An unusual intestinal lymph drainage disorder:
 
 Date: Sat, 03 Mar 2001 00:29:07 -0000
 Subject: Re:  Lymphangiectasia
 
Thanks for being patient on this one.  I needed to do some review on
lymphangiectasia, to see where we could go with this.  I think that I
have at least come up with a game plan.
 
There are actually two types of lymphangiectasia - primary and secondary.
Primary is actually less common - this is usually a physical abnormality
of lymph drainage.  The second type is secondary - an artificial blockage
of lymph drainage - most often due to severe inflammation.  It is well
known that ferrets with certain intestinal disorders get severe
inflammation - ECE is probably the most common.  Has Tasi ever had ECE?
Was inflammation mentioned in the biopsy report - sorry, I can't remember
if it was.  It we have a concomitant inflammatory reaction, there is a
good chance that if we can get a handle on it, the lymphangiectasia will
subside.
 
If possible, I'd like to look at that slide.  There are some morphologic
differences in primary vs.  secondary lymphangiectasia that may help
determine what exactly going on here - including the location of the
dilated lacteals.  In primary, lymphatics are dilated throughout the entire
wall of the intestine; in secondary, there are generally dilated only in
the inflamed mucosa.
 
Can you refresh me on her albumin levels - this is a fairly good indicator
of the severity of the condition.  Animals with lymphangiectasia lose
protein from the dilated lymphatics into the lumen, so we can track the
severity by something as simple as albumin - it's a rough indicator, but
helpful.  Also her weight is an important indicator.  While I know she has
loose stools, I'm not as worried if her albumin stays up and her weight is
stable.
 
Prednisone is recommended in many cases of secondary lymphangietasia, and
I think it may be helpful here.  It will help to diminish any inflammation
that may be present.  I think a standard dosage of prednisone which we
would use in chronic ECE cases (0.5 mg/lb orally once daily) may be
helpful.
 
Regarding the modification of fat - it is true that we want to switch away
from long-chain fatty acids, which are the most common in typical pet
foods.  These long-chain triglycerides are a major stimulus for intestinal
lymph flow, which may hasten protein loss into the bowel lumen.  Generally,
we put them on a low-fat diet (you can try Hills r/d) to start, or a
similar product.  Unfortunately, low fat diets are often not palatable
(as I often say, there is nothing good to eat without fat in it.)
 
While I am not familiar with coconut oil, there are some supplements that
are available from Mead Johnson (they make a medium chain triglyceride oil
which can be administered at 1 to 2 ml per/kg per day).
 
I'd say before we start monkeying around with her diet significantly,
let's take a look at her protein values, her weight, and maybe a good look
at that slide will help shed some more light on this unique case.
 
[Bruce Williams, DVM]
[Posted in FML issue 3349]