hyperglobulinaemia/hypoalbuminaemia in a cocker

Re: hyperglobulinaemia/hypoalbuminaemia in a cocker

Kate Richardson — Thu, 28 Jul 2011 10:29:12 GMT

[quote user="phipps"]

Are you referring to albumin being a "negative" acute phase protein?

[/quote]

That's the one!

Re: hyperglobulinaemia/hypoalbuminaemia in a cocker

Glen McIntosh — Wed, 27 Jul 2011 19:34:27 GMT

[quote user="Kate Richardson"]I think you can also get a decrease in albumin if you have an inflammatory process going on causing globulins to increase, there is a special term for it, but can't remember it.[/quote]

Are you referring to albumin being a "negative" acute phase protein?

That is, albumin is a "negative" acute phase protein because its production by the liver decreases in inflammatory states so that amino acids etc can be shunted towards production of "positive" acute phase proteins by the liver, such as C-reactive protein, fibrinogen, prothrombin and factor VIII - which are increased in inflammatory states.

Therefore decreased albumin can be a marker for inflammation, other things being equal.

Re: hyperglobulinaemia/hypoalbuminaemia in a cocker

Hannah Wynne Richards — Wed, 27 Jul 2011 13:14:37 GMT

Gut feeling 2 probs, acute kidney inflammation/ poss trauma as haematuria causing presenting symptoms, if other liver parameters normal, poss long term underlying mild intestinal malabsorption causing low albumin, or as Kate said low alb going with high globs due to inflammation

Wynne

Re: hyperglobulinaemia/hypoalbuminaemia in a cocker

Kate Richardson — Wed, 27 Jul 2011 10:14:59 GMT

Causes of hypoalbuminaemia would be reduced production by the liver, reduced dietary protein intake, reduced absorption of dietary protein, increased use, or increased loss via either the urinary tract or the GIT, or into a body cavity eg if a pleural or abdominal effusion. I think you can also get a decrease in albumin if you have an inflammatory process going on causing globulins to increase, there is a special term for it, but can't remember it. With an elevated WBC count and hyperglobulinaemia, this would seem quite likely.

If he is eating ok and on a balanced dog food, you can probably rule out reduced intake. Are there any GIT signs- faeces softer or paler than normal? Any history of vomiting?

What were the liver parameters- urea is low normal which could suggest some liver dysfunction, glucose can also be low and liver enzymes can be normal with liver disease, so keep it on the list until ruled out, so consider bile acid stim and ultrasound of liver, ultimately biopsy if indicated.

Urine protein:creat ratio will give you a quantitative measure of protein in the urine and will tell you if there is excessive amount, and yes it does need to be taken in context with a sediment exam, however I thought an active sediment exam usually meant wbcs? Urine C&S definitely indicated as well.

You say the albumin and creat are both decreasing but your figures say they are the same- error? Did you do the bloods in house or via a lab? Potassium can often be artefactually high due to haemolysis or sample ageing, I often get elevated K on samples sent away due to this so I tend to run them in house if possible as soon after collection as possible if I am particularly interested in K levels. Generally with renal disease I would expect hypokalaemia not hyper.

I don't think it unusual to have haematuria with no clinical signs of urinary tract disease, you can often get subclinical UTIs or idiopathic haematuria. He is neutered so prostatic disease less likely (other than neoplasia, but think you would have more signs).

The anaemia is mild, again could be due to blood loss, or secondary to other disease. Have you looked at a blood smear?

Based on your info, I would be going with inflammation causing elevated globulins, low albumin secondary to this (someone will tell me the proper term for this!) You say he is bright and well now, and essentially normal, so I would probably go with repeated urinalysis to see if the haematuria is persistent, UPC, urine C&S, and imaging if persistent haematuria.

Re: hyperglobulinaemia/hypoalbuminaemia in a cocker

HMC — Wed, 27 Jul 2011 08:45:14 GMT

[quote user="Rob Davis"]Urine protein:creatinine ratio to confirm renal protein loss.[/quote]

I didn't think that the UPC would confirm that the protein loss was renal in origin and that that was why you're meant to do a sediment exam at the same time to rule out post-renal causes (which in this case does not rule it out).

He's not losing weight and no signs of dehydration at any of the exams or on other blood parameters.

Re: hyperglobulinaemia/hypoalbuminaemia in a cocker

Rob Davis — Tue, 26 Jul 2011 20:10:08 GMT

Urine protein:creatinine ratio to confirm renal protein loss. Glomerulonephropathy doesn't have to equal decreased renal function, particularly in the early stages. I suspect the creatinine is decreasing as he was slightly dehydrated initially and this is now improved. Is he losing weight?