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Want to know Experts first hand experience and working knowledge of Lymphangiectasia in dogs. I already have all the info I need on the cause and symptoms. I have a dachshund which is in a wheelchair from spinal disk rupture. Started recovery well and was walking in wheelchair. Then the above referenced dx occurred post op. There is no intestinal blockage. Please provide me with known foods or diet that will increase protein intake levels. So far dietary therapy has not helped. Dog is losing weight and has runny stools. Dog eats as though it is starving. I need solid valid answers to give an accept on this one folks so please be sure of your answer. This is my mom's (78) dog and we will not put it down yet. Too much money and emotions involved. Take your time.........no need to hurry. Just give it your best from FHK. Thanks.

Optional Information:
Age: 7; Female; Breed: Stated in bio

Already Tried:
Pred.Diet.turkey and rice. Chicken and rice. 21 percent protein foods..........etc.

Customer (name blocked for privacy)

Status: Closed Value: $25

Have you seen a specialist (veterinary gastroenterologist or internal medicine specialist)?

Has cancer and/or heart disease been eliminated as possible causes?

Are liver and kidney function blood indicators in normal ranges?

Is he/she on any steroid therapy?

Have you tried commercially available prescription diet for low fat diet (ex: Hill's R/D)?

Are you currently using any vitamin supplements?

Your concern has touched me--if you have follow-up questions, or need to clarify your case, please let me know right away! Your "Accept" helps me reach out to others!

Reply to Gen B.'s Post:

Good questions and I will answer them. Actually I should have included this all in my original question.

The dog was dx'd by the UoF Vet School in Gainesville Fl. post op 3months after surgery. They also did the spinal surgery 5 months earlier.

She has a primary vet that is in touch with the UoF.

Cancer has been ruled out although Pleural Effusion was dx'd in Feb. Being tapped with clear fluid 20cc to 40 cc per tapping 2x month.

Sonogram and other testing rules out heart.

Endoscopy was suggested but ruled out due to overall health of dog. Dog was on strong 3rd world antibiotics for 3 weeks for internal parasite prevention/treatment although negative.

All blood work is within range with exception of protein levels. Levels are low but at this time I do not recall the exact range. But very low intake of protein.

Prednizone for current condition to include spine and side effects to make dog drink and eat more as well as to assist with intestinal absorption of food.

Dog is highly allergic to various food types and is on Hypoallergenic dry food. **Although today the vet said give her what ever she will eat**

No supplements at this time. Hard enough just getting meds down.

Thanks for asking these great follow up questions.

I do want to add without scaring the experts off that I need the best first hand knowledge of any known treatment that may have shown improvement.

If good I am open to quality opinions but would rather the above to occur. Please no links. I have them already.

Open to possible alternative meds or treatments as well.

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If Eve were my patient, these would be my recommendations at this point:

1. I would start by increasing the prednisone to twice a day for a week, then I would go down to once/day. This is to treat intestinal inflammation, in case of IBD. If this is the underlying cause of the lymphangiectasia, the dose may be a little low to get the inflammation under control. The dose is weight dependant so I can't give you a specific dose, but it is usually started at 2 mg/ kg twice daily, then decrease to 1 mg/ kg daily

2. I would add azothioprine also, in case of IBD.

3. I would add fiber like I mentioned above.

4. If the pleural effusion is life threatening, then I would try to drain that again, and start Hetastarch infusions to increase the protein levels, which would hopefully slow down further leaking.

5. I would also add a 2 week course of metronidazole in case of small intestinal bacterial overgrowth contributing to the diarrhea.

If indeed this is lymphangiectasia, and it is not responding to therapy, Eve's prognosis, unfortunately, will be poor. Please discuss the above with your veterinarian and maybe we can get some improvement so she won't continue to lose weight. She sounds like a fighter, and I hope she turns the corner soon.

4 Other Experts Agree with this!

Reply to Dr. Vicky Lamb's Post:

Any idea as to why her vets both here and in Gainesville have not mentioned or opted for this med and would just briefly explain it please.

Hetastarch infusions to increase the protein levels, which would hopefully slow down further leaking

Thanks for the patience.

Transfusions with hetastarch is a recommended way to help keep the fluid from leaking out of the vasculature and causing ascites and pleural effusion. I cannot answer why the other vets did not recommend this treatment, but from what I understand, any time the protein level drops below a level that allows pleural effusion to develop, a transfusion with hetastarch or like product is recommended. I will explain why.

Hetastarch is a synthetic colloid solution. Colloid solutions contain large molecules *similar* to protein that do not readily leave the vascular space. (I should have clarified that in my last post) Colloid solutions will perform the same job as albumin; meaning they hold water within the blood vessels and do not allow it to leak out.

Regular transfusion with plasma for increasing protein levels do not seem to work well in patients with protein losing enteropathy. The reason why is that the albumin simply leaks right out again, and many patients are no better. So, in protein losing enteropathies, synthetic colloids are the fluid of choice. Hetastarch actually contains molecules that are larger than albumin. These molecules therefore remain in the circulation rather than leak out via the same route as albumin, and are gradually broken down by the body. Hetastarch only lasts a day or two in most patients, that is why repeated infusions are necessary, sometimes daily, sometimes every 2-3 days. This can prolong the life of many patients until the primary disease process can be controlled so that protein stops leaking out.

If you want to try to do everything you can for her, this is certainly one of the recommended therapies for Lymphangiectasia and other protein losing enteropathies.

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