Twenty-five percent human serum albumin (HSA) is a foreign protein and can potentially cause immune-mediated reactions.  For this reason, the author only recommends 25% HSA use after risk analysis shows that the benefits outweigh the potential risks of adverse events.  If it is apparent that a critically ill animal may succumb to its illness because of the problems associated with severe hypoalbuminemia, the benefit outweighs the risk.

The veterinarian must inform the owner of potential delayed immune-mediated reactions, describe these lesions, and follow the case weekly to ensure that no reaction has occurred.  Although there are many positive attributes to the administration of 25% HSA, there seems to be specific situations in which 25% HSA may be indicated and others in which it may not be indicated.