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Carsten column: The blood chemistry panel and your pet companion

The blood-chemistry panel is an essential part of the health assessment for pet companions. It is used in conjunction with the complete blood count (CBC) to form a more complete picture of health status (see the Aug. 30 Glenwood Springs Post Independent article).

Unlike the CBC, which uses blood that has not clotted, the chemistry panel uses serum. Serum is the fluid that remains after clotting. The serum is removed from the clot before the blood-chemistry panel is performed. Removing the clot also prevents further changes resulting from ongoing contact with the blood cells.

It is important to remember that the CBC evaluates red blood cell (RBC), white blood cell (WBC), and platelet numbers and other blood-cell measures. This is in contrast to the chemistry profile that includes tests for organs like the kidneys and liver as well as basic tests like glucose, cholesterol and electrolytes like sodium, potassium, and calcium. Commonly available test profiles run from a handful of tests up to almost 30.

Beyond the basic chemistry profiles, an extensive list of specialized testing is available. Specialized testing would be requested based on the characteristics of the illness and the pattern of results from the CBC and the chemistry profile.

There are a number of situations where your veterinarian would recommend a chemistry panel (usually in conjunction with a CBC). These include when your pet is ill, when monitoring response to treatment or as part of a wellness evaluation or pre-surgery screening. Individual test results and patterns of results provide guidance for making a diagnosis or determining which drugs to use for anesthesia.

For example, it is recognized that kidney tests (like creatinine) are not abnormal until 2/3 to 3/4 of the kidney function is lost. The SDMA is a newer test that provides earlier indications than creatinine about potential kidney concerns. Adding to the challenge of interpreting kidney blood chemistry results, it is important to determine if the pattern of results indicates a problem preventing the kidney from functioning efficiently like low blood flow to the kidney, a primary kidney problem or something impeding the urine flow like kidney stones. Understanding where the problem is located or what is causing the change in test results related to the kidney is vital for formulating a treatment or support plan.

Another important consideration is determining if the kidney problem is acute or chronic. Pets with chronic kidney disease have the opportunity to adapt to the worsening kidney function, so they can withstand higher numbers for SDMA, creatinine, and BUN (blood urea nitrogen). However, the chronic change in kidney function can lead to elevated phosphorus, anemia and problems with blood pressure. Each of these patterns of results have impacts on how the pet is managed.

Blood chemistry results for liver tests can also be assessed for the pattern of values. Unlike the kidney tests, the typical liver tests don’t directly measure function. For example, the ALT is an enzyme released from liver cells as they die. Some amount of cell turnover (death) is normal. When liver cell turnover becomes excessive, the ALT will rise as long as the liver size is normal. On the other hand, liver tests like ALP provide information about the bile system. Complicating interpretation is that elevations in ALP don’t always mean liver. ALP can be induced to increase when there are increased steroids in the blood, either naturally occurring or given as a medication. Sometimes, it is important to perform additional tests like the bile acids panel to assess liver function.

Other common tests on the blood chemistry panel like the T4 and cholesterol may imply a low functioning thyroid in the dog. However, cholesterol can be elevated when the pet was not fasted prior to obtaining the blood sample. The T4 can be low due to the effect of diseases not directly involving the thyroid or certain medications. Untangling the thyroid results sometimes means performing additional tests like a thyroid panel that includes other tests in addition to the T4.

This brief discussion gives a glimpse of the power of the blood chemistry panel and how the different tests when interpreted together provide a broader understanding of the health of your pet companion. If you have concerns or questions about your companion’s health, contact your veterinarian. Perhaps a blood chemistry panel and CBC are indicated.

Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.

Integrative Pet Vet column: Prepare your pets for your return to work

COVID-19 cases are declining, mask requirements are being lifted, restrictions on indoor and outdoor gatherings are changing, and people are returning to their workplaces. During the past year, workplace changes associated with COVID-19 prompted many to work from home. This led to record numbers of pet companion adoptions across the country. Many pets, newly adopted or longtime companions, have had a high level of interaction with their caregivers while they worked from home.

As the workplace opens up, many caregivers will be away from home more. This change may contribute to heightened levels of separation anxiety, boredom, destructive behaviors, elimination problems and other issues associated with this change in household routine. Our pet companions may also develop an awareness of the anxiety and stress that their caregivers are experiencing, adding to their own anxiety.

It is important to consider the physical and emotional changes that will be affecting our pet companions and make plans for transitioning to a new routine. Preparation and gradual exposure to the anticipated changes in the household can be essential for a stress free transition. Make sure to give yourself and your pet plenty of time to adapt to your new routine.

Cats are generally more independent than dogs, but cats can still be stressed by the significant changes in routine created by returning to work. Avoid or reduce pet anxiety by creating a routine and practicing longer stays at home alone. Depending on your expected work schedule, you could be away form home for eight to nine hours or more. Start with a routine that will be similar to your anticipated work schedule. For example, go out for a coffee around the time that you would usually leave for work. Keep the initial time out of the house brief and build up. This will condition your pet to being home alone. The gradual process can help to reduce anxiety. Select a time that you can go for a regular daily walk with your dog or have a play session with your cat. Pets learn to anticipate these times and activities. They provide mental stimulation as well as exercise. Provide pet friendly toys that can help your pet to be distracted while you are out.

Arrange the feeding times so they function around your anticipated work schedule. Some recommend feeding in a room separated from the pet owner. This can help accustom the pet to being away from you and aid in reducing anxiety with separation, especially if your pet is constantly at your side. Food puzzles can be a way to provide distraction and mental stimulation.

Crate training can be beneficial for some situations. Even though it has advantages it is not the best option for every individual. If you think crate training is appropriate in your situation, start gradually so that your pet becomes accustomed. Make it an enjoyable place for your pet to spend time.

Pet day care or having someone come to your home for play activity is an option for some. Some people like to leave the television or radio on. Look for pet-friendly content options.

Watch for signs of anxiety or excess stress. These include destructive behaviors, excess barking, crying, pacing, shaking, and urination or defecation behaviors. Don’t punish for these anxiety behaviors. It is important to reassure your pet. If anxiety or excess stress is observed, back up and slow the transition process.

Separation anxiety is a complex issue. Sometimes changing the routine gradually and providing the other recommended options can be enough. However, some pets need more than this to manage their anxiety. You can use products that help to reduce anxiety like the calming pheromones in Feliway for cats or Adaptil for dogs, the Bach Flower remedy Rescue Remedy, calming herbs, and nutriceuticals like Composure. Keep in mind that these products can have subtle effects, and the effects are not always immediately observed. For pets with high anxiety, the use of anti-anxiety medications may be needed. Use of anti-anxiety medications should be coordinated with your veterinarian and a behaviorist or trainer.

Be patient with your pet through this process. If you have questions about this important transition process, contact your veterinarian and trainer.

Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.