Understanding Your Dogs Blood Work ~ What Do The Numbers Mean & Why Do They Matter?

If your dog has kidney disease or is displaying any signs of potential kidney disease (see Signs of Chronic or Signs of Acute Kidney Failure, at bottom of page) this post can change your dogs life. Chronic kidney failure is commonly seen in the Cocker SpanielDoberman Pinscher, Standard Poodle,Shih TzuLhasa Apso and Shar-Pei. If you have any of these breeds, definitely read on. For anyone with a Shar-Pei that’s suffering from FSF, Swollen Hock Syndrome, Amyloidosis, or Shar-Pei Fever, this article will empower you with important information.

My Shar Pei MooShu, was diagnosed with FSF at a year old, and moderate stages of kidney failure at 9 years. Each month we had to go in for “bloodwork” and as I’d sign the Amex slip for another $150.00, I’d ask myself why I didn’t know more about what I was paying for and why I needed to be coming so often. I kind of thought it was their way of making money and I would begrudgingly pay the bill and make another appointment. Boy was I wrong.

On the day of each appointment, the routine is to go for a long walk and then head over to the vet for the technician to take her blood, her weight, and check her blood pressure. Why do you have to weigh my dog every time? Likes it’s really important! Well, it can be and that’s why they do it.  After years of going to these appointments, I sat down with all our records and was determined to understand what it all means.

After one of our appointments, the vet called and told me that MooShu needed to go and see her kidney specialist, that her “numbers” had moved enough for immediate concern. Some numbers are better if they are low and some numbers are better if they’re high. If one is too low and one is too high, it means one thing. If those same 2 numbers are high, it means another. If they are both low, it can mean yet another thing. So here I have the information to understand what’s going on in my dogs body and the power to change it.

Below is a chart with the symbols, names and meanings of the CBC blood work screening of a canine. I recommend you get a copy of all your blood screenings (not routinely done so if you already have one, there’s a good chance that it’s important that you know how to read it) and if you don’t have one, ask the vet to take one at your next annual visit. This is especially true for people with purebred dogs as they are prone to more specific problems known to the breed. As it happens, my dog , MooShu, had a genetic disease unique to the Shar Pei that affects 10% of the entire breed, and 1 out of 4 of those sick dogs will eventually die in renal failure. Thanks to the research and hard work of all the folks working on canine kidney disease, we have a huge amount of information and treatment options for the dogs who suffer from chronic or acute kidney disease. Good news also: this information is also constantly changing and improving as the weeks, months and years go by. If kidney disease is caught early enough, we can manage it and slow down the process, giving our pets a longer and better quality of life.

Underneath the chart, I have posted a short but relevant article with information from Dr’s & researchers at Johns Hopkins Medical Institutions among other qualified sources. Let me know your thoughts.

Thanks,

Amy

Owner, The Velvet Snoot

UNDERSTANDING YOUR DOG’S BLOOD WORK
(Please consult your medical adviser for professional assessment)

A typical blood chemistry panel usually includes …

General Metabolism Kidney Function Electrolytes

Liver Function

Thyroid Pancreas

GLU (Glucose)
LDH (Lactate dehydrogenase)
CPK (Creatine phosphokinase)

BUN (Blood Urea Nitrogen)
CREAT (Creatinine)

Na (Sodium)
K (Potassium)
Cl (Chloride)
CA (Calcium)
PHOS(Phosphorus)

ALP (Alkaline phosphatase)
ALB (Albumin)
GGT (Gamma-glutamyl transpeptidase)
SGPT (Serum glutamate pyruvate transaminase
TP (Total Protein)
CHOL (Cholesterol)
GLOB (Globulin)
TBILI (Total Bilirubin)

T3(Triiodothyronine)
T4 (Thyroxine)

AMY(Amylase)
LIP (Lipase)

values for blood chemistry elements for dogs are displayed in the table below.

Keep in mind that each blood chemistry machine and every veterinary diagnostic lab has their own set of
normal values calculated for their particular instrumentation.  The values shown here may be different
from normal ranges your veterinarian refers to when making judgments about patients’ reported blood chemistry values.

BLOOD WORK IS USUALLY DONE AFTER A TWELVE(12) HOUR FAST -
PLEASE CHECK WITH YOUR VETERINARIAN

NORMAL CANINE LEVEL RANGES
FOR A LABORATORY’S  BLOOD CHEMISTRY VALUES

DOGS

GLU- GLUCOSE 67 – 125 mg/dL High levels can help diagnose diabetes and can indicate stress, excess of the hormone progesterone, an overactive adrenal gland. Low levels can indicate liver disease, tumors or abnormal growth on pancreas, an underactive adrenal gland.
ALT – Alanine aminotransferase
10 – 84 U/L An enzyme that becomes elevated with liver disease
Alkaline Phosphatase (ALKP) 20-200 - An enzyme produced by the biliary tract (liver). High levels indicate bone disease, liver disease or bile flow blockage.
TOTAL BILIRUBIN (TBILI) 0.04 – 0.40  mg/dL A component of bile, bilirubin is secreted by the liver into the intestinal tract. High levels can lead to jaundice and indicate destruction in the liver and bile duct.
TOTAL PROTEIN (TP)

5.2 – 7.8 gm/dL Increases indicate dehydration or blood cancer, bone marrow cancer; decreases indicate malnutrition, poor digestion, liver or kidney disease, bleeding or burns.
GLOBULIN(GLOB) .9 – 4.0 Decreased levels indicate problems with antibodies, immunodeficiency viruses or risk of infectious disease. Increased levels may indicate stress, dehydration or blood cancer, allergies, liver disease, heart disease, arthritis, diabetes.
UREA NITROGEN (BUN)
9 – 27 mg/dL BUN is produced by the liver and excreted by the kidneys. Decreased levels are seen with low protein diets, liver insufficiency, and the use of anabolic steroid drug. Increased levels indicate any condition that reduces the kidney’s ability to filter body fluids in the body or interferes with protein breakdown.
PHOSPHORUS (PHOS)
2.6 – 6.8 mg/dL

Affected by diet, parathormone and kidney. Decreased levels shows overactive parathyroid gland and malignancies, malnutrition and malabsorption. Increases with underactive parathyroid gland and kidney failure.

Creatinine (CREA) .4  – 1.4Creatinine is a by-product of muscle metabolism and is excreted by the kidneys. Elevated levels can indicate kidney disease or urinary obstruction, muscle disease, arthritis, hyperthyroidism, and disbetes. An increased BUN and normal creatinine suggest an early or mild problem. An increased creatinine and increased BUN with elevated phosphorus indicate a long standing kidney disease.Amylase (AMYL)200 – 1290The pancreas produces and secrets amylase to aid in digestion. Elevated blood levels can indicate pancreatic and/or kidney disease.Calcium (CA)9.5 – 12.0Blood calcium levels are influenced by diet, hormone levels and blood protein levels. Decreased levels indicate acute damage to the pancrease or undersctive parathyroid. Muscle twitches may occur in decreased level. Increased levels can be an indicator of certain types of tumors, parthyroid or kidney disease. Dr. Goldstein mentioned in his book, Nature of Animal Healing that low calcium level may indicate deficiency of pancreatic enzymes, and high calcium level may indicate poor metabolism of fats and protein.SODIUM (Na)140 – 153 mmol/L CHLORIDE (CI)106 – 118 mmol/L LACTATE DEHYDROGENASE
(LDH)
10 – 273 U/L MAGNESIUM1.5 – 2.7 mg/dL LIPASE (LIP)200 – 700 U/L CPK  (Creatine phosphokinase)20 – 200 GGT  (Gamma-glutamyl transpeptidase)1.2 Albumin (ALB)
2.5- 4.3Produced by the liver, reduced levels of this protein can point to chronic liver or kidney disease, or parasitic infections such as hookworm. High levels indicate dehydration and loss of protein.CHOLESTEROL(CHOL) -110- 314Decreased levels are found in an overactive thyroid gland, interstinal malabsorption. Elevated levels of cholesterol are seen in a variety of disorders including hypothyroidism and diseases of the liver, kidneys, cardiovascular, diabetes, stress.Triglycerides20 – 200 LDH  (Lactate dehydrogenase)30-190 THYROXINE (T4)1.0 – 4.7 ug/dL

HEMATOLOGY:  Normal ranges for blood cell elements for dogs are displayed in the table below.  These values are approximate and may not be the “normal” values established for any other individual veterinary pathology lab or blood analyzer.

NORMAL RANGES FOR A LABORATORY’S  HEMATOLOGY VALUES
(Canine)

DOGS

Red Blood Cell Count (RBC) 5.5 – 8.5 X 100,000/L Responsible for carrying oxygen and carbon dioxide throughout the body. Iron deficiency will lower RBC count. In more reduced count, it may indicate hemorrhage, parasites, bone marrow disease, B-12 deficiency, folic acid deficiency or copper deficiency. RBC lives for 120 days so an anemia of any kind other than hemorrhage indicates a long standing problem.
White Blood Cell Count (WBC) 6.0 – 17 x 1000/L The body’s primary means of fighting infection. Decreased levels may indicate an overwhelming infections (viruses), or drug / chemical poisoning. Increased levels indicate bacterial infection, emotinal upsets and blood disorders.
(MCH) Mean Corpustular Hemaglobin 19.5 – 25.5 pg
(RDW)  Red Cell Distribution Width 14 – 19 percent
Hematocrit – (HCT) 37 – 55 percent or Packed Cell Volume (PCV) – Provides information on the amount of red blood cells (RBC) present in the blood. Decreased levels means anemia from hemorrhage, parasites, nutritional deficiencies or chronic disease process, such as liver disease, cancer, etc. . Increased levels are often seen in dehydration.
Hemoglobin (HgB or Hb) g/L
120-180 The essential oxygen carrier of the blood. Decreased levels indicate the presence of hemorrhage, anemia, iron deficiency. Increased levels indicate higher than normal concentrate of RBC, B-12 deficiency (because there are fewer cells).
Reticulocytes 0-1.5% Immature red blood cells. Decreased count is usually associate with anemia. Increased count is associated with chronic hemorrage or hemolytic anemia
Segs x1000/ul 3.6-11.5
Bands  x1000/ul 0.0-0.3
Lymphocytes  x1000/ul 1.0-4.8 (L/M) – These smooth, round white blood cells increase in number with chronic infection, recovery from acute infection or underactive glands and decrease with stress, or treatment with steroids and chemotherapy drug.
Monocytes  x1000/ul 0.15-1.35
Eosinophils  x1000/ul 0.01-1.25
Electrolytes – (Sodium, Potassium, Chloride) - The balance of these chemicals is vital to health. Abnormal levels can be life threatening. Electrolyte tests are important in evaluating vomiting, diarrhea and cardiac symptoms.
Platelets x 100000/ul (PLT) 2-9 Play an important role in blood clotting. Decrease in number occurs in bone marrow depression, autoimmune hemolytic anemia, systemic lupus, severe hemorrhage or intravascular coagulation. Increased number may occurs with fracture or blood vessel injury, or cancer.

Canine Kidney Failure

Kidney or renal failure occurs when a dog’s kidney suddenly becomes unable to eliminate harmful wastes from the bloodstream and regulate fluids. Kidney failure can be acute (rapid) or chronic (developing over a period of time).

Acute Kidney Failure

Acute Renal Failure (ACF) is a potentially fatal condition that results from a sudden inability of kidneys to regulate the urine production and eliminate toxic wastes from the bloodstream. It can lead to high blood pressure, heart failure and death. If a cat or dog stops urinating, this is an extreme emergency that usually results in imminent death. In some cases, ARF can progress to CRF.

Chronic Kidney Failure

Chronic kidney failure occurs when both kidneys gradually cease to function. Within the kidneys are numerous tiny structures (glomeruli) that filter waste products from the blood and retain larger substances, such as proteins. Waste products and excess water then accumulate in the bladder until excreted as urine. In chronic kidney failure the kidneys suffer progressive damage over a number of months or years.1

Signs of Chronic Kidney Failure

Chronic Renal Failure (CRF) is a slowly progressing disease. The first signs are increased urination and thirst. As your dog ages and his kidneys become less efficient, his body compensates by increasing blood flow to the kidneys trying to improve the filtering process. As a side effect, the dog produces more urine. At the same time, he becomes more dehydrated due to increased fluid loss in the urine. Thirsty, your dog begins to drink more and more water.2

Chronic kidney failure is commonly seen in the Cocker SpanielDoberman Pinscher, Standard Poodle,Shih TzuLhasa Apso and Shar-Pei

Signs of Acute Kidney Failure

The dog produces little or no urine, he doesn’t want to drink any water, and becomes very lethargic. He may also vomit and develop diarrhea. If you notice these signs, bring your dog to the veterinarian immediately. 2

Many factors can cause acute and chronic kidney failure:

  • Toxins. Antifreeze, pesticides, and herbicides. In case of antifreeze ingestion, treatment needs to be given early in the disease to be effective. Inducing vomiting and flushing the stomach out can be very helpful if performed within 1-2 hours of ingestion of antifreeze. Otherwise, the disease progresses very rapidly and if left untreated, results in death.
  • Drugs. Blood pressure medication, aspirin and anti-inflammatory medications, anesthetics, anti-parasite drugs, antibiotics, and NSAIDs. Nephrotoxic antibiotics may be the most common cause of acute kidney failure.6
  • Kidney tumors. Lymphosarcoma and adenocarcinoma (cats); other types of tumors such as lymphoma and osteosarcoma.
  • Heart diseases that result in poor blood supply to the kidneys and poor blood flow. The inadequate blood flow leads to the toxins buildup in the bloodstream.
  • Dehydration
  • Kidney stones. These may obstruct the urinary tract, impair the flow of urine, and cause damage to the kidneys if not corrected.
  • Parasites. These are transmitted by frogs, fish and earthworms. Infected dogs and cats can have blood in the urine, difficulty urinating, or urinate small amounts.
  • Viral infections
  • Infectious agents. These include Leptospira spp. which cause leptospirosis disease. Leptospira organisms can cause acute kidney failure. 6
  • Bacteria. Some bacteria can cause ARF or CRF. Symptoms include fever, depression, lack of appetite, pain, excessive thirst and urination, and weight loss. In the chronic version, sometimes there are no symptoms at all. They are treated with antibiotics for a minimum of 4 weeks, along with supportive care.

Some toxic chemicals can come from inside the dog’s own body. For example, there could be a buildup of calcium or other substances due to a disease in another part of the body. In these cases, the effects on kidney function can last from 1 to 8 weeks, depending on the chemical(s) that caused the injury.5

Treatment of Acute Kidney Failure

Veterinarians treat acute kidney failure with intravenous fluid therapy or peritoneal dialysis to decrease the blood concentration of uremic poisons, antibiotics if needed for infectious causes, antidotes for poisoning, and surgical removal of any blockages or obstructions that may be causing the kidney failure.3 Dialysis provides extended time for kidney repair but is fraught with complications. In animals that survive or maintained by dialysis, partial kidney recovery is expected within 3-6 weeks or longer.4Many dogs die despite intensive therapy. Those dogs that do recover are considered cured and usually do not have residual kidney damage.3

Treatment of Chronic Kidney Failure

Chronic kidney failure is one of the most common cause of illness and death in older dogs. Most dogs with chronic kidney failure are older than 10 years old. The chances of a dog getting it increase as the dog ages. In fact, most older dogs have some changes in kidney enzymes on blood tests. When caught early, the proper diet, supplements, and sometimes fluid therapy can delay and may even prevent kidney disease from becoming kidney failure. Some holistic doctors have noticed that since pet owners began feeding processed pet food, more dogs are getting kidney disease.3


References:
1. The Johns Hopkins Complete Home Guide to Symptoms & Remedies. Simeon Margolis, Johns Hopkins Medical Institutions
2. Your Older Dog: A Complete Guide to Helping Your Dog Live a Longer and Healthier Life. Jean Callahan, Ann Marie Manning
3. 8 Weeks to a Healthy Dog. Shawn Messonnier
4. Veterinary emergency medicine secrets. Wayne E. Wingfield
5. The Merck/Merial manual for pet health. Cynthia M. Kahn, Scott Line

6. Clinical biochemistry of domestic animals. Jiro J. Kaneko, John W. Harvey, Michael Bruss

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