03 May 2017.
BILLY’S BLOOD TEST READINGS
02/05/2017 & INTERPRETATION
I
took Billy to see the vet Dr Lai in Aman Suria, but he had moved! I managed to
see Dr Yeow (no relation!), another vet just round the corner from the Aman
Suria “tree” restaurant, where we have our dinners!
Billy
is rather listless, and have not shit past 4 days – twice, just a teeny weeny
small shit came out! Even though I give him Lactul every day! – and I took him
to the vet to find out. Also, vomits and pee on the curtains in my room!
This
Dr Yeow suggest I do a blood test for Billy – the results tabulated below – and
recommend I do surgery too, to correct Billy’s badly-done hernia op the last
time we did in Animal Vet, Jalan Pekeliling, the useless Indian vets! He
doesn’t do it, and recommend I go to Dr Yeoh (Senior) at Yeoh’s Vet, Taman
Megah, where we have been many times earlier! Costs around RM1,000 he reckons.
When
he sent me these blood tests – which he sent to Pathlab – and charged me
RM200.00 total! – he said it is still OK for Billy to redo this hernia op, so
that the portion jutting out, can be pushed back properly, and he will then
shit normally!
Here
are the Pathlab’s blood tests for Billy, and I took the trouble to Google for
answers to all the parameters which stated Billy is High or Low in this or
that:
PATHLAB (M) SDN BHD
HQ: 87-91,
JLN SS25/2, 47301 PETALING JAYA, SELANGOR
TEL:0378098188
FAX:0378038022
CLIENT ID:
3011929
PATHLAB NO:
11797173
PAGE: 1 YEOW WEI YANG, DR
PATIENT:
BILLY
PETS HEALTH
VET CLINIC &
SEX: M AGE:
13
COLL:
02/05/17 18:37 38-G JLN PJU 1/45 IC NO: #11797173 REGD: 02/05/17 18:37
AMAN SURIA
PETALING JAYA
REF.NO: 1037
PRNT: 02/05/17 19:25 47301 (012)247-1717
WORKER NO:
SPECIES: CANINE
EMPLOYER NO:
ATT:
** FINAL
REPORT **
--------------------------------------------------------------------------------
TEST
NAME
RESULT UNIT REFERENCE RANGE CBCCOMPLETE BLOOD
COUNT .....
RBC
8.4 X10^12/L 5.5-8.5
HAEMOGLOBIN
8.1 G/DL 15-19
PCV
50 % 44-52
MCV
60 L FL 64-76
MCH 22
PG 21-26
MCHC 36 G/DL 31-36
PLATELET
COUNT 474
X10^9/L >200
WBC
6.9 X10^9/L 6-12
DIFFERENTIAL
COUNT ………..
NEUTROPHIL 62
%
LYMPHOCYTE 30
%
MONOCYTE 5 %
EOSINOPHIL 2 %
BASOPHIL 0
%
ATYPICAL
LYMPHOCYTE
1 %
Reasons Why Your Pet’s MCV Might Be Low (Microcytosis) :
A lower than normal MCV number means that your pet’s red blood cells are smaller than normal.
Puppies and kittens less than 16 weeks of age can have low MCVs. Veterinarians believe that is because the iron content of mother’s milk is quite low and they have not had time to build up their iron stores.
Anything that causes iron levels to be low in your pet can cause a low MCV reading. It can be an iron deficiency in their diet (if they are fed bizarre stuff), starvation, intestinal inflammation that prevents iron absorption, chronic diarrhea or significant blood loss for any reason. Heavy intestinal parasite infection (hookworms) can also be the cause.
Certain medications (eg chloramphenicol), pyridoxine deficiency or a copper deficiency have all been associated with low MCV (If you feed a healthy dog or cat a diet that is high in meat and liver, it will get all the iron, pyridoxine, B12 and folate it needs to produce normal blood).
Liver disease and altered liver blood flow (portosystemic shunts) can reduce body iron stores and result in microcytic anemia (=low MCV). So can zinc or lead poisoning.
Some akitas, shibas, and perhaps other oriental breeds seem predisposed to having slightly smaller RBCs (ie a low MCV). They are not anemic and it does not appear to affect their health. In English Springer Spaniels, however, low MCV can be associated with ill health.
Too much anticoagulant (EDTA) in the blood collection tube can shrink the size of RBCs lowering the MCV.
Abnormally low blood sodium levels can trick some automated blood analyzers into reporting a low MCV.
HQ: 87-91,
JLN SS25/2, 47301 PETALING JAYA, SELANGOR
TEL:0378098188
FAX:0378038022
CLIENT ID:
3011929
PATHLAB NO: 11797173 PAGE: 2
YEOW WEI
YANG, DR – PETS HEALTH VET CLINIC
PATIENT:
BILLY
SEX: M AGE:
COLL:
02/05/17 18:37 38-G JLN PJU 1/45 IC
NO:
#11797173 REGD: 02/05/17 18:37 AMAN SURIA PETALING JAYA
REF.NO: 1037
PRNT:
02/05/17 19:25 47301 (012)247-1717
WORKER NO:
SPECIES:
CANINE
EMPLOYER NO:
ATT: **
FINAL REPORT ** --------------------------------------------------------------------------------
TEST
NAME
RESULT UNIT REFERENCE RANGE
MULTIPLE BIOCHEM. PROFILE .....
GLUCOSE
(RANDOM) 4.5 MMOL/L 3.3-6.8
UREA
10.9 H MMOL/L 2.5-9.5
CREATININE 56
L UMOL/L 60-180
CALCIUM
2.61 MMOL/L 1.90-2.90 INORGANIC PHOSPHATE 0.85
L MMOL/L 0.90-2.00
URIC
ACID
0.00 MMOL/L N/A
SODIUM 151 MMOL/L 138-153 POTASSIUM
5.0
MMOL/L 3.9-5.7 CHLORIDE 118
H MMOL/L 101-114
TOTAL
CHOLESTEROL 5.3
MMOL/L 3.0-8.5
TOTAL
PROTEIN 71 G/L 55-80
ALBUMIN 36 G/L 23-41
GLOBULIN 35 G/L 23-45
TOTAL BILIRUBIN 1
L UMOL/L 2-10
ALKALINE PHOSPHATASE 159 H IU/L 0-140
SGOT (AST) 28
IU/L 15-80
SGPT (ALT) 83
IU/L 15-90
GGT 12
IU/L 0-15
EXPLANATION – PAGE 2 OF PATHLAB REPORT:
UREA 10.9 - HIGH:
Renal Failure and Acute Uremia in Dogs
Acute uremia is a sudden-onset condition that is characterized by high
levels of urea, protein products, and amino acids in the blood. This condition usually follows sudden kidney
injuries, or occurs when the urinary tubes that connect the kidney to the
bladder (ureters) are obstructed. As a result, the outflow of urine is
obstructed, creating an imbalance in fluid regulation and leading to a buildup
of potential toxins in the body. Fortunately, acute uremia can be successfully treated and cured if it is
identified on time and treated promptly.
Most dog breeds,
whether male or female, are affected by acute uremia; however, exposure to
chemicals such as antifreeze increases the risk of uremia. Therefore, the
incidence of acute uremia is higher in the winter and fall than in other
seasons. In addition, dogs are most susceptible to acute uremia between the
ages of six and eight.
Symptoms and Types
As this potentially
toxic blood flows through the dog's body, most systems are affected, including
the urinary, digestive, nervous, respiratory, musculoskeletal, lymphatic, and immune systems.
Upon examination, dogs
will appear to be in normal physical condition, with a normal hair coat, but
may appear to be in a depressed state. When symptoms are apparent, signs can
include loss of appetite, listlessness, vomiting, and diarrhea, which may be
tinted with blood. Other symptoms may include inflammation of the tongue, ammonia-smelling
breath (due to urea)(Billy qualify here!), ulcers in the mouth, fever,
abnormally fast or slow pulse, decreased or increased urine output, and even
seizures. The kidneys may feel enlarged, tender, and firm on palpation.
CREATININE 56 - LOW:
Creatinine is a breakdown product of creatine
phosphate, which is a normal component of muscle and is removed from the blood primarily by filtration through the kidneys. Veterinarians measure creatinine levels because it helps to
identify kidney problems.
Creatinine levels have been used reliably to evaluate kidney disease for a long time. There are limitations to the use of this test in the early diagnosis of kidney disease and in dogs and cats with loss of muscle mass. A new test, symmetric dimethylarginine (SDMA), has recently been developed for dogs and cats to support earlier and more reliable diagnosis of kidney disease. Your veterinarian will generally run these tests simultaneously to get an accurate assessment of how well your pet’s kidneys are working.
Creatinine levels have been used reliably to evaluate kidney disease for a long time. There are limitations to the use of this test in the early diagnosis of kidney disease and in dogs and cats with loss of muscle mass. A new test, symmetric dimethylarginine (SDMA), has recently been developed for dogs and cats to support earlier and more reliable diagnosis of kidney disease. Your veterinarian will generally run these tests simultaneously to get an accurate assessment of how well your pet’s kidneys are working.
What could low
creatinine levels mean?
Low levels of creatinine can indicate poor muscle health or severe liver disease. Creatinine can also be lowered by increased metabolic states caused by hyperthyroid disease or extreme weight loss associated with muscle depletion. Lower than normal creatinine levels may occur when pets are fed extremely protein deficient diets resulting in poor muscle mass.
INORGANIC PHOSPHATE 0.85 - LOW:
Your Pet's Blood Phosphorus Level
Phosphate, PHOS
Most of your dog or cat'
s phosphorus is locked away in its bones (85%). There, it is combined with
oxygen and calcium as calcium phosphate (hydroxyapatite). But a small portion circulates in your
pet's blood as phosphate ion (PO4).That portion of phosphorus/phosphate is important for proper nerve function and muscle contraction. Your pet’s kidneys, under the control of parathyroid gland hormone (PTH), help keep that circulating phosphate from rising too high. So when your pet's blood phosphate levels are abnormally elevated, failing kidneys are the most common cause.
Calcium and phosphate circulate in your pet’s blood in a teter totter relationship; when one is high, the other is almost always low. Veterinary laboratories and in-office analytical machines almost always determined both at the same time.
Reasons Why Your Pet’s Blood Phosphorus Levels Might Be Too Low (Hypophosphatemia) :
A low blood phosphorus level is considerably less common that an elevated phosphorus level. The causes are also less well understood.
Anything that causes your pet’s blood calcium level to go up will probably cause its blood phosphorus level to go down. That can include a recent large meal, the use of phosphate binding medications (eg aluminum hydroxide, sucralfate), cortiocsteroid medications or Cushing’s disease.
Certain tumors that release PTH-related peptides, feeding very low phosphorus or low vitamin D diets, insulin or glucose injection and the diuretic (furosemide) have all been associated with low blood phospate.
Low body temperature (hypothermia), hepatic lipidosis in cats, and some genetic kidney defects can also account for low blood phosphate levels.
High levels of bilirubin in your pet’s blood sample or the use of anticoagulants in the collection tube (needs to be a red top tube) can cause falsely-low phosphate results.
Chloride 118 - HIGH:
What is Excess Chloride in the Blood?
Hyperchloremia refers to an excess concentration of chloride in the blood. This is typically caused by changes in free water/electrolyte-rich fluids or acid-base disturbances in the body. Depending on the reason for the condition, symptoms, treatment, and recovery can vary.
Causes of hyperchloremia in dogs can range from something as minor as dehydration (usually at the hand of persistent diarrhea or vomiting) to more major conditions, such as kidney disease and Cushing’s disease.
Treatment specific to hyperchloremia focuses on removing the cause of the excess chloride, as well as administration of sodium bicarbonate.
If hyperchloremia is the only problem, or the underlying cause is minor, recovery should be rapid and complete.
Symptoms of Excess Chloride in the Blood in Dogs Symptoms of hyperchloremia vary depending on the associated causes.
Symptoms of artifactual hyperchloremia relate to free water deficit, while symptoms of corrected hyperchloremia are often related to metabolic acidosis (an excess of acid in the body).
Gastrointestinal irritation Anorexia Weight loss Lethargy Persistent Hyperventilation Excessive thirst Types Artifactual Artifactual hyperchloremia occurs when there are deficits in the body’s free water or lower osmotic pressure in urine.
Examples of conditions where artifactual hyperchloremia is present are hypernatremia (an electrolyte problem in which the total body water decreases relative to the electrolyte levels) and diabetes insipidus (a rare form of diabetes caused by deficiency of the pituitary hormone vasopressin). Acid disturbance Acid-base disturbances can result from excessive intake or decreased output of chloride. This can be associated with diarrhea, therapies of chloride administration, salt poisoning, renal failure, renal tubular acidosis, hypoadrenocorticism, diabetes mellitus, and chronic respiratory alkalosis.
Causes of Excess Chloride in the Blood in Dogs:
Dehydration
Diarrhea
Vomiting
Fever
Excessive exposure to heat
Large doses of diuretics
Excessive intake of potassium chloride
Acidity disruptions
Hyperventilation Chronic kidney disease
Poorly controlled diabetes
Cushing’s disease
Excessive intake of potassium bromide (used to control
epilepsy)
Excessive intake of ammonium chloride (used to increase
urine acidity)
Corticosteroids (hormone supplements for the adrenal
cortex) NSAIDs
(nonsteroidal
anti-inflammatory drugs)
Read more at: https://www.vetary.com/dog/condition/excess-chloride-in-the-blood
Read more at: https://www.vetary.com/dog/condition/excess-chloride-in-the-blood
TOTAL
BILIRUBIN 1 - LOW:
Bilirubin In Your Pet’s Blood
Total bilirubin, TBIL, Hyperbilirubinemia
It is the job of certain cells in your dog or cat ’s liver to concentrate, process and excrete this heme residue into your pet’s bile. Much of it eventually leaves the dog or cat 's body in its feces. Insubstantial amounts (a little) leaves healthy dogs through their urine – none in healthy cats.
Bilirubin is responsible for the reddish brown color of old bruises and the yellow skin of jaundiced pets. It is most noticeable in the whites of your pet’s eyes, the inside skin of its ears and its gums.
Your dog or cat ’s labwork will report the value as Total Bilirubin (TB). It may also report what portion of the bilirubin has already been processed by the pet's liver (Direct post-hepatic or conjugated bilirubin) and what portion has not yet done so (Indirect = pre-hepatic or unconjugated bilirubin). Those two later values give vets hints as to whether too much heme is being produced (ie too many destroyed red blood cells ) or if the liver is unable to process the normal quantities of discarded heme that all pets produce.
In some cases, the liver is working well in its duties, but there is blockage of one sort or another in the gallbladder and duct system that conveys bilirubin from the pet's liver to its upper intestine. Most sick dogs and cats have elevations in both types of bilirubin. But how much of one versus the other sometimes gives a hint to what the cause might be. One of the most dramatic spikes in bilirubin occur when the pet’s bile drainage duct system becomes blocked (as with a gallstone).
Once a liver/bile duct crisis or blood crisis passes, it can take a long time (one to several weeks) for your pet's blood bilirubin values to return to normal.
Causes of Low Blood Albumin in Dogs. Hypoalbuminemia can result as a decreasein the ingestion of protein, a loss of protein through the gut or kidney, or by a failure of the liver to produce protein (therefore causing blood albumin levels to decline). ... Liver or kidney disease. Malabsorption of nutrients from food.
ALKALINE PHOSPHATASE 159 - HIGH:
Your Pet's Alkaline Phosphatase Level
AP, Alk Phos, ALP, SAP, ALP
A mildly elevated level of AP is found in normal dogs and cats when they are immature.
When AP is elevated in mature pets, most causes are associated with a primary or secondary liver problem that prevents the normal flow of bile.
In cats, the two most common causes of elevated alkaline phosphatase are cholangiohepatitis and hepatic lipidosis (HL). In HL, blood bilirubin levels are usually quite high as well. Bile duct obstruction (gallstones) – particularly when GGT enzyme is elevated equally or greater - is sometimes the cause.
Some specialists believe that about 80%
of dogs that have a 3-4 fold increase in their AP levels suffer from Cushing’s disease. (ref) Topical, ear and eye medications containing corticosteroids have also
been blamed for higher than normal AP levels.
Less commonly: diabetes, kidney failure-related hyperparathyroidism, liver and bone cancers, liver-toxic dietary toxins (like aflatoxins), widespread granulomas, abscesses, pancreatitis in dogs and cats, upper intestinal inflammation, anti-seizure medications, autoimmune diseases, gallbladder mucocele, occasionally with mammary tumors, healing fractures and an occasional liver reaction to anti-arthritic NSAID-medication. Mild persistent elevations are more of a worry in cats than in dogs.
Alkaline phosphatase levels sometimes go up in dogs with failing hearts and in genetically-based, copper storage diseases of Dobermans, West Highland White and Bedlington terriers, as well in pregnant cats. Hyperthyroidism, as I mentioned before, can also be responsible for moderately increased AP levels your cat.
MY CONCLUSION:
Poor Billy with so much problems listed above – and at 13 years old – I can’t see the benefits of another surgery, which could also be fatal to his health! These fuck doctors are forever pushing you to do surgery, as it is $$$ to them!
I would suggest we continue the Lactul treatment, and see how Billy fares – Dr Yeow suggests that, rather than giving Billy one 15mg dose of Lactul a day, spread it out into 3x5mg servings, which I just started now – and hopefully, he will be able to shit more comfortably!
Any other opinions from you all? Dad.
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