Albumin in Dogs

Most of physiology and anatomy is shared between human and veterinary medicine. Albumin was not going to be any different.

In this SoyUnPerro article, we'll tell you what it is, how important it is, and how to proceed when there's a deficiency of it, since it could have serious consequences. Here we go.

What Is Albumin and What Are Its Functions?

Albumin is an abundant blood protein (making up between 35 and 50% of total serum protein) synthesized and produced in the liver.

Its levels can also rise with diet and nutrition. A quality, balanced diet with no underlying conditions will maintain a correct level of albuminemia, or blood albumin.

Albumin within normal range and levels helps maintain the balance between the intracellular and extracellular space (correct oncotic pressure).

So it keeps fluids within the bloodstream without leaking into other tissues, which would cause extravasation or edema. It also transports various substances through the body, for example hormones, drugs, vitamins, and enzymes.

After surgery or trauma, correct albumin levels mean a good prognosis for tissue healing. By binding to albumin, toxic substances in the body can be inactivated.

What Factors Cause Hypoalbuminemia?

Hypoalbuminemia means low levels of this protein in the blood. Low albumin levels indicate a deficiency and a problem, with its respective consequences. Adequate levels usually range from two to four g/dl of blood albumin. When albumin concentration drops below two g/dl, symptoms start to appear.

As for the causes, they can be divided into four:

• Decreased synthesis or production.
• Loss of albumin after it's synthesized.
• Redistribution of albumin to places outside the intravascular space (within vessels).
• Dilution of albumin within that space.

A deficiency of albumin means fluid balance between the intra- and extracellular spaces (correct oncotic pressure) can't be maintained, so fluid moves from circulation into the tissues, potentially causing peripheral edema (distal limbs, ventral areas, dependent areas), organ edema, and effusion in the abdominal and thoracic cavities.

Malnutrition, prolonged starvation, or chronic gastrointestinal conditions such as IBD (chronic intestinal inflammation) tend to predispose to low blood albumin, or hypoalbuminemia. In conditions like IBD, nutrient malabsorption tends to occur along with resulting diarrhea, so nutrients won't be absorbed through diet, potentially creating a deficiency.

Liver failure, and specifically damage to hepatocytes (liver cells responsible for synthesizing albumin), will reduce albumin production, as will increased losses in cases such as kidney conditions, burns, or major wounds.

Diagnosis and Tests

As with any condition, the vet will need to get a general idea of the problem through a clinical history. Next, a general physical exam will be performed as protocol. After this, additional tests will be needed.

Running complete bloodwork will be extremely important: a CBC and blood chemistry panel. ALT and ALP results (liver enzymes) should be checked when liver disease is suspected, since in that case they'll be elevated.

High urea (BUN) and creatinine (CRE) values in the blood chemistry panel support a diagnosis of glomerular kidney disease.

Ultrasound will also be important, allowing a thorough, detailed exam of all the organs in the abdominal cavity. Inflammation of these organs can be observed, as well as ascites or free fluid in the abdominal cavity. The integrity of these organs' layers can be checked, along with their shape and the presence of possible masses.

Treatment for Hypoalbuminemia

As with all conditions, treatment will be aimed at resolving the cause behind the hypoalbuminemia. Since, if we only raised blood albumin levels without treating the underlying cause, we'd simply be putting on a patch.

Once we're treating the underlying condition, we need to watch whether blood albumin levels rise. Normally, if the animal improves symptom-wise and is eating well, hypoalbuminemia tends to resolve and normalize its levels.

If, despite treating the cause, levels don't rise, raising them exogenously needs to be considered. This isn't as advanced in veterinary medicine as in human medicine.

Besides a quality diet that's properly eaten, Fresh Frozen Plasma (FFP) can be tried, since it contains equivalent amounts of all the hemostatic proteins (clotting factors, antithrombin, macroglobulins, etc.), albumin, and globulins.

Plasma contains 0.025 g of albumin/ml. Plasma treatment is often inefficient and costly, given the amount of plasma needed to raise serum albumin levels. 20-30 ml/kg/day would be needed for a 0.5 g/dl increase, which becomes especially complicated in severe cases of hypoproteinemia requiring large volumes of plasma.

Human albumin administration can therefore be considered. We can also ask specialists in traditional Chinese medicine for advice, who can help us through acupuncture. As you can see, low blood albumin levels are dangerous, given the important functions this protein has in the body. So it needs to be resolved, and the underlying parallel cause, which usually exists at the same time, needs to be treated.