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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 19580
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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Species: Canine Sex: F Age: Around 15-18 years

Customer Question

Species: Canine
Sex: F
Age: Around 15-18 years
1. Urea 16.1 MMOL/L
2. Creatinine 55 UMOL/L
3.Total Protein 84G/L
4. Globulin 52aG/L
5. Total Bilirubin 1UMOL/L
6. SGPT (ALT) 296 IU/L
Do you mind explain what are the results indicate? What are the causes (or possible causes) and consequences (or possible consequences) of the results above? What to do to minimise the worse? Anything to do with my pet (e.g. food, diet, supplements etc)? Appreciate if you could provide more relevant and or concerned answers/areas than my queries as I totally have no idea.
Thanks for your time and professional reply/advise (in advanced).
Submitted: 10 months ago.
Category: Dog Veterinary
Expert:  Dr. Gary replied 10 months ago.
Hello. Thanks for the question. That bloodwork is pretty normal. The BUN (urea) is high, but the Creatinine is normal. The Creatinine is the more specific kidney enzyme that tests kidney function. That high urea can be due to dehydration. That is likely, given the mild increase in Total Protein. The liver function (Bili and ALT) also looks ok. The ALT is a little high, but not too bad. I wouldn't be too concerned about any of this. I would be more concerned about her weight and degenerative joint disease or arthritis causing the signs vs organ disease. It wouldn't hurt to put her on a liver supplement like Denosyl (SAMe). I would probably try some pain meds to see if that helps with the legs. I would go with a low dose anti-inflammatory (Metacam or Rimadyl) or Gabapentin that is safer on the liver and kidneys. I hope this helps, let me know if you have any other questions.
Customer: replied 10 months ago.
Other than dehydration, any possible causes of high urea? She drinks not much water. The lesser she consumes as she grows older. How to make her drink more water to keep hydrate? Also, i know that dogs will put their tongues out when they are feeling hot, but the problem is my girl does this with quite heavy breathing and most of the time refused to drink water. This makes me so worry. Any ideas? Anything to do with her daily meals or whatever besides keeping hydrate to lower the urea and total protein? What if the results remained?
What are the functions of bilirubin? The reference range in her report is in between 2 UMOL/L and 10 UMOL/L. What if it is too high or too low?
However, her ALT(296 IU/L) is way more higher than the one that stated in the reference range, which is in between 15 IU/L and 90 IU/L. Based on what I know, high ALT may due to liver damage, tumor, pancrease etc. So my concerns are: 1) her ALT is considered a little and not too bad? (The reference range is standardised in every country? All breeds share the same range? Etc); 2) what to do / how to lower the high ALT and maintain at the normal range?; 3) how to be sure of the real cause of the ALT?
She is weighted 4.5kg last week when visiting the vet, and was being told that she is overweight as she is small breed and her legs do not have the strength to carry/support her upper body, as time goes by, her supporting legs now getting weaker and will fall down easily, like the floor is very slippery, even when she wakes, she couldn't afford to stand very stable like she used to.
She had her operation on legs few years back. She was lucky to be saved as the narcotic anaesthetic against her during the operation. And now I am so afraid to send her for operation whenever suggested even the vet said only a small amount of narcostic will be applied as i am not sure whether or not she can afford. Injured, operation and narcotics anaesthetic, could these be part of the reasons of her weak legs?
Expert:  Dr. Gary replied 10 months ago.
I'm sorry for the wait. I was out of town Sun-Mon. The increased Urea can be from a couple other things: dehydration, kidney disease or bleeding in the gut (usually a GI ulcer). Those are the most common 3 causes in order. To increase water intake, you can get multiple water bowls in different rooms. You can use a circulating water fountain. You can also feed a canned food and add water that way to get fluids in. Bilirubin is a function of the liver's ability to process bile and the gallbladder expressing it into the gut to digest fat. It's only a problem when too high. That happens with liver disease, an obstructed gall bladder or red blood cell destruction from a different pathway. ALT can go up and down due to liver disease, toxin ingestion or heavy muscle use. Going for a long run makes the ALT go up drastically. I would use a liver supplement now (SAMe, Denosyl), but I wouldn't get too excited about it unless it's persistent. I wouldn't worry about anesthesia with her. I would just use lower doses of meds if her ALT is high. The narcotics/ opiods are very safe. It's the gas anesthesia that is the most harmful on the body, so we use opiates and other pre-meds to keep the gas concentration as low as possible. I hope this clears some things up. Let me know if you have other questions.
Expert:  Dr. Gary replied 10 months ago.
I'm just following up on our conversation about Coco. How is everything going?
Dr. Gary
Customer: replied 10 months ago.
Hi, she is better now, at least she is playful now like she used to, but the legs are weak. Last time she got sick until she doesn't want to play, easily tired, moody and don't feel like want to entertain us but now she will. Oh yay! Remember I have told you that I brought her to consult a vet when I found that her urine is a bit bloody and the vet gave some antibiotics and anti-inflammatory medicine to her. "If her urine turns better/back to normal, simply indicates that probably it just cause by virus, so not to worry too much when it gets better after antibiotic (but if it didnt turns better, could be a sign of disease)", the vet said. After 2 or 3 days, her urine did turn better (as from what I observed on the towel/pad/floor). I took her urine for urinalysis as well (sent to the clinic within 2 hour as mentioned by the vet). The assistant told me that she can still see her urine a little bloody (may be she viewed under a microscope so can have a clearer and better observation than eyes did). She was then explain or say nothing to me and just asked me to get back to the vet after the antibiotics is finished. So after a week (which means now), i can really see that her urine is bloody again (antibiotics still havent complete yet). Can u give on some suggestions? I'm so worry that it's not something good! Oh! The vet said, her urinary bladder is uneven, but no idea why it is so. She never had mating before and take ligation.
Expert:  Dr. Gary replied 10 months ago.
I'm glad she seems better. The one thing I would do to check the urine is an x-ray of the bladder. That is to look for bladder stones. If no stones, then it may be a urinary tract infection. In that case, I'd get a urine sample straight from the bladder and culture it. A culture and antibiotic sensitivity will tell you what bug is present and how to treat it most effectively.
Customer: replied 10 months ago.
Will bring her to consult the vet again soon. And ask for the possible checking/examination and also solutions (if there is any unwanted results). But still I hope that everything goes well.Is there any possible cause for the uneven bladder other than stone bladder and the bleed in urine? Any solution? What if operation is not encouraged as she is a senior dog.Again, her eyes. As mentioned earlier, glaucoma and cataract. It seems better after cleaning and putting the ointment as instructed by the vet. But now, out of a sudden, I noticed, her eyes turn a little red, not sure if I'm wrong, and the lashes are quite wet. Guess she might feel pain.
Expert:  Dr. Gary replied 10 months ago.
It sounds more like a UTI or stones than anything else. It could be a bladder tumor, but those are pretty uncommon. The redness to the eyes may just be discomfort from the cataracts. It's not uncommon for glaucoma to cause pressure and pain. If not controlled with meds, the recommended treatment is surgical removal of the eye.
Customer: replied 10 months ago.
She is a senior dog, surgery carries high risk on her, she couldn't bear it and since she has been reacted against the narcotics anaesthetic during her previous operation on legs, I am a bit off for considering whenever surgery is recommeneded as I am afraid of the chemical reactions between her and the narcostics/whatever med that will be taken. It's poor to leave her alone in the operation room and if in the event of undesired case, I will hate myself for putting her at risk.I think I am too sensitive on her, if I noticed anything, I will started to worry. It is so hard to get a very kind, helpful, caring and loving, experienced and professional vet here.Regarding to the urine, what if I see that she is actually wanted to pee, but turns out it's just a few very little drops blood? For her age, period (menstrual cycle) is impossible anymore right? So it could be one of the causes u mentioned or other possible cause that requires further check up and monitor to figure out the exact problem and deal with the necessary and appropriate treatments.
Expert:  Dr. Gary replied 10 months ago.
I understand the risk for surgery. I hear it every day. In my experience, serious anesthetic reactions or deaths are quite rare. < 1% rare. Every owner worries, but the actual number don't usually back up that hesitation. If she is intact, she could still have heat cycles. They don't cycle as much, but they can still go into heat later in life. An infection or stones are more common, though.

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