ABSTRACT
100 A 5-year-old male neutered British bulldog presents with a history of chronic diarrhea, weight loss, and a variable to poor appetite. There are no remarkable findings on a routine complete blood count, but a chemistry panel shows hypoalbuminemia (albumin 20 g/L [2.0 g/dL, Reference Range: 22–39 g/L]) and hypocholesterolemia (2.2 mmol/L [86 mg/dL]). A gastroduodenoscopy examination is performed and representative images of the small intestinal mucosa are given (Figures 100.1 and 100.2). Representative endoscopic images obtained from the distal duodenum of a dog presented for hypoproteinemia and hypocholesterolemia. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429401725/9d69b4ae-80d1-4f44-9dcb-659cda134065/content/fig100_1_C.jpg"/> Representative endoscopic images obtained from the proximal jejunum of a dog presented for hypoproteinemia and hypocholesterolemia. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9780429401725/9d69b4ae-80d1-4f44-9dcb-659cda134065/content/fig100_2_C.jpg"/>
i. What lesion(s) are visible in the small intestinal mucosa?
ii. What mechanisms can result in lymphangiectasia?
iii. Small intestinal biopsies in this dog also reveal moderate to marked lymphoplasmacytic infiltration, consistent with a chronic inflammatory enteropathy. How does the presence of lymphangiectasia and protein-losing enteropathy impact this dog’s prognosis?168
