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Common lab tests for pets – part 1
Common lab tests for pets – part 1
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by Shawn Messonnier, DVM
Featured in Animal Wellness Magazine ~ Vol. 19 Issue 3
Lab tests are an important part of your dog or cat’s routine checkups. We take a close-up look at some of the most common tests, and what they can tell you about your best friend’s health.
Whenever you take your dog or cat to the vet for a routine checkup, the veterinarian does lab tests to look for potential health problems. It’s regular procedure, but have you ever wondered precisely what the vet is testing for, and what the results actually mean? This article will give you insight into some of the most common lab tests for dogs and cats, and how understanding them can keep your pet healthy and living longer.*
1. BUN/Creatinine/SDMA
2. ALT/ALP-ALT
ALT stands for alanine aminotransferase, and ALP (also called SAP) for alkaline phosphatase. These two tests are useful for diagnosing problems of the liver, gallbladder and adrenal glands. ALT increases whenever there is any damage or insult to the liver or gallbladder. Unfortunately, while ALT is a good test, it cannot tell us why the liver is damaged; other tests such as radiographs, ultrasound, and liver biopsy are needed to reveal the cause of ALT increases.
ALP can also increase when the liver or gallbladder are damaged; however, ALP most commonly increases when the adrenal glands are diseased, increasing their hormonal output, usually of cortisol. Pets with ALP increases have adrenal disease that may progress to Cushing’s, a severe adrenal condition that at times requires chemotherapy (in addition to natural therapies) to be correctly treated.
Sadly, I see many pets who have been misdiagnosed with liver disease based on increased blood levels of the ALP enzyme. These pets really have adrenal disease and must be treated correctly. Treating them for liver disease (including doing surgery for a liver biopsy) can further injure or even kill them.
Fortunately both liver and adrenal disease, when properly diagnosed, are easily treated with natural remedies. In my practice, most pets properly treated for adrenal disease never develop the more serious Cushing’s, again showing the importance of early lab testing.
3. T4/FT4
Because thyroid disease is so common in dogs and cats (dogs usually have low thyroid issues while cats have increased thyroid hormone disease), checking both Total T4 (TT4) and Free T4 (FT4) values is essential. Because hormonal testing costs more than a simple chemistry profile, many doctors leave these tests out (or only include the less accurate T4 test). When this happens, it poses a potential problem to the pet because thyroid disease can be overlooked. It also poses a problem to the pet owner who must pay for additional testing, which usually costs more than simply doing the correct blood profile (including both thyroid tests) upfront.
Because thyroid disease is so common in dogs and cats, checking both Total T4 (TT4) and Free T4 (FT4) values is essential.
Dogs and cats with thyroid disease can often be treated naturally without medications, especially when thyroid hormones are only slightly “off”. Functional medicine can restore normal hormone levels without the need for medication once thyroid disease is detected. Because thyroid disease resembles other conditions in clinical signs, I believe it’s always valuable to include thyroid testing for every pet.
How often should these tests be done?
To maximize benefits to your dog or cat, and minimize costs to you, I recommend testing doing these tests every six to 12 months (pets under five years of age can be tested annually, whereas older animals benefit from twice-yearly testing). Once a problem is detected, more frequent blood testing (every three months) is helpful.
In Part 2 of this article (Aug-Sept 2017), we’ll examine additional important tests that are of benefit to dogs and cats, including fecal examination, urinalysis, radiographs and ultrasound.
*In a prior article (“Antioxidants and your dog – what you need to know”, Feb-Mar 2017), I discussed the importance of testing for inflammation using CRP, TK and vitamin D, so I won’t discuss those further here.
Addressing slightly abnormal lab results – conventional vs. holistic
Conventional doctors are trained to treat problems with drugs. However, there are no conventional treatments for dogs and cats with slightly abnormal lab results. Supportive treatment can be given, but only once the disease is severe.
Conversely, holistic doctors practicing functional medicine can treat pets (usually with herbs and homeopathics) before illness occurs, as soon as abnormalities are found in the process of wellness testing. Often, the subtle changes in lab values go away with this treatment, and future disease never occurs.
Considering pet insurance
If your dog or cat appears healthy, I encourage you to get pet insurance before his next checkup. In my practice, over 50% of the pets we test using the lab tests outlined in this article show abnormal findings – which are covered by pet insurance once the abnormality is noted. Don’t wait until a problem arises and then try to insure your pet. Play the odds that some test will come back abnormal at some point, and get coverage before problems arise. It will save you money in the long run.
Common lab tests for pets – Part 2
Common lab tests for pets – Part 2
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Lab tests are an important part of your dog or cat’s routine checkups. Take a close-up look at some of the most common tests, and what they can tell you about your best friend’s health.
Whenever you take your dog or cat to the vet for a routine checkup, the veterinarian does various lab tests to look for potential health problems. It’s regular procedure, but have you ever wondered precisely what the vet is looking for, and what the results actually mean? In the first part of this article (see V19I3), we talked about some common blood tests for dogs and cats. Now we’ll focus on some additional testing that should be done, including urinalysis, fecal testing, radiography and ultrasonography.
1. Urinalysis
A urinalysis is typically done when you visit your own doctor, but most veterinarians do not routinely perform this important test. It may be because it’s harder to collect urine from animals, or because the doctors don’t appreciate the value of urine testing. Regardless, a urinalysis is an important adjunct to blood testing.
The urinalysis can complement results noted in blood tests, as well as give us additional information blood testing may not provide. For example, urine testing shows if glucose or ketones are present (indicating diabetes mellitus). A urinalysis can also detect early protein (albumin) loss through the kidneys, again not something a blood profile can do. Examining the urine microscopically also tells us about the possible presence of inflammation, infection, bleeding, cancer, and bladder stones. Whenever possible, your animal’s urine should be analyzed at least once every six months. A urine culture should also be done.
A urine culture
Along with a urinalysis, a urine culture tells us two important things:
I often see animals with “bladder infections/UTIs” diagnosed by other doctors, but who don’t actually have infections. The (mis)diagnosis occurred because it was based on a urinalysis without a culture. While a urinalysis may indicate a possible infection, only a culture can determine if an infection is present and if antibiotics are needed. In order to reduce the need for antibiotics and prevent further antibiotic resistance (many bladder issues are easily treated without them), a culture is a must before antibiotics are routinely used to treat possible UTIs. (Exceptions would include a animal that has heavy bleeding in his urine, or a urinary blockage in which an underlying infection is a likely cause.)
Another important note: if a dog or cat is treated with antibiotics for a UTI based on a culture, a follow-up culture should be done one to two weeks after finishing the antibiotics to make sure the bacteria are killed, thereby preventing a worse infection due to incorrect treatment.
2. Fecal testing
Healthy dogs and cats should be given a fecal test at least twice yearly, since they can harbor intestinal parasites, some of which may be transmitted to other animals and even people. Positive test results usually indicate the need for a de-worming, with follow-up testing to ensure all the parasites are killed.
Fecal testing is also done on animals with any illness, but especially GI illness that includes vomiting and diarrhea. Several tests can help diagnose the cause of GI signs:
3. Radiography
Radiography involves using tiny amounts of X-ray radiation, allowing the doctor to look inside your dog or cat’s body. It is useful for any animal with any type of illness, but is typically used for orthopedic problems (fractures, dislocations) and soft tissue problems (bladder stones, GI obstructions, heart/lung disorders).
Radiography is excellent for the early diagnosis of animals who do not appear to have any specific problems; for example, puppies can be screened for possible hip dysplasia. In my practice, we do radiographs (at a discount) as a screening procedure when the animal is sedated or anesthetized for another procedure such as spaying, neutering and dental cleaning. We often find problems when radiography is done on these “normal” animals, allowing us to present treatment options before they develop serious problems.
We often find problems when radiography is done on “normal” animals, allowing us to present treatment options before they develop serious problems.
One note I want to make deals with two problems I routinely see when clients come in for a second opinion, and bring radiographs with them. First, with very rare exceptions, animals must be sedated in order to get proper positioning for a high-quality radiograph (sedation also minimizes exposure to radiation since fewer pictures are needed). Second, the proper number of radiographs must be taken in order to avoid misdiagnosis. In my practice, I typically take at least three views of the body part and/or the corresponding “normal” anatomy. Poor quality radiographs, or incorrect views or number of views, often mean I have to take even more radiographs.
4. Ultrasonography
I use ultrasonography for several reasons:
I’ll use ultrasonography any time I see an unexplained illness that isn’t diagnosed with other tests.
Ultrasound exams are also useful as screening tests. For example, Scottish terriers have a high incidence of bladder cancer, while larger dogs (especially retrievers) have a high incidence of cancer in the spleen and liver. I recommend these dogs have twice-yearly screening ultrasounds, beginning around five years of age, to screen for these serious and often fatal diseases.
I hope the two-part article has helped you understand the importance of common lab tests performed on both healthy and sick dogs and cats. By intelligently using these tests, you and your vet can extend your dog or cat’s life with an early diagnosis of health problems, allowing for a quick resolution of illness.
Common lab tests for pets – part 1
SHARE ON: Save
by Shawn Messonnier, DVM
Featured in Animal Wellness Magazine ~ Vol. 19 Issue 3
Lab tests are an important part of your dog or cat’s routine checkups. We take a close-up look at some of the most common tests, and what they can tell you about your best friend’s health.
Whenever you take your dog or cat to the vet for a routine checkup, the veterinarian does lab tests to look for potential health problems. It’s regular procedure, but have you ever wondered precisely what the vet is testing for, and what the results actually mean? This article will give you insight into some of the most common lab tests for dogs and cats, and how understanding them can keep your pet healthy and living longer.*
1. BUN/Creatinine/SDMA
- BUN (blood urea nitrogen) is one of three blood tests for kidney function. It is a good screening test but not perfect, since 60% to 70% of kidney function has to be destroyed before it elevates significantly. BUN is also affected by diet, exercise and muscle mass, so results can be skewed due to factors unrelated to the kidneys.
- Creatinine refers to an amino acid constituent of muscle protein. Like BUN, this test also doesn’t show a significant elevation unless 60% to 70% of kidney function is gone, and it can also be affected by diet, exercise and muscle mass (but not as much as BUN). Blood profiles that incorporate only these two tests can accurately diagnose kidney disease once it has progressed to a later stage, but they are not so good for diagnosing very early disease.
- This is why a third test called SDMA (symmetric dimethylarginine), which tests for the amino acid arginine, is recommended. SDMA levels elevate very early in the course of kidney disease – anywhere from 12 to 36 months before BUN and creatinine levels elevate – reflecting damage to only 25% of kidney damage versus 60% to 70%. From a functional medicine perspective, adding the SDMA test to the blood profile is extremely beneficial as we can diagnose kidney disease at a very early stage (Note: many veterinarians do not routinely test for SDMA.)
- Other tests that can help diagnose pets with kidney failure include blood levels of phosphorus and calcium. Phosphorus in particular reveals the severity of kidney issues because it elevates when the kidneys are seriously damaged. Pets with elevated blood phosphorus levels and elevated levels of the kidney enzymes mentioned above are much harder to treat and have a poorer prognosis.
2. ALT/ALP-ALT
ALT stands for alanine aminotransferase, and ALP (also called SAP) for alkaline phosphatase. These two tests are useful for diagnosing problems of the liver, gallbladder and adrenal glands. ALT increases whenever there is any damage or insult to the liver or gallbladder. Unfortunately, while ALT is a good test, it cannot tell us why the liver is damaged; other tests such as radiographs, ultrasound, and liver biopsy are needed to reveal the cause of ALT increases.
ALP can also increase when the liver or gallbladder are damaged; however, ALP most commonly increases when the adrenal glands are diseased, increasing their hormonal output, usually of cortisol. Pets with ALP increases have adrenal disease that may progress to Cushing’s, a severe adrenal condition that at times requires chemotherapy (in addition to natural therapies) to be correctly treated.
Sadly, I see many pets who have been misdiagnosed with liver disease based on increased blood levels of the ALP enzyme. These pets really have adrenal disease and must be treated correctly. Treating them for liver disease (including doing surgery for a liver biopsy) can further injure or even kill them.
Fortunately both liver and adrenal disease, when properly diagnosed, are easily treated with natural remedies. In my practice, most pets properly treated for adrenal disease never develop the more serious Cushing’s, again showing the importance of early lab testing.
3. T4/FT4
Because thyroid disease is so common in dogs and cats (dogs usually have low thyroid issues while cats have increased thyroid hormone disease), checking both Total T4 (TT4) and Free T4 (FT4) values is essential. Because hormonal testing costs more than a simple chemistry profile, many doctors leave these tests out (or only include the less accurate T4 test). When this happens, it poses a potential problem to the pet because thyroid disease can be overlooked. It also poses a problem to the pet owner who must pay for additional testing, which usually costs more than simply doing the correct blood profile (including both thyroid tests) upfront.
Because thyroid disease is so common in dogs and cats, checking both Total T4 (TT4) and Free T4 (FT4) values is essential.
Dogs and cats with thyroid disease can often be treated naturally without medications, especially when thyroid hormones are only slightly “off”. Functional medicine can restore normal hormone levels without the need for medication once thyroid disease is detected. Because thyroid disease resembles other conditions in clinical signs, I believe it’s always valuable to include thyroid testing for every pet.
How often should these tests be done?
To maximize benefits to your dog or cat, and minimize costs to you, I recommend testing doing these tests every six to 12 months (pets under five years of age can be tested annually, whereas older animals benefit from twice-yearly testing). Once a problem is detected, more frequent blood testing (every three months) is helpful.
In Part 2 of this article (Aug-Sept 2017), we’ll examine additional important tests that are of benefit to dogs and cats, including fecal examination, urinalysis, radiographs and ultrasound.
*In a prior article (“Antioxidants and your dog – what you need to know”, Feb-Mar 2017), I discussed the importance of testing for inflammation using CRP, TK and vitamin D, so I won’t discuss those further here.
Addressing slightly abnormal lab results – conventional vs. holistic
Conventional doctors are trained to treat problems with drugs. However, there are no conventional treatments for dogs and cats with slightly abnormal lab results. Supportive treatment can be given, but only once the disease is severe.
Conversely, holistic doctors practicing functional medicine can treat pets (usually with herbs and homeopathics) before illness occurs, as soon as abnormalities are found in the process of wellness testing. Often, the subtle changes in lab values go away with this treatment, and future disease never occurs.
Considering pet insurance
If your dog or cat appears healthy, I encourage you to get pet insurance before his next checkup. In my practice, over 50% of the pets we test using the lab tests outlined in this article show abnormal findings – which are covered by pet insurance once the abnormality is noted. Don’t wait until a problem arises and then try to insure your pet. Play the odds that some test will come back abnormal at some point, and get coverage before problems arise. It will save you money in the long run.
Common lab tests for pets – Part 2
Common lab tests for pets – Part 2
SHARE ON: Save
Lab tests are an important part of your dog or cat’s routine checkups. Take a close-up look at some of the most common tests, and what they can tell you about your best friend’s health.
Whenever you take your dog or cat to the vet for a routine checkup, the veterinarian does various lab tests to look for potential health problems. It’s regular procedure, but have you ever wondered precisely what the vet is looking for, and what the results actually mean? In the first part of this article (see V19I3), we talked about some common blood tests for dogs and cats. Now we’ll focus on some additional testing that should be done, including urinalysis, fecal testing, radiography and ultrasonography.
1. Urinalysis
A urinalysis is typically done when you visit your own doctor, but most veterinarians do not routinely perform this important test. It may be because it’s harder to collect urine from animals, or because the doctors don’t appreciate the value of urine testing. Regardless, a urinalysis is an important adjunct to blood testing.
The urinalysis can complement results noted in blood tests, as well as give us additional information blood testing may not provide. For example, urine testing shows if glucose or ketones are present (indicating diabetes mellitus). A urinalysis can also detect early protein (albumin) loss through the kidneys, again not something a blood profile can do. Examining the urine microscopically also tells us about the possible presence of inflammation, infection, bleeding, cancer, and bladder stones. Whenever possible, your animal’s urine should be analyzed at least once every six months. A urine culture should also be done.
A urine culture
Along with a urinalysis, a urine culture tells us two important things:
- if the animal has an infection of the kidneys or bladder;
- and which bacterium is causing the infection.
I often see animals with “bladder infections/UTIs” diagnosed by other doctors, but who don’t actually have infections. The (mis)diagnosis occurred because it was based on a urinalysis without a culture. While a urinalysis may indicate a possible infection, only a culture can determine if an infection is present and if antibiotics are needed. In order to reduce the need for antibiotics and prevent further antibiotic resistance (many bladder issues are easily treated without them), a culture is a must before antibiotics are routinely used to treat possible UTIs. (Exceptions would include a animal that has heavy bleeding in his urine, or a urinary blockage in which an underlying infection is a likely cause.)
Another important note: if a dog or cat is treated with antibiotics for a UTI based on a culture, a follow-up culture should be done one to two weeks after finishing the antibiotics to make sure the bacteria are killed, thereby preventing a worse infection due to incorrect treatment.
2. Fecal testing
Healthy dogs and cats should be given a fecal test at least twice yearly, since they can harbor intestinal parasites, some of which may be transmitted to other animals and even people. Positive test results usually indicate the need for a de-worming, with follow-up testing to ensure all the parasites are killed.
Fecal testing is also done on animals with any illness, but especially GI illness that includes vomiting and diarrhea. Several tests can help diagnose the cause of GI signs:
- A microscopic fecal examination checks for intestinal parasites.
- I also like to do a fecal Gram’s stain to check for overgrowth of abnormal bacteria and yeasts.
- Occasionally, I will also do an ELISA test to look for the protozoan parasite Giardia.
- If these tests are normal but clinical signs are still present, I will send a fecal sample to one of my outside labs for a fecal PCR test. This newer test looks for the DNA of various parasites, bacteria and bacterial toxins.
3. Radiography
Radiography involves using tiny amounts of X-ray radiation, allowing the doctor to look inside your dog or cat’s body. It is useful for any animal with any type of illness, but is typically used for orthopedic problems (fractures, dislocations) and soft tissue problems (bladder stones, GI obstructions, heart/lung disorders).
Radiography is excellent for the early diagnosis of animals who do not appear to have any specific problems; for example, puppies can be screened for possible hip dysplasia. In my practice, we do radiographs (at a discount) as a screening procedure when the animal is sedated or anesthetized for another procedure such as spaying, neutering and dental cleaning. We often find problems when radiography is done on these “normal” animals, allowing us to present treatment options before they develop serious problems.
We often find problems when radiography is done on “normal” animals, allowing us to present treatment options before they develop serious problems.
One note I want to make deals with two problems I routinely see when clients come in for a second opinion, and bring radiographs with them. First, with very rare exceptions, animals must be sedated in order to get proper positioning for a high-quality radiograph (sedation also minimizes exposure to radiation since fewer pictures are needed). Second, the proper number of radiographs must be taken in order to avoid misdiagnosis. In my practice, I typically take at least three views of the body part and/or the corresponding “normal” anatomy. Poor quality radiographs, or incorrect views or number of views, often mean I have to take even more radiographs.
4. Ultrasonography
I use ultrasonography for several reasons:
- Whenever I hear a heart murmur during a physical exam, I need to do an echocardiogram (heart ultrasound) to determine the extent of heart disease.
- If I suspect an internal tumor, I do an ultrasound to screen for cancer.
- I’ll use ultrasonography any time I see an unexplained illness that isn’t diagnosed with the other tests I’ve discussed in both parts of this article, or if my screening test results for inflammation and cancer (TK, CRP, CRA) are elevated.
I’ll use ultrasonography any time I see an unexplained illness that isn’t diagnosed with other tests.
Ultrasound exams are also useful as screening tests. For example, Scottish terriers have a high incidence of bladder cancer, while larger dogs (especially retrievers) have a high incidence of cancer in the spleen and liver. I recommend these dogs have twice-yearly screening ultrasounds, beginning around five years of age, to screen for these serious and often fatal diseases.
I hope the two-part article has helped you understand the importance of common lab tests performed on both healthy and sick dogs and cats. By intelligently using these tests, you and your vet can extend your dog or cat’s life with an early diagnosis of health problems, allowing for a quick resolution of illness.
