Practical Matters: Boost your hypoalbuminemia workup
If panhypoproteinemia (low albumin and globulin) is present, protein-losing enteropathy should be the primary differential diagnosis.2,3 Not all patients with protein-losing enteropathy will present with gastrointestinal signs. Furthermore, some patients may have concurrent protein-losing nephropathy or advanced hepatic disease that may contribute to the hypoalbuminemia. So evaluating for concurrent disease is recommended even in confirmed cases of protein-losing enteropathy.
REFERENCES1. Murphy KF, German AJ, Ruaux CG, et al. Fecal alpha1-proteinase inhibitor concentration in dogs with chronic gastrointestinal disease. Vet Clin Pathol 2003;32:67-72.
2. Kull PA, Hess RS, Craig LE, et al. Clinical, clinicopathologic, radiographic, and ultrasonographic characteristics of intestinal lymphangiectasia in dogs: 17 cases (1996-1998). J Am Vet Med Assoc 2001;219:197-202.
3. Willard MD, Zenger E, Mansell JL. Protein-losing enteropathy associated with cystic mucoid changes in the intestinal crypts of two dogs. J Am Anim Hosp Assoc 2003;39:187-191.
Scott R. Helms, DVM, DABVP