Changes

==Signalment==

==Signalment==

*Often affects older animals but kittens of 16 weeks old and puppies of 20 weeks old have been reported.  

*Often affects older animals but kittens of 16 weeks old and puppies of 20 weeks old have been reported.  

==Description==

==Description==

'''Lymphocytic - plasmacytic enteritis''' (LPE) is the most common form of [[Inflammatory Bowel Disease - WikiClinical|Inflammatory Bowel Disease]].  As its name suggests, the predominant cell type in the intestinal mucosa is '''lymphocytes''' and '''plasma cells'''.  Enteric parasites, bacteria in dogs and ''Toxoplasma'' in cats have been reported to associated with LPE.  This disorder in cats have also been shown to associate with concurrent disease of the pancreas and liver such as pancreatitis, cholangitis and hepatic lipidosis.  This disease in animal has been compared to the human dsease.  LPE is believed to be caused by an abnormal MALT response to luminal bacterial, dietary or self-antigens.   

'''Lymphocytic - plasmacytic enteritis (LPE)''' is the most common form of [[Inflammatory Bowel Disease|Inflammatory Bowel Disease]] (IBD).  As its name suggests, the predominant cell type in the intestinal mucosa is [[Lymphocytes - Introduction|'''lymphocytes''']] and '''plasma cells'''.  Enteric parasites, bacteria in dogs and [[Toxoplasma gondii|''Toxoplasma'']] in cats have been reported to associated with LPE.  This disorder in cats have also been shown to associate with concurrent disease of the pancreas and liver such as [[Pancreatitis|pancreatitis]], [[Cholangitis|cholangitis]] and [[Hepatic Lipidosis|hepatic lipidosis]].  LPE is believed to be caused by an abnormal [[Regional Lymphoid Tissue - Anatomy & Physiology|mucosal associated lymphoid tissue (MALT)]] response to luminal bacterial, dietary or self-antigens.   

 

==Diagnosis==

==Diagnosis==

===Clinical Signs===

===Clinical Signs===

Most common:

Most common:

*small intestinal diarrhoea.

*small intestinal diarrhoea

*weight loss

*weight loss

*protein - losing enteropathy in severe cases

*protein - losing enteropathy in severe cases

*chronic vomiting (more common presentation in cats compared to the other signs)

*chronic vomiting (more common presentation in cats compared to the other signs)

*Thickened small intestinal loops and mesenteric lymphadenopathy may be detected on physical examination in cats

*thickened small intestinal loops and mesenteric lymphadenopathy may be detected on physical examination in cats

Others:

Others:

*Appetite changes

*appetite changes

*Excessive borborygmi

*excessive borborygmi

*Abdominal discomfort

*abdominal discomfort

*Ascites or subcutaneous oedema if severe PLE resulting in hypoproteinaemia

*ascites or subcutaneous oedema if severe PLE resulting in hypoproteinaemia

*Concurrent systemic immune-mediated response and thromboembolism (rare)

*concurrent systemic immune-mediated response and [[Thromboembolism|thromboembolism]] (rare)

 

===Laboratory Tests===

===Laboratory Tests===

====Haematology====

====Haematology====

*Panhypoproteinaemia (non-sepecific)

*Panhypoproteinaemia (non-specific)

====Biochemistry====

====Biochemistry====

====Other Tests====

====Other Tests====

Serum trypsin-like immunoassay (TLI) to rule out exocrine pancreatic inssuficiency (EPI)

*Serum trypsin-like immunoassay (TLI) to rule out [[Exocrine Pancreatic Insufficiency|exocrine pancreatic insufficiency (EPI)]].

Faecal analysis to rule out endoparasite and pathogenic bacteria.

*Faecal analysis to rule out endoparasite and pathogenic bacteria.

===Diagnostic Imaging===

===Diagnostic Imaging===

Abdominal radiography is unremarkable, but it can be used to eliminate other differential diagnosis.

*Abdominal radiography is unremarkable, but it can be used to eliminate other differential diagnosis.

Addominal ultrasonography may reveal thickened intestinal walls, mesenteric lymphadenopathy or abdominal effusion.

*Abdominal ultrasonography may reveal thickened intestinal walls, mesenteric lymphadenopathy or abdominal effusion.

===Histopathology===

===Histopathology===

Intestinal biopsy is needed for a definitive diagbosis once all the other differential diagnoses have been eliminated.

Intestinal biopsy is needed for a definitive diagnosis once all the other differential diagnoses have been eliminated.

==Treatment==

==Treatment==

 

 

==Prognosis==

==Prognosis==

 

*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

*Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) '''BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition)''' ''BSAVA''

*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''.