Need “Expert Owner” Advice re: albumen & calcium

[Weezie]

My (just turned 8 years old) female English Bulldog had a senior panel/series of tests that showed she has low calcium and low albumin. She is otherwise in good health With some gastrointestinal diarrhea issues currently being controlled by Rx food.

Our vet suggested we test further for the low calcium/albumin readings but this one test may necessitate further tests, ultrasounds, etc. Regardless of my decision to test for this specific issue, we will definitely monitor it probably every six months or so with blood tests.

I understand this may not be clear but it might be to others who’ve gone down this road before. I’m willing to do what is best for my dog but I’ve not heard of this very specific health issue before and would appreciate any advice. Thank you all in advance.

 

[anatess]

Yikes.

This can be as simple as nutritional deficiency that can be corrected by adjusting nutritional intake (high protein diet, in my opinion, I'm not a vet).

Or, this can possibly be some kidney or liver failure that is causing the low albumin counts.

So, if this was my dog, I'd go for further tests specific to the albumin/calcium reading in addition to a nutritional adjustment. I'm worried about vets and their Rx foods. Not many vets carry good food.

 

[hollyd26]

I agree with the prior Yikes comment. Speaking from experience, please do not take low albumin levels lightly. Further, the diarrhea could be related. Also, watch for fluid retention which is sometimes harder to notice on a bulldog due to their extra skin.
My girl was found to have protein losing enteropathy (PLE) and inflammatory bowel disease as a result of the PLE. It was a long and tough road and she was near death at one point but with my very knowledgeable vet and frequent visits to check her albumin and other protein levels, homemade meals, and a regimen of medications, she pulled through.
Well wishes to you and yours!

 

[Weezie]

I agree with the prior Yikes comment. Speaking from experience, please do not take low albumin levels lightly. Further, the diarrhea could be related. Also, watch for fluid retention which is sometimes harder to notice on a bulldog due to their extra skin.
My girl was found to have protein losing enteropathy (PLE) and inflammatory bowel disease as a result of the PLE. It was a long and tough road and she was near death at one point but with my very knowledgeable vet and frequent visits to check her albumin and other protein levels, homemade meals, and a regimen of medications, she pulled through.
Well wishes to you and yours!

Thank you for your thoughtful response. Might I ask how old your female Bulldog was when she was going through the PLE? It's not like I'm not all over this problem, and my bulldog has always been fed high quality human grade, fresh food (prior to being on the Rx food right now) from a local resource. The word "yikes" in this context was and is terrifying to me. I'm just looking for some personal insight from other Bulldog owners who've faced this problem. Thank you again.

 

[hollyd26]

I'm so sorry, I didn't mean to scare you. I guess seeing the low albumin levels and gastro issues brought me back to my situation and scared me! I honestly haven't even been on this site in a long time as my Ellie had passed away a few months ago but I saw your question come up in my email and felt obligated to share what little insight I may have, which may be way off base for your situation but I just thought if I mentioned it, it is something that you could look into further to see if it fits and then discuss with your vet.

I would estimate that Ellie was approximately 5-7 when she was going through it. She was a rescue from a mill so it's hard to know her true age as well as any medical history. It started when I brought her into emergency upon noticing severe edema and was initially dismissed because they attributed it to being fat rather than fluid but I insisted. It didn't help that her skin was still very lax and sagging from being bred. Very long story short, they thought perhaps Cushing's but eventually ruled that out then suspected PLE and had to scope her to confirm, which they did and confirmed. She became very sick and weak in the interim, had terrible diarrhea that she could not always control. (she was often a "7" on the chart I attached which I used to gauge and report to the vet). The usual regimen for PLE includes steroids, amongst other meds, but the one steroid we tried beyond prednisone (name escaping me but different reactions for everyone) almost killed her so I asked to try budesonide a second time, which is more systemic so less side effects, and it started working...it just needed more time.

It probably was almost a year of trying different meds and combinations of such before her albumin finally got around 3.0...the vet called her a miracle! We never took her off the regimen of meds entirely so as not to trigger any recurrences, just lowered dosage and frequency. The long term effects of steroids include muscle weakness so once she was better, we started twice weekly water treadmill therapy to help.

Oh and I tried the Rx food also but it didn't help and I definitely did not like the list of ingredients so I switched her to ground turkey, carrots, green beans, and rice. She had a lot of allergies too.

I hope that gives you a jumping off point and leads you in the right direction! It took us a minute to get her diagnosis and it took some insistence on my part to convince them that something wasn't right but by no means am I speaking negatively of my clinic...they see so much, I understand how they can conclude differently at first so that's where you come in if anything doesn't sound right. You know your dog best!!

 

[rjisaterp]

This is from PetMD: https://www.petmd.com/dog/conditions/cardiovascular/c_dg_hypocalcemia

Hypocalcemia in Dogs​

If your dog has lower than normal levels of calcium in its blood, it is suffering from the medical condition known as hypocalcemia. Calcium plays an important role in vital bodily functions such as bone and teeth formation, blood clotting, milk production, muscle contraction, heart pumping, vision, and in the metabolism of hormones and enzymes. Therefore, calcium deficiency is a serious condition that requires immediate treatment.

Symptoms and Types​

Symptoms vary depending on the underlying cause and severity of the problem. However, some of the more common symptoms include:

• Muscle twitching and trembling
• Uncoordinated or stiff gait
• Panting
• Face rubbing against objects
• Vomiting
• Lack of appetite
• Fever
• Weakness

In mild cases, no symptoms may be observed until total calcium level fall well below normal (6.7 mg/dL).

Causes​

Albumin is a protein found in the blood and significant fraction of calcium remains bound to albumin along with free calcium in the blood. If the level of albumin falls (hypoalbuminemia) due to some other problem or disease, it also affects the total calcium level. Although it accounts for more than 50 percent of hypocalcemia cases, low levels of calcium associated with hypoalbuminemia are not generally associated with any symptom.
Hypocalcemia may also be due to:

• Kidney failure (acute or chronic)
• Poor calcium absorption in the gut
• Alkalosis (condition in which the body fluids have excess base alkali)
• Hypoparathyroidism (Inadequate secretion of parathyroid hormone resulting in abnormally low levels of calcium in the blood)
• Hypoparathyroidism secondary to surgical removal of the thyroid gland (thyroidectomy)
• Nutritional secondary hyperparathyroidism
• Oxalate toxicity (e.g., lily, philodendron, etc.)
• Hypomagnesaemia (low levels of magnesium in the blood)
• Acute pancreatitis (inflammation of the pancreas)
• Rickets (early age disease caused by deficiency of vitamin D and sunlight associated with impaired metabolism of calcium and phosphorus)
• Puerperal tetany (Clinical neurological syndrome characterized by muscular twitching and cramps and seizures; associated with calcium deficiency [hypoparathyroidism] or vitamin D deficiency or alkalosis)
• Phosphate-containing enemas used in patients with severe constipation
• Citrate toxicity in patients with multiple blood transfusions were conducted for some other health problem

Diagnosis​

There are occasions where a laboratory error reflects hypocalcemia when in fact your dog is just fine. To verify, it is important you give a detailed history of your dog’s health, onset and nature of symptoms, and possible incidence that might have precipitated the condition. Your veterinarian will also perform a thorough physical exam to evaluate all body systems to evaluate overall health of your dog. Routine tests including complete blood count, biochemistry profile, and urinalysis will provide valuable information about the blood calcium levels and information about the possible inciting cause(s) of hypocalcemia in your dog.
If kidney failure is the precipitating cause of hypocalcemia, complete blood count may show anemia in dogs with chronic kidney failure. Anemia may also be present in patients with nutrition related secondary hyperparathyroidism or poor intestinal absorption of calcium in the gut.
In case of infection or inflammation (like pancreatitis), the number of white blood cells may have found to be abnormally high. In some dogs with pancreatitis, amylase and lipase enzymes are also found to be elevated. In dogs with low levels of albumin (hypoalbuminemia), the biochemistry profile will show levels of albumin and disturbances in calcium levels. Meanwhile, if alkalosis is a cause of hypocalcemia, the blood gas analysis will reveal abnormally high levels of carbon dioxide in the blood of your dog.
Dogs with with kidney failure ethylene, glycol toxicity, or oxalate toxicity may present abnormally high levels of Blood Urea Nitrogen (BUN) and creatinine. Phosphorous derangements are also common in conditions leading to low calcium levels and in patients with kidney problems, ethylene glycol toxicity, oxalate toxicity, and hypoparathyroidism, biochemistry profile may show abnormally high levels of phosphorous. High phosphorous levels and hypocalcemia may also be found in the blood if enemas containing phosphorous are used in patients requiring enema; in constipation, for example. Urinalysis may reveal abnormally low concentrated urine and presence of glucose in patients with kidney problems or ethylene or oxalate toxicity.
To determine if the low level of calcium is responsible for the symptoms present, your veterinarian may order further testing to find the concentration of ionized fractions of calcium, which is the active form of calcium in the blood. In case of ethylene glycol toxicity, the ethylene glycol test will be performed to confirm the toxicity. Your veterinarian will draw a blood sample from a vein of your dog and will send it to the laboratory to determine the levels of ethylene glycol in the blood. Normally, the level of ethylene glycol in the blood should be zero. If hypoparathyroidism is suspected, more detailed tests to evaluate the functions of the parathyroid gland will be conducted.
Radiography of the abdomen may reveal smaller than normal sized kidneys in dogs with chronic kidney failure and large-sized kidney in animals with ethylene glycol toxicity, oxalate toxicity, or acute kidney failure. Dogs with nutrition related secondary hypoparathyroidism, meanwhile, may display low bone density on bone X-rays.

Treatment​

Generally, hypocalcemia is corrected through calcium supplementation therapy under close monitoring, so as to prevent side-effects related to calcium overload. Your veterinarian will also monitor the electrocardiogram data (EKG) because calcium has a direct effect on heart and significant calcium level changes leads to abnormal EKG findings.
After intravenous calcium therapy, your veterinarian may like to continue calcium supplementation for an extended period of time to prevent relapse. In addition, severe cases of hypocalcemia may require extended hospital stays.

Living and Management​

In cases with transitory hypocalcemia, the initial calcium therapy will generally resolve the problem. However, if the hypocalcemia was due to a serious health problem, it will need to be treated further to prevent future episodes. Hypocalcemia due to nutrition and parturition (the act of giving birth) may also require further action.
If your dog's hypocalcemia is related to nutrition, for example, your veterinarian will make new dietary recommendations. While bitches that have recently given birth may be separated from their puppies. In these cases, the puppies can be nursed by hand until the dog's hypocalcemia has properly been addressed.

I hope this helps.

Best regards,

Roger

 

[rjisaterp]

It's not funny, but my Jewelie Girl is in the ER now with similar symptoms above and we will ask the doctor about her blood work paying attention to those causes mentioned above

We hope your Bella bully is OK.

Roger

 

[Weezie]

It's not funny, but my Jewelie Girl is in the ER now with similar symptoms above and we will ask the doctor about her blood work paying attention to those causes mentioned above

We hope your Bella bully is OK.

Roger

Hi Roger,
Thank you very much for your very thoughtful and helpful response. I hope your Jewelie Girl is (and gets) better very soon.
Donald

 

[2BullyMama]

No insight, but I will be praying for your baby!
@oscarmayer … any insight?

 

[chauncey_pancakes]

We have tried every store brand & holistic brand dry and wet food, he is 12 years old now. We've seen a dermatologist, allergist, ER Visits, injections, and allergy medications such as Apoquel over several years. All of which has helped but the side effects/cost/results did not work out for us. We have ruled out neurological conditions from seizures, kidney/liver disease, blood disease etc. His weight and protein/liver enzymes were elevated when i had him on dry kibble, so we tried fresh food.

We have been using The Farmers Dog since Feb 2022 and i have noticed instant results with his weight and allergies. My dog has lost 5 pounds so far and is now excited about food. His GI/stool has improved and his energy is up. His dry eye has improved by over 75% IMO and skin, paws, ears have been great. This this was our absolutely last option due to the $$, but noticed results within 2 to 3 days. His protein/liver lab results have stabilized.

I'm not sure if fresh food is the way for your dog but maybe this can give you some insight for your dog's nutrition treatment.

Good luck and wishing you all the best for your pal.