Lymphangiectasia

[Gail Egounis]

Hi everyone.....I joined this list because this was the only place I have been able to get answers to this horrible disease..Lymphangiectasia.

I have all rescued dogs....1 deformed Belgian Malinois, 1 Redbone Coonhound, and 3 Rottweilers...one of which is 9 years old come this Saturday and she was just diagnosed 3/21/08 with Lymphangiectasia.

Basically I'm hereto learn more about what to expect with this disease.

Gail
Wells, Maine
Odd Dog Rescue~NORTH~

[JBCB]

Hi Gail,

It was here that I found the information about this disease that gave us 4.5 years more with our Kaeleigh that we figured we wouldn't have had otherwise. If you do a search of "lymphangectasia" you will find a ton of info, but the first thing to know is diet is crutial. Of course you first have to get the disease under control, and that's usually done with a steroid like prednizone. But with the proper diet the disease is easily manageable.

I would say our resident "expert" is moondog, who will post here as soon as she see this. She helped us with Kaeleigh, and probably knows more about this disease than most vets. Take what she says to heart.

My mantra with respect to this disease is to explore alternative vet care (holistic/homeopathic, I always forget which is right) as well as the modern. We managed to get Kaeleigh's blood proteins in the normal range again using it in combination with our "regular" vet. And it was kidney disease not the lymphangectasia that took her from us at 7 years of age.

So with the proper care, most of which is diet related, your 9 year old can live a good while yet!

[Gail Egounis]

Thank you Jay for your reply and I hope to hear from Moondog... who's emails I read and that is why I joined the other day. I have Kota on the correct diet and on meds(see below)..and she has been on this since diagnosis 3/21/08.
Now my concern today is... Whatelse can I do for her?

I see a dog that is only interested in food....is down to an activity level of about 2 on a 1 to 10 scale....(she was an 8 before her spleen was removed and diagnosis of "L") I'm wondering whatelse I can do for her.......Vitamin injections??? She seems depressed......and Ya, I'm depressed.

I want my dog back.

Gail Egounis
Kota: 9 yo(DOB 5/3/99) 75# rottie girl with Lymphangiectasia (diagnosed 3/21/08) Meds: Azathioprine 50mg every other day, Metronidazole 500mg 2x daily, Prednisone 30 mg 2x daily, Pepcid AC 20mg 2x daily. DAILY SUPPLEMENTS: Vit E 400 mg, B12, , L-Glutamine 500 mg, No and low fat diet with High Protein.

[ChristyM]

You have come to the right place and as stated above Moondog is very knowledgeable. The knowledge that she gained and is sharing from her dog Luna is tremendous. Trying to find a vet that knows anything about this is a problem(well at least it was for us). Once you start the new diet, I recommend that you keep a diary of all the amounts of food, time of day, pills, vitamins, and supplements so you can track any changes that are undesired. This is a slow process that can not be rushed. Here is a link following http://www.rottweiler.net/forums/vet...nosed-ple.html to s thread following the improvements for our dog Kodi. It was this time last year(April 2007) that he got sick and it was September before his protein levels were back in the normal range, with early July as an all time low for a positive outlook. There is a list of links there with other dogs that Moondog was giving advise to as well. I would read over them if you haven't already so you can know what to expect and get yourself ready for the long battle.

[moondog]

Originally Posted by Gail Egounis

I have Kota on the correct diet and on meds(see below)..and she has been on this since diagnosis 3/21/08.
Now my concern today is... Whatelse can I do for her?

I see a dog that is only interested in food....is down to an activity level of about 2 on a 1 to 10 scale....(she was an 8 before her spleen was removed and diagnosis of "L") I'm wondering whatelse I can do for her.......Vitamin injections??? She seems depressed......and Ya, I'm depressed.

I want my dog back.

Hi Gail.........so sorry this disease found its way to your house. Have you had a chance to read through all the threads we've got on this? There's a ton of info there and it does take a bit for it all to sink in.

As for what you can do for her......I found that doing less...and frequently that also means perhaps doing a bit differently..... works better than doing more. With the digestive system in such a state of chaos and inflammation that occurs when they are first hit with this, everything you do needs to be done with the goal of calming the system down. I totally understand the desire to do more in an effort to "fix it", but my experience with this is that adding more only fuels the flames.

As for the depression, I'm sure she doesn't feel very good right now so that's one thing..and it can also be a side effect of the prednisone that will reverse when the dose can be reduced. AND...just so I'm clear on this....the prednisone is a NECESSITY so I'm in no way implying it shouldn't be given. It's a lifesaver for this condition, but it does come with side effects. Once the inflammation is under control and she can stabilize (which takes time) then the dose can be VERY SLOWLY reduced. When that happens, I think you'll find that her depression will lift also.

I have a couple questions - first, why was her spleen removed? Are they sure she doesn't have hemangiosarcoma?

Second, what EXACTLY are you feeding her? Which commercial diet, or ingredients if you're home cooking. I found Luna did much better on moderate protein (mostly from tofu) than high protein. The higher protein sounds good in theory, but if it causes or sustains inflammation, it is not necessarily the best thing.....depends on the dog and how well they tolerate the protein being fed.

Third, do you know what her serum proteins are (albumin and globulin)?

[Gail Egounis]

Originally Posted by moondog

Hi Gail.........so sorry this disease found its way to your house. Have you had a chance to read through all the threads we've got on this? There's a ton of info there and it does take a bit for it all to sink in.

As for what you can do for her......I found that doing less...and frequently that also means perhaps doing a bit differently..... works better than doing more. With the digestive system in such a state of chaos and inflammation that occurs when they are first hit with this, everything you do needs to be done with the goal of calming the system down. I totally understand the desire to do more in an effort to "fix it", but my experience with this is that adding more only fuels the flames.

As for the depression, I'm sure she doesn't feel very good right now so that's one thing..and it can also be a side effect of the prednisone that will reverse when the dose can be reduced. AND...just so I'm clear on this....the prednisone is a NECESSITY so I'm in no way implying it shouldn't be given. It's a lifesaver for this condition, but it does come with side effects. Once the inflammation is under control and she can stabilize (which takes time) then the dose can be VERY SLOWLY reduced. When that happens, I think you'll find that her depression will lift also.

I have a couple questions - first, why was her spleen removed? Are they sure she doesn't have hemangiosarcoma?

Second, what EXACTLY are you feeding her? Which commercial diet, or ingredients if you're home cooking. I found Luna did much better on moderate protein (mostly from tofu) than high protein. The higher protein sounds good in theory, but if it causes or sustains inflammation, it is not necessarily the best thing.....depends on the dog and how well they tolerate the protein being fed.

Third, do you know what her serum proteins are (albumin and globulin)?

Kota went into the vets on 3/5/08 because I noticed that her eyes looked different....droopy bottom lid, but she was still very active and no diarrhea.
Test Results 3/5/08 ALB....1.8 (2.5-4.0 ref range)
and Globulin 2.3 (2.1 to 4.5 reference range)

Surgery was done on 3/17/08 to remove her spleen after an ultra sound spoted a growth....4 sections were sent out came back non cancerous.

The intestine samples lab report reads: two sections of the Jejunum to reveal severe lymphangiectasia of Lacteals as well as dilated lymphatic vessels in the submuscosa, tunica muscularis and serosa..Nearly all of the villi have mild to severely dilated lacteals with many of the lacteals containing stainable chyle. The lymphangiectasia is accompanied by only mild lymphocytic, plasmacytic and eosinophilic enteritis with the inflammation being restricted to the muscosa.

On 4/16/08 Tests results Albumin (up a little) 2.0 (2.5-4.0) Globulin 2.2 (2.1-4.5)

Next test is scheduled for 5/14/08

This past Friday 5/2/08 we cut back the Predisone to 20mg 2x a day from the 30mg 2x a day I asked if this could be done as she was so quiet and depressed it seemed and she panted alot.......I notice a change in her personality already, guarding her dish,guarding her non fat frozen cottage cheese bone, and wiggling her nub and moving around more. Kota also had a Vitamin B shot after I asked if Vit B in pill form would help...vet said no that because she was experiencing loose stools the pills would not be absorbed.

I have tried Hills RD diet (YUCK CORN) from the vet which once upon a time said on the Hills website that this diet was recommended for weight loss AND for LYMPHANGIECTASIA....since I called HILLS with questions about the diet, the recommendation has been removed from the site.

I am currently experimenting using the following items: NO Fat cottage cheese, Tofu, white rice, egg whites, Tapioca, pasta and barley.....not all in the same day or in same meal.....lean rinsed hamburg, white fish (1 g of fat and 17 g protein in 4 oz serving) I still use the RD dry.....and have found CORE Reduced Fat (dry) by Wellness to be something that I use now and then. My problem with both of these LOW FAT products is.....What KIND of fat is in the product??? My vet says RD is MCT....I can't get an answer from Wellness.

I guess I can say that I know what Doesn't work at all (White meat Chicken.....Gasey for Kota and I believe diarrhea)....and am not sure of what works on some days and not others. Kota never had loose stools before the operation......she now has an AM firm stool to Start that turn to soft serve at the end of the stool, and a PM stool that can be anything from firm to start to all soft like a cow flap. She holds the food in her system for atleast 6 hours and goes twice a day ONLY.


She is not sure on her hind legs sometimes (had cruciate repairs to both legs and was doing well for an old girl).....other times during the day she moves to quickly running to get food. The entire kitchen is covered with heavy large area rugs so she won't slip on the tile. The panting I believe was because she needed to urinate and holds it as she is unsure on the dog ramp..or stairs....also because of the predisone that was a very High dosage. I now go out with her all the time anyway to check the END result.



In the AM she looks to be all backbone with boney head.....by the end of the day she looks like an old horse with a big belly....and a boney head, but I love her and will do what I can that I feel is within reason for my 9 year old rottie girl.

Hope I answered all your questions.

And Thank you for helping me and listening.

Gail
Gail's Gang

[moondog]

Originally Posted by Gail Egounis

Kota went into the vets on 3/5/08 because I noticed that her eyes looked different....droopy bottom lid, but she was still very active and no diarrhea.
Test Results 3/5/08 ALB....1.8 (2.5-4.0 ref range)
and Globulin 2.3 (2.1 to 4.5 reference range)

Her proteins are comparable to what my Luna had.....not terrible, but not great, either. It's good you were able to catch it so early...with Luna it was dog fine one day, dog at death's door the next - she just crashed all at once and we never did discover what the trigger was for her.

Originally Posted by Gail Egounis

Surgery was done on 3/17/08 to remove her spleen after an ultra sound spoted a growth....4 sections were sent out came back non cancerous.

Most older dogs do develop growths on their spleen - sometimes malignant, sometimes not. Luna had one that was discovered after she developed bone cancer (4 years after the onset of Lymphangiectasia) and it was a moot point with the osteosarcoma whether it was malignant or not, so no further testing was done for that. I'm glad Kota came back clean!

Originally Posted by Gail Egounis

The intestine samples lab report reads: two sections of the Jejunum to reveal severe lymphangiectasia of Lacteals as well as dilated lymphatic vessels in the submuscosa, tunica muscularis and serosa..Nearly all of the villi have mild to severely dilated lacteals with many of the lacteals containing stainable chyle. The lymphangiectasia is accompanied by only mild lymphocytic, plasmacytic and eosinophilic enteritis with the inflammation being restricted to the muscosa.

The good news is the mild lymphocytic, plasmacytic and eosinophilic enteritis along with inflammation being limited to the mucosa. That makes it much less severe than it could be.

Originally Posted by Gail Egounis

On 4/16/08 Tests results Albumin (up a little) 2.0 (2.5-4.0) Globulin 2.2 (2.1-4.5)

This may not sound all that good to you, but I think this is GREAT! ANY movement in the right direction means something is working. Luna's proteins climbed very, very slowly (as did her weight), but as long as we were moving in the right direction I considered it a blessing.

Originally Posted by Gail Egounis

This past Friday 5/2/08 we cut back the Predisone to 20mg 2x a day from the 30mg 2x a day I asked if this could be done as she was so quiet and depressed it seemed and she panted alot.......I notice a change in her personality already, guarding her dish,guarding her non fat frozen cottage cheese bone, and wiggling her nub and moving around more.

These are all side effects from the high dose of pred needed in the beginning to slam the inflammation. I found the panting to be the most disturbing of the side effects myself.In one of my previous threads I explained how an auto immune condition develops with this, and in order for progress it has to be brought under control. That's the primary function of the high dose of pred. Her hind end weakness can also be a side effect of the pred - Luna had quite a bit of hind end weakness in the beginning. In order to stabilize them, it's a necessary evil. All these side effects do reverse when the dose can be brought down to a maintenance level.

Originally Posted by Gail Egounis

I have tried Hills RD diet (YUCK CORN) from the vet which once upon a time said on the Hills website that this diet was recommended for weight loss AND for LYMPHANGIECTASIA....since I called HILLS with questions about the diet, the recommendation has been removed from the site.

Luna was first put on Eukanuba Low Residue. She promptly stopped eating altogether and it became very apparent that there was no commercial diet that would work for her. I home-cooked.

Originally Posted by Gail Egounis

I am currently experimenting using the following items: NO Fat cottage cheese, Tofu, white rice, egg whites, Tapioca, pasta and barley.....not all in the same day or in same meal.....lean rinsed hamburg, white fish (1 g of fat and 17 g protein in 4 oz serving) I still use the RD dry.....and have found CORE Reduced Fat (dry) by Wellness to be something that I use now and then. My problem with both of these LOW FAT products is.....What KIND of fat is in the product??? My vet says RD is MCT....I can't get an answer from Wellness.

I guess I can say that I know what Doesn't work at all (White meat Chicken.....Gasey for Kota and I believe diarrhea)....and am not sure of what works on some days and not others.

You have to be very careful about switching foods all the time because, while variety is good for a healthy dog, dogs with intestinal disease cannot handle it, and dogs with lymphangiectasia can't tolerate more than a very small amount of fat in their diet because the fat is what causes the swelling in the lacteals and they can actually burst from it, making everything worse. They are VERY sensitive to miniscule changes in diet.

The simpler the diet the better. If there is one carb source she does well on, use that and stick with it unless it doesn't work any more. For protein, I used non-fat cottage cheese, tofu, and a very small amount of shredded chicken (really just for flavor more than anything else). It sounds like Kota does okay on the cottage cheese and tofu, both very easily digested, so I would stick with that and add very little meat source proteins, at least for now.

Originally Posted by Gail Egounis

Kota never had loose stools before the operation......she now has an AM firm stool to Start that turn to soft serve at the end of the stool, and a PM stool that can be anything from firm to start to all soft like a cow flap. She holds the food in her system for atleast 6 hours and goes twice a day ONLY.

With this disease, it will take her longer to heal than normal from a surgery. My dog was so sick neither the vet or I thought endoscopy was safe for her, so I didn't do it. Her blood panels pretty much told the story as far as diagnosis goes, so I went with that.

The reason Kota can hold it is because the inflammation is in the small intestine rather than the large intestine. Dogs with IBD, which generally originates in the large intestine, can't hold their stool. Dogs with lymphangiectasia can. Luna was an inside dog her entire life, and had very few accidents in the house the entire time she was sick. That always amazed me, and then the vet told me why!

Originally Posted by Gail Egounis

I now go out with her all the time anyway to check the END result.

Keeping a daily eye on her stool can tell you a lot about how things are going. Color, consistency, frequency and volume can all provide clues. I wrote it all down on a daily basis, along with everything she ate and all her medications. If you do that, after a while it begins to tell a story that is useful to you in figuring out what's upsetting her system if she goes through an upset. Upsets are to be expected. I found that they were fewer and farther between as time went by (another indication that treatment is on the right track), but they DO occur.

Originally Posted by Gail Egounis

In the AM she looks to be all backbone with boney head.....by the end of the day she looks like an old horse with a big belly....and a boney head, but I love her and will do what I can that I feel is within reason for my 9 year old rottie girl.

Bless her heart, I LOVE the 9 year old Rottie girls! Try being very strict and consistent with her diet instead of doing so much experimenting. And while a "beer belly" is another symptom that can be attributed to pred, her belly bloating at the end of the day may be from a fluid accumulation that is being exacerbated by too many different foods, keeping the flames fanned for the inflammation. Keep it as simple as possible.

Originally Posted by Gail Egounis

Hope I answered all your questions.

You did! Good job!

Originally Posted by Gail Egounis

And Thank you for helping me and listening.

You're welcome. I hope I was able to answer some of your questions. If you have any others, or if something doesn't make sense, let me know and I'll do my best to help.....

Give your sweet girl a big scritch behind the ears for me, and if she likes hugs, give her one of those, too!!

[Gail Egounis]

Tears in my eyes.......You have no idea of how fortunate I feel to have found you and this forum. There is no other place to learn or talk about this disease with regards to DOGS.

I have kept a daily book since this all started...Everything is written in it and yes it does tell a story.

I did try Oatmeal with tofu and NFcottage cheese (thank goodness for CC) It seemed to agree with her. Did you ever try Oatmeal?

Also I think I mentioned the Vitamin B shot she had. What do you feel about that?

Did you give fat soluable vitamins to Luna after she stablilized? Any vitamins?

Kota is panting as she is lying next to me as I type...and yes that is the thing that disturbs me the most......I run to her with water..thinking she is thirsty or hot.....now I know that it is definately the MEGA dosage of Predisone. (I have a another that has Addison's disease and he is on only 1.25 mg of pred and .6 florinef daily..with little side effects.)

Gail

[moondog]

Originally Posted by Gail Egounis

Tears in my eyes.......You have no idea of how fortunate I feel to have found you and this forum. There is no other place to learn or talk about this disease with regards to DOGS.

Oh, but I do know how fortunate you feel! I came here 7 years ago worried to death about a dog that hadn't eaten in 3 days and was deathly ill, desperately looking for help to save my precious girl's life. There wasn't any info on lymphangiectasia to speak of at the time, but a wonderful member here is the one who got me home-cooking for Luna and without that help, I certainly would have lost her way back then. You are not alone!

Originally Posted by Gail Egounis

I did try Oatmeal with tofu and NFcottage cheese (thank goodness for CC) It seemed to agree with her. Did you ever try Oatmeal?

If she tolerates oatmeal, use it. It is a good source of L-glutamine, which helps with gastric inflammation and cell regeneration in the intestinal tract. The benefits take time to materialize, but they do, so if she does well on it, I'd stick with that as your carb source.

My dog did very well on white rice and after so many problems finding a diet she could tolerate I was reluctant to mess with success. As I learned more about nutrition and the benefits of oatmeal, I did try giving her a small amount, but it triggered an upset so I relied on the white rice instead. I tried an L-glutamine supplement, but that didn't agree with her. Each dog is very individual in what they can tolerate, so when you find what they do well on, stick with it!

Originally Posted by Gail Egounis

Also I think I mentioned the Vitamin B shot she had. What do you feel about that?

As long as she did okay with it, I see no problem with that at all.

Originally Posted by Gail Egounis

Did you give fat soluable vitamins to Luna after she stablilized? Any vitamins?

Yes, after she stabilized on the stripped down diet, I added a human vitamin/mineral vitamin. I tried really high quality vitamins, and she couldn't handle them, so I wound up using the Nature Made multi vitamin/mineral supplement and she did very well with those.

Originally Posted by Gail Egounis

Kota is panting as she is lying next to me as I type...and yes that is the thing that disturbs me the most......I run to her with water..thinking she is thirsty or hot.....now I know that it is definately the MEGA dosage of Predisone. (I have a another that has Addison's disease and he is on only 1.25 mg of pred and .6 florinef daily..with little side effects.)

Yep, that panting bothered me the most. Hang in there, and if the next set of blood results comes back good, you may be able to VERY slowly reduce the pred - I found that once it can be reduced to maintenance the dogs adjust very well to it and side effects are minimal if noticeable at all. The caution is to not rush that, though.....if she needs the higher dose for awhile it's better for her to have it than not. I reduced Luna's pred dose at half the normal rate vet's recommend for twice the period between reductions because I really had to be careful about triggering an upset. She did get down to 10mg on alternate days (every other day), which is the best way for long term use so the adrenal glands don't atrophy and cease to produce cortisol on their own.

[Gail Egounis]

If she tolerates oatmeal, use it. It is a good source of L-glutamine, which helps with gastric inflammation and cell regeneration in the intestinal tract. The benefits take time to materialize, but they do, so if she does well on it, I'd stick with that as your carb source.

My dog did very well on white rice and after so many problems finding a diet she could tolerate I was reluctant to mess with success. As I learned more about nutrition and the benefits of oatmeal, I did try giving her a small amount, but it triggered an upset so I relied on the white rice instead. I tried an L-glutamine supplement, but that didn't agree with her. Each dog is very individual in what they can tolerate, so when you find what they do well on, stick with it!

She didn't tolerate the oatmeal.....or the unprocessed bran I thought I'd try....It had worked for my cat with IBD as it absorbed the excess water.........

Was Kota SICK Tuesday ...and so sick Friday morning 2AM and 5AM she was throwing up.Went to the vet at 9AM and the vet read me the riot act. NO MORE NEW THINGS for Kota. I'm sticking with the White rice (works well for her) No fat cottage cheese...the Wellness Core reduced fat kibble, the RD kibble and tofu. Kota had a real bad day Friday....MY FAULT......the vet gave her an Pepcid AC injection and Vitamin B injection........today Mother's Day she looks wonderful.....and her stools are FIRM.....KNOCK on Wood. My Mom gets a charge out of me........She says " I've never seen anyone get so happy about dog Poop." lol lol

Gail

[roybetz]

Hello-
I found this site as I am searching for answers. I have nine year old rott named Sam. He has always had what I thought was bad gas, until recently when I was introduced to what is really bad gas. He has lost control of his bowels when he passes gas he squirts diarea. He has in the last two days really had a lot of fluid building up in his stomach and rear legs. He has low counts on both of the proteins. Lower than his last bloodwork less than 4 months ago. The symptoms seem to match what I have read about here. I am currently waiting on the results of an ultra sound to rule out cancer but am trying to line up how I should treat him if we are lucky enough to avoid the cancer diagnosis. He does have very bad hips to start so him retaining this fluid in his legs is really hard on him. I have neen feeding him boiled ground beef and rice the last two days along with a powder dewormer just incase it is such an easy solution. Any help you can give would be greatly appreciated. (The age is an estimate as he was a "Recycled Rott" so his records are not available prior to 4 yrs ago)
Thanks in advance!

Roy