Health Screening for Protein-Losing Enteropathy (PLE), Protein‑Losing Nephropathy (PLN), Renal Dysplasia (RD), and Addison's Disease
Recommended by SCWTCA and its Researchers

Soft Coated Wheaten Terriers have been found to have a higher frequency than other breeds of certain serious diseases. Our veterinary researchers, Meryl Littman VMD DACVIM, Shelly Vaden DVM DACVIM, and David Williams ECVIM-CA/ACVIM, recommend owners test their Wheatens annually for evidence of:

• Protein-Losing Enteropathy (PLE)
• Protein-Losing Nephropathy (PLN)
• Renal Dysplasia (RD)
• Addison's Disease

Their recommendations to owners and their veterinarians include:

1.  Run the following lab tests:

1. Biochemical profile, including:
   • Total protein (TP)
   • Albumin (Alb)
   • Globulin
   • Creatinine (Cr)
   • Blood Urea Nitrogen (BUN)
   • Cholesterol (Chol)
   • Sodium (Na)
   • Potassium (K+)
   • Phosphorus (Phos)
2. Complete Blood Count
3. Routine Urinalysis, including:
   • Specific gravity
   • Dipstick
   • Urinary sediment
4. Urine Protein/Creatinine Ratio

Your client may also ask you to run the ERD Test for Microalbuminuria or arrange for a Fecal Alpha-1 Protease Inhibitor (Fecal API) test through Texas A&M. If these results lead you to suspect RD or Addison’s, the following tests can be run:

• Renal Dysplasia (RD):
  • Abdominal radiographs/Ultras`ound
  • Final confirmation of RD: Kidney biopsy (wedge, not Tru-cut); call Dr. Meryl Littman (see the end of this letter for her contact information) to discuss size
• Addison's:
  • ACTH stimulation test

2.  Note the differences and similarities between these diseases:

Source: 1999 ACVIM PROCEEDINGS: Soft Coated Wheaten Terrier PLE-PLN;
Meryl P. Littman VMD DACVIM, Philadelphia PA

	RD	PLN	PLE	Addison's
Age of Onset	<1-3 yrs	Mean ~ 6 yrs	Mean ~ 4.5 yrs	Young (in general)
Sex Predilection	None noted	Female: male=1.6	Female: male=1.7	Female (in general)
Polyuria/Polydipsia	Yes	Only 25% had PU/PD	No, unless on steroids	Yes
Vomiting/Diarrhea	Yes	Yes	Yes	Yes
Ascites/edema	No	Possibly	Possibly	No
Azotemia	Yes	Eventually	No	Possibly (pre-renal)
Kidney Size	Small	May be normal	Normal	Normal
Hypoalbuminemia	No	Yes	Yes	Possibly (melena)
Hypoglobulinemia	No	No	Yes	Possibly (melena)
Hypercholesterolemia	No	Yes	Hypocholesterolemia	No
Low Na/K ratio	Not noted	Rarely (~10%)	Rarely (~10%)	Yes
Urine Specific Gravity	Isosthenuria	Mean 1.023	Mean 1.033	Low (medullary washout)
Proteinuria	None or mild	Yes	No	No
Histopathology    K = kidney    I = intestine	Fetal glomeruli, fetal mesenchyme (K)	Glomerulonephritis, glomerulosclerosis (K)	IBD, lymphangiectasia, lymphangitis (I)

3.  Look for these additional lab results

RD	PLE	PLN1	Addison's2
Elevated creatinine Elevated BUN	Eosinophilia Lymphopenia Low total protein	Elevated serum creatinine Elevated BUN Elevated Urine Protein Creatinine Ratio** **Very important!	Elevated serum creatinine Elevated BUN

Dr. Shelley Vaden, ACVIM, North Carolina State University and Dr. Meryl Littman, ACVIM, University of Pennsyvania state that:

"Research suggests that any dog with UPC ratio in excess of 0.4 and no evidence of urinary tract infection should be closely monitored for the development of glomerular disease. This finding should be of particular concern in any breed of dog that is known to have familial glomerular diseases, such as the Wheatens."

If any lab results show any abnormalities, you can consult with Dr. Meryl Littman or Dr. Shelly Vaden for current recommendations on diagnosis and treatment. They are working under SCWTCA and American Kennel Club Canine Health Foundation sponsored research grants to help us better understand, treat and one day, prevent these diseases.

Find an ACVIM veterinary internist near you.

Dr. Meryl P. Littman Associate Professor of Medicine University of Pennsylvania School of Veterinary Medicine 3900 Delancey Street Philadelphia PA 19104-6010 (215) 898-9288 (215) 573-6050 fax (include cover sheet)

Dr. Shelly Vaden Professor, Internal Medicine North Carolina State University College of Veterinary Medicine 4700 Hillsborough Street Raleigh NC 27606 (919) 513-6235 (919) 513-6336 fax (include cover sheet)

Issued May 2004