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Dr. Lee
Dr. Lee, Veterinarian
Category: Veterinary
Satisfied Customers: 5355
Experience:  7 years of experience in veterinary medicine and surgery
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I have a dog who keeps swelling up with fluid and has a malaborbtion

Resolved Question:

I have a dog who keeps swelling up with fluid and has a malaborbtion problem.
Submitted: 4 years ago.
Category: Veterinary
Expert:  Dr. Lee replied 4 years ago.
Chat Conversation Started
Dr. Lee :

Hi. I'm Dr. Lee and will do my best to help.

Dr. Lee :

Where exactly is the swelling located?

Dr. Lee :

How was the malabsoprtion problem diagnosed?

Dr. Lee :

Hello? Are you there?

Customer :

Yes

Customer :

He stomach swells. The Vet I take him to said he is not absorbing protein.

Customer :

This all started around the time he was stung by a wasp and had a terrible reaction.

Dr. Lee :

Did your vet run any tests? What tests? And what were the results?

Customer :

He seems to be very allergic. I just came back from a new vet visit and she was supposed to help me with his diet. She did not,

Customer :

I have his test results

Customer :

What do you want me to look at on them?

Dr. Lee :

What tests were run?

Customer :

Let me get his file

Customer :

I have a histopath report

Dr. Lee :

One of the thing I am interested in is the histopath report.

Customer :

ok

Customer :

Do you want the prognosis?

Customer :

Or findings?

Dr. Lee :

I want the diagnosis.

Dr. Lee :

yes the findings.

Customer :

Full thickness large intestine with mild lymphlasmacytic proprial infiltrates

Customer :

The number of inflammatory cells in the mucosa appears low and within normal limits-

Dr. Lee :

Anything else from the findings/report?

Customer :

The reason for the reported clinical finds thus,

Customer :

remains uncertain. Changes may or may not be reflective of processes occuring elsewhere such as small intestine-

Customer :

A mild degree of an inflammatory bowel disease like process is not ruled out-

Customer :

The diagnosis of inflammatory bowel disease is necessarily one of exclusion.

Customer :

I'm so confused!

Customer :

do you want me to send more

Dr. Lee :

yes please.

Dr. Lee :

Also, can you tell me where the fluid was obtained? From the belly/abdomen?

Dr. Lee :

And what color is the fluid? Did your vet send the fluid to the lab for analysis? If so, what is the result/finding?

Customer :

examined are good sized sections of full thickness large intestine. in the mucosal propria are low numbers of lymphocytes, plasma cells, and a few neutrophils and eosinophils. inflammatory cells do not appreciably extend into deeper tunics. multifocally in the mucosa, submucosa and muscularis there is mild congestion and hemorrage agents or evidence of neoplasia are not found.

Customer :

The fluid came from abdomen

Customer :

It looks pinkish to me

Dr. Lee :

Was the fluid sent to a pathologist for analysis?

Customer :

If it was I can't find it on the report. Is there something they would call it. I also have blood reports.

Dr. Lee :

Any abnormal findings from the blood report?

Dr. Lee :

I assume the total protein and albumin are both very low?

Customer :

I'm about to lose my mind with trying to solve his problem. Nothing wrong with his labs.

Customer :

I can give you the number

Customer :

3.0

Customer :

protein is 5.1

Customer :

first was albumin

Customer :

His ribs stick out his spine sticks out. He weighs 70 pounds.

Customer :

People think I starve him

Dr. Lee :

Those numbers are good and normal.

Customer :

He burps all the time a lot of time after drinking water he will vomit a small amount of it but not his food only water.

Dr. Lee :

With protein number being good, it is not likely an absorption problem.

Dr. Lee :

I would look more into liver disease.

Customer :

What else do you suggest I do

Dr. Lee :

I would highly suggest to get an abdominal ultrasound done.

Dr. Lee :

That would allow us to look into the liver for any problems.

Customer :

He did test his liver

Dr. Lee :

It can look inside, the architecture, and not just the outside as in during surgery.

Dr. Lee :

What tests was run on the liver?

Customer :

And he looked it over himself also sent in a lymp node

Customer :

Blood work and also a biopsie

Dr. Lee :

He only looked at it grossly during surgery, which is not the same as looking inside the liver.

Dr. Lee :

Ultrasound is needed.

Dr. Lee :

Biopsy of liver is not useful unless a lesion is seen.

Customer :

So who do I need to take him to

Dr. Lee :

Another thing I would suggest to do is to ask your vet to run a cobalamin and folate blood test. This will check for malabsorption diseases.

Dr. Lee :

As well, ask your vet to give him vitamin B12 injections.

Customer :

ok

Dr. Lee :

For ultrasound, it is best to find a board-certified radiologist for this.

Customer :

Would you mind writing something up for my vet?

Customer :

ok

Customer :

I'm so upset by my vet visit tonight it was a new vet i'm not thinking clearly

Dr. Lee :

But since you have done so much already, I would suggest to see a internal medicine specialist for a second opinion, and they can then refer for ultrasound.

Dr. Lee :

You can find a specialist here: www.acvim.org

Customer :

ok, i'll try to find a vet. thank you.

Dr. Lee :

All the vets you find on that website are board-certified.

Customer :

This new vet kept saying it was his heart. it is not his heart.

Dr. Lee :

Oh...did they detect a heart murmur?

Customer :

I told her you can't hear the sounds clearly because of the fluid

Customer :

no

Customer :

It's the fluid in him

Customer :

I know it is

Dr. Lee :

Given the complexity, I would definitely say find an internal medicine specialist as soon as possible.

Customer :

I will. it started after he was stung by a wasp and had a terrible reaction. I will find someone new to take him to.

Dr. Lee :

Great. Do you have any other questions or concerns?

Customer :

Just that i'm at a loss here. I don't know why he started doing this. I'm doing everything I know how to do.

Dr. Lee :

well, if there is liver problem, or malabsorption, that will lead to this problem. It can be a congential problem that just appeared now.

Dr. Lee :

Heart problem is possible, but that requires further testing.

Dr. Lee :

With no heart murmur, I would not put too much weight on that however.

Customer :

I'm a surgical tech I've worked with animals 25 years and have never seen anything like this. But I will take him to someone new I thought I did that this evening with the new vet and it ended up being a joke she wouldn't focus on anything but his heart.

Dr. Lee :

General practioner can only do so much. So definitely a specialist is the best bet now.

Customer :

Thank you. I'll write back and let you know what the vet says after we see him.

Dr. Lee :

You're welcomed. You can press Accept to end the live chat. Any followup can be posted on the Q&A session without further charges.

Customer :

ok. thank you. Goodnight.

Dr. Lee, Veterinarian
Category: Veterinary
Satisfied Customers: 5355
Experience: 7 years of experience in veterinary medicine and surgery
Dr. Lee and 5 other Veterinary Specialists are ready to help you

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Dr. Lee
Dr. Lee
Veterinarian
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7 years of experience in veterinary medicine and surgery