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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 26811
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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He is retaining fluid. I began to notice 3 weeks ago that he

Customer Question

He is retaining fluid. I began to notice 3 weeks ago that he was changing. Growing larger, heavier.. He stopped eating kibble but did not lose his appetite, he would counter surf and eat/steal anything he could find. We had an ulrasound done and they noted that it was water retention and removed about a gallon of fluid. They also noted that his intestinal wall was thickened and suspected IBD. Sent me back with high protein, low fat dog food. He continued to drain water for the next 3 days until he was back to normal, however, the food caused severe diarreah and gas. I have swapped out different foods (chicken breast and potatos, fish and potatos) and added probiotics but cannot get his diarreah to subside. I measure him every night and tonight I find that he is 1 inch larger,, so he is beginning to retain water again. Any ideas?
JA: I'm sorry to hear that. The Veterinarian will know what to do. What is the dog's name?
Customer: Max
JA: Is there anything else important you think the Veterinarian should know about Max?
Customer: 9 years old.. has been very active up til now.. not that he isn't still active, but as he gains this weight, he is not able to move around normal. Lays around more.
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the fully-refundable deposit now. While you're filling out that form, I'll tell the Veterinarian about your situation and connect you two.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry to hear of this with your dog. The abdominal effusion concomitant with thickened intestinal walls suggests a protein-losing enteropathy (PLE). When albumin (a small protein) is lost through the bowel there isn't enough to maintain the proper osmotic pressure within vessels and so fluid extravagates out of vessels and fills "third spaces" such as the abdominal cavity. Do you know what your dog's albumin value was? Can you upload a copy of all of his test results to our conversation? I understand that you might not have a copy at home but his vet can give you one which you can scan into your computer and then give me file link or you can photograph the pages and upload them by using the paperclip icon above your message box (if you can see the icon) or by using an external app such as dropbox.com/

The main cause of PLE is lymphangectasia - a disorder of the intestinal lacteals (lymph vessels). There are quite a few associated disorders:

  • Inflammatory bowel disease (IBD)
  • Adverse food reactions (e.g., gluten-sensitive enteropathy)
  • GI infection (e.g., histoplasmosis, salmonellosis, hookworms)
  • Intestinal neoplasia (e.g., lymphoma, adenocarcinoma)
  • Mechanical enteropathy (e.g., chronic foreign body, chronic intussusception)
  • GI ulceration (e.g., nonsteroidal antiinflammatory–induced, hookworm infection)
  • Lymphatic compromise/dysfunction:
    • Confined to GI tract (i.e., intestinal lymphangiectasia)
    • Generalized
  • Venous hypertension (portal hypertension, right-sided cardiac disease, pericardial disease)
  • Low plasma oncotic pressure:
    • Ascites, pleural effusion, pitting edema
  • Anemia secondary to ulcerative or erosive GI disease:
    • Microcytosis suggests iron deficiency.
  • Thromboembolic complications from loss of antithrombin:
    • May affect lungs, brain, limbs

Ideally, scoping and biopsying his GI tract should be performed in an attempt to clarify the pathology in his GI tract resulting in protein loss. A poorly function liver which can't produce enough albumin and poorly functioning kidneys through which protein is lost in the urine need to be considered as well. Hence, my wanting to review all of his diagnostics.

Please respond with further questions or concerns if you wish.