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Recent research has begun to provide guidance in the diagnosis and treatment of PLN and PLE in the Soft Coated Wheaten Terrier. The preliminary observations involve only a small number of dogs. Therefore, the findings are not yet broadly published.

In the spring of 1995, the investigation of possible causes of PLN and PLE in the Wheaten was greatly enhanced by the establishment of protocols for diagnostic testing and post mortem examination. These protocols provide the opportunity for consistent data collection from a much larger number of dogs than has been possible to date.

This pamphlet is meant to provide the veterinarian with a ready reference to the diagnostic and post mortem protocols and the names of the researchers involved.

The Soft Coated Wheaten Terrier Club of America (SCWTCA), supported by breeders and owners of Wheatens throughout the U.S. and Canada, has established funding for these ongoing investigations. The veterinarian specialists conducting the research will provide consultative help to local practitioners on a veterinarian to veterinarian basis. However, it will be the sharing of experience as new cases are discovered and treated that will provide the greatest benefit to each affected dog and the breed as a whole.

The following information is from articles reporting on research being done on the affects of protein-losing diseases on the Soft Coated Wheaten Terrier.

Protein-Losing Diseases and the Soft Coated Wheaten Terrier

Protein-losing diseases are complicated conditions rarely seen in general practice and misdiagnosis of protein related or kidney diseases has occurred. These diseases occur in the Wheaten in two forms: Protein-losing Nephropathy (PLN) and Protein-losing Enteropathy (PLE). They cause the loss of large amounts of protein in the urine and in the feces. PLE and PLN can occur separately or together.

Most Wheatens affected by protein-losing disease are five to six years of age, however the range is two to eleven years. The female seems to be more at risk than the male. A survey conducted by the SCWTCA showed that PLN and PLE affect 3 to 5% of the Wheaten population. To date PLN has resisted treatment, however PLE has been successfully treated with medications and diet. With the early detection and early treatment it is hoped that many of the affected dogs will live relatively normal lives.

Protein-Losing Disease Research Findings

Of the Soft Coated Wheaten Terriers with PLE and/or PLN studied by Dr. Meryl Littman; the dogs were found to:
    - be related according to their pedigrees
    - have various immune-mediated gut and renal lesions
    - are often found to have hypoproteinemia, ascites/effusions, lymphangiectasia,
      lymphocytic-plasmacytic enteritis, granulomatous enteritis/peritonitis, glomerulonephritis,
      proteinuria and thrombosis leading to pulmonary emboil or pancreatitis.

Clinical signs of PLN

PLN is difficult to diagnose and the stages of the disease may be mistaken for liver, glandular or other enteric or kidney diseases. An abnormality on the glomeruli usually causes PLN. Some of the common signs and symptoms are:
    - increased water consumption
    - increased urination/ or no urination,
    - incontinence
    - listlessness/depression
    - decreased appetite, vomiting, weight loss
    - poor haircut
    - poor growth in young dogs
    - ascites, edema, pleural effusion

Laboratory abnormalities associated with PLN:
     - hypoalbuminemia
     - elevated serum creatinine
     - eosinophilia
     - hypocholosterolemia
     - elevated urine protein/creatinine ratio
     - hypercoagulopathy

Clinical Signs of PLE

PLE in the Wheaten is usually caused by lymphangiectasia or infiltrative diseases of the small bowel such as lymphocytic-plasmacytic enteritis, eosinophilic enteritis or pyogranulomatous lymphocytic/enteritis. In affected Wheatens there is a stimulation of the immune system in the bowel wall. Some of the common signs and symptoms are:
    - vomiting, diarrhea, weight loss
    - ascites, edema, pleural effusion

Laboratory Abnormalities Associated with PLE:
    - hypoalbuminemia
    - hypoglobulinemia
    - eosinophilia
    - hypocholesterolemia
    - lymphopenia
    - hypercoagulopathy

Diagnosis of Protein-losing Diseases.

Recommended Protocol for Protein-losing Enteropathy/Nephropathy Screening

Factors involved in the diagnosis of protein-wasting diseases include; family history, physical examination, and diagnostic testing.

Diagnostic Tests: - biochemical profile (often called chem screen or vet screen). This must include: total protein, albumin, and creatine. Cholesterol optional.
    - complete blood count (optional)
    - routine urinalysis (specific gravity, dipstick, urinary sediment)
    - urine protein/creatinine ratio.

If these test results show any abnormalities, please contact Dr. Littman or Dr. Vaden for further advice.

Dr. Meryl P. Littman
School of Veterinary Medicine
University of Pennsylvania
3900 Delancey Street
Philadelphia, PA USA. 19104-6010
Office: (215) 898-9288
Fax: (215) 573-3925

Dr. Shelley Vaden
College of Veterinary Medicine
North Carolina State University
4700 Hillsborough Street
Raleigh, NC USA 27606
Office: (919) 829-4235
Fax: (919) 829-4336

Post-Mortem Protocol: All dogs that die of PLE and/or PLN or are suspected of having PLE and/or PLN should have a post-mortem examination and tissue collection as per the following protocol set out by Dr. Littman.

1. After a thorough examination of all organs, please submit the following tissues as stated so that each tissue can be readily identified.
   a. Kidneys - cut in halves longitudinally: submit in entirely in formalin. For the University of
      Pennsylvania: Freeze one kidney and submit in aluminum foil via overnight delivery (not to
      arrive on weekend). Note: for puppies with suspected Renal Dysplasia, only kidneys need
      to be submitted.
   b. Jejunum, ileum, cecum, colon: submit section which contains all four tissues as found in situ.
   c. Duodenum: submit with section of pancreas attached.

For adequate fixation, place in volume of formalin that approximates 10 to 20 times the volume of tissue.

2. Send tissue samples, together with copies of all medical reports (including blood and urine tests and biopsy results) and a copy of the pedigree (four generations, if possible) to Dr. Littman or Dr. Wilcock:

Dr. Meryl P. Littman
School of Veterinary Medicine
University of Pennsylvania
3900 Delancey Street
Philadelphia, PA USA 19104-6010
Office: (215) 898-9288
Fax: (215) 573-3925

Dr. Brian Wilcock
Ontario Veterinary College
University of Guelph
Guelph, Ontario Canada N1G 2W1
Office: (519) 824-4120 ext. 4655

Tissue samples may be sent to either Penn or Guelph. Penn is particularly interested in dogs from areas where Lyme disease is prevalent. The Soft Coated Wheaten Terrier Club of America (SCWTCA) will pay for histopathological exams; owners/breeders will be responsible for local vet charges for tissue removal and shipping costs. Guelph does not require kidney samples be frozen for overnight delivery.

Veterinary Consultants as Reported by SCWTCA Health Committee:

Contact these veterinarians for consultations and assistance with diagnosis and treatment of protein-losing diseases in the Wheaten.

Soft Coated Wheaten Terrier Club of America Inc. Research Coordinator
Dr. Elizabeth Ampleford
P.O. Box 298
Batesville, VA USA 22924
Office: (804) 823-7971

Dr. Meryl Littman VMD, DACVIM
School of Veterinary Medicine
University of Pennsylvania
3900 Delancey Street
Philadelphia, PA USA 19104-6010
Office: (215) 898-9288
Fax: (215) 573-3925
    - pedigree research and clinical studies of PLE and PLN

Published by Wheatens on the Red
551 McNaughton Avenue
Winnipeg, Manitoba, Canada R3L 1S7
(204) 284-2114

Prepared by
Helen Larson
Healthy Wheaten Coordinator

August 1995

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