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Hi, I'm Dr. Deb. I recently came online and see that your question about RB hasn't been answered. I'm sorry that you've had to wait for a response but if you still need assistance, I'd like to help if I can. 1. Yes, certain lines of shelties are prone to hypercholesterolemia and you're correct to be concerned, especially if he's already had two pancreatitis episodes.Each lab is different in terms of high normal when it comes to values but a cholesterol of 323 isn't terribly high. For example, high normal for the lab I use is 328 with low normal 112. A non-fasted sample can also cause this value to be elevated as can the diet that is fed.Risk factors associated with "true" elevated cholesterol levels can include the following: a) Pancreatitis b) Changes of the eye such as lipid keratopathy, stromal dystrophy, lipid in the aqueous humor, uveitis, blindness, and lipemia retinalis. c) Changes in the skin (although these are less commonly seen) such as itching and hair loss.2. Low fat diets with a fat content of between 12-15% are usually suggested for those dogs at risk for developing recurring episodes of pancreatitis. I usually recommend prescription food Royal Canin Low Fat or Hill's I/D which is also a good choice.3. Human/table food can definitely increase the lipids in the blood and thus shoud be avoided for those dogs at risk.4. Omega 3 fatty acids dosed at 10-30 mg/kg a day may be helpful. Welactin or 3V capsules are good choices since quality control issues exist with supplements. As to the Hemoglobin levels, the range is 12-18 g/dL for the lab I use.To be honest, I don't worry about mild elevations in this number in a clinically normal patient, since it's usually secondary to a difficult blood draw or hemolysis during handling/storage of the blood.As to the Circovirus that's been receiving attention in certain states, there isn't enough information known about it to make definitive statements.To quote the Ohio Department of Agriculture: Dog CV is newly isolated and there is very little information available about the virus, where it came from and how it spreads. The limited research available shows that canine circovirus can cause vasculitis and hemorrhaging in infected dogs. I researched a veterinary database about it and the information that I found pretty much confirms the above statement: we just don't know enough about it yet.Again, I'm sorry that you've had to wait for an answer to your questions, but I hope this helps. Deb
Rb gets no other food... Zero human or other dog treats. Only kibble and green beans. His cholesterol check was a fasting one since he was getting his teeth cleaned and could not have anything after mid night of the night before. Does this additional info change anything? Lamb is high in cholesterol, so is this contraindicated for him? Unfortunately, a blood test that was done a couple of years ago due to several bouts of diarrhea suggested that as he was allergic to chicken, eggs, beets, salmon, lamb dog food was his least reactive protein and thus his sole dog food source. Should we get another cholesterol test done? What blood test or other event confirms a dx of hyperlipidemia in dogs (pet MD notes that a strict fast of 12 hours and a blood test result of 300 confirms hi c in dogs thus fueling our confusion and concern)? If this was your beloved dog, what action would you pursue under these circumstances especially since our dietary options are extremely limited. As to the hgb values, what might higher than normal be suggestive of? Could they be a sign of gastritis? Thank you for responding initially and hopefully subsequently.
Your replies have been most helpful, thorough, and very educational for which we are most grateful.
In searching prior vet visits, when the most comprehensive blood work panel was done back in 12/12, it revealed a cholesterol of 274,Triglycerides of 75, Glucose 107, T4 1.8, with the HGB still running high 19, and HCT 54. All of his other prior HGB and HCT tests have also run consistently around 19 and 55. Albumin also tends to run in 4.2 Range. Additionally, back in 2011 a vet did an ACTH test which we were told was negative.
With regard to your specific comments about if this was your dog/ patient, and that steroids can elevate cholesterol, LO AND BEHOLD, RB did get a 2mg injection of VETALOG for his allergies about 3 days or so before this reading!
So, any chance you have an office in either Michigan or Florida? Compounding our situation medically, is that we divide our time between these two states and thus have two vets providing treatment and thus we lack uninterrupted continuity of care, and at times receive differing perspectives.
So, unless we hear back from you with what appear to be other great insights, we will repeat his cholesterol and triglyceride blood work and ensure that he has had nothing for a full 12 hours before. We will also work on reducing the fat content of his grain free lamb kibble, perhaps by going back to a mix of the grain free (16 fat) and lamb and rice (11 fat) to bring the final total down within the recommended range 0f 12-15. We were doing this before the Cal Natural recall with no apparent adverse consequences.
Thank you again for being so responsive and providing such a comprehensive reply!
I'm glad that I've been able to help.Unfortunately, I live in New England so it doesn't look like I'll be seeing you as a client anytime soon:) I do understand how difficult it can be if there's not continuity of care and I also know that vets have differing opinions about many things. Veterinary medicine, similar to human medicine, is sometimes as much of an art as it is a science, unfortunately. That's interesting that RB received a vetalog injection prior to the blood tests; since it's a long acting steroid, it may certainly have falsely elevated the cholesterol level.It will be most interesting to see what the values are when repeated and this drug is no longer in his system.
Most of the chemistry panel results that you provided are within a normal range, especially the triglycerides which aren't even close to being high. The albumin is the only one that's slightly elevated (high normal is 4.0 for my lab).As to his consistently mildly high Hematocrit of 54% with HGB also correspondingly high, this may be normal for him, especially if he is asymptomatic. Not all dogs fit within the reference ranges of a particular lab. I try not to overinterpret the lab values if they're outside the normal range and I have a healthy patient. Sometimes I think we have a tendency to forget to look at the dog and not the numbers, if that makes sense.
But if he's not a big water drinker, mild dehydration could cause an elevated hemotacrit as well as mildly elevated albumin.
I also think that being proactive with respect to the fat content of his food is prudent.I'll be interested in knowing what the repeat testing shows if you have a chance to send me an update at that time.
Even after you've rated (if you do, of course), we can still continue to communicate at no additional charge to you. I can also send you a follow up email in a few weeks to which you can respond when you have the time to do so.
Best regards, Deb