VETERINARY SKILLS: how to read blood test BIOCHEMISTRY results

Summary

In this video, Nick, the veterinary expert, provides a comprehensive guide to interpreting key clinical biochemistry parameters from veterinary lab results. He covers essential values like total protein, albumin, globulin, kidney markers (urea and creatinine), electrolytes (sodium, chloride, potassium), and various liver enzymes, offering insights into their clinical significance. Additionally, Nick explains how changes in these values can indicate specific conditions like dehydration, liver disease, kidney issues, and more. Aimed at aspiring veterinary professionals, this educational video is designed to enhance diagnostic skills and deepen understanding of lab reports.

Takeaways

• 😀 Total protein is the sum of albumin and globulin. Both can be lowered due to overhydration, blood loss, or diseases like FIP in cats.
• 😀 Urea and creatinine are vital kidney parameters. Elevated levels in both suggest kidney disease, but their relationship with urine specific gravity helps confirm the diagnosis.
• 😀 Sodium levels reflect hydration status. High sodium can be due to low water intake or dehydration, while low sodium can be linked to water retention or diseases like congestive heart failure.
• 😀 Chloride levels often follow sodium changes. If chloride is high, it may indicate water deficit or GI losses, while low chloride could be linked to diuretics or vomiting.
• 😀 Potassium is crucial for heart function. Elevated potassium can occur with kidney disease or Addison's disease, while low potassium might result from diabetes or kidney issues.
• 😀 Calcium and phosphorus are closely related. Low calcium may indicate renal disease or pancreatitis, while high calcium can be caused by diseases like Addison's or hyperparathyroidism.
• 😀 Low glucose can signal issues like hepatic failure, sepsis, or insulin overdose. High glucose may indicate diabetes, stress, or certain medications.
• 😀 ALT and AST liver enzymes help diagnose hepatocyte injury. ALT is more specific for liver damage, while AST may indicate muscle injury or use of certain drugs.
• 😀 Alkaline phosphatase (ALP) is elevated in biliary diseases and bone growth but can also rise due to glucocorticoid treatment or anticonvulsants.
• 😀 Gamma-glutamyl transferase (GGT) is another indicator of cholestasis and biliary hyperplasia. It can also rise due to glucocorticoid use.
• 😀 Cholesterol and triglycerides are markers of hyperlipidemia. Elevated levels can indicate endocrine disorders, liver diseases, or obesity, while low levels are linked to conditions like liver failure or Addison's disease.

Q & A

What is the significance of measuring total protein, albumin, and globulin in veterinary clinical biochemistry?

Total protein is the sum of albumin and globulin. These levels help in diagnosing various conditions such as overhydration, blood loss, protein-losing enteropathies, liver disease, or inflammation. Both albumin and globulin levels can give insights into the hydration status, liver function, and immune system status of a patient.

What can elevated urea and creatinine levels indicate in a patient?

Elevated urea and creatinine levels usually indicate kidney disease, specifically renal azotemia. Creatinine is a good marker of glomerular filtration rate (GFR), so when both are high, it suggests impaired kidney function. Urea may also be elevated in cases of liver disease or dehydration.

How does sodium relate to a patient’s hydration status?

Sodium levels typically reflect the body's hydration status. Elevated sodium can indicate dehydration or excessive water loss, whereas low sodium may be caused by water retention or conditions such as congestive heart failure or nephrotic syndrome.

What is the clinical significance of changes in chloride levels?

Chloride levels usually follow sodium levels, so changes in chloride often reflect similar hydration status or electrolyte imbalances. Elevated chloride can indicate dehydration or hypobicarbonatemia, while low chloride can be associated with the use of diuretics or loss due to vomiting.

Why is potassium important in clinical biochemistry, especially concerning cardiac health?

Potassium is crucial for proper muscle and cardiac function. Abnormal potassium levels, either high (hyperkalemia) or low (hypokalemia), can lead to life-threatening cardiac arrhythmias. Potassium imbalances are commonly seen in kidney disease, Addison’s disease, and diabetic conditions.

What are some causes of low calcium levels in a patient?

Low calcium levels may occur due to lactation, pregnancy, vitamin D deficiency, pancreatitis, renal disease, or ethylene glycol toxicity. It is also important to monitor calcium levels, as low calcium can lead to serious clinical consequences.

What does elevated phosphorus indicate when it occurs together with high calcium?

Elevated phosphorus along with high calcium can point towards conditions like vitamin D toxicosis or hypoparathyroidism. However, the most common cause of high phosphorus independently of calcium is a decreased glomerular filtration rate (GFR), commonly seen in kidney disease.

What are the possible causes of low glucose in a veterinary patient?

Low glucose can be caused by several conditions, including hepatic failure, Addison’s disease, neoplasia, pregnancy, lactation, sepsis, starvation, Xylitol toxicity, or insulin overdose. It’s important to evaluate the full clinical picture to identify the root cause.

What role do liver enzymes like ALT, AST, and alkaline phosphatase (ALP) play in diagnosing liver disease?

ALT and AST are enzymes that indicate hepatocyte injury, with ALT being more specific to liver damage. ALP is an enzyme found in biliary cells, and its elevation suggests cholestasis or biliary injury. However, ALP can also be raised in juveniles due to bone growth or in cases of glucocorticoid treatment.

How does creatine kinase (CK) relate to muscle injury, and why is it particularly significant in cats?

Creatine kinase is an enzyme that indicates muscle injury, including skeletal, cardiac, or smooth muscle damage. In cats, an elevated CK level suggests muscle catabolism, often due to anorexia, where muscle tissue is being broken down for energy.