Clinical features, intestinal histopathology, and outcome in protein-losing enteropathy in Yorkshire Terrier dogs

Abstract

Background: A poorly understood protein-losing enteropathy (PLE) disorder has been reported in Yorkshire Terrier dogs.

Objectives: To describe clinical features, intestinal histopathology, and outcome in Yorkshire Terrier dogs with PLE, and to identify variables predictive of outcome.

Animals: Thirty client-owned Yorkshire Terrier dogs with PLE.

Methods: Retrospective study. Records of dogs with a diagnosis of PLE were reviewed. Intestinal histopathology was interpreted using the World Small Animal Veterinary Association gastrointestinal histopathology classification system. Discriminate analysis techniques were used to identify variables predictive of outcome.

Results: Females outnumbered males (20/30). Median age was 7 years (range 1-12). Common clinical signs were diarrhea (20/30), vomiting (11), ascites and abdominal distension (11), and respiratory difficulty (8). Histopathologic abnormalities included villous lymphatic dilatation, crypt lesions, villous stunting, and variable increases in cellularity of the lamina propria. All dogs were treated with glucocorticoids. Of 23 dogs with long-term follow-up, 9 had complete, and 3 had partial, resolution of signs, and 11 failed to respond to treatment. Median survival of responders was 44 months and of nonresponders was 12 months, with 4 dogs experiencing peracute death. Vomiting, monocytosis, severity of hypoalbuminemia, low blood urea nitrogen concentration, and villous blunting were predictive of survival <4 months.

Conclusions: In addition to classic GI signs, Yorkshire Terriers with PLE often show clinical signs associated with hypoalbuminemia and low oncotic pressure. Lymphatic dilatation, crypt lesions, and villous stunting are consistent histopathologic findings. Clinical outcomes are variable, but many dogs experience remission of clinical signs and prolonged survival.

Keywords: Endoscopic biopsy; Inflammatory bowel disease; Lymphangiectasia.

Figure 1

Duodenal endoscopic biopsy. Four to 5 villi are expanded by markedly dilated lacteals.

Figure 2

Duodenal endoscopic biopsy. Numerous crypts are markedly distended and contained amorphous material with cellular debris (“crypt abscesses”).

Figure 3

Kaplan–Meier survival curve for 23/30 dogs that had follow‐up information available.