Case 6

Based on the degree of proteinuria that Roxy has in the face of the hypoalbuminemia, you add a UPCR to her urinalysis. This test quantifies renal protein loss. Normal dogs should have a value < 0.5.

Roxy's UPCR = 0.2. Thus, her proteinuria may have been physiologic. This transient proteinuria can occur secondary to seizures, excessive exercise, fever, or stress but is not due to a permanent glomerular disease.

Now that you know Roxy's hypoalbuminemia is not due to kidney disease, what's next? It's possible the problem may be due to underlying GI disease or decreased hepatic production. No overt evidence of vasculitis is present, so protein loss is unlikely. Two things may indicate one organ system over the other. Typically, dogs with hypoalbuminemia due to liver disease have a low albumin concentration but a normal or elevated globulin concentration because the body tries to normalize osmotic forces in the face of hypoalbuminemia by increasing globulin production. And patients with hypoalbuminemia due to GI loss often have both globulin and albumin losses, so both protein concentrations may be low. However, in patients with protein loss due to glomerular disease, the albumin concentration is low but the globulin concentration is normal (or perhaps elevated) since albumin is a smaller molecule and the first to be lost through damaged glomeruli.

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