Differential Diagnosis: Hypocholesterolemia

Julie Allen, BVMS, MS, MRCVS, DACVIM (SAIM), DACVP (Clinical), Durham, North Carolina

ArticleLast Updated March 20191 min readPeer Reviewed
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A small Yorkshire Terrier sits on green grass, looking directly at the camera with a curious expression. The dog has a shiny, well-groomed coat with a mix of black, brown, and tan fur, and is wearing a blue collar.

Following are differential diagnoses, listed in order of likelihood, for patients presented with hypocholesterolemia.

  • Severe icterus (false decrease)

  • Protein-losing enteropathy (eg, lymphangiectasia, inflammatory bowel disease, lymphoma, infectious agents such as Heterobilharzia americana)

  • Liver disease such as portosystemic shunt, ductal plate malformation, or liver failure (eg, secondary to toxins such as Sago palm)

  • Hypoadrenocorticism

  • Exocrine pancreatic insufficiency

  • Hemophagocytic syndrome; can be seen in association with a variety of infectious and noninfectious diseases, including immune-mediated diseases and certain tumors (due to decreased synthesis and/or increased catabolism secondary to inflammatory cytokines)

  • Histiocytic sarcoma (dogs)

  • Multiple myeloma (cats)

  • Acute myeloid leukemia

  • Lymphoma