Metabolic

On Other Pages:

Visit Our Other Sites Too:

The Animal Rescue Fund of South Carolina: our no-kill, non-profit shelter for pets in need of treatment, love, and a new home.

The Horse Doctor:

about the treatment of diseases and problems in horses and much more. Includes info on the new treatment for fescue toxicosis.

Martial Arts Karate:

about judo, karate, hapkido, jujitsu, tai-chi,

tae kwon do, and personal development.

The Scout Path:

about scouting and many other groups dedicated to helping young people develop into fine human beings.

Also about similar groups for adults dedicated to enhancing and enjoying the great outdoors.

Blue Grass Theater:

about and for people who love acustic guitar music, old cowboy music, blue grass, and American Folk music.

Also about Community Theater.

People In Trouble:

Everyone needs a helping hand now and then...sometimes we need a lot of help.

Clients who think cats trigger asthma in children might be mistaken

I thought this was interesting: A study funded by the National Institute of Allergy and Infectious Diseasees and the National Institute of Environmental Health Sciences found that high levels of cat allergen decrease the risk of asthma

by altering the body's immune response to cats. Researchers measured the levels of antibodies in children and found that although low-to-medium amounts of cat allergen trigger allergies, high amounts reduce immunoglobulin antibodies and the likelihood of asthma.

For more information, visit

www.niaid.nih.gov

For more information about asthma and other respiratory diseases in pets; go to our
Respiratory Page

"Esse Quam Videri" from Cicero's Essay on Friendship:
To be rather than to seem.

Something Unrelated to Metabolic Disease...but

Is This Stuff True?

In Lebanon, men are legally allowed to have sex with animals, but the

animals must be female. Having sexual relations with a male animal is

punishable by death. (Like THAT makes sense.)

2. In Bahrain, a male doctor may legally examine a woman's genitals, but is

prohibited from looking directly at them during the examination.

He may only see their reflection in a mirror. (Makes you hope you never need

surgery!)

3. Muslims are banned from looking at the genitals of a corpse. This also applies to undertakers; the sex organs of the deceased must be covered with a brick or piece of wood at all times. (A brick??)

4. The penalty for masturbation in Indonesia is decapitation. (Whoa!)

5. There are men in Guam whose full time job is to travel the countryside and deflower young virgins, who pay them for the privilege of having sex

for the first time...Reason: under Guam law, it is expressly forbidden for

virgins to marry. (Let's just think for a minute; is there any job anywhere else in the world that even comes close to this?)

6. In Hong Kong, a betrayed wife is legally allowed to kill her adulterous husband, but may only do so with her bare hands. The husband's lover, on the other hand, may be killed in any manner desired. (Ah! Justice!)

7. Topless saleswomen are legal in Liverpool, England - but only in tropical fish stores. (But of course!)

8. In Cali, Colombia, a woman may only have sex with her husband, and the first time this happens, her mother must be in the room to witness the act. (Makes one shudder at the thought.)

9. In Santa Cruz, Bolivia, it is illegal for a man to have sex with a woman and her daughter at the same time. (This was a big enough problem that they

had to pass this law?)

10. In Maryland, it is illegal to sell condoms from vending machines with one exception: prophylactics may be dispensed from a vending machine only "in places where alcoholic beverages are sold for consumption on the

premises." (Is this a great country or what? ... Not as great as Guam,

though!!)

Help me out with this Page:

If you would like to contribute information or articles that would be helpful, please eMail me at:

foxnest@metacrawler.com

Thanks. We will be glad to link to your site as well as give you credit for the article.

Visit our Wild Life Page

Just for Fun:

Mosquito repellents don't repel. They hide you.

The spray blocks the

mosquito's sensors so they don't know you're there.

Dentists have recommended that a toothbrush be

kept at least 6 feet away

from a toilet to avoid airborne particles resulting from the flush.

The liquid inside young coconuts can be used as

substitute for blood plasma.

No piece of paper can be folded in half more

than 7 times.

Donkeys kill more people annually than plane crashes.

You burn more calories sleeping than you do watching television.

Oak trees do not produce acorns until they are

fifty years of age or older.

The first product to have a bar code was Wrigley's gum.

The king of hearts is the only king without a mustache

A Boeing 747's wingspan is longer than the Wright brother's first flight.

American Airlines saved $40,000 in 1987 by

eliminating 1 olive from each salad served in first-class.

Venus is the only planet that rotates clockwise.

Apples, not caffeine, are more efficient at waking you up in the morning.

The plastic things on the end of shoelaces are called aglets.

Most dust particles in your house are made from dead skin.

Barbie's full name is Barbara Millicent Roberts.

Michael Jordan makes more money from Nike

annually than all of the Nike

factory workers in Malaysia combined.

Marilyn Monroe had six toes.

All US Presidents have worn glasses. Some just didn't like being seen wearing them in public.

Walt Disney was afraid of mice.

Pearls melt in vinegar.

Thirty-five percent of the people who use personal ads for dating are already married.

The three most valuable brand names on earth:

Marlboro, Coca Cola, and Budweiser, in that order.

It is possible to lead a cow upstairs...but not

downstairs.

A duck's quack doesn't echo and no one knows why.

The reason firehouses have circular stairways is

from the days when the

engines were pulled by horses. The horses were

stabled on the ground floor and figured out how to walk up

straight staircases.

Richard Millhouse Nixon was the first US president whose name contains all the letters from the word "criminal." The

second? William Jefferson Clinton.

And.....

Turtles can breathe through their butts

On This Page

This page is a bit of a hodge podge of diseases that don't quite fit in any one category and include metabolic diseases, liver diseases, and problems associated with out of whack hormones.

Please be patient...I'll try to address all these topics soon

Contents: Click on the topic that interests you or just scroll down:

Addison's Disease (hypoadrenocorticism)

Cushing's Disease (hyperadrenocorticism)

Diabetes; What to Expect at Our Clinic

Diabetes; Articles and Information

Heat Stroke; What to Expect at Our Clinic

What do all those Lab Tests Mean? (At the bottom of this page)

Growth Hormone Disorders

Liver Diseases I now have liver diseases on a separate page: Click here to go there

Immune Mediated Diseases

Thrombotic Diseases (Blood Clots)

Thyroid Diseases:

Hyperthyroidism in Cats

Hypothyroidism in Dogs

Pancreatitis: Go to our Intestinal Page Please

Sex Hormone Disorders: Please go to our Reproduction/Sex Page

Addison's Disease

(hypoadrenocorticism)

by Roger Ross DVM

Addison's disease is a condition that occurs when the adrenal glands stop producing hormones.

We vets often miss this disease because the symptoms are vague...just not feeling well, off and on digestive and intestinal problems, weakness, and so forth. Poor body condition, dehydration, a weak pulse, a slow heart rate, and blood in the stools are other common signs, but that's true of a lot of diseases. And the signs often come and go over a long period of time.

One of the big hints that your pet may have Addison's is that it gets sick fairly often, but everytime the vet gives it fluids and/or steroids, it gets better for a while.

Often, it's not until the patient is critically ill that diagnose the disease. This is yet another example of why performing routine blood work on sick animals is beneficial: we can diagnose these types of problems before they become an emergency.

Blood work may indicate: anemia, electrolyte imbalances (elevated potassium, low sodium, and low chloride), low blood sugar, elevated calcium, acidosis, and elevation of liver and kidney values

Any age dog can get this disease, but it tends to be seen in middle aged female dogs. Especially female dogs that haven't been spayed. About one third of cases are mixed-breed dogs, but there appears to be some breed predilection toward Poodles, Portuguese water dogs, Great Danes, Sheperds, and Rottweilers.

There is no "cure", but with treatment, (lifelong) most pets live a pretty normal life. The drugs most commonly used to treat Addison's disease are some combination of prednisone, Florinef, and DOCP. We need to monitor your dog's blood on a regular basis so we can adjust the doses of these medications as needed. All three of these medications frequently cause mildly troublesome side effects, so we often have to deal with those. We refer to this process as "careful management" .

Approximately 35% of dogs with this disease present in what is known as Addisonian crisis; this is a true emergency and immediate treatment is required to save the dog's life. These animals have the classic signs of shock: mental dullness, pale mucous membranes, weak pulses, and cold extremities. In addition, they have an abnormally slow heart rate due to elevated blood potassium levels.

A Little About The Disease:

Mammals, in general, have 2 adrenal glands. Their job is to produce the steroidal hormones that help regulate cellular function. In Addison's disease, the part of the adrenal glands that produce cortical steroids is diseased and not functioning well.

There may be no clinical signs of disease until 90% of the adrenal cortex has ceased to function. The usual cause of the destruction of the adrenal glands is thought to be auto-immune...for reasons we don't understand well, the body's immune system attacks it own cells. This occurs in other organs as well. In fact, many of our diseases are auto-immune type problems.

One of the more interesting causes of Addison's Disease is from steroid therapy. Usually it's associated with long term steroid treatment for something like severe skin allergies, and then for some reason or other, the steroid treatment is stopped. Another medication called Lysodren can cause Addison's disease as a side effect.

DIAGNOSIS

Once we suspect your pet has Addison's Disease, there is no simple, cheap, in-clinic test to prove it, which is a nuisance, but there is a fairly straight forward test called an ACTH Stimulation test that is definitive. ACTH will stimulate a normal adrenal gland to produce alot of cortisol. If very little cortisol is produced, then we know for certain that your pet has Addison's Adrenal Gland Disease. Once a certain diagnosis is made, then life long treatment will be needed if you want to keep your pet.

TREATMENT

Inital treatment of a dog in suspected "Crisis" is lots of IV Fluids and high dose steroid injections. Your vet will do everything he or she can to get the body temperature up to normal and treat the other secondary problems associated with a patient in shock.

At the same time, expect a lot of testing to be done to confirm the suspected diagnosis and to look for other problems. These dogs that are in Addisonian Crisis are rapidly dying and we need to rule out heart failure, toxic shock, poisoning and other causes of weak, cold, slow heart rated emergency patients.

Once the patient is stablized, treatment involves replacing synthetically the hormones a healthy adrenal gland would produce. Since the adrenal gland produces two major types of steroid hormones (cortical or gluco-corticoid and mineral-corticoid) we usually treat this disease successfully by giving prednisone (inexpensive and readily available) and either fludrocortisone (Florinef) orally or a once a month injection of DOCP (Percorten-V) These last two meds are a little expensive and your vet may not keep them on hand. It's not quite as easy as I make it sound, like diabetes, it takes repeat testing, trial and error, and frequent adjustments in the medication to get everything just right so that your dog can lead a long and comfortable life.

Cushing's Disease

(hyperadrenocorticism)

This disease is a bit complicated and this page is getting rather long, so please click here to go to my seperate page about Cushings. Thanks, RR

Diabetes in Cats and Dogs: Our basic approach and Treatment

What to expect at our Clinic.

(Of course, your veterinarian may handle similar cases differently)

We treat a number of pets for diabetes. The owner often has no clue that their pet has diabetes, and frankly, neither do I at first...you simply bring in your pet because it's not acting well.

Although we certainly get suspicious if the history includes drinking or urinating a lot. Or if the history includes a bladder infection. Or other animals spending more that usual attention to sniffing your pet's "privates".

We sometimes discover this disease during our routine testing of sick pets...

This discovery of diseases we wouldn't otherwise detect is why the expense and trouble of running the tests is often worthwhile. And that, of course, is why we run them.

While increased urination and drinking are the most famous of symptoms, diabetes affects almost every organ...eyes, skin, heart, etc...as well as every process; wound healing, circulation, and disease resistance. So all kinds of symptoms, from vague to obvious are possible.

Here's what to expect if you brought a pet into our clinic:

Exam and History:

As indicated above, we often get suspicious of diabetes with just a history. Other clues are early onset of cataracts, obesity, mouth ulcers, and the odor of the breath.

Sometimes in cats, the posture is changed due to neuro disease caused by the diabetes...they walk with their hocks touching the ground. Pets with diabetes often come in with depression, nausea, and weakness because diabetes can cause a condition called ketoacidosis...the diabetes may have been around for a while but the ketoacidosis and the signs it causes are new. And since diabetes so often causes other problems we will be examining everything thoroughly.

Lab work:

A. This disease is mainly confirmed by blood work; a CBC and Chemistry. The only trouble is that a cat's blood sugar can sometimes go sky high due to the stress of being in the clinic and getting a blood sample, so we won't necessarily jump to immediate conclusions, but will likely retest and if necessary sedate a little and retest later after being calm for a while.

Other vets might confirm the disease with more accurate serum insulin concentration tests or intravenous glucose tolerance tests.

B. Urinalysis: it's important to see glucose elevated in both the blood and the urine to make the diagnosis. Plus, we don't want to miss a bladder infection...which is
common in diabetic patients.

C. Thyroid testing. Sometimes associated with diabetes in both dogs and cats

Treatment Options to Consider:

1. Stabilize the sick patient: Since a lot of pets that we discover have diabetes are brought in because they are suddenly so ill (keto-acidosis), the first thing is to stabilize these patients. This usually means hospitalization, IV Fluids, steroid and antibiotic therapy, insulin injections, supportive therapy and repeated tests until the patient is doing a lot better (or dies).

This is a serious disease...I didn't mean to be insensitive, but despite treatment, diabetic keto-acidosis is often fatal.

2. If the patient is successfully stabilized (or not especially sick when we make the diagnosis), then we control the disease the best we can with:

A. Diet; some patients are well controlled with high fiber diets alone and with feeding smaller, more frequent meals.

B. Weight loss: some patients are cured, if that's an accurate description, if you can cure their obesity.

Our most successful weight loss program is with Hill's R/D diet.

C. Insulin Injections. This is not as difficult as you might imagine...luckily the needle is extremely tiny and even cats will often allow you to inject them with a minimum of fuss. Needs to be done 1-2 times daily.

Results are quite different for each patients; a lot of our patients live

long, fairly normal lives and others have major complications from their disease despite treatment.

This is true in human medicine too...diabetes is a major killer. Insulin can kill if too much is given and the dose frequently needs to be adjusted so you have to be willing to retest you cat or dog every 4-14 days.

Some vets insist on keeping the patient for the first 3-14 days to monitor and regulate their insulin injections until they get it just right, but this is expensive and often not needed in my opinion, but nonetheless, each case is different...be prepared for some expense and the hassle of repeated asscessments and treatment changes.

D. Which leads me to recommend referral of all diabetic patients. If you can't afford the care of a specialist, I am often successful with the above treatments, but understand that diabetes is often a complex and life threatening disease and as a general practitioner I am not an expert in the treatment of this disease and all it's complications.

E. Fairly frequent rechecks to include blood chemistry every 3-12 months depending on the case to keep an eye out for the other problems associated with diabetes such as pancreatitis, kidney and liver disease.

Coming soon: Articles and General Information about Diabetes in Pets

Heat Stroke:

The trouble with heat stroke in pets is not the diagnois...any fool with a thermometer has a good chance of getting the diagnois correct...the problem is keeping the patient alive. In this sense, heat stroke is similar to being shot with an arrow.

The trouble with this disease is that all kinds of terrible things happen inside the body when the internal body temperature rises over 4 degrees above normal. (Normal body temperature for both cats and dogs ranges from 100-102 degrees F)

The Blood Clots

The Intestinal system absorbs micro-organisms and toxins into the bloodstream

Cells die leading to all sorts of inflammatory reactions by the body.

And if that isn't enough...all kinds of other biochemical stuff goes haywire

EXAM: We notice a prostrated patient breathing a million miles an hour and we take it's temperature. Very High. Like I said, this part is a "no brainer". We go right to treatment:

TREATMENT PROTOCOL:

Luke warm bath (we don't want to shock with over cool water if possible)

High dose Dexamethasone Injection to stablilize capillaries and minimize reactions

Atropine Injection

Start Antibiotic Injections

IV Fluids (This is the most Important Step of all)

B Vitamin injections

Oxygen therapy (we are learning that maximizing oxygen to the cells is life saving)

Consider AntiSerum IV to minimize the effect of endotoxins absorbed from the gut

Consider Oxyglobin to greatly increase tissue perfusion (very expensive)

Antihistamines

Hospitalize until better. Usually these cases are quickly resolved...one way or the other.

POST STABLIZATLON:

Antibiotics to fight and prevent infections associated with intestinal leakage of bacteria

Antioxidants to minimize free radical damage

Prednisone

Uncaria tomentosa (an herbal remedy that I think helps the GI system)

CoEnzyme Q 10 to promote tissue perfussion

P/D Diet or other recovery diet. I also like to recommend Chicken Soup or other electrolyte source.

Buffered Aspirin to reduce blood clotting, DIC

Vitamin and Mineral supplementation for a while

Some cases aren't serious enough to warrant all of the above and that's great, but it's a fairly common misconception that all you have to do is "hose em down with water".

"Hosing down with water" is the First Aid treatment for heat stroke and is very helpful, but is not nearly enough if your pet is in the advanced stages of the disease. And I'm sure you've heard the stories...in the right conditions...especially inside parked cars...it doesn't take long.

Growth Hormone Disorders

coming soon...more information, articles, etc

Liver Diseases

coming soon...more information, articles, etc

Immune Mediated Diseases

coming soon...more information, articles, etc

Thrombotic Diseases (Blood Clots)

coming soon...more information, articles, etc

Thyroid Problems In Pets

Coming soon...a discussion of the role of the thyroid gland and other interesting information. From a practical point, the two most common problems we see as general practioners is too much thyroid in cats...and too little thyroid in dogs, so I will tackle those two topics first:

Hyperthyroidism in the Cat

Hyperthyroidism is the overproduction of thyroid hormone by the thyroid glands. Hyperthyroidism occurs most commonly in older cats and is rare in dogs. The average age of cats with hyperthyroidism is 13 years of age; only about 5 % of hyperthyroid cats are younger than 10 years of age. There are 2 thyroid glands located in the neck. One or both of the glands can enlarge and overproduce thyroid hormone. Involvement of both glands is more common than involvement of one gland. Thyroid hormone affects the function of most organs in the body, so the signs of hyperthyroidism are quite variable.

Signs of hyperthyroidism can include:

· weight loss

· increased appetite

· increased activity and restlessness

· aggressive or "cranky" behavior

· a poor hair coat

· a fast heart rate

· increased water drinking

· increased urination

· periodic vomiting

· increased amount of stool or diarrhea

· occasionally difficulty breathing

· occasionally weakness

· occasionally depression

The average age of cats with hyperthyroidism is 13 years old.

A diagnosis is made by feeling enlarged thyroid glands, increased blood levels of thyroid hormone or by a thyroid scan.

A diagnosis of hyperthyroidism is made when the level of thyroid hormone is increased in the blood. Most hyperthyroid cats have very high levels of hormone but some cats will have signs of hyperthyroidism with normal or only slightly increased levels of thyroid hormone. Thyroid hormone levels can vary over time so it may be necessary to check blood levels several times or perform a different test called a T3 suppression test. The enlarged thyroid gland(s) can often be felt in the neck. If the diagnosis is not obvious by blood tests, a nuclear medicine scan of the thyroid glands can be performed at certain specialty veterinary practices. The cat is given a small dose of a radioactive compound that travels by the blood to the thyroid glands. Hyperactive thyroid glands accumulate more of the compound than normal glands. After this test the cat must be hospitalized for a few days while it clears the radioactive compound from its body.

A blood panel and urinalysis are also performed to screen for abnormalities in other organs such as liver and kidney that may be present due to the advanced age of the animal.

High levels of thyroid hormone may cause heart disease. The heart may appear enlarged on x-ray or ultrasound and may show abnormal electrical activity on an ECG (electrocardiogram). Heart disease may cause fluid to build up in or around the lungs. Cats with serious heart disease and hyperthyroidism need to be treated for both diseases. The heart disease will reverse in many cats after successful treatment of hyperthyroidism.

Treatment for hyperthyroidism includes: oral pills, surgery or radioactive iodine treatment. There are three types of treatment for hyperthyroidism:

· life long oral anti-thyroid medications

· surgical removal of affected thyroid glands

· treatment with radioactive iodine

All three treatments will reduce thyroid hormone levels and the signs of hyperthyroidism. Discuss the 3 options with your veterinarian. If your pet has other diseases, one treatment may be better for your cat than another.

The anti-thyroid pill is methimazole, also known as Tapazole®. Methimazole is given one to three times daily and must be continued life long. It takes several weeks for methimazole to reduce blood thyroid hormone levels to normal. If methimazole is discontinued, thyroid hormone levels will return to high levels over a few weeks. Methimazole may be used to reduce thyroid hormone levels to normal before surgically removing the thyroid gland(s). Cats with heart disease may be too sick and fragile to anesthetize for surgery in which case methimazole can be given until the heart improves and the cat is stronger. Some owners (and their cats) find it difficult to give pills daily and may decide, after starting anti-thyroid pills, to later have their cat treated with radioactive iodine or surgery. Methimazole may produce side effects in cats including depression, vomiting and lack of appetite. These signs usually resolve without stopping the medication. A more serious side effect is the development of low blood cell counts which are more likely to develop during the first 3 months of treatment. Blood cell counts should be evaluated every 2 weeks during the first 3 months. If blood cell counts decrease methimazole is stopped and another treatment method should be considered.

Cats can have ectopic thyroid tissue in locations other than the neck.

Enlarged thyroid glands can be surgically removed. Methimazole is given for 1 to 2 months before surgery so that thyroid hormone levels are normal at the time of surgery. If both glands are enlarged, they can both be removed and most cats will still produce enough thyroid hormone by a few thyroid cells scattered through out the body to prevent hypothyroidism (abnormally low thyroid hormone levels). A few cats will become hypothyroid and may need to take thyroid pills. Surgical removal of the thyroid gland(s) can usually be performed without complications. Occasionally complications may develop including damage to the parathyroid glands, which are closely attached to the thyroid gland, damage to nerves close to the thyroid gland or damage to the voice box. Parathyroid gland damage causes low blood calcium that may cause seizures. Low blood calcium is treated with calcium or vitamin D. Nerve damage causes abnormal size of the pupils of the eyes and droopy eyelids. Damage to the voice box causes a change in voice.

Some cats will remain hyperthyroid after surgical removal of the thyroid glands. These cats have thyroid cells in abnormal locations, including inside the chest cavity where surgical removal is difficult. This extra thyroid tissue is called ectopic thyroid. If you and your veterinarian decide that surgery is the best treatment option for your cat, a nuclear medicine scan (described in the diagnosis section) could be performed at a specialty veterinary practice before surgery to see if your cat has ectopic thyroid tissue. If ectopic thyroid tissue is seen on the nuclear medicine scan, then a different treatment, either methimazole or radioactive thyroid treatment should be selected. Cats that have had surgery may have recurrence of hyperthyroidism. Blood thyroid hormone levels should be measured once or twice a year.

Treatment with radioactive iodine is only performed at selected specialty veterinary practices.

Treatment with radioactive iodine is only performed at selected specialty veterinary practices. Radioactive iodine is given intravenously and will accumulate in the abnormal thyroid tissue killing the abnormal thyroid cells but sparing the normal thyroid cells. Radioactive iodine will also accumulate in ectopic thyroid tissue. Radioactive iodine treatment is very effective and rarely causes hypothyroidism. The cats do not have to be placed under anesthesia for the procedure. The disadvantages of radioactive iodine treatment include the need to travel to a facility that offers this treatment and the need for the cat to remain hospitalized until the level of radioactivity decreases to a safe level as determined by the state radiation control office (usually 1 to 3 weeks).

Older cats with hyperthyroidism often also have kidney disease. Treatment of these cats is a delicate balancing act. Hyperthyroidism can actually improve kidney function by increasing blood flow to the kidneys. Some cats with kidney disease will show a worsening of kidney function after treatment for hyperthyroidism. Talk to your veterinarian about monitoring kidney function in hyperthyroid cats.

It's not like we stick a blood sample into a machine and the machine tells us what disease your pet has...although sometimes that happens...lab test results are more like little clues in a murder investigation:

What Do Those Lab Tests Mean?

The results of laboratory tests on a patient are compared to reference ranges established by measuring the laboratory parameters in a group of normal animals. The reference ranges for each laboratory test differ between laboratories and across species. Be careful interpreting laboratory tests. An occasional animal will have a value for a laboratory test that falls outside the reference range, but the value may still be normal for that animal.

Your veterinarian will interpret laboratory tests in light of the entire evaluation of your pet. Sometimes laboratory tests need to be repeated to evaluate trends, which may provide more information than measurement of a single test.

The results of laboratory tests may be influenced by drugs your pet is receiving and some are influenced by a recent meal. Always provide your veterinarian with information about any drug your pet is receiving. Inquire when you make an appointment for veterinary care, whether you should fast your pet before the visit in case laboratory samples are collected.

CBC

Complete blood count (CBC)

The complete blood count measures the number of cells of different types circulating in the bloodstream. There are three major types of blood cells in circulation; red blood cells (RBC), white blood cells (WBC), and platelets. Red blood cells are produced in the bone marrow, which is the soft center of bones. RBCs pick up oxygen brought into the body by the lungs, and bring that oxygen to cells throughout the body. Red blood cells live in the blood stream for about 100 days although the actual time varies with the type of animal. Old red blood cells are removed from the blood stream by the spleen and liver. Red blood cell numbers can be decreased (anemia) if they are not produced in adequate numbers by the bone marrow, if their life span is shortened (a condition called hemolysis), or if they are lost due to bleeding. Increased red blood cell numbers is called polycythemia and is usually due to concentration of the blood due to dehydration.

The complete blood count also includes a measure of hemoglobin, which is the actual substance in the red blood cell that carries oxygen.

There are several types of white blood cells in blood, including neutrophils (PMNs), lymphocytes, monocytes, eosinophils and basophils. Lymphocytes are produced in lymph nodes throughout the body. The other white blood cell types are produced in the bone marrow along with the red blood cells and platelets. The majority of white blood cells in circulation are neutrophils, which help the animal fight infections. Neutrophils can be decreased in pets with bone marrow disease, in some viral diseases, and in some pets receiving cancer chemotherapy drugs. Neutrophils are increased in pets with inflammation or infection of any part of the body and in pets receiving prednisone or other cortisone-type drugs.

Lymphocytes also help fight infection and produce antibodies against infectious agents (viruses, bacteria, etc.). Lymphocytes may be increased in puppies and kittens with an infection, they can be decreased in pets who are severely stressed, and lymphocytes might be lost in some types of diarrhea. Certain drugs, such as prednisone (a cortisone-type drug) will decrease the number of lymphocytes in the blood stream.

Monocytes may be increased in pets with chronic infections. Eosinophils and basophils are increased in pets with allergic diseases, or parasitic infections (worms, fleas, etc.).

Platelets are produced in the bone marrow and are involved in the process of making a blood clot. Platelets live a few weeks and are constantly being produced by the bone marrow. Low platelet counts occur if the bone marrow is damaged and doesn't produce them, or if the platelets are destroyed at a faster rate than normal. The two primary causes of platelet destruction are immune-mediated destruction (ITP or IMT) and DIC (disseminated intravascular coagulation). Immune-mediated thrombocytopenia happens when the animal's immune system destroys platelets. DIC is a complex problem in which blood clots form in the body using the platelets faster than the bone marrow can produce new ones. Animals with a low platelet count bruise easily and may have blood in their urine or stool.

Packed cell volume (PCV) (called hematocrit, HCT, in humans) is another measure of red blood cells. A small amount of blood is placed in a tiny glass tube and spun in a centrifuge. The blood cells pack to the bottom of the tube and the fluid floats on top. The PCV is the percent of blood, that is cells, compared to the total volume of blood. In normal dogs and cats, 40-50% of the blood is made up of blood cells and the remainder is fluid.

Blood and urine tests are performed to get an initial overview of the health, and sometimes the function, of body organs. Some blood tests are very specific for a single organ, whereas other tests are affected by several organs. Blood tests are often performed as a biochemistry profile, or chemistry panel, which is a collection of blood tests to screen several organs at one time. The makeup of a biochemical profile varies with the laboratory in which it is performed. Following are some of the more commonly performed chemical tests:

albumin

Albumin is a small protein produced by the liver. Albumin acts as a sponge to hold water in the blood vessels. When blood albumin is decreased, the pressure created by the heart forcing blood through the blood vessels causes fluid to leak out of the blood vessels and accumulate in body cavities such as the abdominal cavity or in tissues as edema. Albumin is decreased if the liver is damaged and cannot produce an adequate amount of albumin or if albumin is lost through damaged intestine or in the urine due to kidney disease. The only cause of increased albumin is dehydration.

Alkaline phosphatase

Alkaline phosphatase originates from many tissues in the body. When alkaline phosphatase is increased in the bloodstream of a dog the most common causes are liver disease, bone disease or increased blood cortisol either because prednisone or similar drug is being given to the pet or because the animal has Cushing's disease (hyperadrenocorticism). In cats, the most common causes of increased alkaline phosphatase are liver and bone disease.

ALT

ALT is an enzyme produced by liver cells. Liver damage causes ALT to increase in the bloodstream. ALT elevation does not provide information as to whether the liver disease is reversible or not.

Amylase & Lipase

Amylase is an enzyme produced by the pancreas and the intestinal tract. Amylase helps the body breakdown sugars. Amylase may be increased in the blood in animals with inflammation (pancreatitis) or cancer of the pancreas. Sometimes pancreatitis is difficult to diagnose and some dogs and cats with pancreatitis will have normal amounts of amylase in the blood. Lipase is another pancreatic enzyme which is responsible for the breakdown of fats and which may be increased in patients with pancreatic inflammation or cancer.

Bile acids

Bile acids are produced by the liver and are involved in fat breakdown. A bile acid test is used to evaluate the function of the liver and the blood flow to the liver. Patients with abnormal blood flow to the liver, a condition known as portosystemic shunt will have abnormal levels of bile acids. The bile acid test measures a fasting blood sample and a blood sample two hours after eating.

Bilirubin

Bilirubin is produced by the liver from old red blood cells. Bilirubin is further broken down and eliminated in both the urine and stool. Bilirubin is increased in the blood in patients with some types of liver disease, gallbladder disease or in patients who are destroying the red blood cells at a faster than normal rate (hemolysis). Large amounts of bilirubin in the bloodstream will give a yellow color to non-furred parts of the body, which is called icterus or jaundice. Icterus is most easily recognized in the tissues around the eye, inside the ears and on the gums.

BUN

BUN (blood urea nitrogen) is influenced by the liver, kidneys, and by dehydration. Blood urea nitrogen is a waste product produced by the liver from proteins from the diet, and is eliminated from the body by the kidneys. A low BUN can be seen with liver disease and an increased BUN is seen in pets with kidney disease. The kidneys must be damaged to the point that 75% of the kidneys are nonfunctional before BUN will increase. Pets that are severely dehydrated will have an increased BUN as the kidneys of a dehydrated patient don't get a normal amount of blood presented to them, so the waste products do not get to the kidneys to be eliminated.

Calcium

Calcium in the bloodstream originates from the bones. The body has hormones, which cause bone to release calcium into the blood and to remove calcium from the blood and place it back into bone. Abnormally high calcium in the blood occurs much more commonly than low calcium. High blood calcium is most commonly associated with cancer. Less common causes of elevated calcium are chronic kidney failure, primary hyperparathyroidism which is over-function of the parathyroid gland, poisoning with certain types of rodent bait and bone disease.

Low blood calcium may occur in dogs and cats just before giving birth or while they are nursing their young. This is called eclampsia and occurs more commonly in small breed dogs. Eclampsia causes the animal to have rigid muscles which is called tetany. Another cause of low blood calcium is malfunction of the parathyroid glands which produce a hormone (PTH) that controls blood calcium levels. Animals poisoned with antifreeze may have a very low blood calcium.

Cholesterol

Cholesterol is a form of fat. Cholesterol can be increased in the bloodstream for many reasons in dogs. It is much less common for cats to have increased cholesterol. Some of the diseases that cause elevated cholesterol are hypothyroidism, Cushing's disease, diabetes and kidney diseases that cause protein to be lost in the urine. High cholesterol does not predispose dogs and cats to heart and blood vessel disease as it does in people.

Creatinine

Creatinine is a waste product that originates from muscles and is eliminated from the body by the kidneys. An elevation of creatinine is due to kidney disease or dehydration. Both creatinine and BUN increase in the bloodstream at the same time in patients with kidney disease.

Creatinine kinase (CK)

Creatinine kinase (CK) is released into the blood from damaged muscle. Elevation of creatinine kinase therefore suggests damage to muscle including heart muscle.

Glucose

Glucose is blood sugar. Glucose is increased in dogs and cats with diabetes mellitus. It may be mildly increased in dogs with Cushing's disease. Glucose can temporarily increase in the blood if the dog or cat is excited by having a blood sample drawn. This is especially true of cats. A quick test to determine whether a glucose elevation is transient or permanent is to look at the urine. If the glucose is chronically elevated there will be an increased amount of glucose in the urine as well.

Low blood sugar occurs less commonly and can be a sign of pancreatic cancer or overwhelming infection (sepsis). Low blood sugar can cause depression or seizures. Low blood sugar can be seen if the blood sample is improperly handled. Red blood cells will use glucose so typically red blood cells are removed from the blood sample and the clear part of the blood (plasma or serum), is used for analysis.

Phosphorus

Phosphorus in the bloodstream originates from bones and is controlled by the same hormone, PTH (parathyroid hormone) which controls blood calcium. Phosphorus is increased in the bloodstream in patients with chronic kidney disease. Like BUN and creatinine, phosphorus increases in these patients when about 75 percent of both kidneys is damaged.

Potassium

Potassium is increased in the bloodstream in the pet with acute kidney failure such as kidney failure caused by antifreeze poisoning, in dogs with Addison's disease and in animals with a ruptured or obstructed bladder.

Potassium is lost from the body in vomit, diarrhea and urine. Pets that are not eating may have a low blood potassium. Low blood potassium can cause the pet to feel weak. Cats with low potassium may develop painful muscles.

Sodium

Sodium may be slightly increased in the blood if the patient is dehydrated although many dehydrated dogs and cats have a normal blood sodium. Low blood sodium is most commonly seen with Addison's disease (hypoadrenocorticism).

Total protein

Total protein includes albumin and larger proteins called globulins. Included in the globulins are antibodies which are protein molecules. Total protein can be increased if the dog or cat is dehydrated or if the pet's immune system is being stimulated to produce large amounts of antibody. Total protein is decreased in the same situations which reduce albumin or if the pet has an abnormal immune system and cannot produce antibodies.

Urinalysis

Urinalysis: A urine sample can provide information about several organ systems. The concentration, color, clarity and microscopic examination of the urine sample can provide diagnostic information.

Urine may be obtained by catching a sample during normal urination, by passing a catheter into the bladder or by placing a small needle through the body wall into the bladder, a procedure called cystocentesis. Depending upon why the urine sample is being collected, one collection method may be preferred over another. Inquire at the time you make an appointment for veterinary care if a urine sample may be collected. Preventing your pet from urinating prior to the appointment will assure that your pet's bladder will contain urine for sampling.