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.
I would be happy to look at the blood test results for you.
I have a 13 yo female Pomeranian
and her blood tests aren't so good, so I would like a second opinion on them
shall I upload the files?
sure, you can do that and I'll look at them right away.
this is her blood report from last year, August 2013. I will attach this years blood report right now, as a second file.
can you see the values clearly?
yes, I can
the reports show a CBC (complete blood count),
and the results are close to normal.
the first row is the kind of test, the second row is Bearta's result and the third row is the accepted values
the white blood cell count is just slightly elevated, but not so high that I would have major reason for concern,
I would be more interested to see a full blood chemistry profile in addition to the blood count.
the vet told me it might be a sign of cancer :(
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.
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
I would need to know what kinds of illness Bearta is showing,
and 2014 are 1056, which is double the maximum limits
an elevated PLT level is often associated with non-specific inflammation, and really does not indicate a specific disease.
it certainly does not mean that cancer is the only possibility.
Bearta currently doesn't show any symtoms. She is healty, active, eats normally and doesn't have any problems.
then I would have no reason to be worried about cancer.
it may even be an error in the measuring equipment.
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
it is much more important to look at the patient, than to focus on laboratory results only.
and i am attaching now these results
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
ok, thank you,
the ALT level is elevated, and could suggest a liver problem may be present,
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.
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
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.
it is also an option to try a liver supplement such as S-Adenosylmethionine, or milk thistle, for example.
is the ALT value something to worry about?
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),
but with the ALP and other levels normal, I am not very concerned at this point.
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.
I would suggest rechecking the blood test in 2-3 weeks before doing an ultrasound or biopsy.
sometimes the ALT can return to normal or at least close to normal.
i have an appointment for next week and the doctor told me that i should buy her Denosyl or Samilin
yes, those are good suggestions.
which support the liver, if I am not wrong
should the dog get this medication for the rest of her life?
well, it depends on what the cause of the problem may be,
those products are very safe to use long-term if needed,
but it is possible that 1-2 months may be all that is necessary.
it's just that I am against using pharmaceuticals to people or animals for no reason
well, those products aren't drugs.
they are supplements.
ok, so what will the ultrasound scan show in her case?
will it help define what is the problem that's causing the high PLT and ALT?
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.
by tumour you mean cancer on the liver?
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.
in the case of a tumour
is it curable?
sometimes yes, sometimes no.
if the tumor can be removed, then it may be curable.
but depending on how much of the liver is affected, it may not be able to be removed.
what determines one or another?
and what about cysts?
generally a cyst is benign, and would not require treatment.
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?
it is worthy of a recheck - but I would not be too worried since there are no signs of illness.
in case of a cancer on the liver
which would be the early symptoms?
weight loss, poor appetite
also, WBC values of 2013 are 10.0 while 2014 ones are 17.6
with an accepted value of max. 17
is that something to worry about?
it almost doubled in 1 year
I explained that earlier in our conversation,
it is just a small bit above normal and would not indicate a real reason for concern,
unless there was signs of illness.
yes, but truth is
with dogs you can't tell the signs apart from loss of appetite and not being active
they can't tell us if they hurt somewhere
so the only thing we can rely on is blood test results
no, that is entirely untrue. a Physical examination, and careful observation of activity level and appetite are much more important.
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.
yes but the dog is active and eating as normal, but the blood test results are all over the place
I hardly consider the results you have posted, to be "all over the place".
the bot***** *****ne here, is if YOU are worried, pay for the ultrasound.
it seems like you need to have further knowledge of the situation, and that is the next step.
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
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.
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.
i am thinking that the result might not be reliable because now she's taking the Denosyl supplement
so the results might be compromised because of it