Latest numbers, any thoughts?

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maxs_mommy
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Latest numbers, any thoughts?

Postby maxs_mommy » Wed Dec 14, 2016 11:11 pm

So we had blood work done 2(?) weeks ago. I've been sitting on the numbers trying to make sense of them. Some stuff I know is cushings related but try as I google, I'm so confused. There a also a lot of border normal values that are just within tolerance. Anyone adept at reading bloodwork to interpret? The Alk phos and cholesterol are consistent with cushings, as is the barely low T4. My concern is the sodium levels and the hemolysis even thought his hematocrit looks good. All I get out of hemolysis is IMHA and I have no link to that with the cushings though IMHA is not uncommon, though it used to be more common, in cockers.

Patient: MAX
Species: CANINE
Breed: COCKER SPANIEL
Age: 10Y
Gender: MALE

Test Result Reference Range

TOTAL HEALTH PLUS : CHEM 27 w/ SDMA
ALP 497 5 - 160 U/L HIGH
ALT 77 18 - 121 U/L
AST 59 16 - 55 U/L HIGH
CREATINE KINASE 217 10 - 200 U/L HIGH
GGT <1 0 - 13 U/L
AMYLASE 500 337 - 1469 U/L
LIPASE 97 138 - 755 U/L LOW
ALBUMIN 3.5 2.7 - 3.9 g/dL
TOTAL PROTEIN 5.9 5.5 - 7.5 g/dL
GLOBULIN 2.4 2.4 - 4.0 g/dL
TOTAL BILIRUBIN 0.3 0.0 - 0.3 mg/dL
BILIRUBIN CONJUGATED 0.1 0.0 - 0.1 mg/dL
BUN 17 9 - 31 mg/dL
CREATININE 0.7 0.5 - 1.5 mg/dL
CHOLESTEROL 488 131 - 345 mg/dL HIGH
GLUCOSE 89 63 - 114 mg/dL
CALCIUM 12.0 8.4 - 11.8 mg/dL HIGH
PHOSPHORUS 3.0 2.5 - 6.1 mg/dL
TCO2 (BICARBONATE) 27 13 - 27 mmol/L
CHLORIDE 101 108 - 119 mmol/L LOW
POTASSIUM 4.7 4.0 - 5.4 mmol/L
SODIUM 136 142 - 152 mmol/L LOW
ALB/GLOB RATIO 1.5 0.7 - 1.5
BUN/CREATININE RATIO 24.3
BILIRUBIN UNCONJUGATED 0.2 0.0 - 0.2 mg/dL
NA/K RATIO 29 28 - 37
HEMOLYSIS INDEX (1) 3+
LIPEMIA INDEX (2) 3+
ANION GAP 13 11 - 26 mmol/L
SDMA (3) 13 0 - 14 ug/dL

Comments:
(1) Index of 3+ may decrease ALP and Direct Bilirubin by 25 to 50% and increase AST by 25 to 50%.
(2) Index of 3+ may decrease Direct Bilirubin by 25-50%.
(3) BOTH SDMA AND CREATININE ARE WITHIN THE REFERENCE INTERVAL which indicates kidney function is likely good. If SDMA and/or creatinine is at the upper end of the reference interval, early kidney disease cannot be ruled out. Evaluate a complete urinalysis to confirm there is no other evidence of kidney disease.

TOTAL HEALTH PLUS : T4
Test Result Reference Range
T4 (1) 0.9 1.0 - 4.0 ug/dL LOW

Comments:

(1) Interpretive ranges:
<1.0 Low
1.0-4.0 Normal
>4.0 High
2.1-5.4 Therapeutic

Dogs with no clinical signs of hypothyroidism and results within the normal reference range are likely euthyroid. Dogs with low T4 concentrations may be hypothyroid or "euthyroid sick". Occasionally, hypothyroid dogs can have T4 concentrations that are low normal. Dogs with clinical signs of hypothyroidism and low or low normal T4 concentrations may be evaluated further by submission of free T4 and canine TSH. A high T4 concentration in a clinically normal dog is likely variation of normal; however elevations may occur secondary to thyroid autoantibodies or rarely thyroid neoplasia. For dogs on thyroid supplement, acceptable 4-6 hour post pill total T4 concentrations generally fall within the higher end or slightly above the reference range.

TOTAL HEALTH PLUS : CBC STANDARD
Test Result Reference Range
WBC 16.8 4.9 - 17.6 K/uL
RBC 7.69 5.39 - 8.70 M/uL
HGB 17.7 13.4 - 20.7 g/dL
HCT 45.1 38.3 - 56.5 %
MCV 59 59 - 76 fL
MCH 23.0 21.9 - 26.1 pg
MCHC 39.2 32.6 - 39.2 g/dL
% RETICULOCYTE 0.3 %
RETICULOCYTE 23 10 - 110 K/uL
% NEUTROPHIL 81.6 %
% LYMPHOCYTE 13.2 %
% MONOCYTE 3.5 %
% EOSINOPHIL 1.7 %
% BASOPHIL 0.0 %
PLATELET 474 143 - 448 K/uL HIGH
REMARKS: SLIDE REVIEWED MICROSCOPICALLY. NO PARASITES SEEEN. REACTIVE LYMPHOCYTES PRESENT
HEMOLYSIS PRESENT, RBC,HCT,MCV,MCH,AND MCHC AFFECTED BY THE PRESENCE OF HEMOLYSIS.
LIPEMIA OBSERVED MAY ARTIFCIALLY INCREASE HGB, MCH AND MCHC.

NEUTROPHIL 13709 2940 - 12670 /uL HIGH
LYMPHOCYTE 2218 1060 - 4950 /uL
MONOCYTE 588 130 - 1150 /uL
EOSINOPHIL 286 70 - 1490 /uL
BASOPHIL 0 0 - 100 /uL
Max "the ninja"-American Cocker Spaniel G-day 3/2009
Charlie "the middle child"- Orange Tabby G-day 7/2005
Sadie - Grey Tabby 9/1996-8/4/2012 RIP

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