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Old 04-02-2010, 12:24 PM   #1
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I'm new to this board and I came across it while I was google-ing Lymphagiectasia (sp). I have a 3 yr old Boston Terrier. We've had here since Dec of '08, rescue from a puppy mill. She's always had some problems with periodic vomitting and/or diarrhea but it always went away within a day. Approx. 2 weeks ago she didn't want to eat her kibble and had diarrhea that looked like brown water. We tried the beef & rice and it didn't help so we took her to the Vet a few days later who thought maybe she ate something or something was stuck in her intestine's or something like that. Gave us Endosorb and Flagyl and sent us home. By Monday she was not doing better at all so we took her back for a GI Series or X-rays and some blood tests. Blood tests showed low protein, sodium & cholestrol as well as albium & globulin (sorry for the misspelling). She has had no significant weight loss (maybe 1lb within a week) The Vet at that point metioned Lymphagiectasia and I looked it up online and saw that it is commen in Yorkies - thats how I found this site. Well after some more tests they are now talking about possible liver problems (the xray showed a small liver) because the Bile Acids tests was abnormal, but she also had intestinal leakage & a small amt of fluid in the lungs. We are a young couple and have spent almost $1300 so far in tests and now she wants to do a biopsy which there is no way we can afford.
I'm asking for advice I guess on what to do from here.We are taking her to the Vet at 5 today and are going to dicuss alternative options to the biopsy. We did have her on Reglan for a week and the Vet said to try to take her off, we took her off on Tues and as of yesterday starting vomitting again - it's a white mucousy saliva-like liquid with pieces of undigested food in it. I put her back on the Reglan last night and she's had 3 doses so far but is still continuing to vomit.
I guess I'm scared for her, this is the first dog I've ever owned and I don't want to lose her. The diarrhea hasn't stopped and she still has a lot of wet burps/regurgitaion, and she's very lethargic (although at times she is very playful).
If anyone has any advice or anything they can say to help me out I would greatly appreciate it.

Thank You,
Melissa
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Old 04-02-2010, 12:33 PM   #2
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what were the bile acid tests results pre and post?

medicines can affect the liver so it may not be a liver issue per se

the blood work is indicative of lymphangiecstasia

i would recommend a consult with Holistic Veterinarian Pet Nutritionist Holistic Pet Care as she helps alot of yorkies with ple which is also a loss of protein

Loss of protein is pretty serious - also pm luvmysissy as she knows alot about this as well as bleuboybarber

What diet are you feeding? If liver issues you never want to feed beef - the problem is with ple i believe you need to feed a high protein diet but with liver disease you need to feed a low protein diet

what breed is your dog? Usually dogs that get lymphangiecstasia have had on going ibd issues - it is usually diagnosed with low protein, low calcium -have you read the other links i have posted on ?
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Old 04-02-2010, 12:38 PM   #3
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Thank you for your quick reply!
She is a Boston Terrier.

at this time I don't have the blood work but I will be asking for a copy when we take her into the Vet shortly. I am considering seeking a 2nd opinion as our Vet seems to have a negative outlook on this disease.

Maddie (my dog) has PLE. Her protein was tested in Nov. and it was low but not dangerous as it was last week.

The Vet thinks it is a liver issue because in the X-Ray it showed that her liver was small and the Bile Acid test was abnormal (before she was on any meds).

The diet the Vet has prescribed is Hill's I/D with 1 scrambled egg or small meals of boiled chicken throughout the day, which was heling up until yesterday when she starting vomitting again. Up until yesterday she seemed to be ok (besides the diarrhea).

I will get a copy of the blood work and update when I return later.

Thank You!
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Old 04-02-2010, 12:51 PM   #4
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ok let us know and yes i would go to an internal medicine specialist and if bats are less than 100 mvd related but you have two issues that need to be treated differently and a little complex. Susan Davis is a nutritionist and i strongly recommend you consult with her and fax her the blood work. If adding egg and chicken and i/d has pork you have alot of protein going on there which helps with lymphangiecstasia but not good on liver this is a tough situation so give us all the highs and lows on blood work and bat numbers - this thread is a good one to read as alot of info but the dog did not have low protein, low cholesterol or low calcium and it ended up being a fungal infection. For lymphangiecstasia they treat with steroids but with fungal infection you cannot do that what meds did they give you? as another tough thing is steroids affect the liver as well

http://www.yorkietalk.com/forums/sic...me-nuts-3.html

here is some info

Lymphangiectasia
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Old 04-02-2010, 12:55 PM   #5
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on urinalysis did they find protein in the urine ?
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Old 04-02-2010, 03:34 PM   #6
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Well we just got home from the Vet. We've opted at this point not to do the biopsy just because of the cost.
We've got a new med: Pepcid because she's been vomitting so much in the past day and the Vet heard her burping and thinks she has a bit of reflux.
No food tonight, just meds, to ease her stomach.

Bile Acids before food was 35 after was 39

Blood work results:
Lymohocytes were 291 - LOW
Atypical Lymph were 97 - HIGH

B/C Ration (not sure what that is) was 25.6 - HIGH
Alk. Phos. was 21 - LOW
Calcium was 7.2 - LOW
Cholesterol was 82 - LOW
Amylase was 1541 - HIGH
Total Protein was 3 - LOW
Albumin/Globulin each 1.5 - LOW
Sodium was 140 - LOW

Everything else was in the normal range.

Vet did find Bilirubin in the urine as well.

Had a TLI - normal,
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Old 04-02-2010, 03:42 PM   #7
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Sorry for some reason my earlier post posted - but I thought I deleted it so I re-wrote it lol

Well we just got back from the Vet, at this point we've opted not to do the biopsy because we don't have $1300 right now. They did give us Pepcid to help with the acid reflux, and told to continue the Reglan, no food/water tonight to calm the stomach.

Blood Work that was abnormal:
Cobalamin Fasting <150 ng/L
*consider doing TLI to rule out EPI
TLI was normal.

Folate Fasting 4.8 ug/L
*consistent with disease affecting the proximal small intestine.

Bile Acids, Fasting - 35
Post Fasting - 39

CBC showed:
Hgb 18.8 - High
Hct 58.5 - High

Total Plasma Solids 3.4 - Low
PCV (Spun Hot) 56 - High
Lymphocytes 291 - Low
Atypical Lymph 97 - High

B/C Ratio 25.6 - High
Alk. Phos. 20 - Low
Calcium 7.2 - Low
Cholesterol 82 - Low

Amylase 1541 - High
Total Protein 3 - Low
Albumin/Globulin each 1.5 - Low
Sodium 140 - Low

Without biopsy she's saying the intestinal disease is more significant that the liver (microvasular displaysia she says could be a possible with the liver) ... so the intestinal disease is either IBD or Lymphagiectasia.

No Pred yet she says, but possibly in the near future.

Right now she's on I/D (1 can day mixed with chicken)
Reglan 3/day
Endosorb 3/day
Flagyl 2/day
Pepcid 1/day
and lots of TLC from both parents

Where to go from here - no idea?

Last edited by BuffaloMelissa; 04-02-2010 at 03:43 PM.
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Old 04-02-2010, 04:11 PM   #8
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PLE Can be controlled at times ....with the correct meds and diet. High protien and low fat....I have some info that I've filed that was published by the YTCA, but don't know where at this moment, will look and get back to you..
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Old 04-02-2010, 04:38 PM   #9
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Quote:
Originally Posted by BuffaloMelissa View Post
Well we just got home from the Vet. We've opted at this point not to do the biopsy just because of the cost.
We've got a new med: Pepcid because she's been vomitting so much in the past day and the Vet heard her burping and thinks she has a bit of reflux.
No food tonight, just meds, to ease her stomach.

Bile Acids before food was 35 after was 39

Blood work results:
Lymohocytes were 291 - LOW
Atypical Lymph were 97 - HIGH

B/C Ration (not sure what that is) was 25.6 - HIGH
Alk. Phos. was 21 - LOW
Calcium was 7.2 - LOW
Cholesterol was 82 - LOW
Amylase was 1541 - HIGH
Total Protein was 3 - LOW
Albumin/Globulin each 1.5 - LOW
Sodium was 140 - LOW

Everything else was in the normal range.

Vet did find Bilirubin in the urine as well.

Had a TLI - normal,
b/c is bun to creatinine ratio and that is indicative of kidneys

those bats are fine it is probably mvd and the vet wanted to do a biopsy ?????? yeah you need to deal with internal medicine possibly as no way would i biopsy a dog with low bats like that

yeah sounds like lymphangiecstasia low protein, low calcium and low cholesterol so no need to worry about liver at this point your bigger concern is protein loss as that is most critical right now. I strongly recommend contacting susan davis - the phone consult is $90 but well worth it and contact luvmysissy on here she knows a ton on this - I will try to call her and see if she can get on here as she is not on this site as much lately

sometimes the gall bladder contracts when pulling blood for bats so sometimes it is not real accurate as well but if below 100 not a huge concern - my yorkie has mvd and her bats were 73,54 and now 26 on low protein but the low protein on blood work is more critical at this point for your dog

Last edited by dwerten; 04-02-2010 at 04:42 PM.
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Old 04-02-2010, 04:44 PM   #10
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b/c is bun to creatinine ratio and that is indicative of kidneys-- so what was high the bun or the creatinine as bun is usually dehydration and creatinine is more critical number so did they break it out as usually they do bun, creatinine and then b/c ratio?

since the tli is normal it is not epi as they ruled that out which is good as that is another protein losing disease so now you are down to ple and lymphangiecstasia but i think your vet is right on with the lymphangiecstasia so vet did not recommend steroids as usually that is used to treat this

Last edited by dwerten; 04-02-2010 at 04:46 PM.
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Old 04-02-2010, 04:49 PM   #11
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Top Intestinal Lymphangiectasia Protein-Losing Enteropathies Yorkie, PLE, Inflammatory Irritable Bowel Disease

here is more info and i bet it was the bun that was off as probably dehydrated as diarhea is much more dehydrating than vomitting so watch the gums and make sure they do not get sticky if so get her in for some sub q's
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Old 04-02-2010, 04:55 PM   #12
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Quote:
Originally Posted by BuffaloMelissa View Post
Sorry for some reason my earlier post posted - but I thought I deleted it so I re-wrote it lol

Well we just got back from the Vet, at this point we've opted not to do the biopsy because we don't have $1300 right now. They did give us Pepcid to help with the acid reflux, and told to continue the Reglan, no food/water tonight to calm the stomach.

Blood Work that was abnormal:
Cobalamin Fasting <150 ng/L
*consider doing TLI to rule out EPI
TLI was normal.

Folate Fasting 4.8 ug/L
*consistent with disease affecting the proximal small intestine.

Bile Acids, Fasting - 35
Post Fasting - 39

CBC showed:
Hgb 18.8 - High
Hct 58.5 - High

Total Plasma Solids 3.4 - Low
PCV (Spun Hot) 56 - High
Lymphocytes 291 - Low
Atypical Lymph 97 - High

B/C Ratio 25.6 - High
Alk. Phos. 20 - Low
Calcium 7.2 - Low
Cholesterol 82 - Low

Amylase 1541 - High
Total Protein 3 - Low
Albumin/Globulin each 1.5 - Low
Sodium 140 - Low

Without biopsy she's saying the intestinal disease is more significant that the liver (microvasular displaysia she says could be a possible with the liver) ... so the intestinal disease is either IBD or Lymphagiectasia.

No Pred yet she says, but possibly in the near future.

Right now she's on I/D (1 can day mixed with chicken)
Reglan 3/day
Endosorb 3/day
Flagyl 2/day
Pepcid 1/day
and lots of TLC from both parents

Where to go from here - no idea?
this is not ibd it is lymphangiecstasia as ibd none of the blood work will be off usually and if it is off it is the amylase and lipsase and cpli not protein, calcium, or cholesterol. I have an ibd yorkie and he has ibd in small intestines.

with ibd our internal medicine specialists says to avoid chicken as ibd is associated to allergies as well and chicken is an allergent to these dogs.

can you explain more how this all started and what may have triggered it as ibd is usually affected in small intestines by inflammatory foods and in small intestines vomitting occurs but in large intestines there is diarrhea

the other thing that concerns me is the lymphocytes are low which is indicative of lymphangiecstasia.

has your dog been losing alot of weight?
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Old 04-02-2010, 04:56 PM   #13
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just want to be clear were they wanting to do a liver biopsy or intestinal biopsy with endoscope?
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Old 04-02-2010, 05:06 PM   #14
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Amylase - Wikipedia, the free encyclopedia

here is info on the amylase and why it was so high is probably because of calcium being low


(EC 3.2.1.1 ) (CAS# 9014-71-5) (alternate names: 1,4-α-D-glucan glucanohydrolase; glycogenase) The α-amylases are calcium metalloenzymes, completely unable to function in the absence of calcium. By acting at random locations along the starch chain, α-amylase breaks down long-chain carbohydrates, ultimately yielding maltotriose and maltose from amylose, or maltose, glucose and "limit dextrin" from amylopectin. Because it can act anywhere on the substrate, α-amylase tends to be faster-acting than β-amylase. In animals, it is a major digestive enzyme and its optimum pH is 6.7-7.0. [1]
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Old 04-02-2010, 05:09 PM   #15
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Thank you again for getting back to me.

The Vet did suggest steriods, just not yet. Mainly because we don't have an official diagnosis & she'd like to treat without steriods if possible. I am seeking a 2nd opinion from another Vet in our area who has more experience with this disease since I asked our Vet when the last case of Lymphagiectasia seen and she said it had been a long time.

We gave her the Pepcid about 2 hours ago and actually she hasn't gotten sick - so that's a plus. We're hoping we can treat with just the I/D, reglan, endosorb & flagyl - to the point where we can get her back to how she was 2 weeks ago.

They did do another CBC today so we should have those results hopefully Monday or Tuesday. I'm hoping her Total Protein is up - with all the chicken & egg she's been getting I can't see why it wouldn't be. She is still having diarrhea yes but only about 3x per day and it's a small think pudding like pile.

At this point I guess it's a wait & see deal - we're just trying to take it 1 day at a time. We're very frustrated because we've only had her 16 months and we're not ready to let her go.
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