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Case 13

May 7, 2013

You explain to the owner that there are many potential differential diagnoses for PU/PD and again recommend that a logical next step would be a CBC and a serum chemistry profile, as well as an abdominal radiographic examination to look for bladder uroliths. Although there is no evidence of inflammation in Olivia's urinalysis, you cannot rule out the possibility of occult infection as bacteriuria and pyuria may not always be visible in dilute urine. You plan on awaiting the results of the next set of diagnostic tests, however, before deciding whether a urine bacterial culture is still indicated in this case.

The owner agrees to bring Olivia in the following day for the blood tests and radiographs. Here are her results:

CBC

Patient values

Reference range

WBC (/µl)

12,900

4,000-15,500

-Neutrophils (/µl)

10,400

2,060-10,600

-Monocytes (/µl)

540

0-840

-Lymphocytes (/µl)

1,850

690-4,500

-Eosinophils (/µl)

110

0-1,200

Hct (%)

35

36-60

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Hgb (g/dl)

12

12.1-20.3

MCV (fl)

52

58-79

MCHC (g/dl)

35

30-38

Platelet count (103/µl)

273

170-400

Serum chemistry profile

Patient values

Reference range

BUN (mg/dl)

10

6-31

Creatinine (mg/dl)

0.8

0.5-1.6

ALP (IU/L)

120

5-131

ALT (IU/L)

145

12-118

AST (IU/L)

70

15-66

Bilirubin (mg/dl)

0.1

0.1-0.3

Albumin (g/dl)

2.5

2.7-4.4

Globulin (g/dl)

3.6

1.6-3.6

Calcium (mg/dl)

10.2

8.9-11.4

Glucose (mg/dl)

85

70-138

Sodium (mEq/L)

142

139-154

Potassium (mEq/L)

4.3

3.6-5.5

Cholesterol (mg/dl)

88

92-324

Triglyceride (mg/dl)

210

29-291

QUESTION 3

Which of the following analytes on a routine serum chemistry profile is not an indicator of hepatic function?

a) Blood urea nitrogen (BUN)

b) Albumin

c) Alanine aminotransferase (ALT)

d) Cholesterol

e) Glucose

<< Back | Next Step >>

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