Small Animal Referral Hospital Lymphangiectasia

• Lymphangiectasia is an intestinal disease causing loss of protein and fat in the intestine
• Lymphangiectasia is one of a group of diseases that causes a Protein Losing Enteropathy (PLE)
• Low-fat or ultra-low fat diets are a key component of therapy in the majority of patients

Lymphangiectasia is one of a group of diseases that causes a Protein Losing Enteropathy (PLE). PLEs are intestinal diseases resulting in protein loss in the intestines.

Lymphangiectasia is a disease of the intestinal lacteals (the vessels in the intestines that transport fats and proteins into the blood stream). In patients with intestinal lymphangiectasia, the lacteals become dilated and leaky, causing protein and fat loss into the intestine. Associated common clinical signs include appetite changes, diarrhoea, weight loss and abdominal swelling.

Some breeds (Soft Coated Wheaten Terrier, Rottweiler, Yorkshire Terrier, Maltese, Chinese Shar Pei, Norwegian Lundehund) are predisposed to intestinal lymphangiectasia. In other breeds, lymphangiectasia often occurs as a secondary complication of intestinal inflammation (please see our handout on chronic inflammatory enteropathies).

Some patients with lymphangiectasia (particularly French Bulldogs) develop large focal masses (lumps) of inflammation within their intestine (lipogranulomatous lymphangitis) - these can cause blockages of the intestines, necessitating surgery (although depending on the severity of the lymphangiectasia elsewhere, this is not always feasible).

Treatment often includes:

• Dietary management - either a low fat, ultra-low fat, or hydrolysed diet is likely to be recommended, depending on whether your pet as lymphangiectasia alone, or a concurrent chronic inflammatory enteropathy
• Steroids to reduce associated inflammation
• Adjunctive treatment as needed - often including vitamin (B, D) supplementation, anti-thrombotics
• Symptomatic treatment as needed - including appetite stimulants, anti-emetics, pre/probiotics

Please see our web page on Protein Losing Enteropathies (PLEs) for complications patients with lymphangiectasia may experience.

Prognosis Lymphangiectasia remains a relatively poorly understood disease in dogs and the prognosis is not well characterised in the literature. Typically, a survival time of months, rather than years, is expected, although this is likely highly variable between individuals.