In dogs with PLE, ascites may be the only presenting sign.

• A. False
• B. True
• C. Cannot be determined from history alone
• D. Ascites is never seen as the only sign

Answer: (B)

Protein-losing enteropathy can cause a substantial loss of albumin into the gut, which lowers the serum oncotic pressure. When oncotic pressure drops, fluid tends to shift from the vasculature into third spaces, including the peritoneal cavity. That fluid accumulation can be the only outward sign in some dogs, so ascites may be present even in the absence of other GI symptoms like vomiting, diarrhea, or overt weight loss. This is why the statement that ascites may be the only presenting sign is correct. In practice, when a dog has unexplained ascites and hypoalbuminemia, PLE should be on the radar, and further workup to confirm intestinal protein loss can be pursued.