A little clarity. A lot of love.
AI DiagAnimalsMADE FOR THE ONES YOU LOVE
English

Language and region

Understand their results
Menu
DISEASE · DOGS

Protein-losing enteropathy in dogs: when albumin is lost through the gut

In protein-losing enteropathy (PLE), proteins from the blood leak into the intestine. It is not a single disease but a syndrome with several causes. Blood tests often find it first: a low albumin, frequently with a low globulin and low cholesterol, sometimes in a dog with few digestive signs.

Written by the AI DiagAnimals editorial teamReviewed by the AI DiagAnimals TeamUpdated Our editorial policy

The essentials

A low albumin together with a low globulin and a low cholesterol is the classic blood picture of PLE. Vets first rule out protein loss through the kidneys (urine protein:creatinine ratio) and liver failure (bile acids). PLE most often comes from chronic inflammatory bowel disease or lymphangiectasia, sometimes lymphoma; an intestinal biopsy is needed to find the cause. Low calcium, magnesium and vitamin B12 are common, and dogs with PLE have a risk of blood clots.

Have your dog’s results in front of you? Get every value explained in plain language. Upload the report

What PLE is and which dogs get it

PLE is a syndrome that develops in many diseases of different causes [1]. In dogs it is most often a feature of chronic inflammatory bowel disease, and less often of intestinal lymphangiectasia (dilated lymph vessels in the gut wall); gut lymphoma and infections are other causes [1, 2].

In a pooled analysis of 469 dogs, the most common breeds were the Yorkshire Terrier, Border Collie, German Shepherd and Rottweiler; the Soft Coated Wheaten Terrier, Norwegian Lundehund, Maltese and Shar-Pei are also predisposed to lymphangiectasia [1]. Diarrhea, vomiting and weight loss are common, but some dogs show mainly fluid in the belly or a swollen body.

What the blood work shows

ValueTypical findingTo know
AlbuminLowPresent in all 30 Yorkshire Terriers of one study [3]. See albumin and globulin.
GlobulinsOften lowLow albumin plus low globulin points to protein loss through the gut or bleeding; low globulin is not always present [3, 4].
CholesterolLowLow albumin, low globulin and low cholesterol together are classic for PLE [5].
Calcium and magnesiumOften lowCalcium was low in all 30 Yorkshire Terriers and magnesium in 40% [3].
Vitamin B12 (cobalamin)Sometimes lowAn inconsistent finding, but linked to a poorer outcome [1].

How to read the albumin line

Here is an example line from a dog with PLE.

An annotated line from a lab report · Illustrative example
AbbreviationResultUnitLaboratory intervalFlag
ALB Albumin1.4g/dL2.3–3.1L
  1. Abbreviation ALB or albumin.
  2. Result 1.4 g/dL in this illustrative line: markedly low.
  3. Unit g/dL in the US; g/L elsewhere (× 10).
  4. Laboratory interval An illustrative dog interval; each laboratory sets its own.
  5. Flag L: below the interval. Read it with globulin and cholesterol: if both are low too, protein loss through the gut is likely [4, 5].

Ruling out the kidneys and the liver

  • Kidneys: a urine protein:creatinine ratio (UPC) checks for protein loss in the urine. Protein-losing kidney disease often comes with a high cholesterol, unlike PLE [1, 5]. See protein in urine.
  • Liver: bile acids before and after a meal check liver function. In a dog with low albumin, normal bile acids and a normal UPC, PLE is probable [1]. See the bile acids test.
  • Addison’s disease can look like PLE, so a basal cortisol is often measured [1].

Finding the cause

Ultrasound can show bright streaks in the intestinal lining, which suggest PLE but are not specific [1]. No blood or imaging test makes the definitive diagnosis: an intestinal biopsy, usually by endoscopy, is needed to tell inflammation, lymphangiectasia and lymphoma apart [1].

Blood clots and outlook

Dogs with PLE lose anti-clotting proteins and can form blood clots, sometimes suddenly and even when the gut disease seems quiet; clots are reported in about 6% of cases and are probably underestimated [1].

The outlook varies widely. Across pooled studies, about half of the dogs died of the disease [1]. In 57 dogs with inflammatory PLE, 61% had a good outcome at 6 months, and those dogs lived a median of 996 days [6].

Related articles

En français : l’entéropathie exsudative du chien.

Questions to ask your veterinarian

  1. Are the albumin, globulin and cholesterol all low?
  2. Have the kidneys (UPC) and liver (bile acids) been ruled out?
  3. Are the calcium, magnesium and vitamin B12 low?
  4. Is a biopsy needed, and by endoscopy or surgery?
  5. Is my dog at risk of blood clots?
YOUR PET’S FULL REPORT

Get your dog’s proteins and chemistry explained together.

AI DiagAnimals reads albumin, globulin, cholesterol, calcium and the rest of the panel together with your laboratory’s intervals, and prepares the questions for your vet. The service opens soon: leave your email to be told first.

Explain my dog’s reportSee a sample report

Frequently asked questions

What is protein-losing enteropathy in dogs?

A syndrome in which blood proteins leak into the intestine, most often because of chronic inflammatory bowel disease or lymphangiectasia [1].

Which dog breeds get PLE?

Yorkshire Terriers are the most frequent; Soft Coated Wheaten Terriers, Norwegian Lundehunds, Maltese and Shar-Peis are predisposed to lymphangiectasia [1].

Can a dog have PLE without diarrhea?

Yes. Some dogs have few digestive signs, and the low albumin on a blood test or fluid in the belly is the first clue [1].

Why is cholesterol low in PLE?

Low cholesterol with low albumin and globulin is the classic pattern of PLE, and a useful clue that proteins are lost through the gut rather than the kidneys, where cholesterol tends to be high [4, 5].

What is the life expectancy of a dog with PLE?

It varies widely with the cause and the response to treatment. Dogs that respond well can live for years [1, 6].

Sources

  1. Craven MD, Washabau RJ. Comparative pathophysiology and management of protein-losing enteropathy. J Vet Intern Med. 2019;33(2):383-402. doi.org/10.1111/jvim.15406
  2. Salavati Schmitz S et al. Diagnostic features, treatment, and outcome of dogs with inflammatory protein-losing enteropathy. J Vet Intern Med. 2019;33(5):2005-2013. doi.org/10.1111/jvim.15571
  3. Simmerson SM et al. Clinical features, intestinal histopathology, and outcome in protein-losing enteropathy in Yorkshire Terrier dogs. J Vet Intern Med. 2014;28(2):331-337. doi.org/10.1111/jvim.12291
  4. eClinPath, Cornell University College of Veterinary Medicine. Albumin. eclinpath.com/chemistry/proteins/albumin
  5. eClinPath, Cornell University College of Veterinary Medicine. Cholesterol. eclinpath.com/chemistry/energy-metabolism/cholesterol
  6. Economu L et al. The effect of assisted enteral feeding on treatment outcome in dogs with inflammatory protein-losing enteropathy. J Vet Intern Med. 2021;35(3):1297-1305. doi.org/10.1111/jvim.16125

Laboratory methods and reference intervals vary. This article explains; it does not diagnose. For a decision about your pet, use the original report and talk to your veterinarian. Our editorial policy.

Cookie Policy