Low Blood Albumin in Cats

Low blood albumin, or hypoalbuminemia, is not itself a disease but is a symptom of an underlying disease or other causative factor. Since the liver is responsible for manufacturing albumin and maintaining optimum levels in the blood, liver disease is often suspected. However, low blood albumin can also be the result of malfunctioning kidneys, digestive problems such as inflammatory bowel disease (IBD), pancreatitis, malnutrition, or extensive damage to the skin from burns, infection or mites. Because diagnosing the underlying cause is critical to proper treatment, a trip to the veterinarian is in order.

Albumin is a blood protein that is manufactured in the liver. The main functions of albumin are circulating necessary molecules throughout the bloodstream in support of metabolic processes and binding with water to stabilize blood pressure by preventing leakage from blood vessels. Low levels of albumin in the blood can be caused by inadequate production of albumin in the liver or by loss of albumin through the kidneys, digestive tract, leaking blood vessels, or seeping skin. While fluid leaking from the skin is easy to identify as a problem, other less obvious signs of low blood albumin range from swelling of the chest or abdomen, puffiness in the legs, lethargy, lack of appetite or vomiting.

Since low blood albumin is essentially a side effect of some other underlying malady, symptoms of the condition will vary depending on the cause. Cats with low blood albumin may exhibit:

• Swelling of the abdomen
• Distended chest cavity
• Edema in the limbs, which is swelling from leaking fluid rather than from injury or trauma
• Panting, or shortness of breath
• Lethargy
• Poor appetite
• Vomiting
• Diarrhea
• Fluid seeping from the skin due to injury, infection or infestation

Hypoalbuminemia is caused by a disruption of albumin production in the liver, or through a depletion of the protein via blood loss or blood disease. The most common causes include:

• Liver disease
• Cholangiohepatitis, which is a malfunction of the liver that also includes the pancreas and/or gallbladder
• Chronic pancreatitis
• Inflammatory bowel disease
• Kidney disease
• Intestinal parasites
• Malnutrition or diet too low in protein
• Pyoderma, or skin infection
• Skin parasites such as demodectic or sarcoptic mange
• Widespread burns to the skin

Since hypoalbuminemia can have varying causes, your observations will be helpful to your veterinarian in determining which diagnostic tests to perform. Be prepared to tell your vet about your cat's diet and any variations in appetite. The vet will ask if the cat has had diarrhea, vomiting or other digestive changes. Mention any unexplained weight loss, and note whether there has been excessive urination. Based on your answers and any apparent physical symptoms such as areas of swelling or shortness of breath, your vet will conduct a thorough physical exam and may perform the following tests:

• Blood tests, including complete blood count, pancreatic lipase, and biochemical profile
• Blood pressure test
• Urinalysis
• Stool sample
• X-ray
• Ultrasound

Your veterinarian will review the results of the varying tests to determine the origin and probable cause of the malady. An imbalance of albumin and globulin proteins might suggest a problem with the liver itself, or it might be an indication of a problem elsewhere. High white blood cell counts can indicate infection. Abnormal blood urea nitrogen and creatinine levels suggest kidney problems. Pancreatic lipase numbers measure pancreas function. X-ray and ultrasound results can help identify abnormalities in specific organs or reveal the presence of tumors. It is in comparing the results of your cat's tests against normal values that your veterinarian can determine where the problem lies.

In cases which the issue is obviously a skin disorder, your veterinarian will still likely conduct blood and urine screenings to discover the extent of the skin problem's impact on the cat's total system. To determine the underlying cause of the skin disease itself, your veterinarian will conduct some or all of the following tests to identify the presence of bacterial infection or skin parasites:

• Skin swab
• Skin scraping
• Biopsy

The underlying cause of low blood albumin in cats will need specific treatment once a diagnosis has been made, but the symptoms of hypoalbuminemia must also be addressed, with severe cases requiring hospitalization. If your cat is experiencing fluid build-up in the abdomen or chest cavity that is impeding normal metabolic functions, the fluid can be drained to provide quick relief. Diuretics may be also administered to draw off excess fluid. IV fluids are likely to be administered to provide nutritional support, but fluid volume must be cautiously monitored to ensure that albumin levels do not decrease further as a result. 

Additional therapies may be administered due to underlying causes of hypoalbuminemia.

Liver Disease or Cholangiohepatitis

If the liver is harmed by infection or inflammation, it can sometimes regenerate and regain normal function once the problem is resolved. Antibiotics and anti-inflammatory medications may be prescribed. Tumors or blockages may require surgery with follow-up treatment as necessary. Even chronic diseases that cannot be fully cured can often be managed through a high protein, low-fat diet with supporting supplementation and medication.

Kidney Disease

Similar to liver issues, diseases of the kidney are often maintained rather than cured. Antibiotics for infection, corticosteroids for inflammation, and surgery for blockages or tumors may restore adequate function for continued quality of life. A prescription diet containing high quality protein with specifically balanced minerals typically provides the best long-term results.

Inflammatory Bowel Disease (IBD)

Although IBD is not a single disease but a group of diseases with related symptoms, treatment can typically be narrowed to target the most likely causes. Intestinal parasites are one cause of IBD that can be treated and eliminated. Other potential causes include food allergies, imbalanced gut bacteria, and non-specific immunodeficiencies. Rely on your veterinarian for proper diagnosis and treatment.

Skin Disorders

If your cat is suffering low blood albumin due to chronic infestation of skin mites such as sarcoptic or demodectic mange, your veterinarian will prescribe treatment to kill the mites and help heal the skin. Pesticides delivered via shampoos, soaking or sponging dips, and oral medications are normal, with some topical applications best performed by hospital staff in the clinic for safety reasons. Staph infections will be treated with antibiotics via injection, topical application, oral medication or a combination of methods.

Once the underlying cause of your cat's hypoalbuminemia has been treated, follow-up visits will be necessary to ensure that both the initial problem and the low albumin levels are under control. Simple laboratory tests of blood, fecal and urine samples to monitor organ function are likely, at least for a period of time. Skin scrapings to confirm the elimination of pests will be in order for cats being treated for mange. Chronic diseases will require monitoring for the long term. Changes to the diet are typical in many instances, and regular exercise may be prescribed to help eliminate edema in the limbs.