5 year old with PLE
 

I have a newly diagnosed yorkie with Protein Losing Enteropathy due to IBD. Her name is Holly, and she is 5 years old. :animal36

It has been a roller coaster ride getting here. I went to 3 different vets within a 2 week time because I knew something was wrong. The third vet did blood work, including testing for liver shunt. When that came back negative she referred us to Purdue.

She spent 3 days in ICU at Purdue University small animal clinic. The did biopsies, and confirmed the PLE. Lucky for us, there is a vet there who specialises in PLE.

We are home, and giving medicine, and she is on a special diet that she does not like. If I hand feed her I can get her to eat a little.

Her belly is still enlarged, but we are seeing a little bit of an improvement. I will be asking about a pet nutritionists.

When this started, I went to bed at night not knowing if she would be alive when I woke up. So much better than that, but her not eating is not helping her get better.

Her protein level did increase last week, but at .8 we have a way to go to get in the normal range.

I've read the thread about "Cookie" and feeling hopeful that we can get past this and get my baby girl on the road to recovery.

So sorry you and little Holly are having to go through this! It's got to be so hard watching her not feeling well, and you feeling helpless. But just know, you *will* get her through this and get her well again. :)

You might find this helpful: http://www.yorkietalk.com/forums/die...itionists.html

Not really much of an update yet, but Purdue has given us a different kind of food for her, and at least for tonight she finally isn't hungry. On the menu tonight was potato and venison, and she gobbled it. She has a doctor appointment tomorrow to check her protein levels, and get her a B12 injection.

Great! Purdue should be able to recommend a pet nutritionist.
May here have used Dr Rebecca Remillard. I think I would stick close to the diet your specialist is recommending as long as things were improving.

Keep us posted!

Oh, I didn't see that you had started this thread. :) I am happy to hear that they gave a food that she likes!

Looking forward to hearing how her blood work is....

Vet visit over for this week. Protein level dropped this week. Now it is .6 - it was .8 last week so we are losing ground. She did eat a little of the new food this morning.

I did find out the vet at Purdue who is consulting with my vet is a certified animal nutritionist.

My vet is faxing the blood test results to her to see if something needs changed. This is week 3, and she said we should see results by week 4.

Not feeling very hopeful right now. The only change we have seen is her diarrhea is gone. She still has a very fluid filled tummy. Spends most of her time just laying.

So heartbreaking to be unable to help this baby.

What meds is she on? When she was hospitalized, did they give her hetastarch? They just used that on Cookie recently when she was hospitalized...she had pancreatitis and also a relapse of the PLE with fluid in her abdomen. They may just need to adjust her meds. Don't give up hope...sometimes it takes time to get them on track. If she does not eat, ask them about Mirtazapine.

Keeping her and you in my thoughts and prayers....

It is doubtful that the vet at Purdue is a vet nutritionist. I suppose it is possible, but it doesn't make sense to me. To find out if he/she is boarded, here is a link to the directory of all boarded vet nutritionists:

Directory | ACVN

She was not given hetastarch while hospitalized. She is currently on Prednisone 5 mg twice a day, Tylosin 1 mg twice a day, and famotidine 10 mg, 1/4 tablet twice a day.

Her protein level was .4, went up to .8 last week, and down to .6 this week. It needs to be up to 2, but she is eating very little. Her belly is huge, but the rest of her is bony.

Before she got sick, she was eating Fromm grain free.

I am assuming she was scoped since you did say it is due to IBD.

My guess is they are hopeful if she eats this will turn around. I urge you to ask them about Mirtazapine. There is a thread here about a pup named Lola who had PLE due to a fungal infection. I told her mom about that med and the turn around was amazing. Lola would not eat and was really, really sick...once she started on Mirtazapine and started eating, she made a turn around. It isn't like that always, but when it does work, it is really wonderful. I have had great success with it with various pups who would not eat. Renal failure causes them to not eat as well.

I cannot find the post where Lola started taking Mirtazapine, but here is a post where her mom posted about it. Lola was really, really sick and not eating...her protein was very low. The Mirtazapine totally turned her around ..

http://www.yorkietalk.com/forums/3011854-post326.html

Yes, she was scoped, and ultrasound, and biopsied.

I was told there is no cure, but she will have to be on this restricted diet for the rest of her life. If I understand it right, her body is not able to process protein, so it backs up and that is what causes the bloat.

First food was hydrolyzed protein. If she ate any, it was because I handed her bites at a time. Definitely not enough. Now it is a limited ingredient. She ate last night pretty good, but not much today. Maybe a 1/4 can in 24 hours, and a few pieces of the same kind of kibble.

The Doctor we were referred to at Purdue University is supposed to specialize in PLE, meaning that is what I was told but I have no way to confirm that.

Was the first food Hill's Z/D? I have a pup on it and he really likes it. He has IBD and is borderline lymphangectasia. He had some issues with enlarged lacteals but so far is not losing protein.

That's great that the specialist is an expert in PLE ... the one who cares for Cookie and also Rookie (the one mentioned above) also has a special interest in PLE.

The biggest challenge is getting them to eat so that the body can get back to normal. I cannot emphasize enough calling your vet about the Mirtazapine. It is anti nausea, anti emetic and also an appetite stimulant...it is an anti depressant and has been used for some time in animals who have stopped eating. I know I probably sound like a broken record, but it is so important to get her to eat and this med may help that.

Spent the morning at Purdue with Holly. We are waiting on results of blood tests to see if there is ANY improvement in her protein level and her white cell count that was high.

There was much discussion about me not being willing to watch this dog starve herself to death, and so far she is not interested in any of the food we have been given. She still has a fluid filled belly although it is better. With the fluid we don't know what her true weight is but we can feel lots of bones so we know she is losing.

We now have a supply of Mirtazapine so we will see if it makes a difference. She is working on a diet plan of what I can cook and feed just to get her to eat.

75% of dogs with PLE have shown improvement by this time but Holly is in the 25% and I am not willing to give up on her.

I made it very clear that I will cook what I need to if it will help her heal.

Until they get a diet for her, you might try sweet potatoes just to see if she likes them. The trick with the IBD is finding a protein they can eat/handle. My Cookie is on Tilapia and it has been fine for her. She is not doing so well right now ... she was in ICU for a week and her protein is still low and pancreatic enzymes elevated. :( We see the specialist again tomorrow.

I really, really hope the Mirtazapine helps Holly. Please keep us posted. I am happy you updated...I have had Holly on my mind.

She and you are in my thoughts and prayers.

Just got the phone call about blood results. Her protein level has not changed at all which isn't surprising since she won't eat.

They also noted that her liver enzymes are not elevated which they expected due to the prednisone which now makes them think she is not absorbing the prednisone either.

They havent made a decision yet about doing the prednisone through injections instead of pills.

I hope Cookie starts getting better soon. I've followed the posts about her having a rough patch again. Praying for your baby too!!!

Yes, the ALKP is usually elevated when they are on prednisone. I imagine it is a good thing that the protein levels are steady. I hope. :)

Do hope the Mirtazapine works for her and she starts eating.

Thanks for the well wishes and prayers for Cookie. I will see what the specialist says tomorrow.

The protein levels staying steady is NOT a good thing. Her level is extremely low, because of the PLE she isn't able to absorb the protein, and not eating means there isn't anything to absorb.

I'm really struggling tonight! The mom in me (the protector of this small innocent creature) is debating going against medical advice and just feeding her some white fish and yams, or some egg whites!

She did eat really good tonight. One crunchy bite at a time after I dipped it in warm water. Trying not to get my hopes up but we shall see what tomorrow brings.

I didn't mean it was great....but they are not dropping is what I meant.

Glad she ate something! Hope it continues!

Update - I'm cautiously optimistic that Holly might just be a little better today. She is on Mirtazapine now, and we are now able to get her to eat at least a little 2 or 3 times a day. I am adding some shredded parmesan cheese on top of her food so she can smell it. She LOVES the cheese.

She woke up 3 days ago with her tummy noticeable smaller from fluid. They changed her antibiotic to a different kind for 10 days, and her diarrhea was back and really bad for one night.

I know these are all just little things, but I'm calling it huge from where she was to where she is today.

Purdue has asked for a list of all the protein sources she has had in the past 6 months, and carbohydrate sources. They are working on her diet, so I know what to cook.

YAY! :cheer::cheer::cheer: I am SO happy to see this update!

I went through the diet history thing with Cookie...that is how she ended up on the tilapia and sweet potatoes...she had never had them. I am very excited for you! :)

Cookie is better....they are reformulating her diet. Now that she has pancreatitis as well, they are wanting lower fat.

It is with great sadness I have to let you know that Holly crossed the rainbow bridge yesterday morning.

i could say I am heartbroken, but really I just think I am numb from the pain of losing her. She has been my constant companion, and even though I know in my heart we did everything we could, I still feel like I failed her.

Thanks for listening!

Oh no.....you did not fail her. I am soooo very sorry for your loss of your sweet baby.
You did so much for her and tried so hard. So heartbreaking....

I wish I had the words to make it better.

You will be in my thoughts and prayers.

RIP Holly

Oh, I just read your whole thread and I am so sorry to hear about yours and Hollys struggle. She is lucky to have such an advocate and you clearly worked hard to save her. I am so sorry for your loss :rbyorkie:

I am very sorry for your loss of your beautiful Holly. You did everything humanly possible for your girl. She was loved, and she was very lucky to have you as her mom. I am praying for your comfort and peace.

Run free on the other side of the Rainbow Bridge, Holly.

Yeah that's right she will be okay soon! Pet nutritionists? That's a good idea it will help you and advice you for what you need to do for her faster recovery. Just always monitor her improvements everyday.

I am so sorry for your loss.....Hugs

I am so sorry for your loss. RIP Holly

I am so very sorry to hear of your sweet Holly's passing. :love:

I am so incredibly sorry for your loss :(. You did everything you could for her, and that was a real blessing.