Blood Work – Opinions please!

[calico76]

Misty recently had a dental and had some blood work drawn. Misty is about 4 ½ years old and is in very good health. However, I am concerned about these numbers showing early CRF. This was a fasting draw, so no water or food for about 10-12 hours. Iâ€[emoji]8482[/emoji]m not sure if that would impact the results or not.

I have already spoken to my vet and gotten his advice, but there are so many very knowledgeable people on this site that I would love to put up the results and hear what you think as well.

Again, this is not a full panel as it was only drawn as a precaution to the general anesthesia for the dental. Mistyâ€[emoji]8482[/emoji]s numbers are in the middle, the normal range is in parentheses to the right.

BUN\t34 mg/dL\t (16-36)
CREA\t2.5 mg/dL\t(0.8-2.4)
TP\t8.1 g/dL\t (5.7-8.9)
ALT\t121 U/L\t\t(12-130)
ALKP\t30 U/L\t\t(14-111)
GLU\t135 mg/dL\t(74-159)
Na\t165 mmol/L\t(150-165)
K\t3.8 mmol/L\t(3.5-5.8)
Cl\t123 mmol/L\t(112-129)

Also written at the bottom of the paper is PCU = 50, TS=8. Iâ€[emoji]8482[/emoji]m not sure what these values mean…

As you can imagine, I am very concerned. Any help is much appreciated.

 

[otto]

I'm not sure, what is you concern? the only number not in normal range is the creatinine, which is 2.5, .1 above normal. Because she was fasted, this is most likely just dehydration from being fasted.

If you need peace of mind, by all means ask your vet to do a superchem on her. They are expensive, as most clinics send the blood out to a lab for this kind of thorough info, but peace of mind is worth it.

 

[icklemiss21]

I would love if mine had 'normal' results, especially after fasting. You also have to remember that like people, the normal values do not apply to everyone - I have one who has several values above norms but is not at all sick - the vet says his norms are just higher than many other cats.

She was stressed, in need of dental and fasting, I wouldn't worry to much about higher values that are within the norms, but would have regular bloodwork to check for increases, or ask for a superchem on a day when she is not having surgery to get a better baseline

 

[calico76]

Thank you guys so much for responding. It may seem silly, but the vet has me very nervous. When I asked about the results he was concerned about the BUN being high normal and the K being low normal and of course the CREA being high.

He would like her to come back for the same test however, this time fast her but let her drink so as not to become dehydrated. If we get the same results, then a urinalysis. I know most of her numbers are great, but I know just enough to make myself crazy. Using the ranges here, what numbers would make you (someone more experienced in CRF) nervous?

I knew you guys would be able to put things in perspective for me. I will probably still do the test the vet wants but maybe not panic yet.

 

[violet]

You'll hate me for this, but I completely agree with your vet. You absolutely have to do a retest. In your situation I would have everything done at the same time. CBC, complete chemistry profile and urinalysis. (There may be something important in the CBC, that's why it needs to be included.)
BUN and creatinine are way too high for a cat Misty's age. (At that age you would want to see much lower numbers.) Also, potassium is definitely on the low side. And I don't like the ALT value either. Even though it's still within range, for some reason it's high. Here too you would want to see a much lower number.

May I ask you what kind of diet are you feeding? Dry? Wet? Mixed?

 

[calico76]

Hi Violet I don't hate you. I come here to draw on everyone's experience so I know what to expect. I thank you for being honest. What is the ALT and what does that number tell you? Is it related to CRF?

Misty eats dry and wet grain free. Her dry food is Taste of the Wild, we just switched from Wellness Core about 3 months ago. Wet food is Meow Mix natural goodness. The only way I can get any of my cats to eat wet is if it is NOT pate. So, I went with what they like and I like the grain free. She eats about 1.5 ounces of this every day, not much more.

Misty also has 1 patch of EGC that pops out every once in a while and she'll get a steroid shot every year and a half to two years.

 

[violet]

ALT (alanine aminotransferase) is an enzyme produced in the liver cells. It can become elevated for a number of reasons and, unfortunately, even careless sample collection can result in an increased number.
When the elevation is mild, it may be difficult or even impossible to find the exact cause.
(Other values in the blood work, including the CBC, might provide some clues.)

At this point I would have the ALT checked every three months to see if there is any change. It can go down, it can stay about the same, or it can go up. (If it ever goes up, an ultrasound will be warranted.) Right now I would just keep a close eye on this value but I wouldn't worry a whole lot.

Some info in this article
http://www.nwlabs.co.uk/testinterp2.htm

And here
http://www.vet.uga.edu/VPP/clerk/figlio/index.php

I'm just wondering, do you think it might be possible to go way down on the dry and feed no more than 1 Tbsp per day as a treat? That would mean going up on the canned, possibly having to find other brands as an addition to the one you're feeding now.

 

[sharky]

Originally Posted by otto

I'm not sure, what is you concern? the only number not in normal range is the creatinine, which is 2.5, .1 above normal. Because she was fasted, this is most likely just dehydration from being fasted.

If you need peace of mind, by all means ask your vet to do a superchem on her. They are expensive, as most clinics send the blood out to a lab for this kind of thorough info, but peace of mind is worth it.

Originally Posted by icklemiss21

I would love if mine had 'normal' results, especially after fasting. You also have to remember that like people, the normal values do not apply to everyone - I have one who has several values above norms but is not at all sick - the vet says his norms are just higher than many other cats.

She was stressed, in need of dental and fasting, I wouldn't worry to much about higher values that are within the norms, but would have regular bloodwork to check for increases, or ask for a superchem on a day when she is not having surgery to get a better baseline

I agree with the above... knowing what your feeding the ?s I had disappeared as different feedings can cause some results to be naturally higher or lower ...

 

[violet]

Calico76, I hope you won't mind one more suggestion from me. (I really think what I have in mind would be the best thing for your peace of mind.)

My vet does BUN and creatinine readings just by themselves (to save clients money when blood work has to be done more often).
Could you possibly ask your vet to do the same thing for you before you take Misty for the retest he suggested?

He would like her to come back for the same test however, this time fast her but let her drink so as not to become dehydrated.

That way you would get a picture of kidney function on a regular day with normal eating and drinking and practically no extra stress. Comparing the two results would give you and your vet all the info you need on this.

And one other thing. Dry food is terribly dehydrating, so it would have been very helpful to stop feeding dry three days before Misty wasn't allowed to eat or drink anything for 12 hours. I don't want to think about how thirsty and how miserable the poor baby must have been before the dental. This is one thing vets normally don't think about, so they don't talk to clients about it.