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Common causes for PLE are altered lymphatic drainage or increased mucosal permeability.69, 115 A predisposition for primary intestinal lymphangiectasia exists in Rottweilers, Yorkshire Terriers, Chinese SharβPeis, Maltese, Norwegian Lundehunds, Basenjis, Soft Coated Wheaten Terriers, and German Shepherd Dogs.115, 116, 117, 118, 119, 120, 121, 122, 123 Secondary intestinal lymphangiectasia is associated with mucosal inflammation in IRE/NRE, intestinal neoplasia, or infectious diseases (eg, GI histoplasmosis) in dogs.69 Prevalences of hypocobalaminemia range from 43%β75% in dogs with nonβneoplastic, noninfectious causes of PLE.65, 107, 124 Hypocobalaminemia was also associated with decreased serum alpha 1 βproteinase inhibitor concentrations (presumably due to PLE) in Yorkshire Terriers.125 Serum cobalamin concentrations should be evaluated in all dogs with PLE and, if needed, supplemental cobalamin be started early.69 4.3.3
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