Lymphangiectasia

Lymphangiectasia is an obstructive disorder involving the lymphatic system of the gastrointestinal tract,  resulting in Protien-Losing Enteropathy.   As part of the normal circulatory system, lymph fluid is collected from tissues throughout the body and returned to the blood by way of the lymphatic vessels. In intestinal lymphangiectasia, normal drainage is blocked so that intestinal lymph leaks into the intestines instead of being returned to the circulation. This results in the loss of proteins, lymphocytes ( a type of white blood cell), and lipids or fats into the stool. 

Lymphatic obstruction results in dilation and rupture of intestinal lacteals with subsequent loss of lymphatic contents (plasma proteins, lymphocytes, and cylomicrons) into the intestinal lumen.  Although the proteins may be digested and reabsorbed, excessive entric loss results in hypoproteinemia.  Hypoproteinemia causes decreased plasma oncotic pressure leading to edema formation, ascites, and pleural effusion.

The prognosis for this disease is unfortunately, a tough one. The albumin (protein) count in the blood is usually very high with this disease. The problem arises when the intestines stop absorbing the proteins in the their food and it passes right through them plus it passes through the intestinal walls into the blood stream causing major allergen reactions throughout the body.

Intestinal lymphangiectasia may be congenital (present from birth) due to malformation of the lymphatic system, or it may be acquired in association with another disease.

Systems Affected  

Symptons

Signs of intestinal lymphangiectasia usually develop slowly over several months, and may come and go. Your dog may fail to gain weight or may progressively lose weight. The loss of protein into the bowel causes loss of fluid from the circulation into the limbs, the abdomen, or the chest. Your dog's legs and/or abdomen may appear swollen and he/she may have trouble breathing. There may be a chronic persistent or intermittent diarrhea due to the loss of protein, fluid and fat into the bowel.

This condition can not be cured but it can generally be well-managed by you and your veterinarian.   This is done through diet, and medication to reduce inflammation in the intestinal wall. An ideal diet for dogs with intestinal lymphangiectasia contains minimal fat, and an ample quantity of high-quality protein. There are commercial prescription diets available which fulfill these requirements, or your veterinarian can give you information to prepare a low-fat diet at home. In either case, you will need to supplement your dog's diet with fat-soluble vitamins, due to the poor absorption of fat that occurs with this condition. Feed MCT's (Medium Chain Triglycerides) to supplement fat and increase the calories. 

Corticosteroids are given to reduce inflammation, and thereby reduce loss of protein and associated diarrhea. Your veterinarian may also prescribe antibiotics.   Prednisone, Tylosin, and Metronidazole have been used. Antibiotics can be used to control secondary bacterial overgrowth. 

Oncotic agents like plasma, dextrans, hetastarch help maintain normal fluid distribution in the body and may be of benefit in critical cases that are severely hypoproteinemic and need immediate attention.
 

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