Intestinal Protein Loss in Dogs
Key takeaways
Protein Loss Enteropathy (PLE) describes a group of diseases which cause protein leakage from the bloodstream into the gastrointestinal (GI) tract.
- In cases of PLE, proteins pass with fecal matter, creating a deficiency in proteins which disrupts fluid balance and blood clotting
- This is a severe condition which may result in the formation of blood clots or edema (fluid accumulation in the legs or abdomen)
- PLE can be caused by different forms of GI disease
- Symptoms include diarrhea, abdominal distension, lethargy, rapid breathing, and collapse
- Diagnostics include physical examination, blood work, urinalysis, biopsies, and diagnostic imaging
- Treatment targets the underlying condition, alongside supportive care such as IV fluids, anticoagulant medications, and nutritional support
- In most cases, the prognosis for intestinal protein loss is guarded
- If the underlying condition cannot be treated, euthanasia may be considered
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A closer look: Intestinal Protein Loss in Dogs
Protein-losing enteropathy is uncommon in dogs. PLE is a severe condition that increases risk of blood clots and fluid accumulation in tissues (edema). Edema in the chest and around the heart increases pressure on the heart and lungs, which may be fatal. Any dog presenting with symptoms of protein loss requires emergency medical attention.
Supportive treatments to manage symptoms of PLE are intensive and require hospitalization. If the underlying condition cannot be determined or treated, euthanasia is often considered.
Risk factors
Some blood proteins, such as antithrombin, are involved in preventing blood coagulation during normal blood flow. When antithrombin is lost due to protein loss, blood clotting within the vessels may occur.
Protein loss also encourages fluid buildup throughout the body (edema), by disrupting the balance of fluid between the tissues and the bloodstream.
Since PLE is associated with multiple forms of GI disease, any dog at risk of (or who already has) associated GI diseases is at risk of developing PLE. There is some correlation between breeding and PLE, suggesting a genetic predisposition.
Possible causes
Under normal conditions, proteins from the bloodstream leak into the digestive tract, where they are broken down and reabsorbed. In cases of PLE, either the absorption rate is affected, or the rate of proteins entering the GI tract is greater than the body’s ability to reabsorb them. Protein levels within the bloodstream are one of the major factors that prevent fluid from accumulating in tissues. When blood protein levels are low, unregulated fluid buildup occurs throughout the body.
There may be a genetic predisposition to PLE, as some breeds present with PLE more frequently than others. Alternatively, GI diseases can lead to PLE.
Congestive heart failure can also lead to protein loss by increasing pressure within vessels, increasing protein movement into the gastrointestinal tract.
Main symptoms
Symptoms of PLE typically stem from underlying GI conditions.
Testing and diagnosis
Diagnostics include:
- Physical examination
- Bloodwork
- Diagnostic imaging, including X-rays and ultrasound
- Urinalysis
- Diet trials
- Biopsy
- Endoscopy
Steps to Recovery
Treatment varies, and targets the underlying cause. This may include anti-parasitic medication, surgical intervention, and dietary changes.
Supportive care includes IV fluid therapy to restore protein levels, and anticoagulant medication to prevent blood clots. Edema is treated by removing excess fluid (abdominocentesis or thoracocentesis). Dogs with intestinal protein loss often lose their appetite, and may require nutritional support through a feeding tube. Prognosis for PLE is guarded, depending on the underlying cause. PLE is not always treatable, and euthanasia may be considered due to the poor prognosis.
Prognosis is grave if blood clotting events such as pulmonary thromboembolism develop.
Prevention
The wide variety of underlying conditions which lead to PLE make it difficult to prevent. Proper dietary management, treatment of injuries, and early detection afford the best chances for treatment.
Some GI conditions are contagious.
Is Intestinal Protein Loss in Dogs common?
PLE is more common in dogs than cats, and some breeds are more predisposed than others.
PLE is also more common alongside GI diseases and congestive heart failure.
Typical Treatment
- Protein replacement with IV fluid therapy
- Anticoagulant medication
- Anti-parasitic medication
- Surgery
- Dietary changes
- Abdominocentesis/thoracocentesis
