Problem list
• Difficulty rising, decreased range of motion
• Hepatomegaly
As part of Spot's annual visit, you will run a CBC and serum chemistry panel, but given his hepatomegaly and difficulty rising, you also recommend abdominal and pelvic radiographs. The owner declines since she thinks Spot is doing fine and wants to wait and see what the blood tests show.
Laboratory results
These are the notable findings from your CBC and serum chemistry profile.
CBC with differential
All results normal
Serum chemistry panel
Patient values
Reference range
ALT (IU/L)
46
12-118
ALP (IU/L)
526
5-131
Bilirubin (mg/dl)
0.1
0.1-0.3
Albumin (g/dl)
3.2
2.7-4.4
Globulin (g/dl)
2.9
1.6-3.6
Glucose (mg/dl)
92
70-138
Cholesterol (mg/dl)
216
92-324
T4 (µg/dl)
1.2
1-4
QUESTION 1
What would be a reasonable next step in working up the elevated alkaline phosphatase (ALP) activity in this patient? (There is more than one correct answer.)
a) Inform the owner that we need to schedule Spot for a liver biopsy.
c) Perform a low-dose dexamethasone suppression test.
d) Recommend an abdominal ultrasonographic examination.
e) Perform fasting and postprandial serum bile acid testing.
f) Measure the corticosteroid-induced ALP isoenzyme.
<< Back | Next Step >>