Interpreting Lab Results in Context: Cookie’s Elevated Kidney Values

When your dog’s lab results show irregularities, don’t panic but don’t ignore them either. Figure out what is going on.

It has been my experience that often one value or another can be off on blood panel.

With Jasmine, every other panel had something out of range. The question is what to do when that happens? Investigate.

Interpreting Lab Results in Context: Cookie's Elevated Kidney Values

Immediate values and trends

It’s good to note any values out of normal range but also trends over time.

Values that are off are easy to spot. Then the task is figuring out why they are out of range; what does it mean. Depending on the value and how far out of range it is it might be important or it might be just a fluke. Jasmine would have one value or another out of range every now and then. As long as it was a different one each time and corresponding results were normal, we didn’t worry about it too much, though we always investigated and brainstormed to understand why that might have happened.

With Cookie’s elevated ALT there were two considerations. Firstly, the elevation of that particular liver enzyme needs to be taken seriously, and secondly, it remained elevated from one blood work to another. That’s why we pursued further diagnostics.

On Cookie’s last blood draw the ALT dropped back down to within normal range.

“The liver enzymes are looking good,” the vet said, “We got something new here.”

Just to keep me on my toes, I guess, both Cookie’s BUN and creatinine were above the normal range. “Crap, what now?” I thought to myself, not happy having those two in the red.

Kidney values

BUN and creatinine are values associated with kidney function.

The BUN (blood urea nitrogen) is more ambiguous and can be elevated for a number of reasons. Jasmine’s would be slightly elevated every now and then but her creatinine always remained normal. On the next blood draw, her BUN would be back to normal.

Elevated creatinine is much scarier.

But Cookie didn’t look like a dog with kidney problems.

There were no signs of a kidney issue and the TCVM exam also didn’t show anything of concern. “I’m not feeling what the lab work is saying,” the vet said.

However, the elevation of these two values is to be taken seriously.

What can get kidney values out of whack?

It could have been from dehydration (Cookie’s tongue did confirm that she was a bit dehydrated) because she had high protein snack earlier (we were just curious about the ALT so didn’t bother to fast her for the blood test). Cookie was also quite stressed this time.

Nothing else on that blood panel was off. We concluded that they kidneys ought to be fine but to be on a safe side, we decided to follow up with urinalysis.

Meanwhile, as I came home I pulled out Cookie’s previous blood work to look for any gradual increases in her creatinine levels.

Detecting problems before values become abnormal

Trends can reveal brewing problems before they get into the red.

Particularly with something such as creatinine it’s good to look at trends. Even if the values remain within the normal range but are gradually increasing, it is something to take seriously.

Cookie’s previous results did not reveal an upward trend.

DateLabCreatinineNormals
8/23/2013IDEXX11229 – 135
3/6/2014IDEXX10744 – 133
10/23/2014Walden8727 – 124
1/14/2015Walden9727 – 124

That was a good sign. I still couldn’t help being nervous about what the urinalysis might reveal.

Urinalysis

Urinalysis is non-invasive and a great way to assess kidney function.

We collected Cookie’s first-morning urine.

Our trusty urine picker-upper.
Works really great, though not originally intended for that purpose.

For some tests, the fresher urine the better. But for checking kidney function, it is the first-morning urine one needs, freshness is secondary to that. I looked nice and golden in the jar, that was a good sign also.

I was very happy to get the call from the vet’s office that the urine is normal. It didn’t reveal any kidney problems or any other problems.

Finally, I could truly celebrate the fact that her ALT went down again, and that the kidney blood values were not elevated because of unhappy kidneys. Must have been the dehydration after all.

Related articles:
Canine Kidney Function Screening: Checking Your Dog’s Kidney Function
SDMA Kidney Function Test: Veterinarian Share Opinions and Experience With The New Way Of Monitoring Kidney Health In Dogs

Further reading:
Why Is My Dog’s Blood Creatinine Level High Or Low?

Categories: Blood work • Diagnoses • Dog health advocacy • Interpreting lab results

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Jana Rade

I am a graphic designer, dog health advocate, writer, and author. Jasmine, the Rottweiler of my life, was the largest female from her litter. We thought we were getting a healthy dog. Getting a puppy from a backyard breeder was our first mistake. Countless veterinary visits without a diagnosis or useful treatment later, I realized that I had to take Jasmine's health care in my own hands. I learned the hard way that merely seeing a vet is not always enough. There is more to finding a good vet than finding the closest clinic down the street. And, sadly, there is more to advocating for your dog's health than visiting a veterinarian. It should be enough, but it often is not. With Jasmine, it took five years to get a diagnosis. Unfortunately, other problems had snowballed for that in the meantime. Jasmine's health challenges became a crash course in understanding dog health issues and how to go about getting a proper diagnosis and treatment. I had to learn, and I had to learn fast. Helping others through my challenges and experience has become my mission and Jasmine's legacy. I now try to help people how to recognize and understand signs of illness in their dogs, how to work with their veterinarian, and when to seek a second opinion. My goal is to save others the steep curve of having to learn things the hard way as I did. That is the mission behind my blog and behind my writing. That is why I wrote Symptoms to Watch for in Your Dog, which has turned out being an award-winning guide to dog owners. What I'm trying to share encompasses 20 years of experience.

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