Pomeranian with reccurent hge

RE: Pomeranian with reccurent hge

Andrew Kent — Sun, 23 Aug 2020 10:25:16 GMT

Always difficult to know if the biopsies are representative of the disease or if inflammation may be more severe elsewhere. If the proteins are only mildly low I would often pursue diet alone first but this is personal preference.

if the dog is doing well I would try to taper the steroid and maintain on diet if you can.

Andy

RE: Pomeranian with reccurent hge

skatealexia — Sun, 16 Aug 2020 16:26:52 GMT

So some increased cellularity in the lamina propria with plasma cells and lymphocytes with several crypt abscesses in two sections but not in sufficient levels to be classed as an enteritis

RE: Pomeranian with reccurent hge

skatealexia — Sun, 16 Aug 2020 16:22:18 GMT

Actually there was minimal inflammatory infiltrate less supportive of the inflammatory process. It was a bit odd and put down as protein losing enteropathy. Wasn't sure if the steroids were entirely necessary

RE: Pomeranian with reccurent hge

Andrew Kent — Sun, 16 Aug 2020 15:27:20 GMT

Thanks for the update.

Presumably there was an inflammatory infiltrate as well as the crypt abscesses? This is not unusual in the chronic inflammatory enteropathy patients so fits with that option. Hopefully this dog will do well, perhaps just on diet longer-term.

Andy

RE: Pomeranian with reccurent hge

skatealexia — Sun, 16 Aug 2020 15:22:41 GMT

Acth stim was normal

RE: Pomeranian with reccurent hge

skatealexia — Sun, 16 Aug 2020 15:22:29 GMT

Thanks for your reply Andrew. Referred patient for endoscopic biopsies which showed the duodenum had some abscess in the crypts. The b12 was low so started supplementation. Currently on 1mg/kg pred, 1/4 clopidogrel 75mg, b12 supplement and specific allergen management plus hydrolysed protein diet

RE: Pomeranian with reccurent hge

Andrew Kent — Thu, 06 Aug 2020 12:18:36 GMT

Hi Skatealexia,

Apologies for the slow reply.

A few questions I suppose:

[quote userid="14379" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/29261/pomeranian-with-reccurent-hge"] Basal cortisol normal.[/quote]

What was the exact value?

[quote userid="14379" url="~/001/veterinary-clinical/small-animal/medicine/f/expert-help/29261/pomeranian-with-reccurent-hge"] No response to strict hypoallergenic diet[/quote]

Which hypoallergenic diet did you use?

I think these patients can be tricky - initially we tend to think that there might be a specific trigger that sets off these bouts, such as scavenging, although maybe an odd breed for that. If that could be an issue then walking in a muzzle can sometimes help.

With very frequent bouts we certainly start to consider that these things could be manifestations of a more chronic enteropathy - the B12 may help there - has that returned yet?

Andy