Inside Your Pet's Health: The Importance of Blood Work
Have you ever wondered why your veterinarian recommends regular blood work for your pet? Blood work provides crucial information about your pet's health and can help detect potential health issues before they become serious problems. Blood work can tell us a lot about our pets, from their red and white blood cell counts to their kidney function and glucose levels.
Unfortunately, blood work is not a magic solution and may not provide all the answers. Veterinarians often have to do more than just blood work to make a diagnosis. Nevertheless, blood work is an essential tool in a veterinarian's diagnostic toolbox and can provide valuable insights into your pet's overall health. In this episode, we will explore the importance of blood work in our pets and what we can learn from common blood tests.
What You’ll Learn:
How veterinarians generally go about getting blood from pets.
The most common blood tests done for your pet.
What a CBC is.
Signs to look out for that your pet is anemic.
When blood work can show early signs of cancer.
What tests can show problems related to the kidneys.
Causes of low calcium in your pets.
What to look out for when it comes to low glucose levels.
What causes pancreas problems.
Why your veterinarian may request a urine sample from your pet.
Ideas Worth Sharing:
“When BUN is really high, that is a concerning sign of kidney failure.” - Tyler Sugerman
“Doing other tests is still important, even if their blood work is normal.” - Tyler Sugerman
“Just because blood work is normal doesn’t mean that your pet doesn’t have cancer, and just because the blood work is abnormal doesn’t mean that your pet does have cancer. It just points us in the direction we need to go.” - Tyler Sugerman
Resources Mentioned:
ASPCA 888-426-4435 or pet poison helpline 855-764-7661
Read The Transcript:
Welcome to Vetsplanation. I'm your veterinary host, Tyler, or you can call me Suggs. This podcast is about educating pet parents about what is going on with their furry little loved ones. As an emergency veterinarian, I understand how hard it is to explain complex diseases in terms that are understandable for pet parents in a few short minutes before the next critical case comes in.
In this podcast, we can dive deeper into understanding of what our pets are going through and break down those complex medical terms into easier to understand chunks of information.
Just a quick disclaimer: this podcast is for informational purposes only. This is not meant to be a diagnosis of your pet. If you have questions about diagnostics or treatment options, please talk to your veterinarian about those things.
Remember, we are all practicing veterinary medicine, and medicine is not an exact science. Your veterinarian may have different treatment options. The information I provide here is to help pet parents, and it's not related to my place of work. I'm here for you guys to provide free information and knowledge.
If you like our podcast, consider sharing this podcast with at least one friend or someone else who has pets and could benefit from this.
Now, let's jump into this week's episode.
Tyler Sugerman: Hey everybody, welcome back to the podcast. This week, we're going to be talking about blood work. A lot of people want to know like what does blood work tell us? Why do we need to get blood work? And my most asked question is usually, will the blood work tell me if my dog has cancer?
So, I'm going to kind of get into some of the questions that I get commonly asked, and I won't get into the nitty gritty about each one of the blood work parameters, but just kind of some overviews about what we're looking for on blood work, and why a lot of times we would need to do more than just blood work.
Alright, so let's talk about just like blood work in general. Like how do we get blood from a dog or a cat? So, in general, we usually do have to get it from a vein. Usually just the same way with us. So, thinking about you going in to get your blood drawn. You typically put your arm out on the table and somebody puts a tourniquet around the arm, is able to get blood from the vein and then puts a little band-aid on it.
Unfortunately, our pets will not sit still for us to do that. We can't just like ask them to put their arm out there. So, a lot of times it's just gently holding them, giving them some comfort while we're able to get blood.
So, there's a couple places we get blood from. There is the biggest vein that we can get it from is usually the neck. So, it's called the jugular vein and it usually just means that they're kind of looking up at us while the other person is able to draw the blood.
We don't need to put a bandage around that because we don't really want to put one around the neck. The other places are going to be the legs. So, usually the front legs or the back legs, either one even for a cat or a dog, it doesn't matter. Either one is able to be accessed for a blood draw, and then we do the same thing.
So, we are the ones who are doing the tourniquet, essentially. We put our hand around like the elbow area or around the hip area to be able to hold off just like a tourniquet would, and then we're able to drop blood that way.
And then when we're done, we usually put a bandage on or hold the area off for a little while. Sometimes if we keep a bandage on, people forget to take the bandages off and so we try not to send them home with bandages, so that way it doesn't get forgotten and the leg doesn't swell.
But in general, it's just making sure that they don't continue to bleed after that, which most of the time they don't. Our bodies are really good about being able to clot blood without us having to put bandages and stuff on them.
So, that's how we get blood and then we're able to run it through a machine. Now, it kind of depends on what kind of blood work we're doing and what practice you're at as to whether this is something that can be done immediately or if this is something that needs to be sent out.
So, the most basic blood work, it's usually called a CBC, a chemistry, and a urinalysis. We'll get to what each one of those are in a minute, but those are usually some pretty simple tests that can be done in-house depending on where you are.
So, let's say you go to an ER clinic, 90% of the ER clinics usually will have all of that blood work machine there in the hospital to be able to run automatically or run immediately so that you'll get results back within an hour, two hours, or so.
And you'll be able to kind of go over all of those results very quickly, versus some of the general practices, they don't necessarily need that blood work to come back right away, and so they'll send their blood out to an outside lab.
When they do that, it takes one or two days for that blood work to get back, and then that's when they'll usually be able to contact you and let you know what that blood work looks like. But a lot of them don't have capabilities to do all of that blood work.
Some will have like small machines that can give them readings of just a couple different readings just so that they'll have something to be able to go off of if there is some sort of emergency. But most of them do need to send their blood work out.
And those are just the simple tests. Like I said, there are multiple different types of tests more than what we're going to talk about on the podcast today, but some of those other more complicated things are things that you have to send out to a laboratory regardless.
It's even like when you go into a lab to get your blood drawn, they'll draw your blood, and then they send it out to a lab to be able to interpret those diagnostics and then give the report back to your doctor.
So, it's kind of the same thing the way that it works with us. If it's something that needs to be sent out, we draw the blood, send it out to the lab, they do all the testing, and then report back to us what they are so that we can then tell pet parent what's going on.
Alright, so let's quickly talk about just some of the normal blood tests that we do, some of the very most common blood tests. So, some of those are going to be what I’ve kind already mentioned was a CBC, a chemistry, and a urinalysis. Alright, so let's start with CBC.
So, CBC means a complete blood cell count or a complete blood count. This is usually looking at things like red blood cells, white blood cells and platelets. There's lots of other little things in there, little details, but those are the three big groups of things that we're looking at.
So, when we're looking at things like our red blood cells. Red blood cells, they are the kind of like you can think about them as like almost like an Uber. So, the red blood cell has to go to the lungs to pick up oxygen. So, your Uber driver pulls up to the lungs, picks up its passenger, which is oxygen.
And then drives it to the tissues in the body. So, maybe the oxygen wants to go down to your little toe. In order to get there, it tells the Uber driver, “Hey bring me down to the little toe.” So, red blood cell Uber driver drives it down to the little toe, drops off oxygen in the little toe.
Picks up other stuff. So, usually that's things like carbon dioxide, but that's not as big of a component as to what we need to talk about right now. But usually, we'll then go back to the lungs to pick up its next passenger. So, as we just mentioned, red blood cells are really important for oxygen.
If we do not have enough red blood cells, that's called anemia and that's not good because if we don't have enough red blood cells, we don't have enough Uber drivers to pick up oxygen and it's just like outside of a concert, just mayhem. Nobody can get anywhere that they need to go.
But our biggest problem is that we can't bring oxygen from the lungs to other parts of the body where it is really needed. Maybe our big toe doesn't need oxygen as much, but our brain does and our heart does, our organs do.
So, we need to be able to get oxygen from the lungs to other places via the red blood cells. So, when we're anemic you might see a lot of pets who are having difficulty breathing because of the fact that they are … essentially like they can breathe in just fine, but they cannot bring enough oxygen to other parts of their body that need it.
So, if we see that a pet is anemic, then we need to start trying to figure out why that pet is anemic or has not as many red blood cells. So, we're looking at things like is it a problem with the bone marrow or is the body destroying those red blood cells, or are they being lost because of bleeding?
And then there's the opposite. There's the high red blood cells. When the blood cells are really high, we call that polycythemia, just means that there are lots of red blood cells. And it's most of the time due to dehydration, but it can also be due to like just our bone marrow producing too many red blood cells.
But in the majority of the time, it's usually of due to dehydration. So, really low is a lot more worrisome than high, but there are some situations where we're worried about really high red blood cells as well.
The second thing we mentioned in a CBC or a complete blood cell count is going to be white blood cells. So, red blood cells carry oxygen, white blood cells, they're equipped to do a couple different things, but the majority of the things that they do is going to be to help kill foreign materials or to help kill off bacteria or to help dying cells.
So, there are multiple different types. I'll just kind of name them and a little bit about what they do. So, the most common one we have, the most of them is called the neutrophils. Those are kind of like our first line of defense.
If there's some sort of inflammation or infection, neutrophils are the first one there to try to help wrangle in whatever it is — the bacteria or the virus or whatever it is that's causing the problem.
You have lymphocytes, which are the next most common one. They're usually produced by the lymph nodes and they're there because that's like the thing that's actually producing your immune system, like it is making your immune system work.
It's producing antibodies which are just basically the little proteins that tell your body that there is something bad that's invading. So, neutrophils are the ones trying to kill everything off. Lymphocytes are telling the body something bad is trying to invade and let's make more white blood cells to be able to fight them off.
You have eosinophils which are just white blood cells that are usually there or elevated because of like parasites, typically. You have basophils which are usually there because of inflammation and monocytes. So, monocytes are typically in the blood going to be high because of some sort of really chronic disease or something that's been going on for a while.
The interesting thing about monocytes is that the exact same cell, as soon as it leaves the bloodstream is called a macrophage, and the macrophages actually go and kind of act like the neutrophils and eat up bacteria and other foreign invaders.
But in general, like the really big thing about white blood cells is that we want to make sure that it is going to kill off any sort of infection or inflammation. So, when they're high, some of the things we worry about are going to be things like infections.
So, that can be bacteria or it can be viruses, it can be due to inflammation. So, they go to sites that there's a lot of inflammation and try to help the cells that are dying off. Or the other thing is it could potentially be from cancerous things as well that were causing them to have like really high or really low white blood cells.
The one big thing I'm going to mention about low white blood cells is specifically low neutrophils. That's the one that's the first line of defense and can go and try to kill off all the bacteria. If the neutrophils are really low, then actually we start worrying about things like sepsis or really serious infections, cancers, things like that.
Because the body should be making a lot of white blood cells, especially when there is a problem. And when the body cannot produce anymore, like it is too tired to even produce anymore, then we get really low white blood cells or low neutrophils and that's concerning for a bacteria that's like too widespread and too serious of an infection.
Then we talked about the third thing that's going to be in a CBC or complete blood cell count. So, we talked about red blood cells, we talked about white blood cells, and then the third category is something called a platelet.
So, I've talked about platelets before when I've talked about things like salmon poisoning, but platelets are really important to help your blood clot. So, they're the first responders of bleeding problems. Your body's always trying to help fix cells constantly, especially even the blood vessels.
So, you might spring a tiny little leak because of a cell that's dying off, and the platelet is this teeny tiny protein that goes to that site wherever there's bleeding that's occurring in the blood vessel, and it tells the body to start making a blood clot there.
So, it’s the first one to go over and say like, “Hey, let's stop this up. We need to stop this bleeding.” All the rest of the clotting factors will come over and help stop that bleeding.
So, it is super important if you don't have the signal from a platelet, your body or your blood vessel would just continue to bleed. It won't be able to stop the bleeding because it doesn't have that first initial person to tell them, “Hey, we have a problem over here.” So, super important.
We mostly worry about when platelets are low, not as much about when platelets are high, but when platelets are low, then we start worrying about bleeding problems. So, those can occur in things like ITP, which I've talked about before on a different podcast. You can go listen to blood clotting problems. It can be due to certain parasites and also from cancers as well.
Alright, that was CBC kind of in a nutshell. Now, we're going to talk about what we call the chemistry.
So, chemistries, what you can think of it as best is it's looking at the function of our internal organs. How are they functioning? So, I'm going to group this into some categories kind of based on our organs.
I feel like that's kind of the easiest way to understand it. And then again, I won't go into too much information because I know it's just going to be so much information, but just kind of like some of the ideas behind like what we're looking for.
One of the first things we're looking for is what's called the total proteins. Total proteins, that's like all the proteins that are in your blood vessels or in your blood. They're broken down into two different things.
One is called albumin and one is called globulins. Albumin is super important. It's kind of like a sponge. Wherever that albumin is, water wants to follow. So, if we have this sponge and we put it in our blood vessels, water wants to go follow into the blood vessel to go into the sponge and make it bigger.
If I didn't have that sponge on the inside, let's say I had the sponge on the outside of the blood vessels, water will want to follow from the blood vessel outside of the blood vessel to where that sponge is or where the albumin is.
So, the biggest problem with albumin is when it's low. When it's low, a lot of water is lost from those blood vessels into other places. So, it can be that they have edema which is basically like fluid under the tissues. It could be that we have fluid in the abdomen. It could be that we have fluid in the chest, and that's not good.
We need that fluid to stay inside the blood vessels and that's what albumin's really important job is. And there are a number of factors that can cause albumin to be low. That can be anything from nutritional problems to it being an autoimmune problem or a liver problem. Lots of different things that can cause that.
So, I said two things for our proteins. Albumin was one of them. The second one is called globulins. When globulins are high, we actually start worrying about things like cancer. Or in cats very specifically, we actually worry really about FIP or feline infectious peritonitis.
So, it usually tells us that there's a lot of inflammation that's happening and in cats like that's just unfortunately happens to be one of those kind of telltale signs is that their globulin specifically will be really high, but not quite as important as albumin.
Alright, now we're going to jump into our next category of organs. We're going to talk about the kidneys because the kidneys have quite a bit that we see there. So, the main ones that we see for the kidneys are going to be what's called the BUN, the creatinine, calcium, and phosphorus.
So, we're going to start with BUN. Some people call it the bun but it's really the BUN. It stands for Blood Urea Nitrogen. What happens is that our body breaks down these proteins into nitrogen which then attaches itself to something else like hydrogen or oxygen, and then that becomes this waste product called urea.
Urea, it's able to travel through the kidneys throughout from the liver to the kidneys, and then it's just urinated out. So, we call it blood urea nitrogen because it's in the bloodstream. Nitrogen becomes urea or this waste product and then our kidneys are able to filter out urea.
Now, when the BUN is really high, that's really concerning for there being kidney failure because if there's a lot of that urea being built up in the blood and it's not able to be filtered through the kidneys into the urine, then that means there's a problem with the kidneys.
The kidneys should be able to filter them out just fine. But if our kidneys are not working correctly, then the BUN may become really high because of that. And our kidney problems can be from tons of things. They could be from a problem with the kidneys structurally like the shape of them. It could be from toxins like we've already talked about grape toxicity and raisin toxicity and lily toxicity.
It can also be from antifreeze, which I'll probably do on another podcast or if that is decreased then we start worried about the fact that maybe there's a liver problem if the BUN is decreased. So, increased we worry about kidneys, decreased, we worry about the liver not making it correctly into urea.
The next one is creatinine. This is actually kind of the more sensitive one for figuring out whether there's a kidney problem or not. There's also other testing called SDMA. I won't get into that here because it's not a common thing that we just automatically do.
It's usually something that has to be added on or that has to be run outside in an outside lab. But creatinine is kind of the most sensitive one we have for kidneys when it comes to our in-house testing that we have.
So, the creatinine, when it increases, we again worry about kidney failure. So, that can again be from like the toxins or a problem with the structure of the kidneys or they're just not working correctly. It can also be from blocked cats, which we talked about in episode one. You can always go back and listen to that one, or even a ruptured bladder can make the creatinine become really high.
The third one that we mentioned was calcium. So, calcium comes from our bones. We have a hormone in our body that tells us or tells our bones to release calcium when we need it in our bloodstream.
And then, when we have an excess or we have enough, then the hormone tell our body to put the calcium back into our bones. When this is elevated, when calcium is elevated, we worry about a couple things.
One is kidney disease. So, we do worry about kidney failure causing that calcium to be really high because there is part of that protein and that feedback mechanism is through the kidneys. Cancers is another huge one on our list that can make that calcium really elevated or there can be other things like toxins, like rat poisons. Certain rat poisons will cause the calcium to be elevated as well.
For decreases in calcium, things we worry about are going to be like eclampsia. So, with people eclampsia we think specifically about giving birth or right before giving birth, having eclampsia. In people, that's a little bit different than in dogs and cats.
In dogs and cats we can have eclampsia or low calcium before giving birth or after giving birth. So, when they have a lot of puppies and they're just like nursing constantly on mom, the mom's body is telling her to pull more calcium out of the bones to give to the puppies.
But there's only so much calcium that she can take out of her bloodstream and out of her bones in order to be able to give to the puppies. And so, eventually, that calcium drops really low and the mother dog will usually start to have tremors and shaking and even potentially have seizures because of it.
Other causes of low calcium are gone be things like a parathyroid hormone problem. So, that's these little organs on the side of the thyroid in your neck that tells the body to produce things like PTH or parathyroid hormone, which is the hormone that tells your body to release calcium.
And then, antifreeze poisoning is another one. Antifreeze poisoning causes kidney failure but lots of other things as well. But the calcium will be low because of antifreeze poisoning. And the fourth thing that we look at for kidneys is going to be the phosphorus.
So, phosphorus also originates from the bone just like calcium does. It's controlled by the exact same hormones, and can be really high when we have a kidney problem. I know that was a lot of information even just for like that one section on kidneys.
So, I still have more stuff to talk about but I just want to go back and reiterate a couple of things. So, as you notice it's not just one value that has told me about kidney problems. I'm looking at multiple values that are telling me whether that pet has a problem with their kidneys or not.
The other thing is that you notice that not a single one of these points to exactly what the cause is. So, I might see that the BUN and creatinine are high and that will tell me that the cat or the dog is having a problem with their kidneys but it cannot direct me to the exact cause of it.
There are multiple things that can cause the kidneys to become elevated or kidney values to become elevated. And so, now after we've like narrowed it down to this is the organ that we were looking at, now we can start trying to figure out like what is the cause of that organ being a problem. Alright, so now we have a couple more.
So, we're going to talk about blood glucose really quickly, nothing to do with kidneys. Just moving on to the next topic, blood glucose. So, blood glucose is pretty commonly that it'll be elevated when we have times of stress. So, like cats, you'll see them have pretty high blood glucose during stressful events like going to the veterinarian and having blood drawn.
But in dogs and in really high amounts in cats, usually that means there's some sort of metabolic problem, meaning things like diabetes. So, diabetes will usually have really high blood glucose just like in people.
When we look at whether they're low or not low things, problems that cause low blood glucose are going to be things like small breed dogs like tiny, tiny teacup puppies tend to have low blood glucose because they're just not being fed as often.
It could be a malnutrition problem meaning they're not getting enough nutrients, whether it's like the type of dog food that they're getting or even because they have worms that are eating all of their nutrients.
It could be things like certain types of cancers can cause that. You can have sepsis (remember we talked about that earlier). So, a bacterial infection in the bloodstream can cause this. Notice it's not just blood glucose but other parameters that kind of tell us whether this pet might be septic or not, whether they have low white blood cell counts.
And the big thing with when we have blood glucose that's really, really low is most of the time it causes tremors and then it causes seizures in pets. So, you'll notice sometimes if we have seizures that will automatically take a blood glucose so that we know if that is the cause of it or not.
And now we're going to move on to the liver. The liver has four big things as well. They're called the ALT, the Alk Phos, the GGT, and the bilirubin. So, the main factors of these is that the ALT and the Alk Phos they kind of just tell us whether the liver is damaged. It's created by a lot of tissues within the liver. And so, when there's some sort of disease or damage to the liver, usually those values will go up.
Sometimes we can tell if it's something a little more specific like a toxin, whether it's being damaged from something else, like let's say, a liver disease specifically versus maybe a toxin. Some certain toxins will only increase the ALT, whereas a lot of the other things that cause some sort of damage to liver will cause both the ALT and the Alk Phos to increase.
GGT can kind of tell us whether there's a problem with the gallbladder, which is very, very closely related to our liver. Everything kind of goes into the liver from the gallbladder. So, we can look at the GGT and kind of tell us if maybe there's a problem specifically with the gallbladder that's creating a problem in the liver as well.
And then bilirubin. So, when you think about people who are jaundiced, so like babies who have jaundice, that's actually because of it's like the yellow discoloration. We call icterus but jaundice is the other human term for it.
And sometimes, you can't even notice just on the body that the patient has jaundice. I mean, sometimes it's very obvious that they are bright yellow like highlighter yellow, but sometimes it's not as obvious.
So, sometimes you look at the blood work and then go back to the pet and be like, “Oh I see that there's this very, very light yellow discoloration now and now, I can see that the pet is jaundiced.”
And then we need to go from there to find looking at our other blood work parameters to see is this because … is the patient jaundiced because of the fact that we have a lot of red blood cells that are being destroyed? Or is the patient jaundiced because we have a liver or gallbladder problem?
So, we're looking at our other parameters besides just the bilirubin for that. The next big one is going to be the pancreas. So, our next organ we're going to jump to. The pancreas has two big ones. One is called amylase and one is called lipase.
The amylase is really important because it's part of the pancreas that helps break down sugar. So, where there's always going to be sugar in everything that they eat. But there's going to be definitely some sugary things but more that they would normally get be used to just in dog food.
I have kids of course they drop stuff so if somebody drops Cheerios or candy or something, they're going to get a lot more sugar than they normally would, and amylase then steps in to help break down the sugar.
The other kind of more important one and one that we see more often that's going to be elevated with a problem with the pancreas is going to be lipase. So, lipase is there to break down fat. So, amylase breaks down sugar, lipase breaks down fat.
And that is what we see more often in our dogs. Like think about all the fatty things that we end up giving them, steaks. The fat from the gristle of a bone, the inside of a bone has bone marrow, which is a lot of fat to it. Deli meat can have a lot of fat to it.
There's all these things that we tend to give them that end up having a lot of fat, and when we give them too much of that, it creates an inflammation of the pancreas, which is then called a pancreatitis.
So, again, like with the pancreatitis, I can see that the lipase is elevated. So, that kind of leads me to believe that there is an inflammation of the pancreas. But the more important thing here is to note that it doesn't tell me exactly why.
It can tell me that we have inflammation but not the cause of the inflammation. That inflammation could be a cause from giving too many scraps, table scraps. It could be from cancer, it could be because there's a toy that's stuck right next to the pancreas in the small intestines and rubbing on the pancreas creating a problem.
It could be that we have an infection inside the abdomen that's creating the pancreas to be really inflamed and then causing a pancreatitis. So, it leads us to know that yes, there is inflammation of the pancreas but not the exact cause as to why.
Alright, the next blood work thing on a chemistry, I'm going to jump into, this is our last one on the chemistry, is called electrolytes. Thinking about the things that you drink. We kind of already talked about some of them like calcium, but we're going to talk really quickly about potassium and sodium.
So, potassium is a really important one for some of our very specific things liked blocked cats, again, episode one. It can also tell us if it's really elevated that it might be that the patient is in a kidney failure. So, let's say there are BUN and creatinine. Those two big kidney problems we talked about, kidney values are elevated.
If the potassium is also elevated, that tells me that something happened very quickly. So, this isn't a chronic kidney problem, it's not something that they've had for a long time. Something happened like very, very quickly to cause them to go into this sort of kidney failure.
Again, that can be things from like toxins. It can also be something called Addison's disease. And I talked about that on a previous episode, on episode two if you want to go back and listen to that. But if it's decreased, that can also tell us maybe that there is a chronic kidney problem.
So, acute kidney problem or something very fast is going to be high potassium versus a low or even normal potassium will tell me that there's more likely a kidney problem if their kidney values are also elevated.
Our next one is sodium. Our next electrolyte is sodium. In elevated sodium that usually just tell us if there is a lot of dehydration. There's like one crazy thing that I have found and I don't know like how much in the literature it is, but in certain situations, I've seen cats who have eaten those Nerf bullets like from the Nerf gun.
I've seen them eat a Nerf bullet and get a foreign body or an obstruction, and their sodium goes up really high like it just skyrockets. I'm not 100% sure why but that it's happened on to me on a couple of occasions.
The other thing that low sodium can be from is from Addison's disease. So, we just talked about that episode two. Addison's disease causes the adrenal glands, which are these little tiny glands next to your kidney, not to produce enough cortisol, which is something that it's like a steroid that your body needs for pretty much every part of its body.
So, Addison's, we can look at both the sodium and potassium, and that can kind of again lead us to thinking that this might be an Addison's patient.
Our last basic blood work thing we're going to talk about (thanks for hanging in here) is going to be urinalysis. So, how do we get a urinalysis? There are a couple of ways depending on what we need. So, sometimes, we can do a free catch, meaning we just put a little bowl or something underneath the pet and we'll let them pee into the bowl, and then we're able to run some urine off of that.
Usually, when we just need to know like how concentrated or how dilute the urine is, that's an easy way to do it. We can just use the little free catch method to be able to get that. If we specifically need to know if the patient has a urinary tract infection, then we have to do either what's called a cystocentesis or a catheterization.
A cystocentesis means that we usually have them on their back. We use an ultrasound and then we use a needle that we guide through the belly or through the abdomen into the bladder. That sounds a lot more traumatic than what it really is. Most of the time they don't even notice that it's happening.
But it's the most sterile way to be able to get a urine sample because there's still a lot of bacteria on the vulva or on the penis. And even when we try to wipe it off, there's all the internal kind of just inside as well bacteria. And as soon as it hits the outside, there's just a lot of bacteria that's going to be on there. So, cystocentesis is usually the most accurate way that we can get that.
The other way is called catheterization. So, if you've ever seen a person who's had a catheter in, it's basically just a catheter that's inserted into the vulva or penis, usually the penis. The vulva is a lot harder to catheterize but still can be done. And then we're able to get a urine end sample that way as well.
That's actually like more uncomfortable to them than doing that cystocentesis where we stick a needle into their belly. Most of the time they don't move at all when we do that versus putting a catheter in, they're definitely a lot more uncomfortable with that.
So, I try not to do that method unless I absolutely have to. So, what are we looking for on a urinalysis? I just talked about one of the things was going to be like how concentrated or dilute the urine is.
So, what that means is like if you think about after you've run a marathon — I'm not going to run a marathon anytime soon, but if I was to run a marathon and I wasn't drinking any water, by the time I got done, my urine end would be dark yellow, be dark, dark yellow.
It's very, very concentrated because I didn't drink enough water to be able to filter through my bloodstream and filter it through my kidneys into my urine. So, it'll be very dark versus very dilute means it's more like water.
So, if I just sat here in my chair and I chugged water for two hours, just multiple liters of water, my urine would look as much like water as possible. So, it'd be very, very dilute. So, that can kind of tell us if the pet is dehydrated or it can also tell us if the pet has a problem with like a kidney problem or if they have things like diabetes.
It can tell us a lot about like how well they're able to concentrate their urine. With our kidney problems, we had talked before about how the BUN and creatinine would be really high, and if that's the case and the cat or dog has a kidney problem, that urine will be really dilute, but it shouldn't be.
Because if that pet was really dehydrated then that urine should be very concentrated. It should be very yellow. It should be like the pet ran a marathon and didn't drink any water and that would tell us that this is more a dehydration problem, not a kidney problem.
The next big thing is going to be that we're going to look for a urinary tract infection. So, we're going to look to see if there's any bacteria in there. Again, like it can't tell us the exact type of bacteria. There are lots and lots of different types of bacteria. Like the closest that we can get is that we can know if it is a cocci or a rod.
It just is two different types of bacteria and that's about it. But there are thousands of different types of cocci and there are thousands of different types of rods. So, we don't know 100% for sure which one it is.
All we can do is see that like maybe we see on that urinalysis that there are a lot of rods. We can make our best guess as to which bacteria it likely is, and then we can treat according to that way. If we need to know exactly what type it is, that usually means we have to send it out to the lab where they grow a sample on a little Petri dish.
It tells us what kind of bacteria it is, and then they take that little growth of the Petri dish and then they also test antibiotics on it to see which antibiotics killed off that bacteria. That is called a culture insensitivity. So, they culture it, meaning they grow the bacteria, and then it tells us what they're sensitive to. What is that bacteria sensitive to as far as antibiotics?
Our next big thing it tells us is crystals. This is super important for our blocked cats. So, we need to know if they have any crystals in their urine because it's usually just from the way that the pet's body is responding to the diet, there's glucose that we're looking for.
So, if there's a lot of glucose or blood sugar essentially in the urine, then that kind of tells us maybe that there's a problem with their diabetes. Like are they diabetic and that's what's causing a lot of this blood glucose to be in there because it normally shouldn't be in there. And there are other factors as well, but I don't think they're as important for the big things that we're typically looking for.
Alright, let's talk about some of the most common questions that I get about blood work. One of the most common questions is, “Why do we need to do blood work?”
So, I listed so many different reasons here. Most of the time a pet comes in and somebody just says they're lethargic, they're just kind of depressed. They're not acting right. Well, I mean unless they tell me what's wrong, which unfortunately, none of the pets so far have been able to do. So, unless they tell me what's wrong, there's no way for me to know just by looking at them.
Yeah, sometimes there are super obvious things on the outside of the body, but a lot of times there's not. If they have a kidney infection, there's no way that I could know that just by looking at them. Or if they have a problem with … let's say they have Addison's disease or they have diabetes, there's no way that I could know just by looking at them. So, getting blood work kind of helps pinpoint as to where we need to go.
It's kind of like if I was to say I've hidden a treasure somewhere in the United States, now you need to go find it. Well, that's like a huge broad area. That's a lot of space to cover, to know like just that it's somewhere in the United States.
And that's kind of what happens when they come in and somebody says that they're just lethargic? Well, there's thousands of different reasons why they could be lethargic. So, using blood work would be one of the ways that to give us a hint as to what part we should be looking at. Or in our treasure analogy, which state at least we should be looking at. It's not going to tell us the exact location, but it's going to get us closer to where we need to be.
And then some people will ask, “Well if I've done the blood work, why do I have to do any of the tests? Shouldn't blood tell you everything?” So, it doesn't … kind of what I had pointed out before. Things might show us that maybe there's a problem with the kidneys or maybe there's a problem with the pancreas, but it won't tell us the exact cause of it.
If I see that the BUN and creatinine are high and that the pet has really dilute urine, then I can kind of assume that this is a kidney problem. But that's not going to tell us what caused the kidney problem in the first place.
Was this a problem from a toxin or was this a problem from the way that the pet's kidneys were developed in the first place? I don't know. All I know is that there is now a problem with the kidney. So, in our treasure analogy, somebody says, “Hey, I buried treasure in the United States.”
Well, now, I've done blood work, and that's kind of our hint that now we've narrowed it down to one thing. We've been able to narrow it down to that treasure is in Washington. So, now we're like, “Okay, we have way less ground we have to cover now.”
Now, we've like kind of narrowed this down to just Washington at least. So, by doing other tests, like doing things like X-rays or ultrasounds or other blood tests, that's going to narrow it down even more for us to try to figure out what the cause of this is.
So, maybe I might say in our treasure analogy, well that treasure I figured out is in Washington by doing blood work. By doing x-rays. I've figured it out that it's in Tacoma. Well, now we've again, way less area that we had to cover, not just the whole state of Washington.
Now we're doing specifically Tacoma. And even Tacoma's a bigger state, we still have quite a few things, few places that it could be. Same thing with blood work. We still have more differentials or more possibilities of what this could be, but we've at least been able to narrow it down.
Another common question that I get is, “Well, if everything is normal on blood work, that means that my pet is not sick. They're totally fine.” Well, no, that's not true either. It could be that their blood work is completely fine, but maybe they have something going on internally and we need to get X-rays or an ultrasound.
I've definitely had a lot of patients who have had a foreign body, so they've eaten some sort of object, some sort of toy or something, and their blood work is perfect, picture perfect, and there is still a problem.
They still ate the toy, which is causing an obstruction. They're still vomiting profusely, but they're just not to the point of being dehydrated yet or showing any abnormalities on blood work. So, doing the other tests is still important even if the blood work is normal.
And then the last big question I get about blood work is, “Well, if the blood work is normal, that means my pet does not have cancer.” Again, that's not 100% true. You can have a lot of cancers that do not show up in blood work.
I have a lot of people that do ask as well, like if I do blood work, will it show if my pet has cancer? I listed cancer under so many different parameters that we just talked about under the CBC, under the chemistry, it could even be even in part of the urinalysis.
So, it can't tell me for sure whether they do have cancer and it can't tell me for sure that they don't have cancer. Again, it can lead me to thinking that maybe this is something that's cancer that could be causing this or maybe that that cancer just doesn't affect the blood at all. You can have cancers that are on the outside of the body.
Mass cell tumors is a big one that hasn’t spread to the inside of the body and is not going to show me anything on blood work. You can have things in the bone like bone cancers that could spread even to the lungs without showing any abnormalities on blood work.
I've even had dogs who have had a bleeding problem. They've had cancer on the spleen, which you would think that they would show signs of bleeding and stuff on blood work, but did not show those yet because those values just hadn't gotten low enough yet.
So, just because the blood work is normal doesn't mean that they don't have cancer. And if the blood work is abnormal, that doesn't mean that they do have cancer. Again, it just kind of points us to the direction of where we need to go. It points us from the United States down to Washington, down to Tacoma, but we still have all of Tacoma that we have to be able to figure out where this treasure might potentially be. So, doing those other diagnostics gets us even further to the exact location of where it might be.
Alright, thank you for bearing with me for all of that. I just get a lot of questions about blood work and it's so much more complicated than what I can even describe on the podcast.
So, hopefully, that just like breaks it down a little bit, at least to make it just even a little bit more understanding. We got to remember that I went to school for four years to be able to learn how to even read this blood work.
So, just doing one podcast or listening to it a couple of times is not going to make you an expert for sure, but if it gives you a little bit of understanding, that's kind of my goal. Alright, so we're going to talk about our fun animal fact real quick.
So, I actually learned this on my kid’s podcast today. She loves Wow in the World and I love them too. I think they have really cool studies that they do and they talk about for kids, which I love science. She loves science, it's amazing.
But this one today was talking about bumblebees. So, it was talking about how they found these bees that like to play ball. Like they like to play with balls as a toy, not as like something that they have to be rewarded for. Because that's what we think about with worker bees.
Like bees or worker bees, they have a job, they get that job done. They're always focused on what they're doing. That's what the whole worker bee thing is supposed to be about. But they've actually found like if they're given a choice between going and doing their job or given a choice between playing with this ball, that oftentimes that they would actually play with a ball.
They weren't doing it for any sort of reward or anything. They weren't doing it because somebody else was playing with it. They would just like see it and just start playing with it. And they actually did show that they play almost something that's very similar to soccer.
But even those ones that didn't play, they weren't actually playing. Even the ones we kind of think about would be on the sidelines were playing just for fun. I think that's pretty cool, because I wouldn't think about them playing, I always just think about them just being like, go, go, go, go, go, always have to be doing something. But I thought that was a super cool study, so.
Anyways, thank you again guys. If you have any questions, please feel free to contact me anytime. I'm happy to go over things with you if you need more clarification on one of the things we talked about, I'm always here. So, please feel free to hit me up. Thanks, guys.
Thanks for listening this week. If you have any questions, comments, suggestions, or you just want to say hi, feel free to email me at suggs@vetsplanationpodcast.com.
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Thank you all again for listening and we'll see you back here next week.