? 31-Dec Mav updated labs

Christie & Maverick

Christie & Maverick

Member Since 2017
Last post

Finally had a chance to get updated labs entered for Maverick. I'm a bit worried that he consistently has low neutrophils, last labs are slightly better than before, but they are still lower than normal. New reading via IDDEXX lab of AST is low, and I'm not sure whether this indicates liver issues. Globulin is also getting close to low end of normal, which I'm also concerned about, and seeing that he has urobilinogen in urine and mild proteinurea :( seems to indicate something is going on with the liver?The good news, SDMA was within normal range, as well as other kidney values, so I'll take it!

Hoping to get some feedback from folks who may happen to have any insights for me, and tagging also
@Marje and Gracie, if you happen to pop by, can you please have a look? I'll send you a PM also since I need your help with my 2019 SS :kiss:
 
Last edited:
Hi Christie. Is Maverick on any medications? Just wondering as some can impact lab values. How is he feeling/acting these days?
l wouldn’t worry about protein in urine at that low point. Neko had proteinuria but we didn’t get further testing until it went higher. It can be an early sign of kidney disease.
 
Wendy&Neko said:
Hi Christie. Is Maverick on any medications? Just wondering as some can impact lab values. How is he feeling/acting these days?
l wouldn’t worry about protein in urine at that low point. Neko had proteinuria but we didn’t get further testing until it went higher. It can be an early sign of kidney disease.
Click to expand...
Hi Wendy, thanks for checking in on us :). Labs were taken about 6 weeks ago, Mav had been doing really well, I thought, playful, eating well, LB all going fine, purring, preening, including his civvie brother! Maybe a little less playful since the reducie, but I've bumped him back up to 1u a few days ago.

With proteinurea, that's my understanding as well, though it's also been noted that it can be associated with diabetes. I guess it depends on whether it is preglomerular, postglomerular or glomerular. Something to watch going forward. I wonder about some underlying chronic infection, his neutrophils have always been low. Shoot, the more I read, the more I confuse myself lol. Even the low AST is baffling, I can't see any other liver indicators off. I suppose low is better than high?! I just don't know.

Thanks, Wendy, hope you have a wonderful, happy New Year!
 
First, I would bring this up with your vet. The first thought that I have is that you have only one test for AST. There's no comparison from previous labs. All of the other liver values are in normal range. (If you look at Mav's ALT, you have one really out of range value back in July 2017 and then everything has been fine since then).

I don't know if there's a means of assessing inflammation in cats. It can be tested with C reactive protein or a sedimentation rate in humans. Neutrophils are often indicators of stress or inflammation. Probably giving Mav something like omega-3s couldn't hurt and they may be helpful with inflammation. Nordic Naturals is a trustworthy brand and makes a variety that is bottled for pets.
 
Sienne and Gabby (GA) said:
First, I would bring this up with your vet. The first thought that I have is that you have only one test for AST. There's no comparison from previous labs. All of the other liver values are in normal range. (If you look at Mav's ALT, you have one really out of range value back in July 2017 and then everything has been fine since then).

I don't know if there's a means of assessing inflammation in cats. It can be tested with C reactive protein or a sedimentation rate in humans. Neutrophils are often indicators of stress or inflammation. Probably giving Mav something like omega-3s couldn't hurt and they may be helpful with inflammation. Nordic Naturals is a trustworthy brand and makes a variety that is bottled for pets.
Click to expand...
Hi Sienne, thanks very much for your comments and suggestions. Both past labs were done in-house, July 2017 was at diagnosis. I'm not sure why they didn't do an AST, so as you noted, I have nothing to compare it to. The second recheck labs were done 5 months later because of my concerns with elevated GGT and bilirubin, luckily those seem to have worked themselves out.

Each vet visit seems to be primarily focused on diabetes, though this issue with possible inflammation somewhere does seem to keep popping up in the back of my mind...I guess since I don't see any signs of issues, I don't really know what to address! I did ask about doing a dental, and they said I can schedule one anytime I want...that makes me quite nervous, I've never had one of my pets go through one :nailbiting:, in the meantime, I'll definitely try some Omega-3s. This new set of labs were sent out to IDDEXX, I asked for a senior panel.

I will certainly follow up with my vet, I had a few things going on, and only just now had a moment to start looking through the labs and ponder a few things...Marje PMd me and said she will pop in to have a look when she has a moment, so I think I'll just stop googling bile duct and liver issues in cats :bookworm::D
 
I wouldn’t worry about the low AST. It’s not a significant finding in relation to his total liver panel. You want to look for trends and not just one number. It’s possible that this could just be Maverick’s “normal”. Not all cats always fit right into the normal ranges and as long as their own range is normal and stable from their baseline, I wouldn’t be worried.

Usually low neutrophils can be caused by medications like methimazole (felimazole) for hyperthyroidism. There are several other meds that can cause low neutrophils. They can also be low due to an infection that the body has been fighting and the body “runs out” of neutrophils. Again, this could be the norm for him and if you have any historic labs that go way back, you might want to check them to see where his neutrophils are. I always keep all my cats’ labs on a SS so I know from kitten hood what their baselines are.

On protein in the urine, it’s not unusual that I see trace or +1 protein in both my civvies. You can have the urine test run again (just take in a free catch) and ask them to also check the microalbumnaria. That’s a less expensive test than the urine protein:creatinine ratio. If the MA is normal, I wouldn’t worry.

On the elevated urobilinogen, DVM 360 states, and IDEXX concurs (in a separate paper):
Also, urobilinogen is very unstable and therefore, should not used as a reliable indicator of disease in dogs and cats.
Click to expand...

In fact, many labs don’t even test for this. Because his bilirubin in his blood and urine is normal, I wouldn’t worry.

I’d discuss with the vet what his/her feeling about the low neutrophils is.

Happy New Year!
 
Excellent info, thanks again Marje, I'll keep this all noted for future reference! I wish I had baseline data but Mavvy was a rescue, and at the time, it didn't occur to me to get prelim blood work at such an early age...lesson learned. I might just call the rescue group and ask if they ran any blood at the time they brought him in, maybe they did, doesn't hurt to ask anyway. The low neutrophils has been a pattern, though this time around, at least it was a tad higher, but I am not sure if the slight increase in value is notable, and given that I am also now comparing with IDDEXX run vs. in-house lab reference ranges. No meds to speak of, so that isn't a contributing factor. All I was told is to keep dosing insulin like I am doing, and come back in a year. You did mention with my previous labs that I should speak with the vet about the low neutrophils, I think at the time I was caught up in the GGT and billirubin discussion with them, so I'll certainly followup ASAP on this topic. The Urobilinogen was interesting, I found something on vca hospitals website, that mentioned it indicated the bile duct was open. That seemed to be a good thing, considering most concerns would arise due to a duct blockage. Your input is definitely more informative ;). I had initially been concerned since there hadn't been anything in the urine previously.

Mav sends you lots of head bumps, and thanks you too! he is happily playing with a spongy ball at the moment :cat::bighug:.
 
Christie & Maverick said:
Excellent info, thanks again Marje, I'll keep this all noted for future reference! I wish I had baseline data but Mavvy was a rescue, and at the time, it didn't occur to me to get prelim blood work at such an early age...lesson learned. I might just call the rescue group and ask if they ran any blood at the time they brought him in, maybe they did, doesn't hurt to ask anyway. The low neutrophils has been a pattern, though this time around, at least it was a tad higher, but I am not sure if the slight increase in value is notable, and given that I am also now comparing with IDDEXX run vs. in-house lab reference ranges. No meds to speak of, so that isn't a contributing factor. All I was told is to keep dosing insulin like I am doing, and come back in a year. You did mention with my previous labs that I should speak with the vet about the low neutrophils, I think at the time I was caught up in the GGT and billirubin discussion with them, so I'll certainly followup ASAP on this topic. The Urobilinogen was interesting, I found something on vca hospitals website, that mentioned it indicated the bile duct was open. That seemed to be a good thing, considering most concerns would arise due to a duct blockage. Your input is definitely more informative ;). I had initially been concerned since there hadn't been anything in the urine previously.

Mav sends you lots of head bumps, and thanks you too! he is happily playing with a spongy ball at the moment :cat::bighug:.
Click to expand...
 
Hi to everyone from M'row&me. Just a thought on lab values; I used to research/development in generating new&better ways to measure compounds in the blood, and the ugly truth is that if you get a panel with values for 20 compounds, one of those values is most likely wrong. I am much more reassured that the second value was much closer to normal. If you are still concerned, you could get it tested again; then you will know what's going on. All the best!!
 
Amina&M'row said:
Hi to everyone from M'row&me. Just a thought on lab values; I used to research/development in generating new&better ways to measure compounds in the blood, and the ugly truth is that if you get a panel with values for 20 compounds, one of those values is most likely wrong. I am much more reassured that the second value was much closer to normal. If you are still concerned, you could get it tested again; then you will know what's going on. All the best!!
Click to expand...
And am an MD, not a vet, so I could be wrong here. However, in a human patient, I'd consider doing a peripheral smear. This involves taking a tiny amount of blood, smearing it on a slide, possibly staining it , looking at the blood cells under the microscope: shows if any of them are suspicious-looking. Good luck!!
 
Christie & Maverick said:
Excellent info, thanks again Marje, I'll keep this all noted for future reference! I wish I had baseline data but Mavvy was a rescue, and at the time, it didn't occur to me to get prelim blood work at such an early age...lesson learned. I might just call the rescue group and ask if they ran any blood at the time they brought him in, maybe they did, doesn't hurt to ask anyway. The low neutrophils has been a pattern, though this time around, at least it was a tad higher, but I am not sure if the slight increase in value is notable, and given that I am also now comparing with IDDEXX run vs. in-house lab reference ranges. No meds to speak of, so that isn't a contributing factor. All I was told is to keep dosing insulin like I am doing, and come back in a year. You did mention with my previous labs that I should speak with the vet about the low neutrophils, I think at the time I was caught up in the GGT and billirubin discussion with them, so I'll certainly followup ASAP on this topic. The Urobilinogen was interesting, I found something on vca hospitals website, that mentioned it indicated the bile duct was open. That seemed to be a good thing, considering most concerns would arise due to a duct blockage. Your input is definitely more informative ;). I had initially been concerned since there hadn't been anything in the urine previously.

Mav sends you lots of head bumps, and thanks you too! he is happily playing with a spongy ball at the moment :cat::bighug:.
Click to expand...
I’m glad he’s doing so well. Headbumps back! Because the neutrophils seem to be low in him over time, it doesn’t really concern me...it could just be him. But it’s worth asking the vet.
 
Bronx's dad said:
Hi Christie! Hope you, Mav & civvie brother a healthy & happy 2019 :)
Click to expand...
Happy New Year, Paul! So glad you stopped by :bighug:, I was just thinking about you and Bronx, wondering how you were doing! Wishing you and Bronx all the best in the New Year, hoping your world is filled to the brim with happiness and health...sending lots of extra belly rubs for Bronx too :cat:
 
You must log in or register to reply here.
Back
Top