taken to mean intestinal lymphangiectasia (in which lymph is lost into the intestinal lumen, producing a [[Protein Losing Enteropathy|protein-losing enteropathy]](PLE) and severe lipid malabsorption) but thoracic and generalised lymphangiectasia have been reported.   

'''Lymphangiectasia''' is a disease of the [[Lymphatic Vessels - Anatomy & Physiology|lymphatic vessels]] that results in the leakage of protein-rich [[Lymph - Anatomy & Physiology|lymph]].  The term is usually taken to mean intestinal lymphangiectasia (in which lymph is lost into the intestinal lumen, producing a [[Protein Losing Enteropathy|protein-losing enteropathy]](PLE) and severe lipid malabsorption) but thoracic and generalised lymphangiectasia have been reported.   

Several parameters may be altered on haematological or biochemical analysis of blood samples.

Several parameters may be altered on haematological or biochemical analysis of blood samples.

====Haematology====

====Haematology====

'''[[Changes in Inflammatory Cells Circulating in Blood - Pathology #Lymphopenia|Lymphopaenia]]''' occurs as lymphocytes are the major type of cell present in lymph and they are therefore lost into the intestinal lumen in large numbers.  If an inflammatory process (such as lipogranulomatous lymphangitis) has developed, there may be a '''monocytosis''' or '''neutrophilia'''.

'''[[Lymphopenia|Lymphopaenia]]''' occurs as lymphocytes are the major type of cell present in lymph and they are therefore lost into the intestinal lumen in large numbers.  If an inflammatory process (such as lipogranulomatous lymphangitis) has developed, there may be a '''monocytosis''' or '''neutrophilia'''.

====Biochemistry====

====Biochemistry====

Preferably, a full thickness intestinal biopsy should be taken to achieve a definitive diagnosis.  Care should be taken as hypoproteinaemic animals are at much greater risk of dehiscence at the biopsy sites, potentially leading to an acute septic [[Peritonitis - Cats and Dogs|peritonitis]].  On histological examination of the biopsy sample, accumulation of lipid-laden macrophages may be detected together with a granulomatous response around distended lymphatics.

Preferably, a full thickness intestinal biopsy should be taken to achieve a definitive diagnosis.  Care should be taken as hypoproteinaemic animals are at much greater risk of dehiscence at the biopsy sites, potentially leading to an acute septic [[Peritonitis - Cats and Dogs|peritonitis]].  On histological examination of the biopsy sample, accumulation of lipid-laden macrophages may be detected together with a granulomatous response around distended lymphatics.

It is essential to distinguish a true lymphangiectasia from secondary lacteal dilation that occurs with [[Inflammatory Bowel Disease|Inflammatory Bowel Disease]] (IBD).  In the case of IBD, an inflammatory infiltrate will be seen in the lamina propria but the degree of infiltration may be underestimated if [[Oedema - Pathology|oedema]] is present.

It is essential to distinguish a true lymphangiectasia from secondary lacteal dilation that occurs with [[Inflammatory Bowel Disease|Inflammatory Bowel Disease]] (IBD).  In the case of IBD, an inflammatory infiltrate will be seen in the lamina propria but the degree of infiltration may be underestimated if [[Oedema|oedema]] is present.

==Treatment==

==Treatment==

==Prognosis==

==Prognosis==

The long-term prognosis is guarded as, although animals may respond to medical therapy initially, they frequently relapse and develop clinical signs associated with hypoproteinaemia.

The long-term prognosis is guarded as, although animals may respond to medical therapy initially, they frequently relapse and develop clinical signs associated with hypoproteinaemia.

==References==

==References==

*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.

[[Category:Intestine_-_Inflammatory_Pathology]]

[[Category:Intestine_-_Inflammatory_Pathology]]

[[Category:To_Do_-_James]]

 

[[Category:Dog]][[Category:Cat]]

[[Category:Intestinal Diseases - Dog]][[Category:Intestinal Diseases - Cat]]

[[Category:Expert_Review]]

[[Category:Expert_Review]]