Protein-losing enteropathy (PLE) is a term that encompasses a heterogeneous group of diseases in which plasma proteins are lost into the gastrointestinal tract. PLE has been documented in association with more than 50 GI disorders in human beings. The classical gold standard for diagnosis of PLE is to quantitate loss of radioactive (51Cr-labeled) albumin into the gastrointestinal tract. This test has not been widely used clinically because it requires a minimum-five day fecal and urine collection in approved facilities and exposes the patient and operator to certain degree of radiation. Fecal alpha1-protease inhibitor (falpha1- PI) assay has been shown to be a reliable alternative method to detect PLE in human beings. Small Intestinal Bacterial Overgrowth (SIBO) is another important complication of spontaneous gastrointestinal diseases in dogs. As in human patients, the gold standard for the diagnosis of bacterial overgrowth in dogs is quantitative anaerobic and aerobic culture of small bowel aspirates. This diagnostic method is technically difficult, expensive and impractical for use on a routine basis. Previous reports have suggested the use of serum unconjugated bile acids as a test for SIBO in human beings as a more practical diagnostic technique. At present there is no practical test for PLE and SIBO in dogs. Thus, this investigation was undertaken to study novel approaches for the diagnosis of these two gastrointestinal disorders in dogs. The results of this investigation revealed that assay of fecal alpha1-PI is promising disease marker for protein-losing enteropathy states in dogs. These observations were substantiated when our results were compared with the classical gold standard (51Cr-labeled albumin) for the diagnosis of PLE. Likewise, Serum Unconjugated Bile Acid (SUBA) concentrations increased 10--20 fold in dogs with SIBO when compared to normal dogs indicating the clinical utility of SUBA for the diagnosis of SIBO in dogs. Availability of these two novel diagnostic assays will facilitate further characterization and better understanding of these canine disorders and may well uncover causes of PLE and SIBO in this species that are not yet suspected.
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