ISSN 2398-2950      

Protein-losing enteropathy

ffelis
Contributor(s):

Synonym(s): PLE


Introduction

  • Protein-losing enteropathies are rare in cats.
  • When they do occur it is more common to detect changes in protein metabolism on biochemistry rather than symptoms of hypoproteinemia.
  • Cause: likely to occur in association with more serious underlying diseases.
  • There must be a high index of suspicion for intestinal lymphoma or severe IBD.
  • Signs: chronic diarrhea, ascites, vomiting, pallor.
  • Diagnosis: history, signs, biochemistry, urinalysis, radiography, endoscopy.
  • Treatment: of underlying cause; fluid drainage.
  • Prognosis: depends on underlying cause.

Pathogenesis

Etiology

  • Chronic intussusception Intussusception (usually in association with hemorrhagic anemia).
  • In theory the following diseases might cause a protein-losing enteropathy:
    • Viral and bacterial enteritis.
    • Suppurative and granulomatous enteritis.
    • Parasites especially Hookworm and histoplasmosis Histoplasma capsulatum.
  • Intestinal lymphoma Lymphoma.
  • Inflammatory bowel disease Inflammatory bowel disease: overview - some cats have hypoalbuminemia and normal or high globulins. Most cases are reported with lymphocytic-plasmacytic enteritis Lymphocytic / plasmacytic enteritis or eosinophilic enteritis Gastroenteritis but this may reflect that these are more common diseases.
  • Cats almost never develop intestinal lymphangiectasia.

Pathophysiology

  • Intestinal disease   →   increased gastrointestinal mucosal permeability to proteins.
  • Bleeding lesions also will result in hypoproteinemia Hypoproteinemia.
  • Increased pressure in the intestinal lymphatic from any cause (congenital defect, obstruction from mass, liver disease or right-sided heart failure).
  • Normal intestinal capillaries have relatively large fenestrations to allow for the absorption of proteins and the mucosal integrity is important in preventing intestinal protein loss.
  • In the classic protein-losing enteropathy both albumin and globulins are lost equally and are reduced in proportion in the serum biochemistry results.
  • Hypoproteinemia, especially hypoalbuminemia   →   decreased blood oncotic pressure   →   clinical signs of protein-losing enteropathy-peripheral edema, ascites and hydrothorax.

Timecourse

  • Weeks to years.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Prevention

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Simpson K W, Fyfe J, Cornetta A et al (2001) Subnormal concentrations of serum cobalamin (vitamin B12) in cats with gastrointestinal disease. JVIM 15 (1), 26-32 PubMed.
  • Fondacaro J V, Richter K P, Carpenter J L et al (1999) Feline gastrointestinal lymphoma: 67 cases (1988-1996). Eur J Comp Gastroenterol (2), 5-11 VetMedResource.
  • Hart H R, Shaker E, Patnaik A K et al (1994) Lymphocytic-plasmacytic enterocolitis in cats - 60 cases (1988-1990). JAAHA 30 (5), 505-514 VetMedResource.
  • Jergens A E (1992) Feline inflammatory bowel disease. Comp Cont Ed Pract Vet 14 (4), 509-518 VetMedResource.

Other sources of information

  • Bush B M (1991) Interpretation of laboratory results for small animal clinicians. Blackwell Scientific Publications, Oxford. ISBN 0-632-03259-6.
  • Guilford W G, Center S A and Strombeck D R (1996) Strombeck's Small Animal Gastroenterology. Saunders, Philadelphia. ISBN 0-721637604.
  • Tams T (1991) Inflammatory bowel disease. In: Consultations in Feline Internal Medicine. Ed August J R. W B Saunders, Philadelphia pp 409-411. ISBN 0-7216-226-7.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code