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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 24358
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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HiI have a 9 year old domestic female cat Molly. Her cholesterol

Customer Question

Hi
I have a 9 year old domestic female cat Molly. Her cholesterol and triglyceride levels have been elevated for years but came finally within normal range 2 years ago. Yesterday she had it checked again and it was normal. The only levels that are not normal are her CK level and her AST level. CK level is 7556 (normal range 64-440). Her AST level is78 (normal range 16-67). Molly is acting normal. Normal appetite and water intake is normal. My vet thinks it could be stress related. There were a lot of dogs there. The vet also said that the levels could be elevated because Molly was fasting for 16 hours. She has been fasting for 16 hours before and it was then normal. Or hyperthyroidism. Molly doesn't show signs of that. Or heart problems. Can someone help me. Could it be a false reading? I am really worried. Lost a 4 year old cat due to an allergic reaction to anesthesia a year ago. I am worried about Molly.
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.
Aloha! You're speaking with Dr. Michael Salkin
Please don't be alarmed. The CK is a muscle enzyme. Just restraining a cat or pricking subcutaneous muscle when drawing blood can cause egregious elevations in CK. It doesn't represent muscle disorders in cats because such disorders are rarely recognized in cats if at all. The AST isn't useful in dogs or cats. The ALT is preferable as a liver enzyme because it's more specific for the liver than AST. I would be pleased to review all of Molly's test results if you'd like but if everything else is normal, Molly is a nicely healthy 9 year old.
Please respond with further questions or concerns if you wish.
Customer: replied 1 year ago.
Thank you. I read an article on the comparative neuromuscular laboratory that during starvation the body breaks down skeletal muscle to provide amino acids for protein synthesis and to supply glucose for tissues that have an obligatory glucose requirement. Molly was fasting for 16 hours because her triglycerides were checked at the same time. Could her 16 hour fast be the reason for an elevated CK level? What is your take on this?
Thanks. Evelyn.
Expert:  Dr. Michael Salkin replied 1 year ago.
No, Evelyn, we regularly fast patients for the most accurate test results and we don't see elevations in CK due to that fast. Significant CK is released as a consequence of myocyte (muscle cell) injury/disruption as seen with the restraint associated with blood acquisition, immune-mediated polymyositis, infectious polymyositis, muscular dystrophy, trauma, shock, and seizures. Only restraint makes sense in an otherwise normal Molly.
Please continue our conversation if you wish.
Customer: replied 1 year ago.
What about hyperthyroid or kidney disease? can that elevate CK levels?
Expert:  Dr. Michael Salkin replied 1 year ago.
No, there's no mechanism for either hyperthyroidism or kidney disease to do so. Hyperthyroidism is easily ruled out with a T4 (total thyroid blood test) under 2.0 ug/dL and kidney disease can be ruled out by a normal BUN, creatinine and well-concentrated urine.

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