PLE (Protein Losing Enteropathy)

[nygmatech]

Hello everyone! My 7-year-old male chocolate, Tank, has recently been diagnosed with PLE (protein losing enteropathy) and it’s been an extremely tough time. He has further testing pending to determine the underlying etiology for his disease. Currently trying different medication and diet regimens. Next step would be endoscopy so the vet says. He does have an IBD (inflammatory bowel disease) panel pending. Currently though, he’s not wanting to eat much and is getting weaker.

But was wondering, has anyone here dealt with this before with your lab? What helped? Any vet testing/advice? I have read a thread started by Snowshoe that was enlightening. However, this already seems to be an incredibly frustrating and resistant disease process, and I just want my ol’ buddy back. Any helpful input you have would be appreciated. Thanks!

[Black Labbies]

Welcome to the board, sorry to read it's due to Tank's poor health that brought you here. Poor Tank and you .

I have no experience with PLE, but have read about it. Anytime you're dealing with the GI tract, there are many components involved.
What are Tank's daily diet and treats? What daily supplements do you give him?

I'm a big fan of using natural things and treatments, have you looked into, or thought of consulting, a holistic veterinarian?

Sending you hopeful thoughts and prayers that Tank will recover soon!

[nygmatech]

Welcome to the board, sorry to read it's due to Tank's poor health that brought you here. Poor Tank and you .

I have no experience with PLE, but have read about it. Anytime you're dealing with the GI tract, there are many components involved.
What are Tank's daily diet and treats? What daily supplements do you give him?

I'm a big fan of using natural things and treatments, have you looked into, or thought of consulting, a holistic veterinarian?

Sending you hopeful thoughts and prayers that Tank will recover soon!

Thank you for your thoughts and prayers, I'm thinking we need as many as we can get! Tank was placed on Royal Canin Low Fat/GI about two years ago just to get a few pounds off. Prior to that he was on Holistic Select grain-free/poultry free as he has some allergies as a pup. His first bout of vomiting/diarrhea was about a year ago. He received antibiotics and recovered well at that time. The second round was about a month ago but didn’t respond to GI canned food or metronidazole this time. He hated the Tylosin powder so that was a no go. Stools were somewhat firming up about a week ago, but now has reverted to and continues with non-bloody, explosive, malodorous liquid stools. Fortunately, he has had no vomiting for a while now (knock on wood). He has had enrofloxacin, dexamethasone, B12 and Cerenia injections on 1/23 due to continued symptoms and anorexia/weight loss. The vet also noted low albumin and total protein levels on his metabolic panel. We've attempted to try him on GI canned food and Hills Science Diet Z/D hydrolyzed diet but he refuses to eat this; he’s always been a picky eater and I think not feeling well hasn’t made this any better. This morning he refused any canned food or kibble...he just stared at me. In the evening I gave him boiled chicken which he has ravenously eaten and seems to be more hungry and a bit perkier after that. So maybe that’s progress?

He's currently not on any supplements, still taking the Flagyl. I have looked into holistic vets but unfortunately they’re all farther away-out of town. Still no results from his IBD panel today; I hope to know something by tomorrow on this. I think I may call the vet and push for abdominal imaging/ultrasound just to be doubly sure; according to the diagnostic algorithm for GI workups, this may be considered. The next step would be endoscopy with biopsy of the small intestine and stomach to definitively diagnose. I just hate to put him through sedation and invasive procedures without knowing more first; but seems it may come to that. At this point, we really just need answers and I need to know what I'm up against. I've always taken great care of him and been successful at anticipating his needs. Being in the healthcare profession; not being able to fix him is getting to me. Definitely feeling a bit helpless at this point. I suppose we'll just take it one day at a time...

[Snowshoe]

Oh dear, this is not going to be fun. Not sure which thread of mine you read and how much info was in it. PLE was our western med Vet's first idea but after western meds failed and we switched to a Holistic Integrative Vet (with western Vet's blessing) things improved immensely.

First, home cooked novel protein and novel carb, stop all meds, except Prednisone which was slowly weaned off. TCM used too. This showed immediate benefit and diarrhoea, our biggest threat, cleared up instantly. Itchies from allergy also stopped, after going on four years.

Second, slow transition to raw with continuing good results.

Relapse avoided by coincidence of blood work asked by Ortho Vet for unrelated injury showed albumin dropped again, gastroscopy, endoscopy, fecal transplant, B12 injections - diagnosis of Lymphangiectasia. L. requires a very low fat diet impossible to do on real raw (hunks of real, frozen meat - not possible to cut all fat off. Prepared low fat products not available at the time and most not as low fat as needed anyway)

Switch to my choice of hydrolysed kibble or Raynes Low Fat Kangaroo. I chose RLFK and that kept Oban healthy for the next 6 years, along with continued TCM. Side benefit was still no itchies. Oban died last June, basically of old age, at 13.5.

I found some FB groups for IBD dogs and what stands out is there is no one cure-all. They are all different, what works for one does not help another. We were lucky to find a protocol that helped right off the bat. Good luck, if you have questions for me I will try to answer.

[nygmatech]

This definitely helps. Did you find any benefit from the fecal transplant? I was reading about this yesterday. I still haven’t heard back regarding his IBD panel…when did your vet consider endoscopy? Mine has mentioned it but on one end I don’t to jump the gun, then again on the other, I don’t want to wait too long. He’s already looking skinny. Diarrhea is now our biggest problem; along with some abdominal bloating and what I think is cramps given his behavior after eating. Also, what novel proteins did you introduce for your home cooked meal? I’ve started with chicken as Tank had been on a poultry and grain free diet for years, however, it’s definitely not a novel diet now…basically just a starting point. I have read about venison as a novel protein source. What carbs did you include? I haven’t gone there yet but he’s going to need some. Thinking I may call the vet and also discuss EPI (exocrine pancreatic insufficiency) as I’ve been doing research on this and no testing has been done to rule it out. All of the things floating in my mind…

[Black Labbies]

Ditto to what Snowshoe posts about diet change to homemade/raw, but I would go more cooked/boiled than raw at this time until Tank settles more. I would also add a good life active cell probiotic 2-3 times daily, to get Tank's digestive tract back on track. This will take a week or two to see good results.

Yay, you're open to gross but good things, such as fecal transplant! We've done this with our past special girl - Zoda/Zoe, who had EPI, with good success! In fact, when we walk in the woods and the girls, past and present, find horse, cow, wildlife, rabbit, (but not dog or cat), poop, we let them chow-down. There is your fecal transplant in it's rawest form, lol.

We've been raw/homemade feeders to our many dogs since 1999, all under the supervision of our wonder holistic vet. Yes, it take time to cook and package, etc, but the results are amazing in the dogs! Dogs with EPI don't live long, Zoe died of cancer 3 months before her 12th birthday. The ER vets were amazed as to how well she looked and did with having EPI. I'm in tears remembering Zoe and all her struggles and how well she did eating raw/homemade and being on the right supplements. Right now, our kibble fed girl is Loua - our show puppy, but she gets her share of raw meats/foods daily and it shows in her coat, body and eyes.

Whatever your name is?, you're on the right track with Tank! You go!!!

[nygmatech]

Well, after a trip to the vet today we seem to have answers and a treatment plan in place. Tank's IBD panel came back today with elevated Anti-porin IgA, Anti-calprotectin IgA, and Anti-Gliadin IgA...all indicative of inflammatory bowel disease. Numbers were off the charts. Not exactly what I wanted to hear, but I suppose it is an answer. His abdominal x-ray and ultrasound were normal. The vet did sent off a serum trypsin-like immunoreactivity assay (TLI) and gastrointestinal PCR at my urging, just to fully round out the workup. Current plan is a prednisone taper over the next several weeks along with completing his round of Flagyl and adding omeprazole to the mix. Currently he is off any other foods or treats, started on Royal Canin Hydrolyzed Protein diet which he seemed to like after some warming up and ice cube "treats" were given for encouragement 😊. Will plan to follow up in about three weeks for repeat chemistry panel and IBD panel to see if his reactivity has improved with the new diet and medication combo. Praying that his body will be responsive to this regimen and can be weaned down to the lowest medication dosage possible!

[Snowshoe]

Well at least you have a plan and some results to guide it.

We did a real fecal transplant from a dog belonging to a Vet tech at the clinic. Nowadays I think you would get a "product" made from dogs, not their actual poop. I think it made the turning point in recovery.

The gastro and endoscopy were early on, to see if there was a blockage. The gastroscopy could not be completed as there did seem to be a blockage, went to the end second.

The novel proteins for us were turkey and sweet potato. Strangely, the turkey came up in a later Nutriscan as the food most allergic, though it was not as high on the chart as some can be. Chicken, which is a problem for some dogs, was fine. Later on I made jerky treats of kangaroo and baked sweet potato the rest of Oban's life. The butcher told me he thought every client he had buying the kangaroo was buying it for their dog.

We did test for EPI along the way, not it.

You go, Tank.

[nygmatech]

Well at least you have a plan and some results to guide it.

We did a real fecal transplant from a dog belonging to a Vet tech at the clinic. Nowadays I think you would get a "product" made from dogs, not their actual poop. I think it made the turning point in recovery.

The gastro and endoscopy were early on, to see if there was a blockage. The gastroscopy could not be completed as there did seem to be a blockage, went to the end second.

The novel proteins for us were turkey and sweet potato. Strangely, the turkey came up in a later Nutriscan as the food most allergic, though it was not as high on the chart as some can be. Chicken, which is a problem for some dogs, was fine. Later on I made jerky treats of kangaroo and baked sweet potato the rest of Oban's life. The butcher told me he thought every client he had buying the kangaroo was buying it for their dog.

We did test for EPI along the way, not it.

You go, Tank.

Very interesting Snowshoe! Tank seems to be feeling better today and poops are now formed!!! 🥳. He enjoyed a walk and has been generally more playful today. Here’s to hoping things continue to be positive. Now if only we could get used to taking oral meds. He’s not a big fan and very stubborn. Not to mention he’s got some Hulk-like jaw muscles 😆. Thanks guys for your insight! I’ll try to keep you posted.