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Protein Losing Enteropathy A Dog’s Trials with an Undetected Illness |
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I awoke the morning of Saturday, January 27, 2005 to a foul smell that had drifted into the bedroom. I noticed Jay was not at his usual place at the side of the bed and feared the worst. I went downstairs to find him by the door asking to go outside. Near him was a large amount of dark-colored diarrhea. I let him out and set to work (at 3:30 am mind you) cleaning the mess. The rest of the day seemed normal enough, with Jay doing his best to keep his bed from drifting away like a greyhound should. He ate one meal that day, and seemed to be drinking more water than usual. Not knowing any better, we figured the rawhide bone we had given him Friday had upset his stomach and he would be fine.
Sunday morning told another story. Jay appeared very restless and was panting. Then he began to vomit a foamy yellow substance – repeatedly. Taking him outside he vomited several more times until, shivering, he simply laid down in the cold and rain. This was a heartbreaking sight. Jay had vomited this yellow substance on numerous occasions before, but never with this frequency. Usually he would do this every 3-5 weeks. Again, not knowing any better, we just figured that dogs get sick and vomit.
With Jay in the backyard and obviously very uncomfortable, we began to get worried in earnest. It appeared that Jay maybe had the flu. I called Mike and Sherry and they concurred, suggesting we feed him some rice and keep an eye on him. We tried the rice, which is one of his favorite foods, but he wouldn’t eat. With Jay refusing a handout I knew for sure this was serious.
We loaded him into the car and drove to the Emergency Veterinary Clinic in Sunset. There, the vets treated him with an IV drip for dehydration and ran blood tests. They discovered his red blood cell count was low which indicated anemia and his albumin levels were critically low. Albumin is a protein that, as I understand it, prevents the walls of blood vessels from allowing blood to seep through. The low albumin levels were causing severe edema, which could be seen in the form of swelling in Jay’s abdomen. Gone was the tucked-up greyhound belly, replaced with an ominous sag. Also, his feet had noticeably swollen. X-rays also revealed a large amount of air in his small intestine, this was likely a great source of discomfort. With no clear diagnosis, the vet suggested exploratory surgery. Surgery however, is met with many risks for greys — most notably is sensitivity to anesthesia. Without knowing how much experience the vet had with greyhounds, I opted against surgery at the facility, preferring instead to keep Jay stable for the night at the clinic and take him to his vet (Dr. James Evans) at the North Ogden Animal Hospital the following morning.
That was a tough night. Around 3 am the vet called me and suggested a blood transfusion due to the dropping albumin levels. Of course, a transfusion had no guarantees and would cost over $1,000. Ouch. Swallowing hard, I refused the suggestion hoping Jay would be able to hang on.
He did make it to Monday morning. We picked him up and rushed him to North Ogden Animal Hospital. He had already lost a noticeable amount of weight and was very weak. After an exam, Dr. Evans suggested exploratory surgery to check for ulcerations or cancer on the small intestine. Neither was found. Instead the exploration found fatty plaques covering the small intestine. A sample was taken for a biopsy. A visit that evening revealed a very sick puppy with a ten-inch scar the length of his abdomen. Dr. Evans started Jay on Prostarch (I think is a synthetic albumin), anti-biotics, and anti-nausea and diarrhea medications. Fortunately, the surgery and subsequent blood work did not show any signs of kidney or liver damage, which is common when PLE strikes.
Tuesday was more of the same, but as Jay continued to stabilize, the albumin and blood cell levels went up marginally.
Wednesday Jay showed signs of improvement. He began to eat a little and drink on his own again. Blood work revealed his red blood cell and albumin levels were near normal. To be safe Dr. Evans chose to keep Jay one more night.
Thursday afternoon Jay came home. He now weighed 64 pounds, having lost over 20 pounds in five days, and a pathetic sight to be sure. We also had the results from the biopsy. Diagnosis: PLE (Protein Losing Enteropathy).
Once home Jay began to improve rapidly. Because of the Prednisone and his damaged gastrointestinal system he needed frequent outside time. As a precaution, I slept in the kitchen with him for several nights, getting up with him 2-3 times a night and fighting for my sleeping bag after each one. During these struggles I discovered just how difficult it is to sleep with a greyhound lying across your legs. I need to thank my mother, sister-in-law Stephanie, and Sherry for helping us with those duties while we were at work.
Fast forward to the end of March 2005. A mere ten weeks after being hospitalized Jay is back, and in my opinion better than ever. His strength and most of the weight have returned and he seems genuinely happier. His appetite is now incredible, likely because eating is no longer uncomfortable. He wakes me up between 4:00 and 5:00 every morning, charging downstairs to wait by his bowl to be fed, eating before taking his first trip outside. He does the same thing in the evening, fortunately I am already out of bed for that feeding. He never did anything like this before the illness. He is fed a special Hill’s Prescription Diet dry food that contains engineered proteins that his body can easily digest. He is still on Prednisone every three days but only for another month. There is a good chance of relapse, and we are realistic about that. As much as we hate to think about it, if he has another episode we’ll have to seriously ask ourselves what the humane thing to do is.
So what is PLE? I’m no doctor and a Google Search will yield you more information than I am going to provide here. PLE is common is humans and other animals. As I understand it PLE is an inflammatory bowel disease where the lining of the digestive tract becomes inflamed. This interferes with the normal function of the gut and causes an abnormal loss of blood proteins from the intestines or an inability for the gut to absorb proteins. It is also an immune related disorder, which may be the body’s response to parasites, bacterial infection, food intolerances, heart, liver and kidney failure and even cancer. It is difficult to pinpoint the cause of PLE.
Low levels of proteins can result in accumulation of fluid (lymph) in the abdomen, shins and ankles (edema). Lymph is a fluid that cleans the blood and if it is blocked and accumulating in other tissues in the body then it will create problems. Abdominal fluid collection will cause inflammation and a disturbance in the digestive tract. A blockage of lymphatic tissues in the abdomen will over stimulate the intestines and put pressure on the liver and kidneys, thus causing damage and/or dysfunction because they are unable to compensate for the losses.
The loss of proteins into stools will result in bowel habits creating vomiting, diarrhea, abdominal discomfort and anemia. Another side effect is the loss of immunoglobulin is an inability of the body to fight infection. So at a time when the system is seriously in need of some support, the immune system is not able to fight off infection. Not all patients, whether animals or humans with this condition will lose blood in their stools or vomit.
Unfortunately, we don’t know and probably never will know what caused this disease in Jay. Earlier I mentioned warning signs. Prior to being diagnosed, Jay would seldom eat two meals in a day. We would feed him breakfast and just figured he slept all day and didn’t get around to eating until evening. Another observation was that rawhide chews and “Greenies” chews would make him vomit yellow occasionally, as would some foods. The dark diarrhea was also a sign. (He had done it once before.) We had no idea the color was indicative of the presence of blood in the stool. It is my opinion that Jay had suffered from PLE for a long time, at least as long as we have had him, and it finally got him that day in January. It has also been stated by Dr. Evans that if we had not taken him to the emergency vet that day we would have lost him. More than once Dr. Evans mentioned just how sick Jay was and how close he was to death. A combination of excellent medical care, youth (Jay is only four), health, and his furry will to fight on is what kept him with us.
Note: Much thanks to Dr. Evans and the super-friendly staff at North Ogden Animal Hospital for their excellent work and patience with me, and what must have been my intolerable amount of questions. I would also like to thank the staff of the Emergency Veterinary Clinic in Sunset for their care and hard work.
Final Note: Please don’t let this information dissuade you if you are thinking about adopting a greyhound, they are a very healthy breed. Problems like this can occur in any breed of dog. I chose to share our story with the hope that it may help others to pay attention to the behavior of their pets and visit their veterinarian at regular intervals to diagnose and treat any health issues before they become life threatening.
Thanks for reading.
Justin “J-Dawg” Fugate
Samantha Fugate
Jay-Dog