Lymphangiectasia
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Lymphangiectasia is an intestinal disease of dogs, and more rarely humans, characterized by chronic diarrhea and loss of proteins such as albumin and globulin. It is considered to be a chronic form of protein-losing enteropathy. Biopsy of the small intestine shows dilation of the lymphatic vessels. Reduced lymph flow leads to a malabsorption syndrome of the small intestine, especially of fat and fat-soluble vitamins. Rupture of the lymphatics causes protein loss into the intestines.
Potential causes of lymphangiectasia include congenital malformation of the lymphatics, inflammation or cancer causing lymphatic obstruction, or increased central venous pressure (CVP) causing abnormal lymph drainage. Increased CVP can be caused by pericarditis.
Chronic diarrhea is almost always seen with lymphangiectasia, but most symptoms are linked to low blood protein levels (hypoproteinemia), which causes low oncotic pressure. These symptoms include ascites, pleural effusion, and edema of the limbs and trunk. Weight loss is seen with longterm disease.
Diagnosis is through biopsy. The presence of hypoproteinemia, decreased blood lymphocytes, and decreased cholesterol support the diagnosis. Hypocalcaemia (low calcium) is also seen due to poor absorption of vitamin D and calcium, and secondary to low protein binding of calcium.
Treatment is multifactorial. A diet low in fat and high in high quality protein is essential. Treatment of humans can also involve the use of MCT (medium chain triglycerides) oil and/or the drug Octreotide. in dogs, fat soluble vitamins (A, D, E, and K) should be supplemented. Corticosteroid treatment may be required for life. Antibiotics can be used to treat bacterial overgrowth. Lymphangiectasia is rarely cured but can remain in remission for a long time. It can be fatal when unresponsive to treatment.
Breeds commonly affected by lymphangiectasia and/or protein-losing enteropathy include the Soft-Coated Wheaten Terrier, Norwegian Lundehund, Basenji, and Yorkshire Terrier.[1]
[edit] References
- ^ Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine, 4th ed., W.B. Saunders Company. ISBN 0-7216-6795-3.
