SERUM CHEMISTRY PROFILES

WHAT DO THEY TELL US?

PART TWO

Mary Lou Gerace

            Last month I discussed the “Normal Complete Blood Count Values”, what the “numbers” mean and how to know if your dog is within the “normal” range. This month I will give you information on what the “serum chemistry profile” panel signifies, along with the “reference range” for normal and abnormal! 

            A serum chemistry profile, much like a CBC (complete blood count) is a panel of tests that provides a broad database into your dog’s general health.  The results will confirm abnormalities found during a physical exam and will also bring to light problems that may be lurking.  A 12-hour fast is recommended prior to testing to assure the most accurate results. 

            The following chart shows the normal ranges used by Antech Diagnostics located in Farmingdale , NY .  This lab is used by a large number of veterinary offices throughout the United States .

SERUM CHEMISTRY PROFILE

TEST                                                               REFERENCE                                      RANGE

 

Calcium                                                            MG/DL                                                8.9-11.4

Phosphorus                                                      MG/DL                                                2.5-6.0

Sodium                                                             MEQ/L                                                139-154

Potassium                                                         MEQ/L                                                3.6-5.5

Chloride                                                           MG/DL                                                102-120

Cholesterol                                                       MG/DL                                                92-324

Triglycerides                                                     MG/DL                                                29-291

LDH                                                                U/L                                                      20-250

AST (SGOT)                                                   U/L                                                      15-66

Bilirubin, total                                                   MG/DL                                                0.1-0.3

GGT                                                                U/L                                                      1-12

(Gamma Glutamyltranspeptidase)

ALT (SGPT)                                                    U/L                                                      12-118

Alkaline Phosphatase (SAP)                             U/L                                                      5-131

Total Protein                                                     G/DL                                                   5.0-7.4

Globulin, total                                                   G/DL                                                   1.6-3.6

Albumin                                                            G/DL                                                   2.7-4.4

A/G Ratio                                                         G/DL                                                   0.50-1.68

BUN                                                                MG/DL                                                6-25

Creatinine, Kidney                                            MG/DL                                                0.5-1.6

BUN/Creatinine Ratio                                       RATIO                                                4-27

Uric Acid                                                         MG/DL                                                0.0-1.0

Glucose, Serum                                                MG/DL                                                10-138

Amylase, Serum                                               U/L                                                      400-2000

Diet, hormone levels and blood protein levels influence calcium levels in the blood.  Calcium is essential for blood clotting and cell membrane health.  If the levels are decreased, this can indicate damage to the pancreas or an under active parathyroid gland.  Increased levels may mean there is a presence of certain cancers, too much protein in the blood, excessive Vitamin D in the system or an overactive thyroid gland.

Phosphorus is affected also by diet, carbohydrate metabolism, kidney function and parathormone levels.  Decreased levels may indicate an overactive parathyroid gland, or malignancies which cause the appearance of an overactive parathyroid gland.  Decreased levels can also indicate malnutrition and malabsorption.  You will find increased levels with an under-active parathyroid and kidney failure.

Sodium is found in bones and body fluids.  The concentration is controlled by the naturally occurring steroid produced by the adrenal glands.  Decreased levels can be caused by lack of sodium in the diet, diarrhea, vomiting, kidney disease, diabetes mellitus and an under-active adrenal gland.  Increased levels rarely occur.  However, they will be noted with salt poisoning and dehydration.

Potassium is found in fluid inside the cells and is excreted by the kidneys.  Decreased levels are associated with prolonged vomiting and diarrhea, an overactive adrenal gland and an increased alkaline pH level in the blood.  An irregular heartbeat may also be detected.  Increased levels can be caused by kidney disease, a blocked urethra, dehydration and under-active adrenal glands.  Extremely high pH levels can cause the death of tissue and may result in cardiac arrest.

Chloride levels are monitored to determine the acid-base balance of the body, including the water balance.  Decreased levels occur with prolonged vomiting (loss of gastric juices) and with hypoadrenocorticism (Addison’s Disease).

Cholesterol is produced by the liver and excreted in the bile.  Decreased levels are found in an overactive thyroid gland.  Increased levels can be caused by an obstruction in the bile duct, kidney disease, dietary intake, diabetes mellitus, an overactive adrenal gland and an under-active thyroid gland.

Triglycerides show how much fat is carried in the blood.  4 to 6 hours after eating, the levels will always be high, no matter what the diet.  A pre-blood test fast of 12 hours is needed to ensure accurate test results.  There is no problem with decreased levels; however increased levels may indicate diabetes mellitus, starvation, under-active thyroid and the sudden onset of pancreatitis.

LDH (lactic dehydrogenase) is an enzyme.  This enzyme is found in many body tissues.  If there are increased levels (up to three times normal), this may indicate a malignancy.

AST (SGOT) is an enzyme with high concentrations in the liver, skeletal muscle and the heart.  Decreased levels are not considered significant.  Increased levels are associated with liver damage, heart ailments (myocardial infarction), skeletal inflammations, tissue damage and red blood cell ruptures.  The results of this test will be reviewed along with others for other diagnostic insights.

Bilirubin is the orange/yellow colored bile pigment.  This results from the breakdown of hemoglobin from old or damaged red blood cells.  It changes chemically in the liver, is secreted into the bile and delivered to the small intestine where it is turned into a waste product, excreted through feces.  Decreased levels are not significant.  Increased indicates bile duct obstruction, or liver disease. 

GGT is a protein enzyme produced by the liver and circulated into the blood.  Increased levels indicate pancreatitis, and/or blockage of bile excretion.

ALT (SGPT) is an enzyme that is present in the liver in large quantities.  Decreased levels are not significant.  Increased levels may be attributed to circulatory problems in the liver, active liver disease, liver trauma, cirrhosis, bile duct obstruction, liver tissue death, liver cancer and acute pancreatitis.

Alkaline Phosphatase (SAP) is another enzyme found in high concentration in the liver, and in the bone.  Young growing dogs will have higher levels than older dogs.  Decreased levels are not significant.  Increased levels indicate congestive liver disease or an obstruction.  They can also indicate an over active adrenal gland, excessive steroid use, anticonvulsants and barbiturate use.  In addition, if there has been a recent bone break/fracture, new bone growth will increase the numbers, as will rheumatoid arthritis.

Total protein is the combination of various proteins produced by the liver and the lymphoid organs.  A decrease will be present with kidney disease, liver disease, starvation and malabsorption syndromes.  Increases are seen with severe dehydration, cancer involving the lymph nodes (lymphosarcoma) and bone marrow tumors. 

Globulins come in three types.  Alpha-which transport fats; Beta-which transports iron; and Gamma-which functions as antibodies.  Globulins totals on the chem profiles are a combination of all three.

Decreased levels indicate deficiencies in the immune system.  Increased levels can be due to infections involving the entire body, bone cancer, parasites in the system, liver disease and cancer of the lymph nodes. 

Albumin is a blood protein which transports the fatty acids and which affects the pressure of the fluid in the cells.  Decreased levels tend to indicate low production of blood protein, which is associated with chronic pancreatic or liver disease, malabsorption, hemorrhage, burns and kidney disease.  Dehydration will be present if the numbers are increased.

BUN (blood urea nitrogen) numbers show how well the kidneys are functioning.  Decreased levels are seen with low protein diets, liver insufficiency and also with the use of anabolic steroid drugs.  Increased levels will occur when any condition that reduces the ability of the kidney to filter fluids in the body or that, which interferes with protein breakdown.  Heart disease, low adrenal gland function and shock can create increased levels.  When 75% of the kidney tissue is in a non-functioning state, whether it is through kidney disease or aging, the BUN will increase.  Injuries to the bladder or urethra will also cause an elevated BUN. 

Creatinine is a non-protein nitrogen waste product.  Decreased levels are not significant and are rarely noted.  Increased levels indicate poor kidney filtration.  Increased BUN and normal creatinine may suggest early or mild pre-renal problems.  A severe pre-renal problem would have both BUN and creatinine numbers high.  Both increased creatinine and BUN with elevated phosphorus would indicate a severe kidney disease (kidney failure).

Uric acid is the end product of purines.  Purines are the end product of proteins.  Decreased levels of uric acid are not important.  Increased levels show cellular destruction.  Diseases associated with increased levels may be leukemia, pneumonia and toxicities associated with pregnancies.  A severe kidney disease would show elevated levels of uric acid, but should not be used alone for that diagnosis.

Glucose is affected by many disease states.  It is highly influenced by diet and the ability of the liver to handle the diet and the rate at which the glucose is excreted.  Decreased levels are seen in insulin overdoses, abnormal pancreatic growths, liver malfunctions, under-active adrenal glands, excessive exercise and long term starvation.  Increases in glucose will be seen in patients with diabetes mellitus, excess progesterone (hormone), over-active adrenal glands and stress.

Amylase is a pancreatic enzyme that is released through the small intestine and which converts starch to sugar.  Decreased levels are not considered noteworthy.  Increased levels show up in certain types of pancreatic diseases or pancreatic duct obstruction.  Severe or acute pancreatic damage should cause a 3 to 4 times increase in the serum amylase.  Stomach problems, poor or an incorrect diet, intestinal obstructions or salivary gland disease can also create elevated levels. 

All blood work should be handled with the utmost care.  12 hour pre-test fasting is usually recommended.  There are some differences in clinical chemistries between breeds.  German Shepherds, Labrador Retrievers and Beagles are a few of the breeds where the numbers will vary from the norm on some of the test results.  The best rule is to establish what is “normal” for your dog and then in subsequent testing, use the same laboratory. 

Remember your dog’s veterinarian is one of the most important people in his or her life.  Choose him or her with care, just as you would choose your own medical professional!! 

As always, the above information is based on my personal research.  References include:

http://www.bichonfriseusa.com/caninebloodwork.htm

http://www.infovets.com/demo/demo/canine/D080.HTM

Holistic Guide for a Healthy Dog (Second Edition)--Wendy Volhard & Kerry Brown, DVM

Comments welcome! 

boomer@trianglenet.net

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