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Case 13
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
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?
b) Albumin
c) Alanine aminotransferase (ALT)
d) Cholesterol
e) Glucose
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