Here are the first results from the lab.
TDDS LAB REPORT
BIOCHEMISTRY
Canine Profile
Total protein 63 g/L (54.0 - 77.0)
Albumin 34 g/L (26.0 - 40.0)
Globulin 29 g/L (20 - 47)
Sodium 151 mmol/L (139 -154 )
Potassium 5.0 mmol/L (3.5 - 6.0)
Na:K ratio 30 (25.0 - 35.0)
Chloride 109 mmol/L (99 - 125)
Total calcium 2.24 mmol/L (2.0 - 3.0)
Phosphate * 1.70 mmol/L High (0.8 - 1.6)
Urea * 11.9 mmol/L High ( 2.0 -9.0)
Creatine 64 umol/L (40 - 106)
Alk Phos 238 U/L High (0.0 - 25.0)
ALT * 29 U/L High (0 - 25)
GLDH * 18 U/L High (0 - 10.0)
Total biliruben 0 umol/L (0 - 9.0)
Bile acids * 11 umol/L High (0 - 10.0)
Glucose NO OXF RECEIVED
CK * 375 U/L High (0 - 190)
Cholesterol * 10.0 mmol/L High (3.8 - 7.0)
Triglycerides * 4.6 mmol/L High (0.45 - 1.9)
Amylase 922 U/L (0 - 1800)
Lipase 39 U/L (0 - 150)
SERUM SLIGHTLY LIPAEMIC
HAEMATOLOGY
RBC * 8.59 x10^12/L High (5.0 - 8.5)
Hb * 19.3 g/dl High (12.0 - 18.0)
HCT * 62.7 % High (37.0 - 55.0)
MCV 73.0 fl (60.0 - 80.0)
MCH 22.5 pg (19.0 - 26.0)
MCHC 30.8 g/dl (30.8 - 37.0)
RDW 17.7 % (12.9 - 17.8)
Platelets 361 x10^9/L (160 - 500)
WBC * 5.45 x10^9/L Low (6.0 - 15.0)
Neutrophils 3.95 x10^9/L (3.0 - 11.5)
Lymphocytes 1.10 x10^9/L (1.0 - 4.8)
Monocytes 0.24 x10^9/L (0 -1.3)
Eosinophils 0.16 x10^9/L (0 - 1.25)
Basophilis 0.00 x10^9/L (0 - 0.2)
Reticulocyte % 1.3 %
Reticulocyte count 111.67 x10^9/L
Platelet comment PLATELET COUNT APPEARS NORMAL IN FILM.
RBC comment SLIGHT POLYCHROMASIA. SLIGHT ANISOCYTOSIS.
Leukocyte comment LEUKOCYTE MORPHOLOGY UNREMARKABLE
MICROBIOLOGY
Urine creatinine 14.45 nmol/L
ENDOCRINOLOGY
Basal cotisol 118 nmol/L ( <125 )
Cortisol Post ACTH 146 nmol/L ( <800 )
Urine cortisol 241 nmol/L
Urine cortisol : creatinin 16.7 (<20 )
Total T4 22 nmol/L (13.5 - 50)
cTSH .16 ng/ml (0.0 - 0.6)
CLINICAL COMMENTS
Serum lipaemia may be artefactually elevating CK , bile acids and phosphate.
Elevations in liver results are mild - moderate - ALP is moderately elevated in contrast to mild elevation in ALT, which may represent a steroid influence (I note your clinical suspicion of Cushing's syndrome), but other causes such as primary hepatobiliary disease are not excluded.
There is mild hypercholesterolaemia - was this a starved sample? Fasting hyperglycaemia may lend support for Cushings disease or other endocrine disease - has glucose been checked in house?
Haemogram is largely unremarkable - neutrophils are lower than expected for Cushings disease ( which usually produces a 'stress' leukogram of neutrophilia with lymphpaeria ), but it does not exclude it. Given your clinical picture, ACTH stimulation may be useful. Monitoring liver enzymes and futher liver investigations (e.g. abdominal imaging, bile acid stimulation ) may also be considered.
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I find this all a little confusing, so if anyone can tell me what it all means, I would be grateful!
The vet has decided to do a SHAP test - not sure what this is, but blood has been sent to the lab for this test and we await the result. The vet is also going to do a scan of her adrenals and of her liver on Monday morning. They will be looking for masses anywhere in the tummy area as well.
It is scary, as I know they are looking for cancer, as well as benign tumours. I am just praying that they don't find any malignant tumour.
I did ask for a test for diabetes, but it seems that it has not been done!? I will speak to the vet about it on Monday.
With regard to her been starved before the blood taken for the ACTH test, she had not eaten for approx. 11-12hrs.
I am trying not to worry before I have the results of all the tests etc. but it is so hard! I just want to cuddle her and carry her around all the time and I have to be firm with myself.
