Quick test interpretation
Sodium
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Sodium | mEq/L | 145-153 | 151-158 | 136-145 | 138-147 | 149-157 | 143-156 |
Increased | |
Artifact | Water loss from blood sample |
Iatrogenic | Hypertonic fluid administration |
Water deficit | Excess water loss: panting, fever, hyperventilation, diabetes insipidus Inadequate intake: water deprivation, primary adipsia/hypodipsia Hypotonic fluid loss: Renal: osmotic/chemical diuresis, renal failure Non-renal: GI, cutaneous, third space losses |
Salt gain | Excess intake: salt poisoning (with concurrent water deprivation) ↑ Renal retention: hyperaldosteronism |
Decreased | |
Artifact | Lipemia, hyperproteinemia, hyperosmolar states |
Iatrogenic | Diuretic therapy, hypotonic fluid administration |
Volume overload (hypervolemic hyponatremia) | CHF, hepatic disease, nephrotic syndrome, advanced renal failure |
Hypertonic fluid loss (hypovolemic hyponatremia) | Renal: Proximal renal tubule dysfunction, hypoadrenocortisim, hypoaldosteronism, osmotic diuresis (diabetes mellitus) Non-renal: GI (vomiting/diarrhea), cutaneous (equine sweating), third space losses (ruptured or obstructed urinary tract, peritonitis, chylothorax) |
Other | Intracellular translocation (muscle injury), decreased intake (anorexia) |
Interpret with: | Electrolytes (K+, Cl–), urinalysis, HCT, protein, urea nitrogen, creatinine, osmolality |
Potassium
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Potassium | mEq/L | 4.1-5.6 | 4.0-5.9 | 2.6-4.5 | 3.8-5.2 | 4.2-5.9 | 4.2-6.0 |
Increased | |
Artifact | Serum K+ > plasma K+ (release from WBC, platelets); anticoagulant (K+ EDTA), hemolysis (horses, camelids, some cattle, some breeds of dogs, pigs), leukocytosis (release from cells with clotting), age (> foals), IV line contamination |
Iatrogenic | IV fluids or IV line contamination with K+ supplementation (rare unless renal disease) |
Transcellular shifts (ICF → ECF) |
Hyperkalemic myopathy, tissue necrosis, exercise, hypertonicity (diabetes mellitus), uroperitoneum (foals), hyperchloremic metabolic acidosis (transient) |
↓ Renal excretion | Anuric/oliguric renal failure, chronic kidney disease (horses), uroabdomen, hypoadrenocorticism, hypoaldosteronism |
Decreased | |
Artifact | Lipemia |
↓ Intake | Anorexia (large animals, especially foals; small animals – rare) |
Transcellular shifts (ECF→ICF) | Primary respiratory or primary metabolic alkalosis, hyperinsulinemia, catecholamine release, endotoxemia |
↑ Loss | GI: vomiting, abomasal stasis, outflow obstruction/torsion, diarrhea and choke (horses, cattle); Third space loss/sequestration Cutaneous: sweating (horses) Renal: ↑ aldosterone, ↑ distal tubular flow rate, renal tubular disease, |
Interpret with: | Electrolytes, UN, creatinine, urinalysis, bicarbonate, AG, blood gas analysis |
Chloride
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Chloride | mEq/L | 105-116 | 113-123 | 96-105 | 92-102 | 106-116 | 102-116 |
Increased | |
Artifact | Lipemia, anticonvulsant medication (KBr, zonisamide) |
Iatrogenic | Administration of Cl–containing fluids (hypertonic saline, ammonium chloride) |
Metabolic acidosis | |
(i) Bicarbonate loss | (Hyperchloremic metabolic acidosis) |
– Primary | GI loss/sequestration of Cl–/HCl: Vomiting (biliary, pancreatic fluids), secretory diarrhea sequestration (e.g.. ileum in horses), diarrhea (horse), loss of saliva (ruminants, horse), Renal loss: Proximal renal tubular acidosis, Addison’s disease Cutaneous loss: sweating (horses) |
– Secondary | Compensatory response to a primary respiratory alkalosis (hyperventilation or hypocapnea – hypoxemia, primary pulmonary disease, pain) |
(ii) Bicarbonate consumption (Titration acidosis) | Production of noncarbonic acid: lactic acidosis, ketosis (diabetes mellitus) ↓ Excretion of noncarbonic acid: sulfates, phosphates Renal failure, toxicity (ethylene glycol, salicylate, methanol) |
Decreased | |
Iatrogenic | Administration of sodium-rich fluids, loop diuretics (e.g. spironolactone) |
Loss of Cl– > Na+ | GI: loss of Cl– rich fluid (vomiting, ptyalism; gastric reflux, diarrhea, gastroduodenal ulcers in horses) Sequestration of Cl– rich fluid: displaced abomasum, abomasal atony, gastric rupture, GDV, ileus (horses) Renal: renal disease (especially cattle) Cutaneous: sweating (horses) |
Interpret with: | Electrolytes (Na+, K+), Urinalysis, bicarbonate, AG, blood gas analysis, |
Bicarbonate
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Bicarbonate | mEq/L | 15-25 | 15-24 | 25-32 | 24-32 | 22-34 | 17-27 |
Increased | |
Artifact | Muscle injury in large animals (rare) |
Iatrogenic | Administration of HCO3− containing solutions |
Metabolic alkalosis | |
(i) Primary | GI loss/sequestration of Cl–/H+: Vomiting (small animals), gastric reflux (horse), abomasal atony/torsion/displacement Cutaneous loss: Sweating (horses) Renal loss: loop diuretics (e.g. furosemide), hypokalemia |
(ii) Secondary | Compensation for primary respiratory acidosis (decreased ventilation/gas exchange, general anesthesia) |
Decreased | |
Artifact | Aged samples, heparin over-dilution, venous stasis |
Iatrogenic | Ammonium chloride administration (hyperchloremic metabolic acidosis) |
Metabolic acidosis | |
(i) Bicarbonate loss | (Hyperchloremic metabolic acidosis) |
– Primary | GI loss/sequestration of Cl–/HCl: Vomiting (biliary, pancreatic fluids), secretory diarrhea sequestration (e.g.. ileum in horses), diarrhea (horse), loss of saliva (ruminants, horse), Renal loss: Proximal renal tubular acidosis, Addison’s disease Cutaneous loss: sweating (horses) |
– Secondary | Compensation for primary respiratory alkalosis (hyperventilation – hypoxemia, primary pulmonary disease, pain) |
(ii) Bicarbonate consumption | (Titration acidosis) Production of noncarbonic acid: lactatic acidosis, ketosis (diabetes mellitus) ↓ Excretion of noncarbonic acid: sulfates, phosphates Renal failure, toxicity (ethylene glycol, salicylate, methanol) |
Interpret with: | Blood gas analysis – Anion gap, electrolytes (corr Cl–, K+), urinalysis, glucose, urea, creatinine |
Anion Gap
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Anion Gap | mEq/L | 17-27 | 18-25 | 11-17 | 18-24 | 14-21 | 17-29 |
Increased | |
Artifact | Artifactual ↑ of sodium/potassium or, ↓ chloride/bicarbonate |
Iatrogenic | Sodium-containing drugs (e.g. penicillin, sodium salts) |
Metabolic acidosis (titration) | Accumulation of non-carbonic acid (e.g. lactate, ketones, uremic acids), toxins (methanol, salicylate, ethylene glycol, metaldehyde) |
Alkalemia | Stimulates lactic acid production |
↑ Albumin | Dehydration, increased albumin production |
↓ “Unmeasured” cations | Ionized calcium, ionized magnesium |
Decreased | |
Artifact | Falsely high chloride/bicarbonate, anticonvulsant (KBr), pyruvate and LDH accumulation (muscle injury) |
Iatrogenic | Bicarbonate-rich fluid administration |
Acidemia | Organic acid accumulation (e.g. lactic, citric, uric acid) |
↓ Albumin | Hypoalbuminemia (e.g. dehydration) |
↑ “Unmeasured” cations | Ionized magnesium/calcium (unlikely), neoplasia (e.g. multiple myeloma), |
Interpret with: | Bicarbonate, electrolytes, blood gas analysis, urinalysis |
Glucose
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Glucose | mg/dL | 63-118 | 64-144 | 71-113 | 53-76 | 102-149 | 37-141 |
Increased | |
Physiologic | Post-prandial, “stress”, pregnancy |
Iatrogenic | Drugs inducing insulin resistance (xylazine, detomidine, propanalol, megestrol acetate, ketamine) |
Sustained hyperglycemia | Diabetes mellitus, hyperadrenocorticism, acromegaly, hyperglucagonemia, hyperpituitarism/pituitary pars intermedia dysfunction (horses), pheochromocytoma |
Transient hyperglycemia | Hyperthryoidism (cats), acute pancreatitis, sepsis |
Decreased | |
Artifact | Bacterial contamination, serum not separated from clot |
Iatrogenic | Insulin administration |
↓ Production | Glycogen storage diseases (e.g. Pompe’s disease, von Gierke’s disease) Juvenile hypoglycemia Hepatic disease |
↓ Intake | Starvation, malabsorption, high grain diet (horse) |
↑ Use | Idiopathic hypoglycemia of hunting dogs and endurance horses Bovine ketosis (Type 1), ovine pregnancy toxemia Exertional hypoglycemia |
↑ Insulin secretion | Neoplasia: insulinoma, mesenchymal tumors (leiomyoma, leiomyosarcoma, hepatic and renal tumors) Xylitol (dogs) |
↓ Counter-regulatory hormones | Hypoadrenocorticism, sepsis |
Interpret with: | Urinalysis, fructosamine, ketones, hepatic enzymes |
Urea Nitrogen
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Urea Nitrogen | mg/dL | 10-32 | 16-36 | 11-28 | 7-18 | 10-30 | 9-35 |
Increased | |
Artifact | Ammonia contamination; artifactual ↓ of creatinine (e.g. severe icterus) |
↑ Protein catabolism | Fever, burns, corticosteroid administration, starvation, exercise |
↑ Protein digestion | Hemorrhage into the GI system, high protein diet |
↓ GFR | Pre-renal, renal, post-renal causes |
Decreased | |
Physiologic | Greyhounds (normal/↓) |
↓ Protein intake, protein anabolism |
Diet, young animals |
↓ Production | Hepatic disease |
↑ Excretion | Causes of polyuria (e.g. hyperadrenocorticism, diabetes mellitus) |
Interpret with: | Creatinine, urinalysis, total protein, albumin, HCT, electrolytes, anion gap, calcium, phosphate, hepatic tests |
Creatinine
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Creatinine | mg/dL | 0.6-1.4 | 0.6-2.0 | 0.6-1.6 | 0.5-0.9 | 1.0-2.4 | 0.4-0.9 |
Increased | |
Artifact | Presence of acetoacetate, glucose, vitamin C, uric acid, pyruvate, cephalosporins and amino acids in sample |
Physiologic | Foals, heavily-muscled horses, Greyhounds, post-protein meal |
↓ GFR | Pre-renal, renal, post-renal causes |
Myoglobin release | Myoglobinuric nephrosis |
Decreased | |
Physiologic | ↓ Muscle mass, pregnancy (↑GFR) |
↓ Production | Starvation, cachexia, liver cirrhosis (↓ creatine production) |
↑ GFR | Portosystemic shunts |
Interpret with: | Urea, hepatic enzymes, CK, LDH |
Uric acid
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Uric Acid | mg/dL | 0.1-0.3 | 0-0.5 | 0.1-0.4 | 0.7-2.1 | n/a | n/a |
Increased | |
Artifact | Dehydation, fecal urate contamination |
Physiologic | Post-prandial |
Renal disease | ↓ GFR, Loss of >70% functional renal capacity |
↑ Deposition | Articular gout |
Interpret with: |
Bilirubin
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Total Bilirubin | mg/dL | 0-0.2 | 0-0.2 | 0.5-2.5 | 0.1-0.2 | 0-0.1 | 0.1-0.2 |
Direct Bilirubin | mg/dL | 0-0.1 | 0-0.1 | 0.1-0.3 | 0-0.1 | 0 – 0 | 0.0-0.1 |
Indirect Bilirubin | mg/dL | 0-0.2 | 0-0.2 | 0.3-2.3 | 0-0.1 | 0-0.1 | 0.1-0.2 |
Increased | |
Physiologic | Fasting (horses), anorexia (cattle, occasionally cats), neonates (especially foals); both indirect primarily |
↑ Production (indirect) |
Heme breakdown (hemolysis, muscle injury, ineffective erythropoeisis) |
↓ Hepatic uptake (primarily indirect) |
Hepatic insufficiency (hepatocellular disease , portosystemic shunts) |
↓ Hepatic conjugation (primarily indirect) |
Hepatic insufficiency |
↓ Hepatic excretion | Cholestasis: – obstructive (intra/extra-hepatic) e.g. hepatocellular swelling, extrahepatic biliary tract obstruction (cholelithiasis, gallbladder mucocele, neoplasia, parasites) – functional inflammation: infectious (E. coli, Staph intermedius), sepsis ↓ transport of conjugated bilirubin |
Inherited | Southdown sheep (defect in bilirubin uptake), Corriedale sheep (Dubin-Johnson syndrome) |
Interpret with: | Hepatocellular and cholestatic enzymes, urinalysis, cbc, cholesterol |
ALP
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
ALP | U/L | 17-111 | 13-83 | 68-260 | 29-111 | 18-113 | 38-862 |
Increased | |
Physiologic | Age, breed (Siberian Huskies – benign familial hyperphosphatasemia; Scottish Terriers), endogenous corticosteroid release |
Iatrogenic | Anticonvulsants (e.g. phenobarbital, primidone), exogenous corticosteroid (dogs), thyroxine |
Hepatobiliary | Cholestasis (structural/functional), neoplasia, acute hepatocellular injury, hepatic lipidosis |
Endocrine | Hyperadrenocorticism, diabetes mellitus, hypothyroidism (dogs), hyperthyroidism (cats), hyperparathryoidism |
Bone | Hyperparathyroidism, fracture healing, hyperthroidism (cats) |
Neoplasia | Mammary neoplasia (dogs), osteosarcoma |
Interpret with: | Other hepatic enzymes |
GGT
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
GGT | U/L | 0-6 | 0-2 | 8-29 | 9-50 | 8-35 | 24-66 |
Increased | |
Physiologic | Neonates – colostral GGT (except horses); Breed (donkeys, burros) |
Iatrogenic | Anticonvulsants (phenobarbital, phenytoin, mysoline), exogenous corticosteroids (dog) |
Hepatobiliary | Biliary hyperplasia, cholestasis, pyrrolizidine alkaloid toxicity, fascioliasis, cholangiohepatitis and cholethiasis (horses), |
Renal | Proximal tubular injury (↑ urinary GGT; serum ↑ is rare) |
Toxins | Pyrrolizidine alkaloids (e.g. Senecio, Crotalaria, Heliotropium), aflatoxins, aminoglycosides, carbon tetrachloride, xylitol (dogs) |
Neoplasia | Primary hepatic, pancreatic, renal adenocarcinoma |
Miscellaneous | Abomasal displacement, dorsal displacement of large colon (horse) |
Interpret with: | Bilirubin, other hepatic enzymes |
ALT
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
ALT/ P5P | U/L | 20-98 | 35-176 | n/a | n/a | n/a | n/a |
Increased | |
Artifact | Hemolysis |
Iatrogenic | Anticonvulsants (e.g. phenobarbital, phenytoin, primidone), corticosteroids, , cephalosporin, cyclosporin, isoniazide |
Hepatic | Bile duct obstruction, neoplasia, trauma |
Muscular | Ischemic myopathy (cats), muscular dystrophy (dogs), trauma |
Toxins | Tetracycline (cats), thiacetarsamide, xylitol (dogs), acetaminophen |
Interpret with: | Bilirubin, Hepatic enzymes |
AST
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
AST/P5P | U/L | 14-51 | 15-44 | 199-374 | 61-162 | 119-286 | 60-147 |
Increased | |
Artifact | Hemolysis (in vitro) from delayed serum separation |
Iatrogenic | Anticonvulsants, imidocarb (goats) |
Physiologic | Exercise (horses) |
Hepatic | FIP (cats) – pyogranulomatous hepatitis, aflatoxins, |
Muscular | Myopathies, muscle trauma, rhabdomyolysis, white muscle disease (vitamin E-selenium deficiency), Clostridial myositis, muscular dystrophy |
Interpret with: | ALT, ALP, total bilirubin, GGT, bile acids and/or sorbitol dehydrogenase (SDH) |
SDH
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
SDH | U/L | 0-8 | 0-10 | 0-11 | 12-50 | 0-7 | 26-76 |
Increased | |
Artifact | Delayed analysis |
Toxin | Doxycycline toxicosis (calves), carbon tetrachloride |
Hepatic | Hepatocellular injury, Fasciolosis? |
Horse, cattle |
Interpret with: | Electrolytes, UN, creatinine, urinalysis, bicarbonate, AG, blood gas analysis |
GLDH
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
GLDH | U/L | 2-11 | 0-4 | 1-8 | 11-83 | 3-19 | n/a |
Increased | |
Physiologic | Neonates (foals) |
Hepatic | Hepatocellular injury |
Note: | Very sensitive in dogs, very specific in avian, rats (for acute injury) |
Interpret with: |
CK
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
CK | U/L | 48-261 | 73-388 | 142-548 | 76-376 | 29-120 | 113-446 |
Increased | |
Artifact | Hemolysis, muscle penetration during venipuncture |
Physiologic | Age (puppies), post-exercise (horse), anorexia (cats) |
Iatrogenic | Intramuscular injection, especially irritant drugs (e.g. tetracycline), pentobarbitone (hamsters), post-surgery |
CK-1(MM) isotype | Skeletal muscle isoenzyme: exertional rhabdomyolysis, polymyositis, vitamin E-selenium deficiency, snake bite poisoning, post-shipping, recumbent and “downer” cows |
CK2-(MB) isotype | Cardiac muscle: doxorubicin-induced cardiotoxicity |
CK3-(BB) isotype | Brain: Thiamine deficiency (ruminants), cerebrocortical necrosis |
Nutritional | White muscle disease (vitamin E-selenium deficiency), polioencephalomalacia |
Inherited | Muscular dystrophy, (Cavalier King Charles Spaniel dystrophin-deficient muscular dystrophy, hyperkalemic periodic paralysis, malignant hyperthermia, |
Toxins | Monensin, gossypol, ricin, myotoxin (snake-bite) |
Interpret with: |
LDH
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
LDH | U/L | 30-236 | 57-451 | 160-453 | 699-1381 | 99-433 | 221-403 |
Increased | |
Artifact | Hemolysis, serum concentrations > plasma |
Physiologic | Exercise |
Hepatic | ↑ LDH1 & LDH2 (cattle, sheep), ↑ LDH5 (horse, small animals) |
Muscle | ↑ LDH5 (ruminants, horse): exertional rhabdomyolysis, white muscle disease, cardiac muscle lesions (rats) |
Neoplasia | Bovine lymphoma |
Interpret with: | ALT, SDH, CK |
Total Protein
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Total Protein | g/dL | 5.3-7.0 | 6.3-8.3 | 5.7-7.7 | 6.9-8.6 | 5.7-7.2 | 6.2-8.0 |
Increased | |
Most common | Hemoconcentration |
↓ Blood volume | Hemoconcentration – dehydration |
↑ Protein production | Chronic inflammation |
Neoplasia | Monoclonal gammopathy |
Decreased | |
↑ Blood volume | Overhydration |
↑ Loss | Protein-losing glomerulopathy, protein-losing enteropathy, severe hemorrhage, exudative dermatopathies; Sequestration (third space losses) |
↓ Production | Malnutrition/starvation, chronic hepatic disease, acute phase response, malabsorption |
Inflammation |
Interpret with: | Albumin, globulin, PCV, urinalysis (urine protein:creatinine), urea nitrogen, creatinine, hematology |
Albumin
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Albumin | g/dL | 3.1-4.2 | 2.8-4.2 | 3.0-3.7 | 3.1-4.1 | 2.9-4.3 | 3.0-4.0 |
Increased | |
Artifact | Heparinized plasma > serum |
Physiologic | Hemoconcentration |
Decreased | |
Iatrogenic | Excessive fluid administration |
↓ Production | Malnutrition/starvation, chronic hepatic disease, acute phase response, malabsorption |
↑ Loss | Protein-losing glomerulopathy, protein-losing enteropathy, severe hemorrhage, exudative dermatopathies, sequestration (third space losses), catabolism |
Interpret with: | Total protein, globulins, PCV, urinalysis, urea, creatinine, liver function tests, |
Globulin
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Globulin | g/dL | 1.9-3.6 | 2.7-4.9 | 2.4-4.4 | 3.1-5.4 | 2.1-3.1 | 3.0-4.6 |
Increased | |
Iatrogenic | Corticosteroids (dogs) |
↑ Production | α-globulins: Acute phase reactant response, nephrotic syndrome β-globulins: Inflammation (acute, chronic), active liver disease, suppurative dermatopathies, nephrotic syndrome γ-globulins: Antigenic stimulation, polyclonal gammopathy, monoclonal gammopathy |
Neoplasia | Multiple myeloma, lymphoma, chronic lymphocytic leukemia, extramedullary plasmacytoma, Waldenström’s macroglobulinemia, |
Infection | Heartworm, FIPV, Ehrlichia canis infection, lymphoplasmacytic enteritis, lymphoplasmacytic dermatitis and amyloidosis |
Decreased | |
Inherited | Primary severe combined immunodeficiency (Basset hounds, Cardigan Welsh Corgis, Dachshunds and Arabian [horses]) Agammaglobulinemia (foals), IgM deficiency (Dobermans, Arabians, Paso Fino, Quarterhorses and Thoroughbreds), IgA deficiency (Sharpei, Beagle, Airedale terriers, and German Shepherd Dogs), Transient hypogammaglobulinemia (Arabian horses, dogs) |
Physiologic | Failure of passive transfer |
Infectious | Virus: FeLV, FIV, Canine Distemper virus, Aleutian mink disease virus, BVD Parasites: Toxoplasmosis, Theileriasis, Eperythrozoon wenyonii, Demodex canis Bacteria: Mycoplasma pseudotuberculosis (Johne’s disease) |
Neoplasia | Lymphoma (cattle, horse) |
Idiopathic | Young llamas – ill-thrift, |
Interpret with: | Albumin, PCV, leukogram, etc |
A/G Ratio
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
A/G | 0.9-2.1 | 0.6-1.6 | 0.8-1.4 | 0.8-1.4 | 1.0-1.9 | 0.7-1.2 |
Increased | |
Decreased | ↑ suspicion of FIP |
Interpret with: | Total protein |
Calcium
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Calcium | mg/dL | 9.3-11.4 | 9.1-10.9 | 10.9-12.8 | 8.9-10.9 | 8.2-10.1 | 8.5-10.6 |
Increased | |
Most common causes | Humoral hypercalcemia of malignancy; hypoadrenocorticism (dogs); chronic/acute renal disease (horses); iatrogenic (cattle); hypercalcemia is uncommon in cats |
Physiologic | Age (puppies) |
Iatrogenic | Thiazide diuretics, calcium borogluconate administration, strontium salts |
↑ Bone mobilization | ↑ PTH: Primary hyperparathyroidism (parathyroid adenoma – common, parathyroid hyperplasia, malignant parathyroid carcinoma – rare) ↑ PTHrP: Humoral hypercalcemia of malignancy (e.g. dogs – anal sac adenocarcinomas, lymphomas, squamous cell carcinomas; cats – lymphoma, pulmonary carcinoma; horse – multiple myeloma) Localized osteolysis |
↑ Intestinal absorption | Hypervitaminosis D: ingestion of cholecalciferol rodenticides and plants (e.g. Cestrum diurnum, Solanum sp.), excessive dietary supplementation, granulomatous disease (e.g. fungal, parasitic), humoral hypercalcemia of malignancy (macrophage and lymphocyte origin e.g. histiocytic sarcoma) Hypoadrenocorticism (dogs) |
↓ Renal excretion | Renal disease, hypoadrenocorticism, primary hyperparathyroidism, humoral hypercalcemia of malignancy |
↑ Protein binding | Hyperalbuminemia |
Idiopathic | Idiopathic hypercalcemia (cats), endometritis and retained fetus (dogs), |
Decreased | |
Most common causes | Low albumin; renal disease (dogs, cats); pancreatitis (dogs); gastrointestinal disease (colic in horses); milk fever (cattle) |
Artifact | EDTA, citrate anticoagulants |
Iatrogenic | Sodium phosphate enemas, exogenous calcitonin, gadodiamide |
↓ Protein binding | Hypoalbuminemia |
Abnormal PTH | Primary hypoparathyroidism, pseudohypoparathryoidism, PTH resistance, ↓ secretion (from low magnesium), |
↓ Absorption | Nutritional secondary hyperparathyroidism (Bran disease) Hypovitaminosis D Renal secondary hypoparathyroidism (dogs, cats, cattle) Toxicosis: oxalate-containing plants (e.g. Kikuku grass, rhubarb, purslane, sorrel, dock, foxtail grass) GI disease: Horses (colic, enterocolitis, endotoxemia); protein-losing enteropathy (dogs) Hyperadrenocorticism (dogs) |
↑ Loss | Renal loss ↑ calcitonin: pancreatitis, hypercalcitonism, ethylene glycol toxicosis, alkalemia from primary metabolic alkalosis, Pregnancy, parturient or lactational hypocalcemia/eclampsia Excess sweating |
Idiopathic | Sepsis, idiopathic hypocalcemia (foals), equine myopathy, cantharidin toxicosis, acute renal injury |
Interpret with: | Albumin, ionized calcium, phosphate, urea nitrogen, creatinine, urinalysis |
Phosphate
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Phosphate | mg/dL | 2.9-5.2 | 2.7-6.2 | 2.1-4.2 | 4.6-7.3 | 3.4-7.8 | 4.5-7.9 |
Increased | |
Artifact | Hemolysis, anticoagulants (EDTA, oxalate, citrate), monoclonal gammopathy |
Physiologic | Post-prandial, age (young animals) |
Iatrogenic | Phosphate enemas (especially cats) |
↑ Intake | Hypervitaminosis D: ingestion of cholecalciferol rodenticides and plants (e.g. Cestrum diurnum, Solanum sp.), excessive dietary supplementation, granulomatous disease (e.g. fungal, parasitic), humoral hypercalcemia of malignancy (macrophage and lymphocyte origin e.g. histiocytic sarcoma) Excessive dietary phosphate: nutritional secondary hyperparathyroidism |
Transcellular shifts | Acute tumor lysis syndrome, severe skeletal muscle injury |
↓ Excretion | ↓ GFR, hypoparathyroidism, acromegaly, hyperthyroidism; post-renal obstruction, bladder rupture (small animals) |
Decreased | |
Artifact | Monoclonal immunoglobulins (causing precipitation out of solution) |
Iatrogenic | Diuretics, corticosteroids, phosphate-binding antacids |
↓ intestinal absorption | Enteral tube feeding (cats), hypovitaminosis D (rare cause) |
Transcellular shifts | Alkalemia due to respiratory alkalosisInsulin or glucose, hypothermia |
↑ Loss | Renal: renal disease, hyperparathyroidism, urolithiasis (ruminants), diuresis (osmotic or solute), phosphatonins, hyperadrenocorticism (dogs) GI: diarrhea, vomiting |
Idiopathic | Hepatic lipidosis (cat) |
Interpret with: | Calcium, urea nitrogen, creatinine, |
Magnesium
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Magnesium | mEq/L | 1.4-2.2 | 1.6-2.3 | 1.3-2.3 | 1.6-2.4 | 1.7-2.4 | 1.5-2.2 |
Increased | |
Artifact | Hemolysis (except in cattle, horses), severe lipemia and icterus, postmortem blood samples |
Physiologic | Post-partum (cattle) |
Iatrogenic | Excessive supplementation of fluids, diet and oral supplements (e.g. antacids) |
↑ Absorption | Exogenous magnesium administration, intestinal hypomotility |
↓ Excretion | ↓ GFR (e.g. chronic kidney disease, urinary tract obstruction), hypocalcemia, hypoadrenocorticism, oliguric/anuric renal failure |
Release from cells | Skeletal muscle, soft tissue necrosis |
↑ PTH |
Decreased | |
Artifact | Citrate, oxalate, fluoride anticoagulants |
Physiologic | Age (Mg absorption ↓ after 6 weeks of age) |
Iatrogenic | Administration of Mg-poor fluids or TPN without adequate Mg supplementation (small animals); nephrotoxic drugs (cisplatin, aminoglycosides, amphotericin B) |
↓ Albumin | Hypoalbuminemia |
↓ Intake | Anorexia (especially lactating dairy cows), high potassium diet, pastures fertilized with nitrates, ammonia, sulphates and potassium |
Translocation into cells | Insulin, hypothermia, sepsis (horses) |
Excess loss | GI: malabsorption, chronic diarrhea, saliva loss (e.g. choke, rabies), hyperaldosteronism (rare) Renal: diuresis, hyperthyroidism, primary hypoparathyroidism, acidosis, ketonuria, renal tubular injury Cutanenous: sweating (horses) |
Hypercalcemia, hypokalemia, phosphate depletion |
Interpret with: | Calcium, phosphate, potassium, albumin, glucose, urinalysis |
Cholesterol
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Cholesterol | mg/dL | 138-332 | 66-317 | 69-130 | 69-130 | 17-88 | 51-126 |
Increased | |
Artifact | Hemolysis |
↑ Production | Post-prandial, nephrotic syndrome (amyloidosis, immune-complex glomerulonephritis – Lyme disease, Ehrlichia |
↓ Lipolysis, abnormal processing | Nephrotic syndrome, hypothyroidism |
Inherited | Familial hypercholesterolemia (Briards, Rottweilers, Shetland Sheepdogs, Dobermans), hyperlipidemia of Miniature Schnauzers, hyperchylomicronemia of cats |
Idiopathic | Cholestasis, diabetes mellitus, pancreatitis, excessive negative energy imbalance (starvation, anorexia; horses, camels), hyperadrenocorticism, adrenal hyperplasia, Rocky Mountain Spotted Fever, pheochromocytoma |
Decreased | |
Artifact | Icterus |
↓ Absorption | Malbsorption, maldigestion (protein-losing enteropathies, exocrine pancreatic insufficiency) |
↓ Production | Chronic liver disease, synthetic liver failure, portosystemic shunts, multiple myeloma (cats), |
Altered metabolism | Inflammatory cytokines |
↑ Lipoprotein uptake | Upregulation of LDL-receptors on cells (peripheral tissues and liver) from rapidly proliferating tumor cells |
Idiopathic | Hypoadrenocorticism |
Interpret with: | Glucose, urinalysis, urea nitrogen, creatinine, hepatic enzymes, bilirubin, triglycerides, |
Triglycerides
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Triglycerides | mg/dL | 22-125 | 25-133 | 14-77 | 5-19 | 6-50 | 15-57 |
Increased | |
Most common causes | Acute pancreatitis, diabetes mellitus, post-prandial, hyperlipidemia (horses) |
Physiologic | Post-prandial, |
Iatrogenic | Corticosteroids |
Inherited | Hypertriglyceridemia in Miniature Schnauzers, inherited hyperchylomicronemia (young cats) |
↑ Lipolysis | Excesssive negative energy imbalance: obesity, pregnancy, stress (e.g. transport) and lactation (horses); pregnancy toxemia, ketosis (camelids) |
↓ Lipoprotein lipase activity | Pancreatitis |
Idiopathic, multiple mechanisms | Hepatic lipidosis, hypothyroidism, cholestasis, diabetes mellitus, hyperadrenocorticism, |
Decreased | No diagnostic relevance |
lactation mares? |
Interpret with: | Cholesterol |
Amylase
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Amylase | U/L | 377-1220 | 532-2008 | n/a | n/a | 732-1602 | 11-73 |
Increased | |
Pancreatic cell injury | Acute pancreatitis |
↓ Renal excretion | ↓ GFR, chronic renal insufficiency |
Idiopathic | Intestinal disease or obstruction |
Most common causes | Pancreatitis, renal disease |
Interpret with: | Lipase |
Lipase
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Lipase-DCL | U/L | 78-765 | 5-222 | 12-39 | 1-35 | 9-173 | n/a |
Increased | |
Iatrogenic | Corticosteroids |
Pancreatic cell injury | Acute pancreatitis |
GI disease | Peritonitis, gastritis, bowel obstruction, visceral manipulation (laparotomy), hepatic disease and neoplasia |
Renal | ↓ GFR, renal disease |
Interpret with: | Amylase |
Iron
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Iron | µg/dL | 78-214 | 53-145 | 75-206 | 83-205 | 82-194 | 98-187 |
Increased | |
Artifact | Hemolysis |
Physiologic | Random transient variations |
Iatrogenic | Dexamethasone (cattle), corticosteroids (dogs, horses), repeated blood transfusions |
Intracellular release | Necrotizing hepatitis |
↑ RBC turnover | Hemolytic anemia, disordered/abnormal erythropoiesis (e.g. primary myelodysplasia and ineffective erythropoiesis) |
↓ Erythropoeisis | Bone marrow aplasia/hypoplasia |
Iron overload syndrome | Mynah birds, lemurs, Saler/Saler-cross cattle |
Decreased | |
Artifact | Anticoagulant contamination (e.g. EDTA) |
Physiologic | Random transient fluctuations |
Iatrogenic | Dexamethasone (cattle) |
↓ Absorption/Intake | Acidosis, hepcidin, copper deficiency, zinc excess, inadequate dietary content, intestinal disease, malnutrition (cattle) |
Sequestration | Mild transient injury/trauma, inflammation, portosystemic shunts. neoplasia |
Loss | External hemorrhage GI: intestinal parasites (e.g. hookworms, whipworms, Haemonchus contortus), gastrointestinal neoplasia, and vascular ectasia or angiodysplasia Urinary Reproductive Respiratory |
Interpret with: | TIBC, % Saturation |
TIBC
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
TIBC | µg/dL | 270-496 | 226-432 | 284-456 | 335-499 | 228-411 | 249-386 |
Increased | |
Artifact | Anticoagulants with chelating agents (e.g. EDTA, oxalate, fluoride) |
↓ Iron | Pigs, horses and cattle; unreliable in dogs, cats or camelids |
Idiopathic | Necrotizing hepatitis (dogs) |
Decreased | |
↓ Production | Acute phase response, hepatic insufficiency, portosystemic shunts, ↓ protein intake |
Loss of transferrin | Protein-losing nephropathy, protein-losing enteropathy, burns |
Transferrin catabolism | Negative energy states |
Most common cause | Acute inflammation |
Interpret with: | Iron, % Saturation, Albumin, Total protein |
Saturation
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Saturation | % | 23-61 | 24-55 | 15-49 | 20-51 | 29-60 | 31-62 |
Increased | |
↓ Transferrin | Loss or decreased production (e.g. protein-losing states) |
Idiopathic | Hemolytic anemia, non-regenerative immune-mediated anemia or pure red cell aplasia, ineffective erythropoiesis, hepatic necrosis, corticosteroids (dogs, horses) |
Decreased | |
↓ Iron | (see iron) |
Interpret with: |
Bile Acids
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Bile Acids (fast/random) | µmol/L | 0-13 | 0-13 | 0-12 | 16-151 | 5-54 | n/a |
Bile Acids (postprandial) | µmol/L | 0-30 | 0-25 | n/a | n/a | n/a | n/a |
Increased | |
Physiologic | ↓ feed intake (horses); postprandial; spontaneous gallbladder contraction |
↓ Clearance from portal circulation | Hepatic insufficiency, portosystemic shunts (congenital/acquired) |
↓ Excretion | Cholestasis: obstructive or functional |
Decreased | |
Physiologic | Prolonged fasting (dogs, cats) |
Enterohepatic | Intestinal malabsorption, rapid gastrointestinal transit |
Interpret with: | Bilirubin, ALP, ammonia, hepatic enzymes |
Cholinesterase
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Cholinesterase | U/L | 1895-5240 | 736-3016 | 2684-5889 | 53-126 | 242-603 | n/a |
Increased | |
Artifact | Hemolysis, citrate anticoagulant |
Decreased | |
Iatrogenic | Physostigmine |
Toxins | Organophosphate or carbamate toxicity, cyanotoxins |
Interpret with: |
BHB
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
BHB | mg/dL | 0-1 | 0-2 | 2-5 | n/a | 0-1 | n/a |
Increased | |
Ketosis | Bovine ketosis (cattle): starvation, diabetes mellitus, lactation demands, displaced abomasum, hepatic lipidosis, subclinical ketosis, clinical (pregnancy) ketosis, alimentary ketosis (spoiled silage with excess butyric acid) Pregnancy toxemia (small ruminants) Clinical ketosis (camelids): stress, anorexia, pregnancy (pregnancy toxemia), lactation, hepatic lipidosis, insulin resistance Diabetic ketoacidosis (small animals): starvation, diabetes mellitus, lactating bitches |
Interpret with: | Glucose, NEFA, triglycerides, AST, Urea Nitrogen, Albumin |
NEFA
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
NEFA | mEq/L | 0.1-1.2 | 0.13-1.32 | 0.01-0.12 | n/a | 0.02-0.26 | n/a |
Increased | |
Artifact | Serum separator tubes, non-cooled samples, delayed sample testing |
Physiologic | Exercise, stress, collection before daily feeding |
Negative energy inbalance | Food deprivation, pregnant and lactating dairy cows; hepatic lipidosis (camelids) |
Idiopathic & Other | Diabetes mellitus, hepatic lipidosis, overfeeding and obesity, food deprivation, post-exercise |
Interpret with: | BHB, Glucose |
Fructosamine
Units | Canine | Feline | Equine | Bovine | Alpaca | Caprine | |
Fructosamine | Umol/L | 222-348 | 174-294 | 235-332 | n/a | 251-431 | n/a |
Increased | |
Persistent hyperglycemia | Diabetes Mellitus |
Idiopathic | Hypothyroidism (humans) |
Decreased | |
Artifact | Hypoproteinemia |
Persistent hypoglycemia | Insulinoma (dogs) |
Idiopathic | Hyperthyroidism (cats) |
Interpret with: | Glucose? |