SERUM CHEMISTRY PROFILES
WHAT DO THEY TELL US?
Mary Lou Gerace
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!
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
following chart shows the normal ranges used by Antech Diagnostics located in
SERUM CHEMISTRY PROFILE
Alkaline Phosphatase (SAP)
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
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
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
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
As always, the above
information is based on my personal research.
Holistic Guide for a Healthy Dog (Second
Edition)--Wendy Volhard & Kerry Brown, DVM
Return to current medical article