Lacey girl with Newly dx PLE
 

my yorkie has recently been dx with ple !! Help !! She now has chronic diarrhea again . She is on prednisone and leukeran.

I am going to ask that this be moved to a thread of its own.

In the meantime, what is the vet telling you? Is she eating well? What food is she on?

For what it's worth, from what I've read, the prednisone and leukeran treatment is the best that's currently available for PLE. Please keep in close contact with your vet, and keep us posted on how she is doing!

How old is your dog. What where her symptoms? I have no experience with it hopefuly someone does on here

Protein losing enteropathy. This is a great link about it.

Intestinal Lymphangiectasia

I have two pups with it. It is common in yorkies. I also have one with PLE which is a protein losing nephropathy which is related to the kidneys.

One of my pups has a thread here from when she was diagnosed. The other one, Rookie, I didn't start a thread about.

Here is Cookie's thread:

http://www.yorkietalk.com/forums/sic...ia-update.html

I have not seen a pup treated with leukeran. Most of the people I know have had their pups on prednisone only.

What is also very, very important for these pups is a low fat diet. I opted to home cook for Cookie and she is on the same diet. Initially the specialist told me she would be on prednisone for the rest of her life (low dose if her protein levels were good)...but he finally opted to take her off of it since her protein levels improved and so far have remained normal. She was diagnosed in Dec 2011.

Oh, just found out you are correct, which I kind of figured. LOL I HAD to go ask and sure enough it has been used for a while now.

There was a recent study that was positive...I am sure that you already know that Phil. LOL

Here is the link to the study:

Comparison of a chlorambucil-prednisolone combination with an azathioprine-prednisolone combination for treatment of chronic enteropathy with concurrent protein-losing enteropathy in dogs: 27 cases (2007–2010)

The survival rate for prednisone + chlorambucil (leukeran) was much greater than that for prednisone + azathioprine, based on a small study. It is still a very scary disease.

Thanks for the link, Phil. Yes, it is scary....I was horrified when they gave me Cookie's biopsy results....BUT that was in Dec 2011 and she is still with me and thriving. I also know other pups who are doing well.

As mentioned above, I do believe diet is key in controlling them.

I agree, diet could very well be an important factor. Here is a very good scholarly article on diet and food sensitivity in Wheaton Terriers with PLE. (Wheaton Terriers are notoriously susceptible to PLE.)

Food Hypersensitivity Reactions in Soft Coated Wheaten Terriers with Protein-Losing Enteropathy or Protein-Losing Nephropathy or Both: Gastroscopic Food Sensitivity Testing, Dietary Provocation, and Fecal Immunoglobulin E - Vaden - 2008 - Journal of

To summarize, five out of six dogs with PLE had food sensitivities. Diets containing food items that elicited food sensitivity also worsened the PLE symptoms. The researchers were not able to determine cause and effect, but the two are definitely associated.

This kind of ties in with the thread on the Nutriscan test for food sensitivities in dogs. I'm still waiting to hear back from veterinary experts to see if it is a legitimate test for food sensitivities. I HOPE that it is, because if food sensitivities turn out to be a cause of PLE, and if the Nutriscan test really works, then a lot of pain and suffering could be prevented. Right now, I'm keeping an open mind and waiting for more evidence.

I just looked at the full article, and this is in the Introduction:

"Food hypersensitivity reactions cause enteritis of varying severity, including PLE, in humans and dogs."

That looks like a smoking gun to me.

Here's another smoking gun from the article:

"Owners of Soft Coated Wheaton Terriers claim that oftemtimes affected dogs must be fed elimination diets to avoid or reduce clinical signs. In some cases complete resolution of clinical manifestations of the disease follows dietary changes."

Another article on PLE in dogs...
 

Here is a technical article on PLE in dogs that should be accessible to everyone:

http://www.wvc.org/images/session_no.../2013_S17A.pdf

It describes the diagnosis, causes, and treatment of PLE in dogs. Apparently, there are three major types of PLE:

(1) Intestinal Lymphangiectasia, which is a common form of PLE found in Yorkies.

(2) Inflammatory Bowel Disease, which is the most common form found in Wheaten Terriers.

(3) Crypt disease.

Other causes of PLE are alimentary lymphoma and fungal infections (histoplasmosis).

Treatment of PLE includes modifying the diet and using medicines to control the underlying inflammation. Here is an excerpt from the article about dietary changes:

"Diet: Dogs with PLE are in a catabolic state, and adequate nutrition is essential. There are currently no published studies critically evaluating nutritional aspects of canine PLE. However, a large body of clinical experience is available. In dogs with primary idiopathic IL, dietary modification centers on feeding a highly digestible diet with low to very low fat content (10-15% on a dry matter basis) to prevent further dilation and rupture of lacteals. Additionally, the diet should contain highly bioavailable dietary proteins and be low in crude fiber. While drug therapy may be administered for a few months (see below) and then discontinued in some cases, dietary therapy should probably be maintained for the length of the dog’s life. In dogs with PLE associated to underlying IBD, many veterinary gastroenterologists report good success with exclusive feeding of a diet consisting of hydrolyzed proteins. Novel protein diets are an alternative approach.

Acceptance of the diet is a critical issue in PLE dogs, particularly in the most severely affected animals, which may be anorexic. For each patient, the veterinary care team needs to identify the most palatable diet. Initially, it might be more important to feed a less optimal diet that the dog will be interested in eating, and progressively transition to a more desirable diet."

Cookie also has IBD. I opted to home cook and chose tilapia because, to my knowledge, she had not had it previously. The vet nutritionist had me start her on it first to see how she tolerated it...then we went ahead with formulating her diet. I believe I was fortunate because we caught it before she had totally decompensated. Once they are really ill and build up fluids, it is often very difficult to get them to eat. We had a member here whose pup had histoplasmosis and she was really, really sick. I suggested she ask about mirtazapine and it worked really well. She started eating almost immediately and survived.

Ple
 

Abby is not responding well to Prednisone and Atopica. Making her food now. The disease and prednisone is really wasting her muscles. I am still trying to make her well. Has anyone ever tried Reiki on a sick dog?