Final ATE2639 Flashcards
(104 cards)
Chemistry
Interference Factors
- Hemolysis
- Icterus
- Lipemia
Albumin
Function
- Produced in liver
- Maintains osmotic pressure (keeps fluid within vascular system)
- Transports certain molecules (Calcium)
Albumin
Increased
Hyperalbuminemia
* fluid has decreased
* dehydration
Albumin
Decreased
Hypoalbuminemia
* decreased synthesis by liver
* loss from kidney disease (check for proteinuria)
* hemorrage or GI loss (if globulin also decreased)
Globulins
Alpha and Beta
* made in liver
* acute phase proteins
Gamma
* made by plasma proteins (B lymphocytes)
* immunoglobulins (think antibodies)
* most common
Globulin
Increased
Hyperglobulinemia
* inflammation / infections
* neoplasia
* tick-borne diseases
* HW disease
* dehydration (if albumin also increased)
Globulin
Decreased
Hypoglobulinemia
* immunodeficiencies
* inherited
* failure of passive transfer
* FeLV / FIV
* hemorrage or GI loss (if albumin also decreased)
Liver Enzyme
Functions
Leakage Enzymes
* inside the cell
* increase when damage to cell
Cholestatic Enzymes
* outside the cell
* found within biliary tract
ALP and ALT
in Cats
Both have a shorter half life in cats
* if it goes up, it will come down very quickly
* if elevated liver values, there is a major issue (it went up super high and is now at the level being seen)
ALT
- Liver-specific
- Leakage enzyme
- Enzyme free within hepatocyte cytoplasm - leakage from damage
AST
- Liver
- Leakage enzyme - hepatocyte damage
- Skeletal muscles - IM injections and exercise
- Erythrocyte hemolysis
AST
Increases
Only elevates with severe liver disease
* if elevated, check for hemolysis and creatine
APL
Enzyme Type
Cholestatic
* with many isoenzymes
ALP
Locations
- Hepatobiliary (liver)
- Bone / Cartilage
- Steriods
ALP
Elevations
Young Animals
* bone developement
Older Animals
* cholestasis
* osteosarcoma
Steriods (dogs only)
Drugs (phenobarbital)
GGT
- Cholestatic enzyme
- Liver (biliary)
- If elevated, biliary in nature
- Elevates with obstructive liver disease
Bilirubin
- Produced from breakdown of hemoglobin
- Elevated due to hepatic damage - bilirubin unable to be secreted into bile after being conjugated
- In IMHA, see this increased because there is so much RBC breakdown, liver can’t keep up
Bile Acid
- Synthesized in liver, stored in gallbladder
- Stimulated by meal to help breakdown fat
- Elevates with liver disease, PSS, and cholestasis
Bile Acid Testing
- 12 hour fast
- Collect sample
- Feed high fat meal (wait 2 hours)
- Collect sample
Bile Acid Testing
Normal Results
- Before Meal: low levels
- After meal: slightly elevated but WNL
Indicators of Normal Liver Function
- Protein (albumin)
- Cholesterol
- Glucose
- BUN
if all are low alongside liver elevations
BUN
Protein waste product removed by kidneys
BUN
Elevated
Pre-renal
* Dehydration
* High protein diet
Renal
* Actual kidney disease causing elevation
Post-renal
* Any type of obstruction
75% of kidney function gone
BUN
Decreased
Contamination of blood with bacteria
* refrigerate sample
* assess quickly