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Ask Dr. Drew Your Own Question

Dr. Drew
Dr. Drew, Dog Veterinarian
Category: Dog
Satisfied Customers: 16844
Experience:  Small Animal Medicine and Surgery
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I would like you to review some blood tests

Customer Question

I would like you to review some blood tests
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Drew replied 2 years ago.
Dr. Drew :

Hello, thanks for your question today! I am Dr. Drew, and I am a licensed veterinarian. I'll be happy to help you in any way I can.

Dr. Drew :

I would be happy to look at the blood test results for you.

JACUSTOMER-2xh9i18p- :

Hello Dr.Drew

JACUSTOMER-2xh9i18p- :

I have a 13 yo female Pomeranian

JACUSTOMER-2xh9i18p- :

and her blood tests aren't so good, so I would like a second opinion on them

JACUSTOMER-2xh9i18p- :

shall I upload the files?

Dr. Drew :

sure, you can do that and I'll look at them right away.

JACUSTOMER-2xh9i18p- :

Full Size Image

JACUSTOMER-2xh9i18p- :

this is her blood report from last year, August 2013. I will attach this years blood report right now, as a second file.

Dr. Drew :

ok

JACUSTOMER-2xh9i18p- :

Full Size Image

JACUSTOMER-2xh9i18p- :

can you see the values clearly?

Dr. Drew :

yes, I can

Dr. Drew :

the reports show a CBC (complete blood count),

Dr. Drew :

and the results are close to normal.

JACUSTOMER-2xh9i18p- :

the first row is the kind of test, the second row is Bearta's result and the third row is the accepted values

Dr. Drew :

the white blood cell count is just slightly elevated, but not so high that I would have major reason for concern,

Dr. Drew :

I would be more interested to see a full blood chemistry profile in addition to the blood count.

JACUSTOMER-2xh9i18p- :

the vet told me it might be a sign of cancer :(

Dr. Drew :

well, any elderly dog with unexplained illness, would have to be considered a suspect for cancer, but I do not see anything on that result that makes me think of cancer immediately.

JACUSTOMER-2xh9i18p- :

as you can see all values are normal except for the PLT which should be between 200 and 500. in 2013 report they are 817

Dr. Drew :

I would need to know what kinds of illness Bearta is showing,

JACUSTOMER-2xh9i18p- :

and 2014 are 1056, which is double the maximum limits

Dr. Drew :

an elevated PLT level is often associated with non-specific inflammation, and really does not indicate a specific disease.

Dr. Drew :

it certainly does not mean that cancer is the only possibility.

JACUSTOMER-2xh9i18p- :

Bearta currently doesn't show any symtoms. She is healty, active, eats normally and doesn't have any problems.

Dr. Drew :

then I would have no reason to be worried about cancer.

Dr. Drew :

it may even be an error in the measuring equipment.

JACUSTOMER-2xh9i18p- :

the vet told me that we need to do further blood tests, and they shaved her neck and took blood from a vain on her neck

Dr. Drew :

it is much more important to look at the patient, than to focus on laboratory results only.

JACUSTOMER-2xh9i18p- :

and i am attaching now these results

JACUSTOMER-2xh9i18p- :

Full Size Image

JACUSTOMER-2xh9i18p- :

as you can see the ALT are triple the accepted values, so the vet told me we have to make an ultrasound to check her liver

Dr. Drew :

ok, thank you,

Dr. Drew :

the ALT level is elevated, and could suggest a liver problem may be present,

Dr. Drew :

there is also slight elevation of BUN which can suggest a kidney problem or it can be due to other less serious things such as mild dehydration.

JACUSTOMER-2xh9i18p- :

but from what I read online the ALB and ALP values are most important as ALT levels can vary a lot from one blood test to another

Dr. Drew :

well, ALT can vary in a short period of time, so I usually suggest a recheck in 2-3 weeks to see if it has returned to normal, or is still elevated.

Dr. Drew :

it is also an option to try a liver supplement such as S-Adenosylmethionine, or milk thistle, for example.

JACUSTOMER-2xh9i18p- :

is the ALT value something to worry about?

Dr. Drew :

if it remains elevated, it can be a sign that there is a liver problem that needs to be investigated further (with ultrasound, or biopsy),

Dr. Drew :

but with the ALP and other levels normal, I am not very concerned at this point.

JACUSTOMER-2xh9i18p- :

this is exactly what her doctor told me that we have to do next, but ultrasound will cost another 80 and biopsy costs another 200. so before proceeding to these, I would like to ask another vet about the results.

Dr. Drew :

I would suggest rechecking the blood test in 2-3 weeks before doing an ultrasound or biopsy.

Dr. Drew :

sometimes the ALT can return to normal or at least close to normal.

JACUSTOMER-2xh9i18p- :

i have an appointment for next week and the doctor told me that i should buy her Denosyl or Samilin

Dr. Drew :

yes, those are good suggestions.

JACUSTOMER-2xh9i18p- :

which support the liver, if I am not wrong

Dr. Drew :

correct.

JACUSTOMER-2xh9i18p- :

should the dog get this medication for the rest of her life?

Dr. Drew :

well, it depends on what the cause of the problem may be,

Dr. Drew :

those products are very safe to use long-term if needed,

Dr. Drew :

but it is possible that 1-2 months may be all that is necessary.

JACUSTOMER-2xh9i18p- :

it's just that I am against using pharmaceuticals to people or animals for no reason

Dr. Drew :

well, those products aren't drugs.

Dr. Drew :

they are supplements.

JACUSTOMER-2xh9i18p- :

ok, so what will the ultrasound scan show in her case?

JACUSTOMER-2xh9i18p- :

will it help define what is the problem that's causing the high PLT and ALT?

Dr. Drew :

it could show a reason for why the ALT is elevated -- there could be a tumor on the liver, or there could be cysts, or other benign changes, or there might be no changes visible at all.

JACUSTOMER-2xh9i18p- :

by tumour you mean cancer on the liver?

Dr. Drew :

yes, that would be one possible explanation -- but again, in a patient with no outward signs of illness, I would have a difficult time thinking that cancer is the cause of this problem.

JACUSTOMER-2xh9i18p- :

in the case of a tumour

JACUSTOMER-2xh9i18p- :

is it curable?

Dr. Drew :

sometimes yes, sometimes no.

Dr. Drew :

if the tumor can be removed, then it may be curable.

Dr. Drew :

but depending on how much of the liver is affected, it may not be able to be removed.

JACUSTOMER-2xh9i18p- :

what determines one or another?

JACUSTOMER-2xh9i18p- :

oh ok

JACUSTOMER-2xh9i18p- :

and what about cysts?

Dr. Drew :

generally a cyst is benign, and would not require treatment.

JACUSTOMER-2xh9i18p- :

so does the 323 value for the ALT indicate some kind of illness or is it something that I shouldn't be too worried about?

Dr. Drew :

it is worthy of a recheck - but I would not be too worried since there are no signs of illness.

JACUSTOMER-2xh9i18p- :

in case of a cancer on the liver

JACUSTOMER-2xh9i18p- :

which would be the early symptoms?

Dr. Drew :

weight loss, poor appetite

JACUSTOMER-2xh9i18p- :

also, WBC values of 2013 are 10.0 while 2014 ones are 17.6

JACUSTOMER-2xh9i18p- :

with an accepted value of max. 17

JACUSTOMER-2xh9i18p- :

is that something to worry about?

JACUSTOMER-2xh9i18p- :

it almost doubled in 1 year

Dr. Drew :

I explained that earlier in our conversation,

Dr. Drew :

it is just a small bit above normal and would not indicate a real reason for concern,

Dr. Drew :

unless there was signs of illness.

JACUSTOMER-2xh9i18p- :

yes, but truth is

JACUSTOMER-2xh9i18p- :

with dogs you can't tell the signs apart from loss of appetite and not being active

JACUSTOMER-2xh9i18p- :

they can't tell us if they hurt somewhere

JACUSTOMER-2xh9i18p- :

so the only thing we can rely on is blood test results

Dr. Drew :

no, that is entirely untrue. a Physical examination, and careful observation of activity level and appetite are much more important.

Dr. Drew :

yes, blood tests are useful, of course -- but they are not to be considered more important than looking at what the patient looks like, and feels like.

JACUSTOMER-2xh9i18p- :

yes but the dog is active and eating as normal, but the blood test results are all over the place

Dr. Drew :

I hardly consider the results you have posted, to be "all over the place".

Dr. Drew :

the bot***** *****ne here, is if YOU are worried, pay for the ultrasound.

Dr. Drew :

it seems like you need to have further knowledge of the situation, and that is the next step.

JACUSTOMER-2xh9i18p- :

do you think i should pay for the ultrasound and biopsy? because that would add another 260 euros to the 120 i have already paid

Dr. Drew :

Based on how much you seem to be worried about this situation, I think you should consider the ultrasound. The Biopsy can be avoided if the ultrasound appears normal, if you wish to avoid further expense.

Dr. Drew :

as I have stated twice already, I would normally suggest a recheck of the ALT level in 2-3 weeks before deciding whether or not to proceed.

JACUSTOMER-2xh9i18p- :

i am thinking that the result might not be reliable because now she's taking the Denosyl supplement

JACUSTOMER-2xh9i18p- :

so the results might be compromised because of it

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