Term
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Definition
Clinical Signs:
- most frequently seen in cats secondary to stress or starvation
- recent onset of anorexia (especially in an obese, diabetic cat), vomiting/diarrhea, depressed/lethargy, hypersalivation (cat), weight loss
- icteric mucous membranes +/- hepatomegaly
- +/- neuro signs/hepatic coma if has progressed to hepatic encephalopathy (uncommon)
Hemogram:
- normocytic, normochromic , nonregenerative anemia (chronic disease)
- +/- Heinz bodies
- +/- poikilocytosis= acanthocytes (altered lipid/cholesterol RBC membrane)
- icteric plasma
- +/- steroid leukogram (mature neutrophilia)
Chemistry Profile: cholestasis due to lipid accumul.!
- hyperbilirubinemia (liver can’t remove from blood stream, physical cholestasis)
- >2X increase in AST/ALT/ALP
- +/- increase in GGT (ALP >>> GGT)
- mild hyperglycemia (stress); UNLESS concurrent diabetes
- decreased BUN w/ normal creatinine (b/c urea from liver); UNLESS concurrent renal disease
Urinalysis:
- USG usually <1.020
- +/- bilirubinuria
Coagulation Panel:
- prolonged PT/PTT (liver produces coagulation factors ALSO anorexia and decreased Vitamin K uptake; rare to have bleeding disorders)
- hypofibrinogenemia
Other:
SBA elevated (liver can’t take up) HOWEVER with hyperbilirubinemia- unlikely to run this test because of no additional value!
May see abnormalities in other chemistry values due to underlying GI disease, renal disease, etc. |
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Term
Hypoadrenocorticism
Addison's disease |
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Definition
Clinical Signs:
- more frequent in middle aged female dogs
- vomiting, diarrhea, depression, lethargy, anorexia, severe weight loss, dehydration, bradycardia (because of hyperkalemia)
- +/- PU/PD
Hemogram:
- Absence of a steroid leukogram in a really sick animal (lymphocytosis, eosinophilia)
- Relative erythrocytosis /polycythemia (dehydration)
Chemistry Panel:
- azotemia (usually pre-renal)
- increased Phos & Mg (b/c of decreased GFR)
- increased Ca2+ (b/c of decreased glucocorticoids)
- decreased cholesterol & glucose (b/c of decreased glucocorticoids)
* - severely decreased Na+, decreased Cl- (may be proportional or disproportional to change in sodium), significant increase in K+ (ALL due to mineralocorticoid deficiency)
- +/- mild acidosis
Urinalysis:
- decreased Na/K ratio (<25:1)
- +/- low USG (<1.018)
Differential Diagnoses:
- Oliguric/anuric renal failure
- GI disease (whipworms, etc) |
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Term
Hyperadrenocorticism
Cushing's Disease |
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Definition
Clinical Signs: 5 P’s!!!
* - PU/PD/PP
* - potbelly (b/c of abdominal muscle weakness/redistribution of fat to the abdomen)
* - panting
- bilateral, symmetrical, non-pruritic , noninflammatory alopecia
- heat intolerance
- lethargy
Hemogram:
* - steroid leukogram
- evidence of RBC regeneration (erythrocytosis)
Chemistry Panel:
- increased glucose and cholesterol
- increased ALT
- increased ALP (steroid effects)
- decreased BUN
Urinalysis:
- USG <1.015
Differential Diagnoses:
- other endocrine diseases |
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Term
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Definition
Clinical Signs:
- pale, tacky mucous membranes
- tachycardia (cats may have bradycardia), tachypnea
- thready/rapid OR weak pulses
- prolonged CRT, cold distal extremities= decreased perfusion and peripheral vasoconstriction
- decreased mentation
Hemogram:
- +/- erythrocytosis/relative polycythemia
Chemistry Panel:
- pre-renal azotemia
- +/- increased proteins
- +/- increased ALT/AST
- +/- increased amylase (b/c of decreased GFR)
Urinalysis:
- +/- urine concentration (dehydration)
All of the above depends on type of shock and whether in compensatory/decompensatory! |
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Term
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Definition
Clinical Signs:
- depression
- panting/tachypnea
- anorexia, weight loss
- pale/icteric mucous membranes
- +/- vomiting
Hemogram:
* - macrocytic, hypochromic regenerative anemia (reticulocytosis, polychromasia)
* - spherocytosis
* - autoagglutination
- inflammatory leukogram
Chemistry Panel:
- increased total bilirubin (b/c of hemolysis)
- increased ALT/AST (result of hypoxia)
- +/- increased ALP/GGT (result of hypoxia)
Urinalysis:
- bilirubinuria
- hemoglobinuria
Differential Diagnoses:
- blood parasites (Ehrlichia, etc.) causing a hemolytic anemia
- drug reactions (sulfas, penicillin), vaccination induced IMHA |
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Term
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Definition
Clinical Signs:
- chronic diarrhea
* - weight loss
- +/- polyphagia
- dehydration
Hemogram:
- +/- anemia (chronic disease) normocytic/normocytic nonregenerative
- lymphopenia (loss from GIT)
Chemistry Panel:
* - decreased total protein (both albumin and globulin low = panhypoproteinemia)
- +/- increased ALT/AST
- +/- hypocholesterolemia (loss from GIT)
Differential Diagnoses:
- liver failure
- hypoadrenocorticism
- renal disease |
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Term
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Definition
Heinz bodies and spherocytes ; anemia= regenerative
Other changes to RBC that can occur in oxidative damage: eccentrocyte/ghost cells, intravascular hemolysis |
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Term
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Definition
Clinical Signs:
- hemorrhage somewhere (or everywhere)
- weakness/lethargy
- ataxia
- dyspnea, pale MM (blood loss)
Hemogram:
- non-regenerative anemia (acutely; after 2-3 days will regenerate RBC; blood loss anemia)
- steroid leukogram
- +/- thrombocytopenia (usually normal)
Chemistry Panel:
- hypoproteinemia (24-48 hrs post-ingestion; blood loss)
Coagulation Panel:
- prolonged PT/PTT (PT= FIRST because the Vit. K dependent factors are 2, 7, 9, 10)
- normal fibrinogen
- normal FDP’s
Differential Diagnoses:
- DIC
- Coagulopathies (VonWillebrand’s Disease, Factor Deficiencies, Platelet Deficiency)
- Blood parasites (Ehrlichia) |
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Term
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Definition
Clinical Signs:
- fever
- depression, lethargy
- anorexia
- arthralgia, myalgia (joint/muscle pain)
- vomiting, dehydration
Hemogram:
- non-regenerative anemia
* - steroid leukogram
Chemistry Panel:
* - azotemia
- increased phos & Mg (b/c of decreased GFR)
- disproportionate decreases in sodium and chloride (chloride down more = alkalosis)
- no opposing change in bicarb w/ decreased chloride = mixed acid-base disorder
- increased anion gap (acidosis)
* - SIGNIFICANT increase in total bilirubin
* - mild to moderate increase in ALP
- +/- increased ALT/AST
Urinalysis:
- bilirubinuria
- proteinuria
- granular casts – tubular disease/sloughing of tubular epithelial cells= cast
- +/- hematuria
- USG <1.019
Differential Diagnoses:
- renal disease
- cholestatic liver disease |
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Term
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Definition
Clinical Signs:
- anorexia
- vomiting, diarrhea
- abdominal pain (cranial)
- weakness
- dehydration
- cats = lethargy, hypothermia
Hemogram:
- inflammatory leukogram (+/- steroid= stress)
- relative erythrocytosis (dehydration)
Chemistry Panel:
- pre-renal azotemia (dehydration)
- increased amylase/lipase (insensitive)
- +/- increased ALT/AST (spillover to liver)
- +/- increased total bilirubin
- +/- increased ALP/GGT
- +/- increased glucose= stress
- +/- increased cholesterol (decreased liver function with spillover)
Differential Diagnoses:
- renal disease
- cholestatic liver failure |
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Term
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Definition
Clinical Signs:
- smaller than littermates (failure to thrive)
* - hepatic encephalopathy
- vomiting, diarrhea
- anorexia, nausea
- PU/PD (dogs, not cats; DUE to decreased BUN)
- hypersalivation (cats)
Hemogram:
* - microcytosis (+/- anemia)
- +/- acanthocytes, codocytes, poikilocytes
Chemistry Panel:
* - decreased BUN (decreased urea production in liver)
- decreased total protein due to decreased albumin (decreased production in liver)
- increased ALT/AST (+/- ALP/GGT)
- decreased glucose & cholesterol (decreased production in the liver)
- Bilirubin normal/high
Urinalysis:
- USG <1.019 (low urea, part of medullary concentration grad.)
- +/- ammonium urate crystals
Coagulation profile: elevated PT/PTT (failure to produce coag. Factors)
Differential Diagnoses:
- liver failure
- renal disease |
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Term
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Definition
• Physical: Swollen pancreas, gallbladder obstruction, tumor, stones (intra vs extrahepatic)
• Serum chemistry: Increase bilirubin, increase ALP / GGT, hypercholesterolemia. Increase bile acid but usually won’t run b/c hyperbilirubin
o Bilirubin in urine. Can also see liver enzymes increase as well in urine.
Metabolic cholestasis (Anorexia) – horses no gallbladder, increase bilrubin but cholestatic enzymes normal
o Leptospirosis, sepsis also
Bili – coming from damaged RBCs, eaten by mac’s in spleen and bili is released from spleen(if hemolysis), after this bili comes to liver and liver takes it up, could be due to lack of hepatocytes(liver failure) or could be anorexia(horses>cow>cat), could be sepsis
- For hemolysis to be the cause of this, should see anemia that is generally regenerative, look for things like spherocytes, schistocytes, Heinz bodies(unless cats)
- Liver failure, anorexia ,and sepsis may be some elevation in ALP/GGT, but not consistent or dramatic
- What causes elevation in ALP/GGT is physical blockage of pathway, if bile stops in the bile ducts and back s up it irritates the epithelial cells, that is what induces increased production of GGT and ALP |
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Term
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Definition
Clinical Signs:
- usually occurs after a heat cycle
- lethargy
- anorexia
- PU/PD (bacterial ADH resistance)
- vomiting
- vaginal discharge (if open pyometra)
- abdominal distension (esp if closed pyometra)
Hemogram:
- inflammatory leukogram (+/- steroid w/ sepsis)
- non-regenerative anemia (early inflammation or chronic disease)
Chemistry Panel:
- increased total protein
- increased globulin (+ phase reactant – increases w/ inflammation)/decreased albumin (negative acute phase protein)
- +/- azotemia (w/ sepsis)
- +/- decreased glucose (b/c of sepsis)
- +/- increased Phos/Mg (b/c of decreased GFR w/ renal damage from sepsis)
- +/- increased total bilirubin and ALP/GGT (septic cholestasis) =biochemical/metabolic
Urinalysis:
- +/- isosthenuria (sepsis)
- +/- proteinuria |
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Term
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Definition
Clinical Signs:
- lethargy
- depressed mentation
- anorexia
- evidence of bleeding (DIC)
Hemogram:
- inflammatory leukogram (sepsis)
- thrombocytopenia (DIC)
- +/- anemia (DIC)
Chemistry Panel:
- increased total proteins (sepsis – probably see decreased proteins with DIC)
- increased globulins (sepsis – response to inflammation)
- significantly increased total bilirubin (sepsis)
- moderately increased ALP/GGT (septic cholestasis)
- +/- azotemia (sepsis or hypoperfusion from DIC)
- +/- increased ALT/AST (sepsis or hypoperfusion from DIC)
Coagulation Panel:
- prolonged PT/PTT (DIC, maybe sepsis if liver damaged enough)
- increased FDPs (DIC)
Differential Diagnoses:
- trauma (DIC)
- coagulopathy (VonWillebrand’s Disease, coagulation factor deficiency)
Sepsis: looking for marked inflammation/toxic change, severe inflammatory leukogram, may see increased bilirubin, biochem. tend to be similar to trauma- due to shock and multisystemic inflammation |
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Term
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Definition
Clinical Signs: visible injury +/- bleeding/hemorrhage
CBC: if bleeding may see an anemia (acutely= will not)
Chemistry Panel:
- +/- increased ALT/AST/GGT/ALP (SDH= large anim.); tissue hypoxia/ischemia
- +/- increased CK (muscle damage; also AST)
- +/- increased FDPs
Urinalysis:
- +/- hematuria |
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Term
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Definition
Clinical Signs: foals
- depression
- anorexia
- vomiting
- +/- abdominal pain
- +/- dysuria/stranguria/no urine production
Hemogram:
- +/- non-regnerative anemia (early inflammation/late chronic disease)
- +/- inflammatory leukogram (+/- steroid if stressed)
Chemistry Panel:
- azotemia
- increased K+
- decreased Na+
- decreased Cl-
- increased anion gap (metabolic acidosis)= uremic acidosis
Urinalysis:
- +/- hematuria
Abdominal Tap:
* - Creatinine/BUN concentration greater than serum concentration
Differential Diagnosis: obstruction in the urinary tract (post-renal azotemia) |
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Term
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Definition
Clinical Signs:
- vomiting (obviously)
- anorexia
- anxiety
- hypersalivation
- dehydration
Hemogram:
- +/- relative erythrocytosis (dehydration)
Chemistry Panel:
- disproportionate decreases in sodium and chlorine (chlorine down more due to high HCl in stomach= alkalosis- loss of major anion, retain other major anion= bicarbonate!)
- decreased K+ (loss of all electrolytes)
Hypochloremic alkalosis (similar to abmosal stasis) |
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Term
| Renal failure vs. blocked cat |
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Definition
Clinical Signs:
- painful abdomen +/- distended abdomen (HUGE bladder OR painful kidneys)
- dysuria/stranguria OR completely blocked= anuria vs .polyuric RF
- vomiting
- depression
- dehydration
- +/- fever (w/pyelonephritis)
Hemogram:
- non-regenerative anemia (early inflammation/renal failure)
- inflammatory leukogram
Chemistry Panel:
- moderate to marked azotemia
- hypocalcemia (CATS)
- increased Phos/Mg (b/c of decreased GFR)
- proportional decrease in Na+ and Cl- with PU (can also be normal/high)
- significantly increased K+ (post-renal obstruction); low K+ (PU renal fail.)
- decreased bicarbonate (metabolic uremic acidosis)
- +/- increased amylase (b/c of decreased GFR)
- +/- hypoproteinemia (glomerular dz= lose ALB)
Urinalysis:
- proteinuria (glomerular vs. tubular); glucosuria (tubular)
- hematuria
- +/- crystals (if stone present)
- +/- pyuria/bacteriuria (w/pyelonephritis)
- +/- USG <1.019 (isosthenuria= 1.008-1.012= NOT functioning at all; need functionally kidneys to dilute/concentrate urine)
Differential Diagnoses:
- Hypoadrenocorticism (Addison’s Disease= similar to oliguric/anuric RF)
- differentiate between oliguric/anuric renal failure (obstruction), chronic renal failure, acute renal failure, pyelonephritis, and glomerular disease |
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Term
| Colic - decreased gut sounds |
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Definition
• Inflammation + steroid leukogram and echinocytes
• Hyperfibrinogenemia= inflammation
• Increase P, Decrease Ca
• Increase Bilirubin – sepsis
• Increase ALP – from intestine and liver spillover; biochemical cholestasis
• GGT and SDH normal
• Increase AST and CK
• Hyperglycemia, stress
• Abdominal fluid (transudate vs. exudates= sepsis) |
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Term
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Definition
• Increase Glucose, Increase cholesterol.
• Urine glucose +, ketone +
• Heinz bodies, increase liver enzymes
• Fructosamine high -> diabetes not well regulated.
• Ketoacidosis
• Increase P and K because lack of insulin |
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Term
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Definition
• Dehydration
• Na increases / decreases depending on if electrolyte loss is greater or less then fluid loss.
• Cl increases / decreases- usually decreases
• K decreases, Gl loss. Usually Na/K change proportional.
• Increase bicarbonate – alkalosis b/c acid lost
• Decrease bicarbonate – acidosis – bicarb lost
Watery diarrhea = increase serum electrolytes, run of the mill = proportional, if drinks a lot of H20 could have decrease |
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Term
| Drug effects - anticonvulsants |
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Definition
Phenobarb.
• PU/PD
• Hepatotoxicity/elevated ALP
• Anemia
KBr: increase in K, Increase in Cl (Br- reads as Cl-!)
Corticosteriods – steroid leukogram (lymphopenia, eosinopenia, monocytosis- dog, mature neitrophilia
• Increase in glucose, increase in cholesterol
• Decrease in Ca, Decrease in P, PU/PD from decrease ADH sensitivity
• Decrease K, increase Na, alkalosis
• Decrease USG (PU/PD)
• Increased ALP in dogs(also in GGT) , potentially increased urea/ BUN (likely more with overt hyperadrenocorticism) |
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Term
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Definition
• Asprin: GI ulcer/inhibit COX
• Acetaminophen: Heinz body anemia, increase liver enzymes
• Rimadyl, Ibuprofen: decrease platelet function due to anti-prostaglandin effects, renal toxicity due to interference with autoregulation of blood flow (esp. with volume depletion) |
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Term
| Failure of passive transfer |
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Definition
• Very sick/septic young animal
• Low -normal albumin
• Dehydration
• Decrease globulins
• Decrease GGT because not as much colostrums - ALP in some |
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Term
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Definition
• Decrease Albumin and decrease TP
• Increase BUN/creatinine
• Urine – protein in urine
o Decrease antithrombin III – hyper coagulable state
o Increase USG sediment – urine protein : creatinein (0.5-15)
o Edema
o Casts
• Hallmark is increase of protein in urine
• Inflamm. leukogram |
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Term
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Definition
• Increase in total body water. Promote increase in CO
• Decrease Na with CHF w/ diuretics, normal leukogram
• Decrease bicarbonate= acidosis
• Fluid loading status
• Decrease CO/poor perfusion – therefore H2O retention +/- dec. Na
• Increase ADH= retain free H2O not electrolytes |
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Term
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Definition
• Increase in total Ca and increase iCa
• Decrease P unless Ca causes renal failure. |
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Term
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Definition
• Major decrease in Total Ca, decrease iCa
• Increase P because no PTH to promote renal loss.
• No steroid effects or pancreatitis |
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Term
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Definition
• older, skinny cat, PP/PU/PD
• Cats T4 increases, increase ALP with cats
• Endocrinopathy causes an increase in liver enzymes
• Glucose increases
• GFR increases
o Hyper kinetic circulation- BP increases
o USG decreases/ PU/PD
o Not usually a decrease in Mg/P.
• Decrease in cholesterol not consistent.
• Often kidney disease is also going on
• Once treat hyperthyroidism, kidney problems may pop up. Check renal throughout treatment.
o Tapazole (methimazole)= tx
• Increase cholesterol (fasted)
• Non reg anemia
• Hypoglycemia rare
• Derm. Signs- alopecia= noninflamm./nonpruritic |
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Term
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Definition
• Hypercalcemia – PTHrP mostly with lymphoma or anal sac apocrine gland adenocarc.. iCa increases =bio active. Ddx: renal failure with increase in Ca or increase Ca causing renal failure.
• Hypoglycemia : large tumors make insulin like growth factor IGF- drives glu into cells.
• Hyperglobulinemia: monoclonal gamopathy/elaboration of single class of AB multiple myeloma, lymphoma. Bence-Jones proteinuria. |
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Term
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Definition
- Glomerular – large protein/ALB stays in, water, electrolytes, glucose, and smaller protein filter through
o Decreased albumin with marked proteinuria if glomerular dz
- Tubular – water,electrolyte and mineral, glucose and protein/amino acids reabsorbed proximally.
o Disease: electrolytes can go up and down depending on the stage, urine: glucose, protein. If BG greater than 200 – 300 than there was too much glucose for tubules to reabsorb (DM); if blood glucose is normal, tubules should have been able to handle/concerned about renal dysfunction.
o If proteinuria and glucosuria think more tubules, if see proteinuria alone with low albumin, think glomerular disease( especially the more protein that is present)
- Urine sediment
o Blood/WBC or inflammation in urine active sediment) could be coming from the bladder (e.g.) urinary tract infection or upper urinary tract- must localize!
- Azotemia
o Significant tubular problem
o May not see in early glomerular disease |
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Term
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Definition
Young
• Low protein: low ALB due to increased total body water/low globulins b/c immunologically naive
• High body water
• Low USG- immature kidney, watery diet, (milk)
• Increased ALP= bone isoenz.(ALL species)
• Ca/P high- growing
• Increased GGT in 1st week – horses and cows(colostrums)
• Increased bilirubin LA (horse, cow) in 1st week, depends placenta type
CBC – reactive lymphocytes: antigenic stimulation/just vax; Neonate cows can have increased segs
Adult
• Higher TP but will decrease in old age
• Globulins increase with age |
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