Slightly Abnormal Bloodwork????
 

Bella is at the vet today for her spay, etc., etc..., and of course I asked them to do pre-surgical blood work. The vet just called me to let me know the results (because I asked him to)....he said that she's just slightly dehydrated (he said it was so right on on the line that he normally wouldn't have even mentioned it to anyone else, but since I asked he was telling me), and one of her kidney values was slightly elevated (he said more like upper limits of normal---normal was 27 and she was at 29)---can't remember which one he said, but I know it wasn't Creatinine because he made sure to say that one was good, and I don't think it was BUN either. He said that this one is probably off because she's dehydrated a little bit.....

Here's the pickle....Bella drinks lots of water and pees a LOT every day, so it's weird to me that she's even slightly dehydrated, unless it's because she hasn't had anything to drink since last night around 9:30 or 10:00 pm???

Also, I've been thinking about switching her to a grainless food since she tears so much, but now I'm worried about doing that since she had an abnormal renal value..... I talked to him about whether or not a grainless diet would be okay because of the test results, and he said he doesn't recommend going grainless because it will set her up for renal problems. I've read a lot about grainless diets, and I thought what I'd read was that grainless diets are not good for dog with renal disease, but it doesn't CAUSE renal disease and is good for a healthy dog??? After saying a grainless diet is not good because dogs need a well-balanced diet, he said he recommends RC and Science Diet. I told him that I'm pretty sure I read about several dogs having problems with and even dying from the RC (that's right isn't it? or am I thinking of something else??), and he said you can't believe everything you read on the internet and if that were true there would be a law suit over it. I told him that I have her on a premium food (Innova California Natural), and that I was thinking of switching her over to Wellness or NV, to which he replied that those newer companies spend most of their money on advertising their product instead of putting their money into the quality of their food. IMO, he obviously doesn't know what he's talking about. I told him that I've never seen any advertising for any of those foods, and he just said that I could feed her what I want to, but those are the 2 he recommends.

Anyone???

When the recalls were prominent in the news...Royal Canine voluntarily pulled some formulas sold in Canada. I don't think any deaths were related to this product. I was actually feeding mine RC at this time. I stopped using it because it gave Reese the itchies.

Science diet isn't considered one of the better quality foods.

I feed mine grain free food. Taste of the Wild.

Btw, I've never even see any type of advertising for RC or Taste of the wild...so I don't know how he can base his opinion on advertising. I have seen print ads for SD though.

It's so funny when vets try to given advice on nutrition because most of what they know, they learned outside of vet school, so you could have the same amount of knowledge as him... Ellie's vet said straight out that they learn very little in school and I could talk to a nutritionist and look online.:p

Nutro is the one blamed on all of those problems...

I have never seen any study that would indicate that high protein causes renal or liver issues but high protein shouldn't be fed if there is a preexisting condition. Whatever you're comfortable with... I personally lean toward lower protein but have no scientific anything to back that up.

Dehydration is very normal when they aren't allowed to have water before surgery. I wouldn't worry about it and if you want to be extra cautious, you could retest in a month.

Okay, sorry, I just got confused.....I found the post that I thought is where I read that RC caused some deaths, but it wasn't RC....it was NUTRO!! Whoops!

I know SD is a terrible food! When he said that I just rolled my eyes....sooo predictable!!

Good advice. I will do that!! In the meantime, I'm going to start giving her kibble in the AM and then NV raw Lamb (I found a place that sells 1 lb. sample bags so I can try it) in the PM. If that exacerbates anything, we'll know when we test again in a month. If she truly had any problems, I would think feeding partially a grainless diet would make sure the values were abnormal when we check again......if they're normal, that would mean she's really normal I would think (because if she wasn't normal, the high protein would just make it worse....)

Oh mercy. :p

Did he also tell you that he probably gets 40% commission on RC and SciDi? And, that almost all SciDi foods contain carcinogens, listed right in their ingredient lists for all to see? And as far as marketing and advertising, that Hills SciDi spends MILLIONS on Vets while they're in vet school so that they'll later sell their food? Hello Kettle=Black! LOL! Just WOW. You sure you want this person as your vet? :rolleyes:

Anyhow, like Crystal said -- higher protein doesn't cause renal/liver/pancreas problems. You just don't want to feed HP diets to dogs w/ diseases of those organs. Also, she is probably dehydrated from being NPO after 10pm - so that's not unusual.

Hang in there as best you can and try not to worry about those test levels. :) I'll be thinking about her.

Exactly!! I knew you guys would looove that!! And no, he is not my vet....she's only with him because he removed her dewclaws when she was very young and still with the breeder, and the left front one grew back. I was pretty comfortable with everything he's said up until today, that is, and on second thought, maybe I shouldn't have let her go back to someone who didn't do it right the first time...no matter how much it saved me! :eek:

I've been seeing a vet in my old town who I really love, but I just found a vet here in the town I live that she will be seeing from here on out I think. They sell Innova products and a few other really good quality dog foods....no Science Diet or Prescription Diet anywhere to be seen!! And one of the vets there practices traditional vet medicine, but the other practices HOLISTIC vet medicine!!! I like that! And people bring their horses to her from all over because she does horse acupuncture?? I don't know the why of it, but I know a lot of people really like it for their horses, and she is in high demand for it. I hope we really like her when we go there the next time Bella needs anything...I'm almost certain we will!

Thank you so much for saying that, I really appreciate it!! She's my baby, just like all of you and yours, so you know I worry. But, I just have to hope that all will go well today, as I'm sure it will. Thank you!

Update....
 

I just wanted to let anyone know who wanted to?? that, just as everyone already knew I'm sure, Bella is just fine!! She's been home for ~3 hours and has slept most of them. The vet broke a tiny blood vessel when he was stitching her tummy up (looks ugly, but it looks worse than it is), and she ended up getting NINE extractions!!! He said all her permanent teeth are in, but she still had nine baby teeth. She has always chewed and chewed and chewed her toys, and we play tug quite a bit every single day....I feel like it's a little bit my fault somehow that she had to have so many extractions :(. He said this was common for very small dogs, though....

She was super THIRSTY when we got in the car and drank lots of water that I brought for her. And the vet said that she probably wouldn't be very hungry if at all tonight, but if she did eat she may throw it up.....but, the bf went out and picked up some chicken and even boiled it for her (since she's was on my lap :) ). She ate a couple of tiny "servings" (maybe 1 1/2 tablespoons full in total) and has kept all that down....I wanted to give her tiny bits at a time with time in between eating so we could make sure she'd keep it down. So far, besides being almost confused about where she wants to go and what she wants to do, she's done great!!

Thank you all for your support. You have no idea how appreciative I am....I know I'm a big baby about stuff like this! So, thanks!!


Oh!! I almost forgot....Wylie's Mom, when we got to the vet, I got to see his nice display of Hills Science Diet and Prescription Diet, as well as Royal Canin. Big surprise, huh!!! Lol!

Oh wonderful!!! She is REALLY doing great, wow!! That is just a great sign that she already has an appetite, ate 1.5T, and kept it down -- really good signs. That also tells me she probably has good pain control :). What a good Mama you are!

Marcel had a bunch of teeth pulled too at his neuter (I think 7) - so it's not uncommon. He healed up just fine, didn't seem to bother him at all!

LOL on the food!! I tell ya.... :rolleyes:

Hugs to Bella and hope your weekend goes well. :)

This is the same frustrating issue I'm having with Gus.

Was Bella tested for a Urinary Tract Infection? If she has a UTI, she will pee a lot, get dehydrated, and drink lots of water.The cycle repeats frequently.

After several months, and no solution, I'm assuming Gus' problem is diet related. Long term, I was feeding him Science Diet - Nature's Best for pups. I'm transitioning him to Wellness for Small Breeds. I noticed that certain chew toys, like Bully Sticks, rawhide bones, & real bones, make him very thirty. He also finds natural chew toys outside like wood chips. In the last month, I've seen enough improvement to continue with the dietary cause.

I doubt she was tested for that specifically, she just had liver enzymes and BUN and Creatinine as well as a CBC. I think her "dehydration" may have just been because she hadn't had anything to drink since 10pm the night before and they didn't do the bloodwork until after 11am the next day. I'm told it's common for them to be a little dehydrated when they've been NPO like that.


She REALLY is! I gave her a little more boiled chicken along with some kibble this morning (she ate all the chicken and most of the kibble I gave her, chewing it all up and not just swallowing it whole) and gave her some more around 2:30 or so because she was so interested in my lunch (she ate all that too)! Poor little girl must be starving!! And no vomiting still--hurray! I did give her a dose of Rimadyl (1/4 of a 25mg chewable) this morning when I first got up. She was barely moving at that point, just standing in one spot and turning to look around but not walking much at all. She chewed it right up like a good girl, just like she does anything I give her, and has been great ever since! For the last hour or so, she's been playing (digging on the bed, chewing my fingers, and she's currently chewing her little rattle mouse)! I think she was just really sore this morning, and I doubt I'll give her anything tomorrow. She has also use her pad every single time to pee and poop!! Yay!!! (I was so worried that she'd revert and have to be retrained all over again like I've heard so many people say they had to do.)

Here are her lab values that were abnormal:
HCT = 55.2% (normal = 37%-55%)----I think this was the hydration indicator??....it was only very slightly high just as he said.

BUN = 29 (normal = 7-27)....I hope this was due to dehydration and it's not anything else; I'll have her retested in a month to make sure.

ALT = 302 (normal = 10-100)....this one worries me! It isn't even close to normal! Why would a liver enzyme be so abnormal like that?? Could it have anything to do with the dehydration?? I'll probably have this checked again too in a month and go ahead and do a bile acid test too. The vet didn't seem worried about it, but he didn't give me a reason why it would be abnormal either--he just said that the value was fine to be able to go ahead with the surgery. I talked to him about liver shunts, but he said she didn't exhibit any of the neurologic signs that would indicate that (I know they don't have to yet though to still have it!) He also said that he was one of the only ones in this area who would do liver shunt surgeries, so he'd seen several cases. IF she did have a shunt, though, I'd take her somewhere they do a lot of them. There's a pretty good vet school in the town I live now, so they may be more familiar?? (which incidentally is where he graduated from).

In the meantime, she has been letting me pick her up and lower her down from the couch and the bed (which I my bf and I had already taken the mattress and box springs off the rails and put on the ground before she came home just in case) for the most part. Only jumped twice....I'm doing what I can!! Tomorrow will probably be much harder, but I was hoping if I could keep her from jumping too much today and tomorrow it would help her heal faster maybe.

did they do urinalysis as when demi had bun of 28 and bun creatinine ratio of 31 they had me do urinalysis and she was +30 protein in urine - if creatinine is normal and demi had .9 usually not an issue but bun is tied to kidney's so that is the concern but it could be due to dehydration as well is what they told me. They are more concerned with demi as she has protein in urine and she is 4 and has periodontal disease but does not sound like the case with yours. Not sure about the other values but I would not be concerned with the bun if the creatinine was normal is what they told me

That's what they told me too....Creatinine was normal, so she's probably just fine. I'm planning to retest in a month, though, just to be sure.

That ALT is way too high. I would not be surprised if something is going on with her liver. When an ALT in a Yorkie is that high, a bile acids test should be done. It could be something like asymptomatic MVD. Anesthetic protocol and pain medications vary for liver compromised dogs, so the vet really should've waited on surgery and did a bile acids test when seeing that number (in my opinion). With an ALT 200 points above the highest it should be and no bile acids test being done, I would not give her any NSAIDs (Rimadyl) but again I'm not a vet and that is my opinion.

That is the poing of preop blood work (to detect problems and do further testing if it is off so surgery is as safe as possible). Why would he do it if he was going to ignore it? I guess I'd wonder why he didn't tell you about the high ALT.:confused:

That is what I was afraid of. :( I didn't understand why he didn't tell me that before the surgery too.....he called after her blood work and told me about the dehydration and the BUN, but he never mentioned her ALT. I don't understand that at all either. Maybe I shouldn't wait a month before I have her tested?? I gave her the one Rimadyl this morning (1/4 25mg chewable), but I won't give her anymore. I'm guessing any lab work would be skewed now anyway because of the pain meds.....I'll have to wait a bit for them to "normalize". How long do you think I should wait? AND, can they do her liver and kidney panels on the same day as a bile acid test? I know she has to go in NPO for the bile acid (or at least nothing to eat anyway...), but can/should the other tests be done NPO? I imagine if she has nothing to drink before, she'll be dehydrated again. I can do an ultrasound on her myself (that's what I do for a living anyway...for people, that is), providing she'll let me of course. I think she will....she's usually pretty good. And I have a lot of experience with people with liver disease. The last place I worked was a big liver transplant hospital. I'll do some research online or make some calls and find out what I need to be looking for on a dog, if anything, that would be different from a human. Maybe I can go to the college library and get a canine anatomy book....that would be the only thing that's really different. AND, the company I work for just ordered me a new transducer that would be more appropriate for her size, and I'm supposed to get that in the mail on Monday. (I'm really excited about that transducer for the kinds of scans I do everyday anyway, but this just makes it better!) The vet she will go to here in town doesn't have ultrasound....they'd have to refer her to the vet school here anyway. We've done MRI's for them a couple of times, so maybe they wouldn't mind answering some of my questions. I know I'm looking for a shunt....I'll just have to find out the normal direction for her vessels (I know them for a human, and I'll bet they're very close to the same.)

Sooo, here's the big question...what will happen if she does have a shunt or MVD?

A blood panel can be done at the same time as the bile acids test. She can have water before either. I would wait a couple weeks because of the drugs she just had and the trauma she just went through. I also wouldn't give her heart worm med a week or two before.

Ultrasounds for shunts are only 60-80% accurate. Unless you want to see the size of the liver or if she has bladder stones, it could be a waste of time and/or money. Protein C testing and scintography are the better tests for this.

With MVD you may need to change her diet and put her on supplements. With an intrahepatic shunt, she may need surgery. That is one very good reason to get the bile acids test done pre-spay...the shunt surgery and spay can be done all at once.

It may be another problem altogether though or just mild MVD, so I would wait til the bile acid numbers are in to figure out what to do next.

I just gave her Interceptor a week and a half ago...could that be why??

I'm so sad now. :( I don't want her to have any liver problems....or any problems at all for that matter!! Not that I get to choose that...no one does.

I wish I had decided earlier to do all this now so I would have had time to find out all the things I needed to do and had time to do them before now. I'm going to feel really guilty if she ends up needing surgery.....

Which begs the question, what if I go ahead and get health insurance for her now? Is it too late since she's had abnormal blood work...would they not pay if she ended up having to have surgery?? Or do they not pay on that anyway since it's basically congenital?

Can I do the blood work in 2 weeks or should I wait a little longer?

Her Creatinine was 0.8.....so that would make her BUN/Creatinine ratio 36.25. Normal for Creatinine says 0.5-1.8, though, so she's well within normal on that. And this says her "TP" (does that stand for total protein??) is 5.9 (normal is 5.2-8.2). Also, her ALKP is normal (178, with a normal range of 23-212) and so is her glucose (104 with a normal range of 74-143).

And now I'm noticing that at the top of the paper it says "Adult Canine"....she is definitely NOT an adult!!! Could this mean those normal values are off??

Ok, now I found this website VetInfo Digest and the normal ranges it lists aren't like the normals on my paper....ALT normal on my paper says 10-100 and ALKP says 23-212....totally different on that site. In fact, if you use that site's normals (10-100 for ALKP), then she is abnormal on that too at 178! I know ranges differ at different "labs" but that's a big difference...23-212 vs. 10-100!!!

I would go by the reference ranges that the vet gave you for the lab that he deals with.

I do not believe that Interceptor would cause ALT to go 200 points above high normal. It may raise bile acids though.

The BUN could very well have been dehydration. That wouldn't be uncommon, but I would not like seeing it even 2 poinds too high with the liver enzymes in question too.

There are so many things that can throw the ALT off. Try not to panic too much but I would definately recheck and do a BAT as soon as possible.

:thumbup: I agree completely with this...go by your vet's reference ranges, and please retest as soon as meds are out of her system. ALT is quite high. Many times when ALT is off like that, so is the BUN.

Is 2 weeks ok?
 

Does anyone think 2 weeks is long enough to wait to retest?? (so that her levels will have time to normalize after all the pain meds she had before, during, and after her surgery)....Or should I wait longer than that? I didn't give her anything today, and I'll hold any other "meds" I give her just in case they were in anyway affecting her labs.

I'm due to give her Interceptor again in ~ 2wks, but I'll wait until after her retest to give it.

And I forgot to mention earlier that I've been giving her Angels' Eyes for about a week (the vet said that it would be just fine to give it to her to see if it would at least clear the red out of her tears, if not help altogether...he said to only give it for 1 month). And she's been getting 1/4 of a children's Maalox too, because she has acid reflux, which we think is because she eats so sporadically...making the acid build up in her stomach. I didn't give either today and won't until we retest.

I am sooo hoping the next test is a good one...I'm worried about my little girl.

Hmmm, Angel Eyes can falsely elevate ALT. That is quite high though, so I would definately retest. Two weeks "should" be fine but it is one of those things where nobody knows for sure. It should be plenty of time for her body to process the meds that she just had. I'd go for it in 2-3 weeks.

I agree...Two weeks is probably good...BAT and a blood panel should be done.
Good luck!! Please keep us posted!