Protein losing enteropathy/lymphangiectasia

[Donna P.]

I have two dogs, a goldendoodle named Bayley and a beardie named Mayzie. This question is about Mayzie. She is 13 and has been dealing with protein losing enteropathy (PLE) for about 3 years. We have been managing it with science diet ID low fat. She has never liked it, but recently she has been refusing to eat more and more and losing weight. I’m hoping that Karen or someone here has some experience and can suggest a home cooked diet that is low fat and balanced.

We have blood drawn every month. Her liver and kidneys are great. All other values are in the normal range. The albumin (blood protein) is low. The bottom of the normal range is 2.6. She hovers between 2.4 and 2.7. The vet was able to rule out problems with the liver and kidneys, narrowing the problem to the gut. When this was initially diagnosed, the vet said that she wanted to see if diet would control it before having biopsies and other invasive and very expensive measures. She has seen success with the ID, so we have been doing that for 3 years, and the albumin has remained fairly constant.

Mayzie has never had any of the usual symptoms of diarrhea, vomiting, fluid retention. Her stools are regular and well formed. She is very active for her age, happy, no food sensitivities. You would never know she is ill. We only discovered the low albumin from blood work we had done for an unrelated issue. She just hates the ID. We tried her on Royal Canin, but she didn’t like it any better and her albumin dropped a little. So we went back to the ID.  I try to make her food a little more appetizing by adding a couple spoons of shredded boiled 97% fat free chicken breast. But she’s now turning her nose up at that.

I’m ready to start a home cooked diet. I have spent hours trying to find some recipes that are low fat. No luck so far. The ID is 6% fat, so I’m wanting to stay at 6% or lower. I found one thread on a schnauzer site discussing low fat diet for IBS. One person had success with Home Kitchen Preference. This is a complete dehydrated diet base, you add your protein of choice. 

Any opinions on trying this with the chicken breast? This food says it provides 6% fat. Or any suggestions at all. This is breaking my heart.

Donna

[Karen, Jasper and Jackdoodle]

Your best bet would be to consult a veterinary nutrition specialist. This is a veterinarian with a DVM who has also attended graduate school to get the specialist's degree, and this would be the only type of "expert" that I would trust to formulate a diet for a dog with PLE. Your other option would be a veterinary internal medicine specialist who treats dogs with digestive disease and can recommend a diet to you. Often, an IMS will work with one of the nutrition specialists at UC/Davis or one of the other big veterinary schools to formulate diets for dogs with digestive disease. Of course, I feel that any dog with PLE or any other serious digestive disease should be in the care of an IMS anyway, so if that is not the case with Mayzie, I'd make an appointment NOW.

GP vets, no matter how caring and knowledgable they may be, cannot be experts in every single disease and cannot be current on every single treatment for every disease. That includes diet. 

Regarding the Home Kitchen food, did you mean Honest Kitchen? In any event, the 6% protein that the food provides is for the base mix only; once you add chicken or any other protein, the fat content climbs considerably. Skinless chicken breast contains 11% fat. You are playing with fire if you follow the schanuzer forum's advice. 
I would strongly caution you against taking diet advice or recommendations from random people online; please see a veterinary nutritionist or other qualified person.

[Donna P.]

Thanks Karen, I’ll do some research for a specialist

[Karen, Jasper and Jackdoodle]

I really do think that's a good idea. It's important to realize that PLE is not really a disease in itself, but an indication of some other disease process that is causing protein loss from the GI tract. I understand the reluctance to leap into expensive and invasive diagnostic testing, but I also do think it's important to know for sure what you are dealing with so that you can properly treat the underlying disease and not just the symptoms. PLE can be indicative of heart failure or liver disease among other causes. An experienced specialist would be better able to make recommendations as to whether or not further testing is warranted as well as diet and other treatment recommendations. 

Good luck, please keep us posted.. 

[Jane, Guinness and Murphy]

I agree with Karen's advice about talking with a Specialist, but I can share how we manage our Doodle (Guinness's) diet.  He must have a diet with less than 10% total fat because he is prone to Pancreatitis.  He gets one feeding of Canine Caviar Special Needs Limited Ingredient kibble which is 9% fat.  I home cook his other meal which is the Honest Kitchen base mix (6%) fat with some boiled chicken breast added.  To control the fat in the chicken I remove any traces of skin and boil it.  I then rinse it to be sure that any of the fat that was released during cooking is washed off.  I also have to be sure that any treat he gets is less than the 10% fat. Did your vet give you a guideline of what % of fat would be acceptable? 

[Donna P.]

Thanks Jane, for the reply. We are aiming for 6%. That is the fat content of the ID she is eating (or not eating, as the case may be). We were topping with a little 3% chicken breast, but she got bored with it. The last couple of days we have been using tilapia. It is 3% fat, and she loves it. She has eaten all of her food for the last three days. We'll see how long this lasts. 

[Jane, Guinness and Murphy]

Wow....6% is really tough....I thought I was restricted with the less than 10% requirement.  I'm glad you discovered the tilapia and that she's loving it.  Fingers crossed that is your answer.