? Is anyone on this board experienced with reading blood test results?

[Elle D & Hugo]

I just got my cat Hugo's test results, and even though the vet said that the results were pretty much normal, there are elevated results. Just curious if anyone could take a look and let me know what they saw?

Mind you he was hospitalized about 2 months ago with hepatic lipidosis.

We are going to see a specialist, but not for another week.

 

[Deb & Wink]

@Larry and Kitties
@Marje and Gracie

These are the 2 people I know that can read blood work.

 

[Sienne and Gabby (GA)]

The elevated ALT is likely reflective of the recent hepatic lipidosis. ALT is a liver enzyme. If you have any previous labs, it would be helpful to know if this is a decrease in where Hugo's levels were 2 months ago. The good news is that AST which can also be an indication of liver issues is normal. Cholesterol and triglycerides are inconsequential. The CPK value is indicative inflammation. It could be a reflection of the HL or if there was an infection/inflammation that caused the ketones to develop, it may be related to that. Eosinophils are typically elevated by an allergic reaction.

What did your vet have to say about the labs?

 

[Elle D & Hugo]

He said everything was normal. Which it obviously isn't.

 

[Elle D & Hugo]

Here's the blood work from February.

 

[Larry and Kitties]

For the high eosinophils see that topic of:
https://www.2ndchance.info/dxme-Eosinophils.htm
What concerns me some is the the urine specific gravity USG) went from 1.029 to 1.020. This decrease and absolute value usually indicate kidney problems. Do you have the blod chemistry results (incuded value like creatitine, potasium and phosphorous)?

 

[Elle D & Hugo]

For the high eosinophils see that topic of:
https://www.2ndchance.info/dxme-Eosinophils.htm
What concerns me some is the the urine specific gravity USG) went from 1.029 to 1.020. This decrease and absolute value usually indicate kidney problems. Do you have the blod chemistry results (incuded value like creatitine, potasium and phosphorous)?

Hugo has asthma, so I guess that makes sense.

Is that not on the sheet? I see those on the reports. Is it a different report?

 

[Elle D & Hugo]

For the high eosinophils see that topic of:
https://www.2ndchance.info/dxme-Eosinophils.htm
What concerns me some is the the urine specific gravity USG) went from 1.029 to 1.020. This decrease and absolute value usually indicate kidney problems. Do you have the blod chemistry results (incuded value like creatitine, potasium and phosphorous)?

Also, he had just gotten SubQ fluids and cerenia the night before. Would that make any difference?

 

[Cassi Jones]

The labs do not look bad at all. ALT is slightly elevated but depending on previous labs could be irrelevant. Other liver values are normal so that is good. CPK also known as CK is a muscle enzyme, mild elevations like these can be seen when there is a difficult blood draw following restraint. So this is also usually not significant. Urine specific gravity for cats should be <1.035 so this also looks good. Diabetics often have UTIs due to high amounts of sugar in the urine, 2 + is not bad considering the very high fructosamine. Your vet even checked a culture which is great! Many do not especially with the UA results and many times will come back with growth despite a good UA. So overall your vet is right concerning the labs and the only real concern is working towards better diabetic regulation. I assume your vet may have increased your dose bc of the high fructosamine.

 

[Elle D & Hugo]

The labs do not look bad at all. ALT is slightly elevated but depending on previous labs could be irrelevant. Other liver values are normal so that is good. CPK also known as CK is a muscle enzyme, mild elevations like these can be seen when there is a difficult blood draw following restraint. So this is also not significant. Urine specific gravity for cats should be <1.035 so this also looks good. Diabetics often have UTIs due to high amounts of sugar in the urine, 2 + is not bad considering the very high fructosamine. So overall your vet is right concerning the labs and the only real concern is working towards better diabetic regulation. I assume your vet may have increased your dose bc of the high fructosamine.

We had gone in because of a highish ketone level and he wasn't eating normally. We took him to an ER vet the day before, where they found trace ketones and slightly acidic blood. They gave him the fluids and cerenia, and said that he could go home as long as we took him to the regular vet to get all his blood work and urinalysis. They also wanted an abdomen ultrasound, but they couldn't do it because they were only taking ER ultrasounds. After we had sent our last curve to the vet, he wanted us to go up an entire unit of insulin, which dipped Hugo into hypo territory, so we panicked and tried to regulate him ourselves, but both of us work on tight schedules (not so much anymore) so there was a lot of flailing. I'm trying to stick with the TR protocol now here but it breaks my heart to see these high numbers and bouncing, which I don't understand at all. Especially the high fructosamine. It's like, well what the hell are we even doing then? And now he's feeling sick again, after we had dodged the bullet with the hepatic lipidosis and high vet bills? I'm so scared for him. Like it can't come fast enough.

 

[Larry and Kitties]

. Urine specific gravity for cats should be <1.035 so this also looks good.

Where do you conclude that. When I worked at a vet most cats has USG>1.040. Also see:
http://www.iris-kidney.com/education/urine_specific_gravity.html
My concern is the decrease of 1.029>1.020

 

[Marje and Gracie]

Where do you conclude that. When I worked at a vet most cats has USG>1.040. Also see:
http://www.iris-kidney.com/education/urine_specific_gravity.html
My concern is the decrease of 1.029>1.020

I agree with Larry. USG below 1.040 bears watching. Certainly when it gets down to 1.029 and lower, we do wonder if it’s an early indicator of CKD. The kidney values are normal at this time but sometimes we see the USG drop before we see the kidney values change.

However, USG does change through the day and it also can drop when fluids are given. The way to know if he is able to concentrate his urine is to get the very first sample of the day when it is most concentrated. Run it to the vet and let them check it with their refractometer. It doesn’t need to be a sterile sample. If it’s above 1.040, then he’s able to concentrate it which means his kidneys are working fine. If it’s below, then there can be other reasons then just CKD.

I agree with Sienne’s comments about ALT and that is just a very mild elevation. But it also bears watching to be sure it comes down. Insofar as CK (CPK), I’d also be sure it comes back down because it can indicate more than just inflammation although his is not really horribly elevated like I’ve seen others.

 

[Cassi Jones]

I work in veterinary medicine. USG measures the concentrating ability of the kidneys. Reference ranges vary by lab. None of the other kidney values are affected. Labs are viewed looking at the whole vs just one value as PUPD status, fluid administration, time of day, how it was measured (urine stick vs cysto collection) needs to be considered as well. There is a wide range of normal in light of hydration status 1.035 to 1.060 for cats. Sorry mistyped in earlier post was trying to help before I fell asleep.

If OP is concerned best thing to do would be to ask their DVM. Maybe more concerned with regulating diabetes as many values will change once regulation is better. I would like to see an SDMA run. Better early indicator of kidney function than bun/creatinine/USG.