"ChiChi" the dog

History:

 

  • "ChiChi" , a 5 year old, male neutered Yorkshire Terrier, presented to his veterinarian for a distended abdomen that seemed to appear over a short period of time.  Chichi had previously been healthy, however the owner did note that he seemed to be having episodes of looser stool with more frequency lately.

  • On initial exam ChiChi's abdomen was quite distended and he looked "pot bellied" but was alert and acting otherwise like his normal self.

  • Initial bloodwork was normal except for very low levels of protein and a minor change to 1 kidney value.

  • X-rays showed a significant amount of fluid in his belly.

  • Ultrasound suggested some intestinal thickening, confirmed free abominal fluid, and did not show any other abnormalities.

  • The preliminary diagnosis was protein losing gastrointestinal disease with underlying rule outs being inflammatory bowel disease (IBD), lymphangiectasia, or intestinal lymphoma (cancer).

  • Small intestinal biopsy was recommended and the veterinarian recommended full thickness biopsies using a minimally invasive approach. 

 

lymphangectasia, laparoscopy

Findings:

 

 

  • A full exploratory laparoscopy was performed using an 11mm operating laparoscope, and all abdominal organs were visualized and appeared normal with the exception of the small intestine.

  • There was a large amount of free abdominal fluid which was sampled during the procedure and sent to the lab along with the biopsies.

  • Small intestinal biopsies were taken from the duodenum, jejunum, and ileum (6 total) using a laparoscopic assisted approach.  All biopsy samples were sent to the pathology lab.

  • ChiChi recovered uneventfully and went home later that day

  • A diagnosis of Lymphangiectasia was made based on the biopsies and appropriate medical management was started.

lymphangectasia, dog, laparoscopy

Discussion:

 

Lymphangiectasia is a relatively uncommon type of gastrointestinal disease in dogs.  Any breed can be affected, however Yorkshire Terriers and Wheaten Terriers tend to have in increased risk/incidence of this disease.  Lymphangiectasia causes significant loss of protein through the bowel, often leading to accumulation of fluid in the abdomen (called ascites).  Chronic diarrhea and weight loss are often seen as well.  Diagnosis of lymphangiectasia is made by obtaining full thickness biopsies of the small intestine.  In fact, this is one of the only types of chronic GI diseases where partial thickness endoscopic biopsies may not provide enough information to make a diagnosis.  Therefore, if lymphangiectasia is suspected full thickness biopsies should be obtained over flexible endoscopy.  There is no specific cure for lymphangiectasia, and management is aimed at normalizing protein levels and GI inflammation.  Quite often the use of very low fat diets combined with steroids is required.

"It Doesn't Have to Hurt"

Dr. Paul Hodges

416-884-1008

phodgesmip@gmail.com