Bloodwork and other Labwork. The following are real issues related to Bloodwork and other Labwork in Dogs that have been treated by Dr. Mike Richards, DVM. Creatine phosphokinase (CPK) or creatinine kinase (CK) value elevations. Causes of Low Amylase and Low Albumin. Increased ALT Levels in a Dog. Rise in White Cell Count. Reasons for High BUN Level. High Levels of Calcium - Hypercalcemia. Lab work - Hematocrit (HCT)High Globulin Count (hyperglobulinemia), Seizures and Lethergy. Causes of Increased Platelet Count. Evaluating Lipase Levels Following Pancreatitis. Elevated Amylase Levels, Pancreatitis and Bladder Problems. High Potassium Levels with Diarrhea. Reasons for High Cholesterol Levels in Dog Serum. Question: Blue, 3 years old border collie, had a blood test today and a week ago. Urea was normal. A urine sample was taken and that was normal. She said it was probably normal for Blue's creatine levels to be a little high because he is a muscular dog. He eats Hill's t/d. Answer: I am assuming that this is the creatine phosphokinase (CPK) or creatinine kinase (CK) value. If this is the case, the most common causes of rises in CK are muscle disorders. If there is no evidence of a muscle disorder, I don't see a reason to worry about one being present. Other possible causes are exertional hyperthermia (technically a muscle disorder, as well), hypothyroidism, heart disease, recent exercise prior to the blood test, selenium/Vitamin E deficiencies and trauma to the muscles. Unless I had some reason to suspect one of these other disorders I think that I would tend to agree with your vet that a slight rise in CK levels is not a good reason to go looking for an inapparent problem. You can always recheck the levels if a problem does seem likely, or even just as a precaution at a future time. Question: What are the main causes for LOW Amylase (6. LOW Albumin (2. 5. Answer: There are no known physiologically significant causes of either low amylase or low lipase levels. If clinical symptoms indicate that there is a lack of production of pancreatic enzymes (diarrhea, weight loss) then testing for trypsin- like immunoreactivity (TLI test) is the best diagnostic test for pancreatic insufficiency. Opinions regarding low-carbohydrate diets vary throughout the medical and nutritional science communities, yet government bodies, and medical and nutritional. Serum blood urea nitrogen (BUN) determinations are considerably less sensitive than BUN clearance (and creatinine clearance) tests, and levels may not be abnormal. Platelets are very small cells that are used.
If there are no clinical signs suggestive of a problem it should be safe to ignore these lab values. Question: My question concerns elevated levels of ALT in my almost 6 year old male Golden Retriever. In August of 1. 99. I had blood drawn for a standard chemistry panel and blood counts so we would have a set of baseline values. All the results were within the normal ranges for chemistry and CBC. His T4 level was 1. Soloxine once a day. On November 2. 9 2. CBC. This time, the ALT was 1. IU/L. The T4 level was 1. The ALT was repeated on December 1. The lab ran a bile acid assay on the same sample next day and it was normal (6. On December 2. 8, the blood chemisty panel and CBC were repeated, along with ammonia and sorbitol dehydrogenase. I realize SDH is more typically used for horses than dogs, but I asked for it and the ammonia as additional ways to look for liver damage. The ALT was 8. 9 which is lower but still out of the normal range, while SDH (7. The dog appears healthy, and is a very energetic athletic dog. Without the blood work there is no way you would suspect that anything was wrong with his health. He runs hard every 2 or 3 days retrieving bumpers and birds as part of his field training and other days goes for daily runs around our pastures. The only thing that changed prior to the November blood test this year was that he had been off the soloxine supplement for about 2 weeks. Are the levels high enough to be really concerned? The thing that bothered me the most was the increase form. Any light you can shed on this will be very welcome. Answer: It is not too unusual to have rises in ALT levels that are found in a blood sample taken for reasons other than suspicion of liver disease and then for these levels to resolve over several weeks to several months. ALT rises when liver cells are damaged and lots of things can lead to enough damage to liver cells to increase the ALT levels. Many of these things never cause any clinical signs of liver disease nor measurable effect on liver function using bile acid or other liver function testing. In most cases we never know what happened, but drug reactions, trauma, bile stasis, blood clots and toxins are all possible explanations. If the ALT level continues to drop, it may not be possible to determine why it became elevated in the first place, but it wouldn't be too important to know, either. It seems reasonable to me to stop the thyroxine supplementation because there is a strong possibility that it is not necessary because total T4 levels are not a reliable way to determine if hypothyroidism is present. The most accurate test that I know of at the present time is a free T4 measurement done by equilibrium dialysis. Even if hypothyroidism is present, it would be unlikely to be harmful to stop thyroxine supplementation for a few weeks to see what happens. If the ALT dropped into normal ranges, I think I'd try for more accurate testing to see if supplementation is really necessary. If the ALT remained elevated you could chose to supplement or not based on clinical signs or other criteria you and your vet are comfortable with. If your vet feels strongly that stopping the dosage of thyroxine is a bad idea, it would probably be better to go with his or her opinion since physical exam findings may be playing an strong role in the diagnostic process. Once in a while rises in ALT alone are the first sign of a more serious liver problem like chronic active hepatitis or copper storage disorders. I hope the level continues to drop. Question: My dog Natty is a Border Collie/Mc. Nabb, eleven years old and weighs 6. In late September I asked our Vet. The test showed her infection fighting cells were high and he put her on tetracycline, 3 pills 3 times a day. At the end of that time her blood was normal. Because a neighborhood dog, a year younger that Natty and a constant visitor at our house, unexpectedly died, I had her blood tested again, just for good measure. Again, the infection cells were high and again she is on tetracycline, same dosage and same length of time, 3 weeks. I is not yet time to retest her blood. What do you think could be causing this problem. She doesn't seem sick. She did seem to be a bit arthritic and I just got the medicine for that which has helped. She eats quality food and her appetite is fine. Can you offer us a reason and a plan of action if her test does not come back normal next week? Answer: It would help a great deal in providing possible diagnoses if you could obtain the results of the complete blood cell counts that have been done so far. There are several types of white blood cells and the total count is not quite as meaningful as the rises in individual cell types. If there is a rise in neutrophils with a concurrent rise in immature neutrophils, then an infection is much more likely. If the total white blood cell count is high due to a rise in neutrophils and eosinophils, then an allergic or parasitic process is most likely. Rises in lymphocytes can indicate cancer. There are other combinations of rises in individual cell types that can be meaningful, as well. So knowing what cells are high, what cells are low and combining that with the findings on a physical exam can help to determine what is happening. Even though you vet is stumped, right now, as symptoms and lab work change over time there may be a recognizable pattern or signs of a specific disorder may emerge. So keep working with your vet. I will be glad to provide a list of differential diagnoses (possible diagnoses) based on the lab work if you can send it. Question: My miniature schnauzer, Dublin (5 months old at the time), was in the vet's getting spaded and when they ran tests her BUN level was at 4. Her Bun/creatine ratio was 3. All other levels were normal. The Vet was very concerned with the high BUN at her age. They tested for kidney function via urine tests and everything appeared fine. We had an ultrasound to look for any abnormalities with the kidney and again everything was normal. The vet put her on Hills KD and her BUN one month later was 2. She has gained weight and the vet suggested we switch her to Hills GD which was less fat. What do you recommend? She is still a bit overweight 1. I am concerned that she is missing critical nutrients being on a Hills GD diet at her age. Please let me know what you suggest and why such a small puppy would have such high BUN levels. Elevations in BUN (blood urea nitrogen) of up to 5. Puppies often have elevated BUN levels due to high protein diets and can quickly develop rises in BUN due to dehydration, since they are more prone to this problem than adult dogs. Some pets just have an elevation in one lab value, that seems to be a consistent finding, that never causes problems during their lifetime. The use of Hill's k/d (tm) in a puppy is not recommended by the manufacturer as a routine thing but it doesn't appear to cause problems when it is used, based on anecdotal reports from several vets I have spoken with who have put puppies on this diet. I would assume that the same thing is true for g/d (tm) diet. Truthfully, I don't see much reason to worry about using any special diet for the sake of the kidneys with the lab values you are reporting, though. It wouldn't be a bad idea to recheck the cholesterol and triglyceride levels, though. Lipemia (high values of lipids like cholesterol and triglycerides in the blood) are a problem in some schnauzers and do seem to cause problems sometimes. I started explaining chronic renal failure and was heading down the road of initiating treatment when my wife (also a vet) pointed out that I was probably jumping the gun, since we had an apparently normal patient with normal creatinine and normal urine concentration. Of course, she was right. Cancer and ABO Blood Group. PETER J. D'ADAMO, NDCopyright 2. WHAT IS CANCER? Cancer: the mere mention of its name generally is enough to warrant concern or trepidation. It is expected that about 1. U. S. Gonzalez- Campora R, Garcia- Sanatana JA, et al.
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