Intestinal Lymphangiectasia: A Protein-Losing Enteropathy (PLE)
 

Greetings,
I had my 7 yr. old Yorkie baby, JaJa's, teeth cleaned & that went went very well. However, the vet did prelim. blood work prior to sedation & found a significant abnormality in her albumin count (1.5 where it should be 2.7 or higher) and sent her blood to a lab. The next day, Fri., the vet phoned w/the opening line "I'm not happy at all".... long story shorter --

she weighs 6.5 lbs, has lost .5 lbs in a month and 2 lbs in the past year, her albumin (protein), chol., calcium and wbc levels were Very low. The vet said not to delay in taking
her to a specialist because it's life threatening.... so I took her to an animal med center.

They did an intestinal ultrasound,
chest xray and took blood for specific tests to rule out/in bone marrow, addison's & liver disease etc. This vet (& my regular's)strong guess was that she has Intestinal Lymphangiectasia: A Protein-Losing Enteropathy,a form of severe ibd ( where the intestines are leaking lymph into body cavities- nutrients are not going where they are supposed to and severe edema could result.)

JaJa's diagnosis: she does have Intestinal Lymphangiectasia: A Protein-Losing Enteropathy (PLE) ( supposedly a "common" Yorkie disease). Supposedly only an endoscopic biopsy gives a definite diagnosis, but since I can't afford that & don't want to put her through that (and the treatment would be virtually the same) the vet said he feels comfortable with this diagnosis without an endoscopy.

So, now she's on prednisone 2x/day (.5 mg & 2.5mg) and metronidaz (flagyl) (0.5ml liquid) 2x/day. Tomorrow 7/10/07 I'm taking her for another ultrasound and blood tests.
Despite all this, she has been and is acting normally and doesn't have any obvious side effects from the meds.

I don't like having her on prednisone and flagyl (metronidaz) especially "long term". I didn't have the luxury of time to explore holistic options and surprisingly there are no recommended holistic vets in New York City....

Any suggestions and comments would be greatly appreciated.
Thanks very much!

I don't have any experience with PLE. I'm sorry.:(

My Yorkie has the same disease
 

How is JaJa doing now?

My Vet told me today that Holly(6yrs old)Yorkie has this awlful thing and put her on steroids twice a day...I am worried about this long term. I was shocked to find this out...he had been treating her for loose stools that lasted 10 days.
When she became very bloated and had a hard time breathing yesterday morning I took her in for tests (x-rays) blood work.

Please let me know how your yorkie is doing now.
Is she doing well on a no fat diet?

Nikeann07

Re:Intestinal Lymphangiectasia: A Protein-Losing Enteropathy (PLE)
 

Hi,
Sorry to hear Holly is ill - hope she is doing better.
It's been 10 months and JaJa is in remission and seems to be fine.
Every month, then every 3 months she has had to have an abdominal ultrasound & blood work. Her 2x/day prednisone has recently been reduced to 1/4 pill prednisone every other day. She is no longer on oral flagyl.
That said, I am not happy that she will be on prednisone for at least another 4-6 months: her appetite is enormous and she urinates like a Great Dane..... Long term prednisone can cause alot of other issues, including UTI but I do think it's "saved her life".
btw, the only definitive diagnosis of Intestinal Lymphangiectasia is an endoscopy with biopsy. I didn't want to put JaJa through that procedure since the vet said the treatment (prednisone, ultrasounds) would be the same. But, her insurance, VPI, didn't pay a penny because I didn't consent to the endoscopy.
A couple of weeks ago she had difficulty urinating & I found blood in the urine. Took her the next morning to the vet and a urinary tract infection (UTI) was diagnosed and was instructed to give her 3/4 pill Clavamox (antibiotic) 2x/day for 1 week. I try to keep Ja off antibiotics because it's cause major digestive problems i the past but her not being able to urinate, & the bllod, were frightening.
Wll, 2 days after she finished the antibiotic she had the urninating urgency again but couldn't pee. I phone he vet who said she wasn't on a strong enough dose for long enough. So she's almost finished with 1 full pill 2x/day for 2 weeks. I'm supplementing that with CranActin cranberry tablets and FortiFlora probiotic powder. I plan on having her get another urinalyisis a week after she finishes the antibiotics.

10 months ago I almost lost my beloved Ja because her albumin count was so low. I never expected her to be on prednisone for so long but it probably saved her...
If you have any info. abut this disease or any other questions please be in touch.
Hope you & Holly are doing well,
Karen

Thank you thank you so much
 

Karen
I am so sorry for all your long trials in giving JaJa back the quality of life she deserves. I am happy she is still with you. My Vet said Holly will probably not be with me in two years even if she responds to treatment. This puts an ache in my heart you probably understand.

Has this illness changed JaJa's personality at all?
Holly sleeps a lot and sits in the sun. I have stopped taking her for walks
I think she misses it. Should I resume her normal routines?

I am on a fixed income, but, plan on cutting back on other things to see Holly through what sounds like a very expensive ordeal in recovering. I don't have dog insurance to cover some of it.

I am happy to have you to talk to about this...and appreciate you being here to let me know what Holly will be going through.

Hard part so far is she is always sooooo hungry and also pees like a Great Dane. The Vet is going to give me a list of what she can eat and it has to be strictly followed. Holly gets me up at night to go out to pee every 3 hours..yet there is pee puddles on the pee pads.

Give JaJa a hug from me.
She is so lucky to have you.


Nikeann07

Re: Thank you thank you so much
 

Hi Nikeann,
I have found that many, if not most, vets are such alarmists! One time I took Ja to an emergency hospital because she was not acting responsive after playing rough ball with a friend. the vet said he thought it might be a stroke & I should see a neurologist... well, it turned out she just strained her neck a bit & was better within a day.

I think vets are great and caring but I wish they wouldn't give us the worst case scenarios so often. When Ja's albumin count was so low, the 1st vet said it was immediately life threatening... Holly's vet doesn't have a crystal ball. Do you knw what her albumin count was... is? Ja's was so low but within a month on prednisone it was up to normal and continues to be. While I know that Ja is not "cured" but in a remission, Yorkies are very sensitive yet hardy and bounce back. I believe that a of of love, as with people, is powerful medicine.

Ja's personality has not changed. In fact, lately when we go for walks she wants to run. Holly's illness is new and until the meds kick in I think it's normal that she's lethargic. I was told that during the beginning of giving her prednisone I shouldn't take her out much because she would be more prone to not healing if she gets a cut etc. So, Holly might be telling you she needs to take it easy for awhile. Did Holly lose much weight before the diagnosis? Ja did, but is now at a good weight.

The vet tried to sell me on prescription food (Ja can only eat duck & potato food) but when I compared the ingredients of the prescip. food to what I've been giving her (Natural Balance Duck & Potato canned & dry) I felt the ingredients in Natural Balance were better... Ja constantly wants to eat...pee..eat etc. - it's tough on me but I love her so much that I will do anything for her. btw, a friend told me today about a product called "belly bands" - it's like a fancy diaper... I'm going to look into it.

Have you ever heard of the no-interest (if you follow the rules) credit card : Care Credit ( @ carecredit.com). Some vets accept it, & some do not. Basically, it allows you to spread the payments over 3 months interest free if the balance is paid on time. In the past year, Ja's vet bills have been about $5000-- 2 years before about $6000.

I hope Holly & JaJa ( and us) both come through this speedily& healthfully.
Don't give up on Holly's healing-- she's probably a fighter like Ja.

Thanks for your kind words. I do know what you're going through & it is scary.
best to you and Holly,
Karen & JaJa

I am so sorry for all your long trials in giving JaJa back the quality of life she deserves. I am happy she is still with you. My Vet said Holly will probably not be with me in two years even if she responds to treatment. This puts an ache in my heart you probably understand.

Has this illness changed JaJa's personality at all?
Holly sleeps a lot and sits in the sun. I have stopped taking her for walks
I think she misses it. Should I resume her normal routines?

I am on a fixed income, but, plan on cutting back on other things to see Holly through what sounds like a very expensive ordeal in recovering. I don't have dog insurance to cover some of it.

I am happy to have you to talk to about this...and appreciate you being here to let me know what Holly will be going through.

Hard part so far is she is always sooooo hungry and also pees like a Great Dane. The Vet is going to give me a list of what she can eat and it has to be strictly followed. Holly gets me up at night to go out to pee every 3 hours..yet there is pee puddles on the pee pads.

Give JaJa a hug from me.
She is so lucky to have you.


Nikeann07

I appreciate your help so much!
 

Karen ...
You are so right in reminding me that Vets do seem to give the worse that can happen.

Holly had me up every three hours last night wanting to go out an pee then eat.
I gave her about 2 tablespoons ID prescription diet

___________

Karen this note to you was interrupted by a call from my Vet
He wanted to know how Holly was doing ...I have an appt with him at 4 today...It is 8 am now.

When I said she passed about 2 tablespoons of Tapeworms in a bloody muscus stool. He was curious. When I said her mucus was gone and her stools were normal and the bloat was gone after the first pill (Lasix) for water....He now wants her on only one water pill a day....and 1 prednisolone a day ...saying he wants to discontinue that pill as soon as possible....and do another worming.

He also said changing her diet will be easier now...because she will eat anything due to her hunger on the steroid. He wants her off the ID prescription diet (to much fat in it)

I will let you know the results of today's appointment at 4 pm...Holly will have a weigh in. The boat caused her to weigh in at 7.8lbs

Holly is playful today and now acts like she has some energy...even more loving and her tail wags again.( Vet says it is because of the steriods that she is feeling better.)

I have a friend who has a Yorkie pup and she loves those pee bands..she uses them when she travels or visits friends. They are cute..You put a "lite days" pad in them.

Is it normal to be angry with the Breeder about all this? Should I let the breeder know? She has been in business for 24 years.

Holly had two litters of pups with the breeder before I got her. I then had her fixed.

I will ask the Vet about the easy payment guide you mentioned...that will be such a relief in worry for me.

I can't thank you enough
If I were there.... I would hug you!!

Nikeann

Here is an update on Holly
 

Hi Karen

I thought you might like to know that Holly was given a prescription can and dry dog food without fat in it. He insisted on it. He wants Holly to gain some ounces back and wants to see her in 7 days. He warned me that she came within hours of dying a few days ago. And things could change for the bad if I don't watch her eating habits and she gains water weight in her chest that will stop her heart.

The Vet took her off of the pills 2x's daily...to just once a day. It is important, he said, that she eats nothing other than this recommended food. If she fairs well on it he will then add some snacks. His goal now is to get her to just the pills once a day every other day. He says it will be easy to get her to like this new change in diet because she is sooo hungry she will eat anything at this point. He also gave me a cup to measure her food and feed her 6 times a day...very small amounts to get her system to process it easier.

Her stool sample I gave him was solid waste which he was happy to see...but, this morning I noticed she was straining to poop. The stool was very dry and hard.

Also she is not liking the new no fat stuff to eat and holding out for something else.....I am suppose to call the Vet if this was to happen...which I will do now. I am hand feeding her now...but is unhappy about it.

I have two other dogs. So I have to put her in a room to herself when I offer her food for the day. I will search the house today for dropped kibble from the other Yorkies.

Hope you and JAJA have a great day.

Nikeann

sounds like Holly is getting better rapidly, as Ja did. What is the prescription food? What meds is she on?
Ja gained her weight back ( about 2 lbs) rapidly once she was on predisone.
I think Holly will be fine - Ja's vet initially told me that she was "dying"... now 9 months after se seems fine . She finished her antibiotics for her UTI yesterday morning and so far no reoccurance.
Please keep me updated.
Hugs to you, Holly and your other pups,
Karen & JaJa

Hi again
 

Thanks for the hug from you and JaJa

I am coping okay about all of this now that I have guideline in Holly's recovery plan.

Answering your question about her food:

She is on z/d prescription food (can and kibble form)...it is high in fiber and no fat. Because of the prednisolone (5mg) she is okay with this diet change...There is no loose stools with her now. He wants her on 1 pill for 5 days...then every other day..until March 31 when he sees her again for a revaluation of her recovery.

She is on Latix for water retention (twice a day) for 5 days. Tomorrow will be the 5th day....Then the Vet wants her off of it. However since she lost the water very quickly and her stools were hard to pass and very dry..He changed the dose to just once a day on day 3.

She gets 2/3 cup of can food divided into 4 meals throughout the day.
She can pick on the kibble (1/4 cup) as a snack.

He said it would take 24 hours to see a change in her stool from eating this new diet. Today she pooped three times and the stool was firm and easy to pass. It is sooooo important (the Vet stressed this over and over) that she
gets nothing but this diet until her weight is up a few ounces and stays around 7 lbs. and gets used to the new food...then he says she may have
something like a small raw carrot to chew on.

He is going at this slowly for he wants her able to handle the disease with just diet alone (this is his goal and direction in caring for her) He wants me to call him before I make any changes in her diet or quits eating.

Today was a good day for Holly. She ate and pooped and played.
I still remember and re-read all of your advice and shared experiences to keep me focus on what's ahead.

Please tell me how JaJa is doing ...it helps me a lot. Things like setbacks and good times etc.

Hugs to you and JaJa
I will keep you posted if you like

Nikeann07

How is Holly doing/?
best,
Karen & JaJa

Hi Karen
 

I hope you and JaJa are doing fine.

I am hanging in there with Holly.
She gained 2 oz this week and the Vet was pleased. (7.4lbs) She looks very frail. She is the last to get up in the morning and the first to go to bed.
She is sitting in the sun right now...her favorite thing. She takes her meds readily and still on W/D formula diet...she is bored with this..but, Vet says to stay with it.

She got her B-12 shot again this week...2 more times before bloodwork again.

Vet suggested not giving her heartguard...but I did give it to my other two Yorkies.

Is there any more you can tell me?
Is JaJa doing well on a meds etc.?


thank you for sharing your experiences about this disease.:animal-pa

Nikeann07

update on Holly
 

Hi

I did a Google search for the use of Prednisone (steroid) and its effects on long term treatment use.

Very informative...

It's used in Holly's case: It's a steroid designed to break down stored fat, sugars, and proteins...so that they may be used as fuels in times of stress in my dog. Side effects...extreme thirst and plenty of pee...over long time use...may make a dog aggressive and jumpy.

The hope is to get Holly off daily use ..because ... over several months it ...will teach the body it can't be without Prednisone..


Nikeann07

Hi,
Hope Holly is continuing to do better- gaining weight is a good sign.
JaJa seems to be doing well-- she does have a massive appetite and pees like a Great Dane, but has alot of energy and seems happy.
Next month I have to take her for her annual exam and hope to hear I can get her off the 1/4 tab every other day of prednisone.
Ja is usually on Interceptor heartworm med (only during the warm months) - do you know why your vet said Not to give Holly Heartguard?

Some fun news to share - JaJa has been selected to be one of the stars of the upcoming (8/08) book "Doggie Style: I'm Too Sexy for My Collar ".

Currently, there's an online contest at*Untitled Document where you can vote for JaJa.

While all the dogs are very cute, I'd appreciate it if you would vote for JaJa (she's in row 9, third/right column wearing a hooded pink boa feather outfit). Thanks.

Let me know how Holly's doing.
best,
Karen & JaJa

I voted for JaJa!!
 

She really is sooo sweet looking...I hope she wins. Let me know the contest results when it happens.

Holly is still always hungry!! I gave her a raw carrot today as a treat...she loved it....I have taken her on trips to a friends house for a play-date with her yorkie pups and I took her to the pet store. It lifted both our spirits.

She looks good and acts happy. I was surprised the Vet trusted me to give her the b-12 injections for the next 6 weeks. but, it will save me about $500.
Then more blood work for her to see where she is at with her protein levels.

the pink boa is adorable on JaJa...thanks for sharing your fun news!!

:p