Vet360 Vol 4 Issue 3 June 2017 Vet360 - Page 33

CLINICAL PATHOLOGY measure albumin on veterinary chemistry analysers is not accurate in rabbits (falsely high), birds (falsely low) and some new world monkeys (falsely high). SPE is necessary to determine albumin concentra- tions accurately in these species. 2. Clinical suspicion of multiple myeloma, based on the presence of bone pain, lytic bone lesions, proteinuria and/or hypercalcaemia. These patients will gener- ally also have a hyperglobulinaemia (based on rou- tine clinical chemistry testing) but can present with normoglobulinaemia. Normal plasma cells produce a wide variety of immunoglobulins, but neoplastic plasma cells in multiple myeloma produce only one, or sometimes two types (or clones). All of these iden- tical proteins will migrate to the same area on the electrophoresis gel, resulting in a high narrow-based peak in either the beta-2 or gamma area (Figure 2). Figure 2: Electrophoretogram showing the appearance of a monoclonal peak in the gamma area. This is called monoclonal gammopathy and is sup- portive for the diagnosis of multiple myeloma. 3. Persistent unexplained increase in globulins: the electrophoretogram will demonstrate an increase in one of the fractions, which may help to guide further diagnostics. 4. Unexplained hypogammaglobulinaemia: This is a rare indication as usually low globulin concentra- tions can be linked to lack of synthesis due to hepatic insufficiency, or loss due to haemorrhage or pro- SPE is not particularly helpful in diagnosing the cause of inflammation or confirming FIP tein-losing enteropathies. Failure of passive transfer in neonates will also result in hypoglobulinaemia due to very low concentrations of IgG – this diagnosis is based on history and direct measurement of IgG, not SPE. SPE is not particularly helpful in: 1. Inflammation: an acute phase response, with de- creased in albumin and increases in alpha globulins, is expected in acute inflammation. An increase in the beta and gamma fractions (immunoglobulins) is ex- pected in chronic inflammation. Other indicators of inflammation, like fever and an inflammatory leuko- gram, are much more obvious and accessible in cats and dogs. If an inflammatory state is suspected in the absence typical leukogram changes, direct meas- urement of acute phase proteins (C-reactive protein, serum amyloid A, haptoglobin) is preferred. 2. Feline infectious peritonitis: the SPE pattern in FIP usually shows an increase in both alpha and gamma globulins, which is typical of chronic inflammation with an active component. This pattern may be seen in immune-mediated and other infectious diseases, neoplasia and chronic hepatitis, and is not specif- ic for FIP. The serum albumin: globulin ratio has a much higher diagnostic value for FIP than SPE.3 References: 1. Stockham SL, Scott MA. Proteins. Fundamentals of Veterinary Clinical Pathology. 2nd ed. Ames, Iowa: Blackwell; 2008:369-414. 2. Eckersall PD. Proteins, proteomics and the dyspro- teinemias. In: Kaneko JJ, Harvey JW, Bruss ML, eds. Clinical biochemistry of domestic animals. 6th ed. Burlington, MA: Elsevier Academic Press; 2008:117- 156. 3. Hartmann K, Binder C, Hirschberger J, et al. Compar- ison of Different Tests to Diagnose Feline Infectious Peritonitis. Journal of Veterinary Internal Medicine. 2003;17(6):781-790. The OVAH Clinical Pathology Laboratory offers Exotic Animal Electrophoresis for R150.00 plus VAT The electrophoresis is run in duplicate, on serum samples, and a minimum volume of 100 uL (0.1 mL) is needed. Samples are generally only run once weekly, but there is flexibility for emergency cases. Please contact the clinical pathology lab on 012 529 8199 or email emma.hooijberg@up.ac. za for further information. Issue 03 | JUNE 2017 | 33