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Abstract

OBJECTIVE

Albumins are protein molecules that account for 50% of total plasma protein. They are imperative in maintaining intravascular colloidal oncotic pressure, act as key scavenger molecules for oxygen free radicals, and perform a major role in transporting numerous substances and in wound healing. Hypoalbuminemia has been reported as the consequence of decreased intake, increased loss, decreased production, and redistribution. While anecdotal evidence of tyrosine kinase inhibitors causing hypoalbuminemia in canine patients exists, to the author’s knowledge there is no formal report to this effect to date. This case report aims to bridge the gap between anecdotal evidence and literature.

ANIMAL

3-year-old neutered male hound-mix canine.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

The patient was presented for recurrent otitis externa refractory to treatments with orbifloxacin/mometasone/posaconazole otic suspension, miconazole/polymyxin B/prednisolone otic suspension, ketoconazole/TrizEDTA, and gentamicin/mometasone/clotrimazole, which prompted consideration of oral antifungals. Baseline blood work prior to initiation of fluconazole showed elevated alkaline phosphatase. Treatment was initiated with fluconazole, and blood work was rechecked and revealed hypoalbuminemia. Multiple diagnostic tests failed to reveal a cause of hypoalbuminemia.

TREATMENT AND OUTCOME

Discontinuation of oclacitinib that the patient was being administered resulted in normalization of serum albumin.

CLINICAL RELEVANCE

It is unclear whether hypoalbuminemia associated with oclacitinib administration is associated with worse outcomes for pathologies in canine patients; however, this seems to be the case in humans according to some reports. This report aims to take a step in the direction of this knowledge.

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in Journal of the American Veterinary Medical Association

, and weight loss. Diagnosis of the disease can be challenging and relies on the presence of hypoproteinemia due to hypoalbuminemia, thickening of segments of the small intestinal wall (> 3 mm) observed via abdominal ultrasonography, positive results of

Full access
in American Journal of Veterinary Research

range, 1 5.8 to 21.0 × 10 3 WBCs/μL), hypoproteinemia (4.2 g/dL; reference range, 1 5.3 to 6.3 g/dL), and hypoglycemia (54 mg/dL; reference range, 1 81.5 to 116.1 mg/dL). Results of a fecal flotation test were negative. Lacking a definitive diagnosis

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in Journal of the American Veterinary Medical Association

these variables was the relative simplicity of sample collection. Hypoproteinemia and hypoalbuminemia are seen with changes in the integrity of the intestinal mucosa. Albumin is the most abundant protein in equine plasma and has a low molecular weight

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in American Journal of Veterinary Research

21 seconds (reference range, 12 to 17 seconds) and aPTT was 108 seconds (reference range, 71 to 102 seconds). The worsening anemia, hypoproteinemia, and prolonged coagulation times were consistent with massive blood loss and a mild dilutional

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in Journal of the American Veterinary Medical Association

chronic inflammation, although stress may have contributed to the lymphopenia. 2,3 Serum biochemical analysis indicated moderate hypoproteinemia (3.9 g/dL; reference interval, 4.9 to 7.6 g/dL 1 ), moderate hypocholesterolemia (105 mg/dL; reference

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in Journal of the American Veterinary Medical Association

reevaluated because of multiple episodes of vomiting and anorexia. The dog weighed 12.2 kg (26.8 lb), and physical examination results were unremarkable. A CBC revealed hypoproteinemia (4.2 g/dL; reference range, 5.0 to 7.4 g/dL) with mild hypoalbuminemia (2

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in Journal of the American Veterinary Medical Association

leukocytosis, prolonged aPTT and PT, hyponatremia, hypochloremia, hypocalcemia, hyperphosphatemia, hypoproteinemia including hypoalbuminemia and hypoglobulinemia, and a high SUN concentration. Figure 1— Plasma protein C activity (A) and serum cholesterol

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate risk factors associated with development of catheter-associated jugular thrombophlebitis in hospitalized horses.

Design—Retrospective case-control study.

Animals—50 horses with thrombophlebitis and 100 control horses.

Procedure—Medical records from 1993 through 1998 were searched for horses with thrombophlebitis. Horses that were hospitalized for at least 5 days, had an IV catheter placed in a jugular vein (other than for solely anesthetic purposes), and had no evidence of thrombophlebitis during admission or hospitalization were chosen as controls. Signalment, history, clinicopathologic findings, primary illness, and treatment were obtained from the medical records. Data were analyzed by use of logistic regression to perform univariate and multivariate analyses.

Results—For a horse with endotoxemia, the odds of developing thrombophlebitis were 18 times those for a similar horse without endotoxemia. For a horse with salmonellosis, the odds of developing thrombophlebitis were 68 times those for a similar horse without salmonellosis. For a horse with hypoproteinemia, the odds of developing thrombophlebitis were almost 5 times those for a similar horse without hypoproteinemia. For a horse in the medicine section, the odds of developing thrombophlebitis were 16 times those for a similar horse in the surgery section. For a horse with large intestinal disease, the odds of developing thrombophlebitis were 4 times those for a similar horse without large intestinal disease. For a horse receiving antidiarrheal or antiulcerative medications, the odds of developing thrombophlebitis were 31 times those for a similar horse not receiving these medications.

Conclusions and Clinical Relevance—Results indicated that patient factors, including large intestinal disease, hypoproteinemia, salmonellosis, and endotoxemia, were associated with development of catheter-associated thrombophlebitis in horses. (J Am Vet Med Assoc 2005;227:1134–1141)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine clinical and laboratory findings associated with protein-losing enteropathy, hypomagnesemia, and hypocalcemia in Yorkshire Terriers.

Design—Retrospective study.

Animals—5 purebred or crossbred Yorkshire Terriers with protein-losing enteropathy, hypomagnesemia, and hypocalcemia.

Procedure—Medical records were reviewed for dogs with protein-losing enteropathy, hypomagnesemia, and hypocalcemia.

Results—Of 8 dogs with these signs, 5 had Yorkshire Terrier breeding. Common findings were diarrhea, abdominal effusion, leukocytosis, neutrophilia, hypocalcemia (ionized calcium), hypomagnesemia, hypoproteinemia, hypoalbuminemia, hypocholesterolemia, and increased serum activity of aspartate aminotransferase.

Conclusions and Clinical Relevance—Yorkshire Terriers are at increased risk for development of protein-losing enteropathy with hypomagnesemia and decreased ionized calcium concentration. Hypomagnesemia and hypocalcemia may have a related pathogenesis involving intestinal loss, malabsorption, and abnormalities of vitamin D and parathyroid hormone metabolism. Serum electrolyte replacement may be required to avoid neurologic and metabolic problems. (J Am Vet Med Assoc 2000;217: 703–706)

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in Journal of the American Veterinary Medical Association