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What cancers cause low albumin?

Cancers that can cause low albumin include gastrointestinal lymphoma, intestinal lymphangiectasia, and alimentary lymphoma, primarily through protein-losing enteropathies.

Cancers That Cause Low Albumin in Dogs

Albumin is a vital protein produced by the liver and found in blood plasma. It plays a significant role in maintaining oncotic pressure, transporting various substances like hormones and medications, and supporting the body's antioxidant defenses. When albumin levels in the blood drop below 2.5 g/dL in dogs, the condition is termed hypoalbuminemia. This is not a disease itself but a clinical indicator of an underlying issue—often serious. One lesser-known but essential cause of hypoalbuminemia is cancer. Several types of cancer can result in significantly reduced albumin levels due to a combination of factors including protein loss, poor production, inflammation, and overall systemic impact. Below is a detailed guide exploring the types of cancers associated with hypoalbuminemia in dogs.

How Cancers Lead to Low Albumin

Cancers can trigger hypoalbuminemia through various mechanisms:
  • Protein-losing enteropathy (PLE): Certain types of cancer disrupt the intestinal lining, leading to abnormal loss of protein into the GI tract.
  • Decreased production: Some malignancies, particularly those affecting the liver, impair the liver’s ability to produce albumin.
  • Systemic inflammation: Cancer often induces a generalized inflammatory state, reducing albumin synthesis as part of the acute phase response.

Types of Cancer Associated with Low Albumin

1. Gastrointestinal Lymphoma This is one of the most common cancers linked to hypoalbuminemia due to its role in PLE.
  • Destroys or inflames intestinal tissue, reducing nutrient absorption and causing protein loss.
  • Often seen in both dogs and cats, especially in breeds predisposed to GI disorders.
  • May be diagnosed via intestinal biopsies or imaging.
2. Alimentary Lymphoma A subtype of lymphoma that targets the digestive tract:
  • Promotes severe inflammation and damage to intestinal structure.
  • Leads to chronic diarrhea, weight loss, and hypoalbuminemia.
  • Common in cats more than dogs, but both are susceptible.
3. Intestinal Lymphangiectasia Though not a cancer itself, this condition often accompanies or is mistaken for GI cancers. It involves dilation of lymphatic vessels in the intestines, leading to:
  • Protein leakage into the intestines.
  • Reduced serum albumin levels.
  • May be diagnosed via endoscopy and intestinal biopsy.
4. Liver Tumors The liver is the primary site of albumin production. Tumors (like hepatocellular carcinoma) may:
  • Impair albumin synthesis directly.
  • Cause significant inflammation that shifts the liver's protein production priorities.
  • Be detected via ultrasound, liver function tests, or biopsy.

Clinical Signs of Low Albumin

Regardless of the cause, hypoalbuminemia presents with non-specific symptoms such as:
  • Abdominal swelling (ascites)
  • Edema in limbs or face
  • Pleural effusion leading to labored breathing
  • Lethargy and weakness
  • Vomiting, diarrhea, or weight loss
  • Poor coat quality and inappetence

Diagnosing the Underlying Cause

To determine if cancer is the cause of low albumin, veterinarians perform a series of diagnostics:
  • Blood tests: Checking serum albumin, liver enzyme levels, and other markers.
  • Urinalysis: To rule out renal protein loss.
  • Imaging: Abdominal ultrasound or X-rays to identify tumors or intestinal abnormalities.
  • Biopsies: Of the intestines, liver, or suspected masses to confirm malignancy.
  • Fecal testing: To rule out parasites that may mimic or aggravate PLE.

Treatment Options

Once a cancer diagnosis is confirmed as the cause of hypoalbuminemia, treatment focuses on two fronts: managing the cancer and stabilizing albumin levels. For Cancer:
  • Chemotherapy (e.g., for lymphoma)
  • Surgical removal of tumors if feasible
  • Supportive medications to manage inflammation and GI symptoms
To Stabilize Albumin:
  • Plasma transfusions in severe cases
  • Ultra-low fat diets for cases involving intestinal lymphangiectasia
  • Anti-inflammatory or immunosuppressive drugs (e.g., prednisolone, cyclosporine)
  • Nutritional support using feeding tubes if inappetence is profound

Prognosis

The outlook varies based on:
  • The type and stage of cancer
  • The severity of albumin loss
  • Response to treatment
Early diagnosis and targeted therapy improve survival and quality of life. Dogs with treatable lymphomas or well-managed intestinal lymphangiectasia can live comfortable and fulfilling lives. However, prognosis remains guarded in cases of aggressive or advanced cancer.

Monitoring and At-Home Care

Regular follow-up is key to managing cancer-related hypoalbuminemia:
  • Blood tests to monitor albumin and treatment response
  • Consistent medication and diet adherence
  • Monitoring for signs of fluid accumulation
  • Maintaining a low-stress, supportive home environment

Conclusion

Cancer is a significant and often under-recognized cause of hypoalbuminemia in dogs. Recognizing the warning signs, pursuing thorough diagnostics, and initiating appropriate treatment can dramatically influence outcomes. Pet owners should work closely with their veterinary team to ensure optimal care and quality of life for their animal companions.

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