-
how many tests are in each type of chem panel
- pre-anesthetic: 6
- genral heath profile: 12-24
- Geriatric profile
- Renal profile
-
What kind of sample is required to run a chem panel
Serum or Lithium heparin plasma (green bullets)
-
Enzymes
formed and function intracellularly thus we should see decreased levels in the blood indicates a problem with thats specific cell/tissue/organ
-
3 reasons for increased enzyme levels in the blood
- 1. Leak out of damaged or dying cells
- 2. Increased production
- 3. blockage of excreatory route
-
Examples of increase of enzyme levels due to leaked out of damaged or dying cells
-Any itis
-
Examples of increase of enzyme levels due to increased production
- young animals-bone growth
- neoplasia
-
Examples of increase of enzyme levels due to bloackage of excreatory routes
HBO-hepatobiliary obstruction
-
what unit is enzymes measured in?
iu-international units
-
what are two things that may interfere with enzyme blood levels
Hemolysis and lipemea
-
liver functions
- protein synthesis
- metabolism of carbs, proteins, lipids
- Cholesterol synthesis
- bile synthesis
- detoxifies blood
- Metabolism of drugs
-
what proteins does the liver synthesis
- Albumin, clotting proteins
- if pt. has liver dz do clotting panel b4 sx
-
Liver Enzymes
- ALT
- AST
- ALK. Phos
- GGT
- Bilirubin
-
ALT
- Alanine aminotransferase
- SGPT
- major source come from hepatocytes in dogs cats and primates
- it is not liver specific horses, ruminants, pigs
-
Reasons for increased ALT
- liver dz
- hepatic trauma
- +/- Neoplasia
- long term use of drugs: steroids, anti-epilectics, nsaid,
- strenuous exercise
-
reasons of decreased ALT
cirrhosis-hepatocytes are replaced with scar tissue
-
AST
- aspartate aminotransferase
- old name is SGOT
- will increase for liver or bone
-
Alk.Phos
- alkaline phosphates
- alp, alk, alkp
- must have the pts age to interepret ^ alk.phos
- made by osteoblast/chondroblast
- not reliable in cattle or sheep because it fluctuates alot
-
Reasons for increased alk. phos
- HBO
- drugs
- bone injury
- bone tumors
- young pts
-
GGT
- Gamma glutamyltranspeptidase
- Not used much in Cat and Dog diagnostics
- liver specific enzyme in Lg. Animals
- primary source of GGT is hepatocytes
-
Reasons for increased GGT
liver dz usually obstructive liver disease lg. animal
-
-
T bili
Total bili=conjugated bilirubin+unconjugated bilirubin
-
I. Bili
indirect bilirubin=unconjugated bilirubin
-
D. Bili
direct bilirubin=conjugated bilirubin
-
reasons for increased I. Bili
hemolysis
-
reasons for decreased D. Bili
- HBO
- Liver dz because it wont store D. Bili
-
Cholesterol
- CHOL
- synthesized by the liver, also through diet
-
Hypercholesterolemia
- HBO-cholesterol is a component of bile
- hypothyroidism-lack of thyroid hormones which play a role in breakdown of cholesterol
- Steroids
- DM, pancreatitis, obstructed liver dz
-
Hypocholesterolemia
- liver failure-unabe to synthesize
- prolonged anorexia/starvation
-
Total Protein
- TP, albumin, and globulin
- total serum protein is lower than total plasma protein because is missing clotting proteins
-
albumin
synthesized by the liver
-
Globulins
- Alpha & Beta are synthesized by liver
- Gamma are synthesized by lymph and are the most abundant in the body
-
Hyperalbuminemia cause
dehydration-relative increase
-
Hypoalbuminemia
- liver dz or failure-cannot synthesize
- Protein losing enteropathy ie parvo due to blood in diarrhea
- protein losing nephropathy-ie abnormal filtration of ALB by the glomerulus
- prolonged anorexia/starvation-decreased diatary intake
-
Hyperglobulinemia
- immune response
- dehydration
-
hypoglobulinemia
- liver dz & failure-cant synth alpha and beta
- Immunosupression-decreased gamma
-
A:G
- Albumin: Globulin
- doesnt mean anything by itself
- used with TP, ALB, and GLOB
-
causes of`decreased A:G
- immune response
- liver disease
- FIP
-
-
kidney fx
- regulates: h20 balance, electrolytes, blood pH
- Excretes: Non-protein nitrogenous wastes (BUN: Creatinine)
- Synthesizes: Renin (enzyme that regs. BP), EPO-erythropoietin
- Conserves: glucose and protein
-
reasons for increased BUN
- pre renal, Post, and primary azotemia
- increased protein diet
- increased breakdown of body protein-fever, exercise, infx, necrosis
-
Reason for decreased BUN
- liver dz and failure-unable to convert ammonia to urea
- young animals-anabolic and drink a lot of water
-
Creatinine
non-protein nitrogenous waste product from muscle cells
-
reasons for increased Creatinine
all azotemias
-
Reasons for decreased CREA
diuresis
-
what is required to diagnose and classify azotemia
BUN, CREA, USG
-
pancreas exocrine fx
- digenstive enzymes: amylase-CHO breakdown typsin
- lypase-fat
-
Pancreas Endocrine fx
- hormones
- insulin decreases blood glucose
- glycogen increases blood glucose
-
Pancreas tests
Glucose-measures endocrine fx must separate serum asap because is will decrease by 10% every hour
-
Hyperglycemia
- DM-animal lacks insulin
- post prandial
- stress, fear, excitement, restraint, especailly cats due to epinephrine release
- pancreatitits
- hyperadrenocorticisim
-
Hypoglycemia
- liver failure-cant store glucogon as well
- prolonged anorexia/starvation
- juvinile hypoglycemia-overstim play with young pups and kits
- insulinoma-common in ferrets
- insulin OD
-
reasons for increased lipase
- DM
- duct obstruction
- steroid tx
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