Illustrated Articles
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Jaundice is caused by the build-up of bilirubin in the tissues due to high blood levels of bilirubin (hyperbilirubinemia). Hyperbilirubinemia occurs either due to increased red blood cell destruction (hemolysis), or the liver is unable to process or excrete bilirubin normally. CBC, biochemistry panel, and urinalysis are tests used to further define the cause of jaundice. Hemolysis will result in significant reduction of PCV/HCT but not affect plasma protein levels. Abnormal RBCs may be seen indicating IMHA or infectious causes of hemolysis. Liver disease severe enough to cause jaundice will result in significant increases in liver values: ALT and AST if the liver has been damaged by toxins, infection or tumors; ALP and GGT if there is a problem with bile flow out of the liver and/or gallbladder such as gallstones or pancreatitis. Obstruction of bile flow may also be detected in urine samples as a lack of urobilinogen. These tests only define where the problem is occurring, not what the problem is, so further diagnostics that may be needed and include ultrasound, X-ray, FNA, liver biopsy and/or bacterial culture from fluid found in or around the liver. More specific tests for infectious diseases include FeLV, feline coronavirus, and fungal testing.
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Tests to diagnose kidney disease include complete blood count, serum biochemistry, and urinalysis. These blood tests will determine if your pet is anemic, determine white blood cell counts, measure blood urea nitrogen, creatinine, and electrolytes. A urinalysis is essential for the proper interpretation of the urea and creatinine values in the serum biochemistry profile and may also provide important clues to the possible underlying cause of kidney disease. A urinalysis will also determine the specific gravity, pH, presence of blood in the urine, and the amount of protein in the urine. An evaluation of the urine sediment will determine the presence of red blood cells, white blood cells, bacteria, crystalline material, and cellular casts all of which provide information to determine the underlying cause of kidney disease in your pet. Further diagnostic tests may be recommended based on the results of these initial screening tests.
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Lameness in your pet can be due to many possible causes. Examination may help determine the cause, but further testing may include radiographs, blood tests, or joint aspirations to help accurately determine the cause. Treatment and prognosis for the lameness will depend on the underlying cause.
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Initial screening tests for liver disease include a CBC, biochemistry panel, and urinalysis. A CBC can be used to differentiate hemolytic icterus from hepatic/post-hepatic icterus by measuring the PCV or HCT. Elevated WBC can also indicate presence of infection or cancer. ALP and GGT elevations can indicate a problem with bile flow through the liver. AST and ALT reflect liver cell damage. Bilirubinemia indicates a problem with the uptake, processing or excretion from the liver as long as hemolysis has been ruled out. Other serum indicators of liver disease include albumin, glucose, BUN, and cholesterol, as low numbers could suggest a reduced ability of the liver to manufacture these components. Certain parameters in urine can change before blood changes are seen making urinalysis a useful tool in diagnosing liver disease. Bile acid testing can be used to detect problems in liver function. More advanced diagnostics to determine the cause of liver disease include abdominal ultrasound, fine needle aspiration of the liver, or liver biopsy.
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Hypoglycemia can be caused by many different things including liver failure, sepsis, Addison’s disease, and overdose of insulin in the treatment of diabetes mellitus. Clinical signs include weakness, tremors, and rarely seizures. After detecting hypoglycemia on a blood sample, determining the cause includes a full history, physical exam, CBC, biochemistry profile, and urinalysis. In some cases, more advanced testing such as imaging, biopsy, or ACTH stimulation testing will be recommended.
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In pets, pallor is usually detected as a loss of color from the gums and inner eyelids and can be a sign of anemia or poor circulation. A pet’s history of illness and a complete physical examination are important in determining the cause of the pallor. However, your veterinarian may also recommend doing screening tests such as a complete blood count, serum biochemistry and urinalysis. Additional tests may also be needed.
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The pancreas is an abdominal organ responsible for regulating blood glucose (endocrine function) and releasing enzymes that aid in digestion (exocrine function). A deficiency in releasing digestive enzymes causes a disease called exocrine pancreatic insufficiency. This disease is diagnosed by measuring blood levels of trypsin-like immunoreactivity that is proportional to the amount of a specific digestive enzyme released into the intestine (trypsin). False negatives can be seen with concurrent pancreatitis or not performing the test on a fasted sample. B12 and folate levels can be supportive of the diagnosis. Endocrine pancreatic dysfunction causes diabetes mellitus, diagnosed by elevated glucose levels in the blood and urine. Pancreatitis diagnosis without a biopsy of the organ is not straightforward. Many abnormalities in blood tests can support the diagnosis, including: increased white blood cells, increased PCV, increased amylase or lipase; but an elevation of pancreatic specific lipase immunoreactivity is the most diagnostic of the blood tests. Ultrasound and X-rays can also show changes supporting pancreatitis.
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Finding the cause of a pet's seizures can be difficult. Screening usually starts with a complete history and physical examination, followed by blood and urine tests to look for underlying diseases that can cause seizures. If the cause still cannot be identified, it is possible that they originate within the brain itself and further neurologic testing might be advised.
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Sneezing and nasal discharge can occur for many different reasons including infection, allergy, foreign body, and tumors. A thorough history and physical exam is the first step in diagnosing the cause of sneezing/nasal discharge. Initial screening tests include CBC, biochemistry profile, urinalysis, and coagulation testing. These tests can be used to indicate the safety of general anesthesia needed for additional testing. Specific testing that may be recommended for determining the cause of nasal discharge/sneezing may include nasal swab for cytology, radiographs of the nasal cavity, nasal flush for cytology, culture and sensitivity testing, and rhinoscopy. Chest radiographs, specific micro-organism DNA testing, more advanced imaging such as CT or MRI, and biopsy may be considered based on initial test results.
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Unexplained bleeding is worrisome because it suggests a problem with the body’s blood clotting or coagulation system. Disorders of the coagulation system can arise for many reasons, including shortages of coagulation factors (clotting proteins), a shortage of platelets (a type of blood cell), defective platelets, and serious systemic disease affecting the whole body.