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Sadie, a usually sprightly 4-year-old Griffon came in to see us because she was feeling rather poorly. Sadie was having chronic diarrhea, losing weight and had developed a pot belly.

Sadie was examined and we were concerned that she may have fluid in her abdomen. We proceeded to investigate with bloodwork and then an abdominal ultrasound. Her blood test showed that she had an extremely low protein level and low Vitamin B12/Folate level. The abdominal ultrasound confirmed that there was clear fluid in her abdomen and her intestinal walls were thickened.

These tests showed that Sadie had a leaky gut. Her intestines were excessively leaking protein and nutrients instead of absorbing them.

If the body cannot absorb protein, it will start to break down muscle protein to keep itself alive.

This “leaky gut” syndrome is called Protein Losing Enteropathy, and can be caused by any severe gastrointestinal disease. The most common causes in dogs are:

1. Inflammatory bowel disease (IBD)

2. Lymphatic diseases like intestinal lymphangiectasia (dilation of lymph vessels)

3. Severe gastrointestinal infections like parvovirus, or parasites

4. Gastrointestinal obstructions

5. Intestinal tumours

With advice from the internal medicine specialist at Animal Referral Centre, the most likely cause for Sadie would be either intestinal lymphangiectasia or IBD. IBD is often diagnosed concurrently with lymphangiectasia. It is uncertain whether one precedes the other or if they both may come from the same process.

Intestinal lymphangiectasia occurs when there is dilation of lymph vessels or obstruction of normal lymph flow. Lymph is a fluid that circulates around the body and is made up of immune cells. The vessels could be blocked by inflammation that occurs in the intestinal tract.

IBD occurs when there is a large number of inflammatory cells that enter the walls of the intestines. This can cause an allergic type response. It can lead to chronic diarrhea, vomiting, weight loss as it will interfere with the dog’s ability to absorb nutrients.

Differentiating these conditions would require biopsies of the gastrointestinal tract for analysis and histology. This can be done ideally via endoscopy or surgically.

In Sadie’s case, her owner elected to do a treatment trial.

We started Sadie on steroids to suppress the severe inflammation and abnormal immune response in her intestinal tract. She was also started on Vitamin B12 and folate supplementation. Dogs that suffer from this disease are also at a higher risk of inappropriate clotting, so an anti-clotting medication was also prescribed.

Diet is very important in managing this disease. A low-fat diet is recommended for intestinal lymphangiectasia as it prevents further dilation and reduce the risk of rupture of the lymph vessels. In dogs with IBD, a hypoallergenic diet or a novel protein diet would be recommended.

Fortunately, Sadie has responded very well! Her protein levels and Vitamin B12 levels are now back to normal. She enjoys her low-fat diet and has no troubles taking her medication at home.

Sadie has got her figure back and is no longer bloated. Her stools are also formed.

Some dogs may require lifelong medication and diet change.

We all hope the lovely Sadie continues to make a full recovery!

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