Six dogs were diagnosed with protein-losing enteropathy (PLE). There was no evidence of inappropriate inflammatory infiltrates or lymphangiectasia in multiple mucosal biopsies of the small intestine of 4 of the dogs. The 5th and 6th dogs had obvious lymphangiectasia and a moderate infiltrate of inflammatory cells in the intestinal mucosa. All 6 dogs had a large number of dilated intestinal crypts that were filled with mucus, sloughed epithelial cells, and/or inflammatory cells. Whether PLE occurs in these dogs because of protein lost from the dilated crypts into the intestinal lumen or whether the dilated crypts are a mucosal reaction due to another undetermined lesion that is responsible for alimentary tract protein loss is unknown. However, when large numbers of dilated intestinal crypts are present, they appear to be associated with PLE even if there are no other remarkable lesions in the intestinal mucosa.Key words: Gastroduodenoscopy; Hypoalbuminemia; Intestinal biopsy; Lymphangiectasia P rotein-losing enteropathy (PLE) is a syndrome in which there is excessive loss of protein from the gastrointestinal tract. In general, PLE is only recognized after animals become hypoalbuminemic, 1,2 although enteropathies in people can produce excessive alimentary protein loss without causing abnormal serum protein concentrations. PLE has been well described in the dog, and certain breeds, such as the Lundehund, 3 Basenji, 4 and Soft-coated Wheaten Terrier 5 appear to be at increased risk of PLE. Various intestinal lesions may be associated with PLE, including lymphangiectasia, immunoproliferative enteropathy, lymphocyticplasmacytic enteritis, eosinophilic enteritis, gastrointestinal ulceration/erosion, giardiasis, chronic intussusception, small intestinal bacterial overgrowth, neoplasia, hypoalbuminemia causing mucosal edema, increased activation of tissue plasminogen activator, systemic lupus erythematosus, vascular lesions in the intestinal mucosa, and chemotherapy/ radiation therapy. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] Most of these diseases can be diagnosed by gross examination or by light microscopic examination of small intestinal tissue samples. However, some of these diseases such as systemic lupus erythematosus or small intestinal bacterial overgrowth cannot reliably be identified with biopsy and routine histopathology. 15,20 Although lesions of small intestinal crypts have been associated with PLE in 1 dog, this dog also had absence of villi and large areas of mucosal ulceration. 21 In this paper, we describe 6 dogs with PLE in which a large number of intestinal crypts were dilated and filled with mucus, with or without inflammatory cellular debris. None of our dogs had discernable ulceration or lack of villi. The purpose of this report is to document this histologic lesion and its apparent association with PLE in the dog.
Materials and MethodsThe cases reported were examined at Texas A&M University between 1989 and 1999, and at Michigan State University in 1997. All dogs had panhypoproteinemia...