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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 26160
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog may have PLE --checking out diagnosis currently. Is

Customer Question

my dog may have PLE --checking out diagnosis currently. Is your advice from four years ago as far as diet still the best knowledge or are there any new thoughts on diets for dogs with PLE. What are your recommendations for diet. Hills?
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.
I can't see which advice you're referring to and so I'll post the latest recommendations for diet for you... Ultra-low fat, easily digestible diets should be fed to patients with intestinal lymphangiectasia (the most common cause of PLE) to minimize fat malabsorption and lacteal (lymphatic) flow. Cottage cheese (1% fat), non-fat turkey breast, and cooked white rice are excellent temporary options or may be added to elemental diets* to improve palatability. Prescription highly digestible diets containing less than 3 grams/100 kcal metabolizable energy from fat may also be acceptable. Hydrolyzed protein or novel antigen diets should be considered in patients with concurrent IBD. Most prescription diets in this category aren't adequately fat restricted for patients with lymphangiectasia; consider a home-cooked diet or one of the hydrolyzed protein diets that are fat restricted. Home-cooked recipes often require a nutritionist's help to formulate as can be found here: http://nutrition.vetmed.ucdavis.edu/. Gluten-free diets should be provided if gluten-sensitive enteropathy is suspected. *Elemental enteral feeding products may be helpful in very compromised patients. Such diets contain free amino acids to facilitate nutrient uptake by a compromised GI tract. Low-fat formulations such as Vivonex T.E.N. are appropriate for dogs with lymphangiectasia. Vitamin B12 supplementation should be provided if serum concentrations are subnormal. Folate, vitamin and mineral, calcium and magnesium supplementation may also be necessary. Please respond with further questions or concerns if you wish.
Customer: replied 1 year ago.
May I fax you the blood results for your thoughts about diagnosis?thank youjoanne
Expert:  Dr. Michael Salkin replied 1 year ago.
Yes, please do, Joanne. I'm not allowed to receive a fax but you can you upload a copy of his test results to our conversation by scanning them into your computer and giving me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or by using an external app such as imgur.com or dropbox.com.
Customer: replied 1 year ago.
the blood work has been added- doco19 pdf. also bob has quite a bit of blood in his stool- thoughts? he is still on predizone-- for one week and five days..
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you! I noticed the low cholesterol which can indicate a poorly functioning liver that isn't producing enough cholesterol or albumin. He may not suffer from PLE but instead liver insufficiency. I would perform a blood test called serum bile acids which is a test for liver function. The blood in his stool (hematochezia) should prompt discontinuation of the prednisone which can be ulcerogenic. Please continue our conversation if you wish.