LYMPHOCYTIC- PLASMACYTIC ENTERITIS OF Basenjis
Lymphocytic-plasmacytic enteritis of basenjis is an immunoproliferative process involving primarily the small intestine. This is a potentially severe form of IBD that is thought to result from a genetic disorder of immune regulation.
There is an intense infiltration of lymphocytes and plasma cells in the intestinal mucosa. Other changes often include gastric rugal hypertrophy, lymphocytic gastritis and/or gastric mucosal atrophy, blunting and widening of intestinal villi, and mild dilation of lacteals.The disorder is often progressive in nature. Clinical signs may tend to be intermittent for a period of time before they worsen and become more persistent. GI signs may be exacerbated by episodes of “stress” such as traveling, boarding, or other medical disorders. Clinical signs usually include small intestinal diarrhea, which may become intractable, vomiting, and/or inappetence. Weight loss can become significant as the disease progresses. Ulcerative dermatitis of the pinnae occasionally occurs in conjunction with this disease. Most affected basenjis demonstrate clinical signs by 3 to 4 years of age.
Basenji enteropathy is commonly associated with hypoalbuminemia and hyperglobulinemia, especially in advanced cases. Neutrophilic leukocytosis and mild nonregenerative anemia are commonly present as well. Early in the disease course, basenji enteropathy may mimic other forms of IBD (e.g., mild symptoms, no significant laboratory abnormalities).
As the disease becomes more advanced, signs and laboratory parameters are characteristic; however, clinicians should be aware that other forms of intestinal disease, such as lymphoma, lymphangiectasia, or histoplasmosis, may be present, and the symptoms of any of these diseases can mimic basenji enteropathy. Therefore it is always best to confirm the diagnosis by doing intestinal biopsies before instituting aggressive immunosuppressive therapy.
Treatment of basenji enteropathy is based on control of the inflammatory bowel component (see guidelines for treatment of IBD in dogs described earlier in this chapter), management of intestinal bacterial overgrowth if it is present, and feeding a controlled or hypoallergenic diet. Because the disease is often progressive, basenjis with this disorder should be carefully monitored. Over time, treatment may need to include combination immunosuppressive drugs and use of longterm antibiotics (e.g., metronidazole, tylosin). If there is evidence of gastric hypomotility, a promotility drug (metoclopramide or cisapride) is also used. Most basenjis die within 2 to 3 years of diagnosis, although some affected dogs can be maintained for a period of years with careful monitoring and ongoing therapy. Affected dogs should not be bred.