What is intestinal lymphangiectasia?
Intestinal lymphangiectasia refers to a dilation of the lymphatic vessels in the intestinal tract, which leads to leakage of lymph into the intestinal lumen and therefore leakage of plasma proteins into the digestive tract. To designate this protein leak, we also speak of exudative enteropathy.
What causes intestinal lymphangiectasia in dogs?
A distinction is made between primary lymphangiectasia, also called congenital lymphangiectasia, and secondary or acquired lymphangiectasia.
The first has no formally identified cause to date except that we suspect a racial predisposition or hereditary transmission (and therefore a probable genetic origin) in certain dog breeds such as the Bichon M altese, the Rottweiler, the soft-haired Irish Terrier or even the Yorkshire Terrier.
As for acquired lymphangiectasia, it can be secondary to right heart failure, inflammatory digestive diseases or even various causes of obstruction of the intestinal lymphatic tract (such as compression by a tumor, for example) .
How does the disease manifest in dogs?
Diarrhea is one of the most common clinical signs of intestinal lymphangiectasia. It is usually intermittent and, as it involves the small intestine, is liquid to semi-solid in consistency.
Dogs with this condition can also suffer from anorexia, chronic or intermittent vomiting and weight loss. They may also be very tired.
In case of hypoproteinemia following protein leakage, ascites (accumulation of fluid in the abdomen), peripheral edema or pleural effusion may occur.
The loss of lymphocytes in the intestinal lumen can also lead to immunosuppression which makes affected dogs more prone to developing inflammatory diseases and/or neoplasias.
How is it diagnosed and treated?
To diagnose lymphangiectasia with certainty, the veterinarian must use intestinal biopsies which will then show a distension of the mesenteric and intestinal lymphatic vessels. These biopsies generally take place following blood tests or an abdominal ultrasound, leading the veterinarian to suspect this pathology.
The identification of the cause of the intestinal lymphangiectasia can also give rise to additional examinations such as x-rays or chest and/or abdominal ultrasounds in search of a possible cardiac anomaly or a mass.
The treatment of intestinal lymphangiectasia is essentially based on dietary measures. The affected dog must then receive a diet low in fat, hyperdigestible and rich in proteins of high nutritional quality. It may possibly be supplemented with fat-soluble vitamins.
If dietary measures alone are not sufficient, the veterinarian may add drug treatment, generally corticosteroid therapy or immunosuppressive drugs.
This treatment can lead to remission in some dogs for several months or even years. However, the prognosis is more guarded in dogs that do not respond well to treatment.