Protein Losing Enteropathy post giardiasis

RE: Protein Losing Enteropathy post giardiasis

Ian Hopkins — Wed, 07 Sep 2022 12:57:34 GMT

Thanks, will set that up

RE: Protein Losing Enteropathy post giardiasis

Andrew Kent — Wed, 07 Sep 2022 12:40:42 GMT

Could well be we are missing a more sinister disease then so ultrasound would be sensible (although disease could be masked by treatment now). If you are having to home cook then I would go novel protein so duck/venison and sweet potato rather than using chicken. Even better get a home cooked ultra low fat diet formulated by a nutritionist.

Andy

RE: Protein Losing Enteropathy post giardiasis

Ian Hopkins — Wed, 07 Sep 2022 12:26:46 GMT

Thanks again,

Only had a pocus scan as is ascitic. Wont eat hydrolysed and on home produced chicken and potato diet. Eats that well, motions semi solid.

Will repeat the ultrasound when review in 2 weeks.

Ian

RE: Protein Losing Enteropathy post giardiasis

Andrew Kent — Wed, 07 Sep 2022 12:18:00 GMT

Thanks Ian.

Any dietary change? Any ultrasound changes to suggest we might be missing a lymphoma?

Personally if I don't see response to chlorambucil over a few weeks I consider switching it out for ciclosporin as another trial. But some of these can be tricky (presumably because the diseased gut doesnt absorb the drugs well) and there is a reason the majority of PLE cases end badly!

Andy

RE: Protein Losing Enteropathy post giardiasis

Ian Hopkins — Wed, 07 Sep 2022 10:58:45 GMT

Thanks Andrew, thanks for your input

albumin 13 (ref >23), globulin 18 (ref > 25), Total protein 31 (ref >52) - idexx in house. No real change 14 days into treatment

Start on pred 2mg /kg sole drug, had a few increased sporadic V episodes.

After one week started on chlorambucil 4.6mg/m2 (4mg sid , wt 25 kg) and dropped pred to 1mg/kg (got a bit nervous to stay on 2mg/kg with 2nd agent!!)

Regards

Ian

RE: Protein Losing Enteropathy post giardiasis

Andrew Kent — Tue, 06 Sep 2022 20:05:00 GMT

Hi Ian,

Not convinced about the Giardia given the lack of response to fenbendazole - presumably no improvement even when giving that?

How low are the proteins? Have they changed on the drugs?

Have you performed diet trials? What with?

What kind of steroid dose have you used? and chlorambucil?

Sorry for all the questions!

Andy