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Old February 21st, 2011, 03:12 AM
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Quote:
Originally Posted by katts View Post
Boi is still on IV fluids, but his recent blood tests have me very alarmed: White cell count has skyrocketed, while RBC, Hemoglobin, and Hematocrit have plumetted.

White cell count = 17.5 (up from 12.1 when we took him in; norm is 4.0-16.0)
RBC = 6.1 (down from 8.6; norm is 6.3-10.8)
Hemoglobin = 86 (down from 116; norm is 104-160)
Hematocrit = 0.27 (down from 0.33; norm is 0.32 - 0.49)
Platelets = 201 (down from 320; norm is 300-800)
The increase in WBC is not unusual, once the body is more able to manage the issue at hand (increase in kidney levels) the immune system can restart it's job of fighting off foreign susbstances, infection, etc. It still hasn't been definatively determined why there was such high numbers in the first place.

The drop in RBC, Hemoglobin, Hematocrit & Platelets can partially be explained by the IV Fluids - you're adding excess fluid into the blood stream which ineffect thins the blood a bit so the values may be off a bit in the sample taken.

When my CRF girl was in the ER Clinic on IV for a weekend (protein allergic reaction) she had a similar result in her CBC results: WBC & Platelet increase; RBC, HG & Hct decrease.

Quote:
Originally Posted by katts View Post
His Urea is now 41.5 and his Creatinine is 570.
His ALT is up to 95 (and was 36 before norm is 28-76).
ALP is up to 59 (was 36 before - norm is 0-62)

They put him on ampicillin because of the white blood cell count, even though they do not know the cause (and are not trying to diagnose the cause in any manner). This makes me extremely nervous. He seems to be going into some sort of liver failure.
Should I switch vets?

I know it's not looking good now.
Good drop in BUN & Cre results so far

ALT & AST - These enzymes elevate relatively easily and are not as important in liver evaluation as ALP elevations but a substantial increase may also warrant follow up liver testing. In the event of hepatic lipidosis or fatty liver, the elevation in ALP is often dramatic

http://ahdc.vet.cornell.edu/sects/cl...em/leakage.htm

ALT is a liver specific enzyme but can also increase in severe myopathies (release of muscle enzyme) and hemolysis

Quote:
ALT is found in the liver, muscle (cardiac and skeletal), brain, kidneys, and erythocytes.
ALP has increased but is still within normal. It is also a liver & bone tissue specific enzyme but can also increase due to other factors including hyperthyroidism, pancreatitis, bile duct obstruction etc.

Again when my CRF girl was in ER on IV for a protein allergic reaction the reg vets were orginally concerned about liver issues because her ALT & AST were elevated & ALP was low, but once she has been retested after 24+ hrs on IV and was also given ampillicin at that time - at that point we also hadn't realized it was a specific protein she was having a reaction against, the next test done showed a drop in both ALT & AST. She was later determined to have a very mild form of IBD & pancreatitis.

Obviously I'm not a vet but my the mild liver enzyme increases may be due to not eating as well as he should in clinic. Often cats that are hospitalized don't eat as much as they normally would, in part due to stress and also being kennelled they are not expending energy moving about therefore need less calorie intake, the restricted activity also promotes muscle wasting which as mentioned above can result in the release of the liver enzymes.

The vet will likely want to run the blood work again before releasing Boi from the hospital, so all these levels can be compared again. You can ask for a Bile Acids Test to determine if there is any liver damage, and/or a Spec fPli test can be done to check for pancreatitis.

Unless you are uncomfortable with the vet & staff or the services they are providing I would leave Boi there as the transfer to another vet would result in retesting & re-evaluating everything & may be more stressful to Boi than necessary.

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