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Pet Forum / Miscellaneous / Animal Health / September 2007test results puzzle
I took my dog Bear to the vets today. My main conceren was that he has a urine smell to him and his BUN has been above normal in the past. Bear is 10 years 9 months old. He weighs 75 lbs, which is a good weight for him. He takes tramadol twice a day for pain after NSAIDS finally started causing GI problems. He also takes glucosamine, thyroid meds and DGP. (Dog Gone Pain)He has moderate HD and arthritis. Urinalysis results Appearance - slightly cloudy Color - med. yellow Protein - trace Spec Grav - 1.090 Bacteria - + PH - 8.0 Urobillinogen - 0-2 Crystals - phosphate Epithelium - + Notes - leuk, nitrate Chemistry results Reference range ALKP = 120 U/L 23-212 ALT < 10 10-100 BUN = 22 7-27 CREA = 0.8 0.5-1.8 GLU = 122 70-143 TP > 121.0 g/dl 5.2-8.2 The vet said the results don't make sense. She's putting him on Vit. C for the PH and is having a pre-kidney test sent out. She ran the chemistry twice as the TP was so high. The second sample was diluted 1-1. Any ideas on what's going on? I'll have the other test results on Wed. What would cause the TP to be so elevated and the PH so high? Thanks for reading, Kate I would vote for a urinary tract infection and a machine malfunction on the protein. He'd be dead if his total protein were really over 100. Obviously something is interfering, or something is wrong with the machine. A bacterial UTI will cause high pH, crystals, and smelly urine. With a urine specific gravity of >1.090 his kidneys are working just fine! I'd put him on antibiotics and recheck UA in 2 weeks. Deborah, DVM >I took my dog Bear to the vets today. My main conceren was that he has a >urine smell to him and his BUN has been above normal in the past. Bear is [quoted text clipped - 35 lines] > > Kate Whoops! Major typo on my part. Total protein is 12 - apparently my fingers got a little out of control. Thanks for taking a look, Dr. Deborah. His vet said that Bear always swims upstream - her way of saying that Bear is rarely a simple diagnosis, I think. Kate etakbear at yahoo com > I would vote for a urinary tract infection and a machine malfunction on the > protein. He'd be dead if his total protein were really over 100. Obviously [quoted text clipped - 44 lines] >> >>Kate .......I'm with Dr. Deb on this one - high pH is caused by bacteria - you can only fix the pH by fixing the infection. ......And was the blood drawn after a 12 hr fast? buglady take out the dog before replying > .......I'm with Dr. Deb on this one - high pH is caused by bacteria - you > can only fix the pH by fixing the infection. > > ......And was the blood drawn after a 12 hr fast? No fast - she's never required that, although I know another that does. Kate I understand the total protein (TP) is 12, thanks for clearing that up. I agree with Dr. Deborah that Bear probably has a UTI. That's the urine smell, the high urine pH, the leukocytes, the nitrate and the 1+ bacteria. Now, for that TP! I'm guessing these values were run on an in-house machine. Hopefully, Bear's blood has already been sent out to a reference lab for more complete testing, but if not, then that would be my strong recommendation. You've got to confirm that TP of 12 and figure out where it's coming from. If it's normal on the recheck with a more accurate machine then you're done and Bear's fine. If not, then the most likely problem is an elevated globulin level. Assuming that's the case, and it's in the 7-9 g/dl range that I'd expect, then I'd recommend a serum protein electrophoresis. This test will differentiate severe inflammation and secondary antibody production from a cancer called multiple myeloma. Dogs with myeloma can seem surprisingly normal, so definitely follow up! Hopefully, the first test was wrong and there's no concern at all. Sandy, DVM > I took my dog Bear to the vets today. My main conceren was that he has > a urine smell to him and his BUN has been above normal in the past. [quoted text clipped - 35 lines] > > Kate Thanks, Dr. Sandy. They ran the test twice but it was in house. I'll ask that it be done at another lab. Any reason not to ask for for the second test as well at the same time besides cost? If there's a possibility of cancer, I'd rather run that credit card up than have to postpone a diagnosis. Kate > I understand the total protein (TP) is 12, thanks for clearing that up. > I agree with Dr. Deborah that Bear probably has a UTI. That's the urine [quoted text clipped - 54 lines] >> >> Kate > Thanks, Dr. Sandy. They ran the test twice but it was in house. I'll > ask that it be done at another lab. Any reason not to ask for for the > second test as well at the same time besides cost? If there's a > possibility of cancer, I'd rather run that credit card up than have to > postpone a diagnosis. I'd wait for the main chemistries to come back before adding the protein electrophoresis. What if the TP is normal? No need to waste $100 or so, I say. Another day or two waiting for the electrophoresis isn't a concern for Bear. Be sure the Dr. sends enough blood to run other tests, though, so the lab can just add the test on and Bear won't need his blood drawn again. Sandy, DVM Thanks again. Bear is hard to get blood from - front legs nada, rear rough and it started to clot. Didn't get enough for a CBC too. Not the best patient. Wonder where he gets that from? <g> Kate >> Thanks, Dr. Sandy. They ran the test twice but it was in house. I'll >> ask that it be done at another lab. Any reason not to ask for for the [quoted text clipped - 10 lines] > > Sandy, DVM I finally have an update. The microalbulin <sp> test came back normal. We'll re-do the chem panel to see if the TP was an error. We'll put him on a Sentinal patch to rule out pain, which she thinks it is. She thinks he's a healthy dog and we need to come up with a pain management plan that won't hurt his liver or upset his GI tract. She thinks the vit. C will clear up the urinary problem (I've got a cold and can't tell if the smell is less but he actually chased the ball twice in a row today!). I feed him a homemade diet but haven't been supplementing vit. C. There's hope! I'll let you know what happens and thanks for being there - it's been a huge help now and over the years. I remembered how I first came across this vet - Drs. John Doherty and Mark Epstein helped with Cal, a cat diagnosed with FIP in suggesting a second opinion and pointing me to the research on titers. She didn't have FIP and we're re-running Bear's test. Thank you vets present and past. Kate - kind of happy weepy >>> Thanks, Dr. Sandy. They ran the test twice but it was in house. I'll >>> ask that it be done at another lab. Any reason not to ask for for the [quoted text clipped - 10 lines] >> >> Sandy, DVM Well, another major mistake in posting. I thought the vet said Sentinal, when actually it's a fentanyl patch. For my next trick..... > I finally have an update. The microalbulin <sp> test came back normal. > We'll re-do the chem panel to see if the TP was an error. We'll put him [quoted text clipped - 28 lines] >>> >>> Sandy, DVM |
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