Hyperglobulinemia will also be seen with chronic liver fibrosis with or without hypoalbuminemia. Other causes of decreased albumin include loss through diseased kidneys, liver, or GI system, and high protein effusions. Decreased production of albumin is seen with chronic liver disease. Causes of hypoglycemia include malabsorption, starvation, extreme exertion during endurance rides, aflatoxicosis, hyperlipidemia in ponies, and hepatic insufficiency. Total bilirubin is increased in hemolysis, massive internal hemorrhages, and hepatic diseases including hepatocellular injury and cholestasis.
Much confusion exists as to the utility of conjugated and unconjugated bilirubin determinations.
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