JOURNAL SCAN
teropathies.
Appetite often returns to normal within 12–24 hours,
and weight gain occurs over the following weeks. A
reticulocyte response will typically occurs 3–4 days
post-administration, and there is often a similar burst
of neutrophil production.
Red blood cell and neutrophil numbers normalize in
2–3 weeks. I treat all dogs with low B12 levels BUT I
treat all cats with levels from mid range downwards as
cats are more prone to B12 deficiencies.
Dosages for injectable cobalamin are as follows:
Cats:
For cobalamin deficiency: 250 µg (per cat) SC once
per week for 6 weeks, then every 1-2 months based
on cobalamin levels or 250 µg SC injection weekly
for 6 weeks; then one injection every 2 weeks for 6
Protein Losing Enteropathy
in Yorkshire Terrier Dogs.
weeks; then monthly injections for the patient’s whole
life.2
Dogs:
For cobalamin deficiency - Injectable cyanocobalamin at 25 µg/kg, or practically, 250 – 1200 µg per
dog (based on dog’s size) SC once per week for 4-6
weeks, then every 14 days for 4-6 weeks, then monthly thereafter to maintain normal serum levels. May take
as long as 3-4 weeks to see a response and lifelong
therapy may be required depending on the status of
underlying cause.
REFERENCES - available on www.vet360.vetlink.co.za
ardised histopathological findings were predictive of
long-term survival.
What they did:
Summarised by Dr Mirinda van Schoor BVSc MMedVet (Med)
They examined the records of Yorkshire terriers that
were suspected to have PLE based on clinical signs
and hypoalbuminaemia. Thirty dogs were included
in the study. The clinical records were examined and
clinical findings and clinical pathology results were recorded. Stored intestinal biopsy samples were examined using the WSAVA standardised guidelines. Outcomes were recorded for a period of 4 months after
the diagnosis.
Why they did it:
What they found:
Protein-losing enteropathy (PLE) has been diagnosed
in many dog breeds including Yorkshire terrier dogs.
PLE is characterised by hypoalbuminaemia or panhypoproteinaemia in cases where urinary protein loss or
decreased hepatic function were excluded. In Yorkshire terrier dogs and some other breeds PLE has
been found to be associated with histopathological
evidence of lymphangiectasia and increased mucosal
cellularity. Veterinary pathologists interpret histopathologic findings in many different ways, resulting
in varied histopathologic diagnoses. The World Small
Animal Veterinary Association (WSAVA) published
guidelines for the interpretation of histopathologic
changes in intestinal biopsies in order to have a more
standardised interpretation of findings. Previously
published cases of PLE in Yorkshire terriers used nonstandardised classification systems for the interpretation of intestinal histopathology samples. This study
was performed to investigate PLE in Yorkshire terriers
and to describe clinical findings of PLE in this breed.
Most common initial complaints included small bowel
diarrhoea (20), vomiting (11), abdominal distention (11)
and lethargy (8). The most common clinical findings
included ascites (15), dyspnoea and tachypnoea (8),
and muffled heart sounds (6). Clinicopathologic findings included mild mature neutrophilia (12) and mild
monocytosis (9), hypoalbuminaemia (30), hypocalcaemia (30) and hypocholesterolaemia (24/26). Imaging revealed peritoneal effusions in 15 cases of which
5 had bicavitatory effusions. Histopathologic changes
included lymphoplasmacytic inflammation of the lamina propria (30), lacteal dilatation (24/30), crypt lesions
(15/17) and villous blunting (17/30). Vomiting was the
only parameter found to be a negative prognostic indicator.
Simmerson SM, et al .Clinical Features, Intestinal Histopathology, and Outcome in Protein-losing Enteropathy in Yorkshire Terrier Dogs. J Vet. Int. Med 2014
(28) 331 - 337
The study examined intestinal biopsy samples using
the WSAVA standardised guidelines for the interpretation of histopatologic changes. The investigators also
determined whether any clinical findings or stand-
vet360
Issue 05 | SEPTEMBER 2015 | 28
Take home message:
Yorkshire terrier dogs can suffer from mild to severe
forms of PLE characterised by body cavity effusions,
hypoalbuminaemia, lymphangiectasia, crypt lesions
and intestinal inflammatory infiltrates. A third of the
cases did not have diarrhoea. Vomiting may be predictive of morbidity. Approximately half of the dogs
responded to treatment, either completely or partially,
while the other half showed treatment failure.
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