Todayโs path rounds are on ๐ฅ๐ฒ๐ฆ๐ฉ๐ก๐๐ง๐ ๐ข๐๐๐ญ๐๐ฌ๐ข๐!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐ฒ๐ฆ๐ฉ๐ก๐๐ง๐ ๐ข๐๐๐ญ๐๐ฌ๐ข๐ is a big crazy word, but if you break it down it makes sense! Lymph- refers to the lymphatic system, angie- refers to vessels, and -ectasia refers to dilation. So putting it all together, lymphangiectasia is dilation of of the lymphatic vessels! Simple 
We typically see this disease in the intestine, but it can occur in other areas.
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Any species can get this technically, however we most commonly see it in dogs. In particular, Yorkshire Terriers and Norwegian Lundehunds seem predisposed!
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
Basically lymphangiectasia is caused by anything obstructing the normal flow of lymph. So, we might consider things like inflammatory cells plugging up the vessel or even a tumour compressing the vessel. A large proportion of cases are considered ๐ข๐๐ข๐จ๐ฉ๐๐ญ๐ก๐ข๐, meaning no obvious cause is identified, so those cases can be a bit of a mystery!
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
The lymphatics of the intestine are the major way that ๐ฅ๐ข๐ฉ๐ข๐ (fat) is absorbed by the body. When these lymphatics are blocked, the animal is unable to properly absorb this fat, and it remains in the intestine. The wall of the intestine is relatively leaky, and it wants to try and dilute out the intestinal contents to maintain balance. This causes a large amount of body fluid to enter the intestine to try and dilute the fat, leading to diarrhea and dehydration. The fluid lost into the intestine is often high in protein, leading to massive protein loss for the animal.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
These animals present with diarrhea, dehydration and weight loss, since they arenโt able to absorb fat properly. They may also have signs of vitamin deficiency, as some vitamins are ๐๐๐ญ-๐ฌ๐จ๐ฅ๐ฎ๐๐ฅ๐, meaning they need to be dissolved in fat to be absorbed properly. On bloodwork, these animals will show a ๐ก๐ฒ๐ฉ๐จ๐๐ก๐จ๐ฅ๐๐ฌ๐ญ๐๐ซ๐จ๐ฅ๐๐ฆ๐ข๐ and ๐ก๐ฒ๐ฉ๐จ๐ฉ๐ซ๐จ๐ญ๐๐ข๐ง๐๐ฆ๐ข๐, essentially meaning low fat and protein in the blood. To confirm a diagnosis, a biopsy of the intestine can be submitted to a pathologist for examination.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
The first line of therapy, if possible, is removing the inciting cause. For example, removing the obstructing tumour, or resolving the inflammation. However, this is often not possible. Therefore, these animals are often managed on a low-fat, high-calorie diet. However, the overall prognosis for this condition is poor, so these animals are often euthanized before their quality of life declines further.
๐๐ก๐จ๐ญ๐จ๐ฌ
1-2) Examples of large lymphatic vessels showing dilation, in the heart and the ๐ฆ๐๐ฌ๐๐ง๐ญ๐๐ซ๐ฒ (tissue supporting the intestines).
3-5) Close up photos of intestines with lymphangiectasia. The intestine is lined by little finger-like projections, each containing a large lymphatic vessel. In this disease, the dilation of the lymphatic vessel makes the little fingers look white, rather than their normal pink colour.
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Photos 1-5 ยฉ Noahโs Arkive contributor Rech, Read, Edwards, Neto licensed under CC BY-SA 4.0.
