Urine Analysis in Veterinary Medicine
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Urine Analysis in Veterinary Medicine

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Questions and Answers

What is the primary role of sodium in electrolyte metabolism?

  • Principal cation in the extracellular fluid (correct)
  • Determination of cardiac output
  • Promotion of fat metabolism
  • Regulation of blood pH

    • Which condition is associated with pseudohyponatremia?

  • Hyperlipidemia (correct)
  • Dehydration
  • Hypochloremia
  • Electrolyte overconsumption

    • What is the typical fractional excretion of potassium in healthy animals?

  • Less than 1% (correct)
  • Greater than 10%
  • Between 5% and 10%
  • Consistently 3%

    • Which factor is commonly associated with the development of hypernatremia?

    <p>Excessive sweating</p> Signup and view all the answers

    What physiological condition can lead to increased loss of potassium?

    <p>Chronic vomiting</p> Signup and view all the answers

    Which statement correctly describes the relationship between osmolal gap and ethylene glycol presence in serum?

    <p>Osmolal gap correlates well with the concentration of ethylene glycol</p> Signup and view all the answers

    What typically characterizes hypokalemia?

    <p>Alkalosis is often associated with it</p> Signup and view all the answers

    Which condition can lead to both hyperchloremia and hypochloremia?

    <p>Conditions causing hypernatremia and hyponatremia</p> Signup and view all the answers

    Which disorder is most likely to cause an increase in circulating bile acids?

    <p>Congenital portosystemic shunting</p> Signup and view all the answers

    What is the most significant consequence when 60% of liver function is lost?

    <p>Increased ammonia concentration</p> Signup and view all the answers

    In the case of steroid hepatopathy, which statement is true regarding liver enzyme levels?

    <p>Induced enzymes are markedly increased</p> Signup and view all the answers

    What might be expected in the biochemical profile of a horse with biliary disease?

    <p>Mildly increased leakage enzymes</p> Signup and view all the answers

    Which condition is least likely to be associated with increased bile acid levels?

    <p>Chronic enteritis</p> Signup and view all the answers

    What change can occur to albumin levels when liver function declines substantially?

    <p>Decrease in albumin levels</p> Signup and view all the answers

    Which statement is true regarding the effects of hepatic microvascular dysplasia?

    <p>It can lead to an increase in bile acids in circulation</p> Signup and view all the answers

    What is a potential consequence of significant hepatocyte injury due to cholestasis?

    <p>Decreased albumin synthesis</p> Signup and view all the answers

    What happens to blood urea nitrogen (BUN) levels during liver failure?

    <p>BUN decreases</p> Signup and view all the answers

    Which statement accurately describes bilirubin levels in advanced liver disease?

    <p>Bilirubin concentration is normal to mildly increased</p> Signup and view all the answers

    What effect does cholestasis have on cholesterol levels in the liver?

    <p>Prevents excretion of cholesterol in bile, potentially increasing levels</p> Signup and view all the answers

    Which enzyme activity is typically associated with end-stage liver disease?

    <p>Moderately to markedly increased induced enzyme levels</p> Signup and view all the answers

    How does chronic liver disease affect glucose levels?

    <p>May cause decreased glucose levels due to gluconeogenesis impairment</p> Signup and view all the answers

    What typically occurs during the presence of portosystemic shunts due to severe cirrhosis?

    <p>They are equivalent to end-stage liver disease changes</p> Signup and view all the answers

    What is the expected effect on coagulation factors in dogs with liver failure?

    <p>Coagulation factors are commonly decreased</p> Signup and view all the answers

    What is a common consequence of decreased gluconeogenesis in liver failure?

    <p>Decreased glucose levels in the blood</p> Signup and view all the answers

    What might cause red or reddish brown coloration in urine?

    <p>Intact red blood cells or hemoglobin</p> Signup and view all the answers

    Which statement accurately describes the sensitivity of dipstick methods?

    <p>More sensitive to albumin than globulins</p> Signup and view all the answers

    What could lead to urine appearing dark brown to black?

    <p>Conversion of hemoglobin to methemoglobin</p> Signup and view all the answers

    What indicates persistent moderate or heavy proteinuria in the absence of urine sediment abnormalities?

    <p>Glomerular disease</p> Signup and view all the answers

    What does cloudy urine typically signify?

    <p>Increased cells, crystals, mucus, or casts</p> Signup and view all the answers

    What factor can lead to a false positive result in urine tests?

    <p>Contamination with benzylalkonium chloride</p> Signup and view all the answers

    What is characteristic of rabbit urine?

    <p>White and opaque due to high calcium carbonate concentration</p> Signup and view all the answers

    What is the threshold plasma glucose level that leads to its appearance in urine in dogs and cats?

    <p>Approximately 180 mg/dL</p> Signup and view all the answers

    What is a primary cause of elevated GGT levels in horses?

    <p>Increased glucocorticoid administration</p> Signup and view all the answers

    In ruminants, what typically causes increases in ALP?

    <p>Cholestasis or osteoblastic activity</p> Signup and view all the answers

    Which statement about bilirubin metabolism is correct?

    <p>Conjugated bilirubin is also referred to as direct bilirubin</p> Signup and view all the answers

    What distinguishes GGT from ALP in the context of cholestasis detection?

    <p>GGT is superior to ALP for cholestasis detection in horses</p> Signup and view all the answers

    What factors can lead to an increase in bilirubin levels?

    <p>Increased hemoglobin production and decreased uptake and conjugation by hepatocytes</p> Signup and view all the answers

    Which animal's colostrum has very high levels of GGT?

    <p>Cattle and sheep</p> Signup and view all the answers

    Under what condition is cholestatic disease associated with elevated ALP in horses?

    <p>Less significant increase compared to other species</p> Signup and view all the answers

    What might not contribute to elevated levels of bilirubin in ruminants?

    <p>High dietary protein intake</p> Signup and view all the answers

    Which component is included in plasma but not in serum?

    <p>Fibrinogen</p> Signup and view all the answers

    What can falsely increase total protein concentration as measured by refractometry?

    <p>Excess lipid</p> Signup and view all the answers

    What does hyperalbuminemia typically indicate?

    <p>Dehydration</p> Signup and view all the answers

    Which globulin fraction is most commonly increased in acute inflammation?

    <p>Alpha globulin</p> Signup and view all the answers

    What condition is likely associated with hypoglobulinemia despite normal or increased albumin levels?

    <p>Failure of passive transfer</p> Signup and view all the answers

    What measurement method is more accurate for albumin concentration evaluation?

    <p>Spectrophotometry</p> Signup and view all the answers

    Which condition is likely to present with both hyperalbuminemia and hyperglobulinemia?

    <p>Dehydration</p> Signup and view all the answers

    Which of the following proteins is primarily measured within the globulin fractions?

    <p>Enzymes</p> Signup and view all the answers

    What does an elevation in serum creatinine indicate regarding renal function?

    <p>Renal mass is functioning at less than 25%</p> Signup and view all the answers

    Which of the following factors can lead to increased blood urea nitrogen (BUN) levels?

    <p>Increased gastrointestinal bleeding</p> Signup and view all the answers

    What is a limitation of using inulin clearance as a standard measurement of GFR?

    <p>Inulin is difficult to measure and not readily available</p> Signup and view all the answers

    In which scenario might a normal serum creatinine concentration not rule out renal disease?

    <p>Even when urine osmolality is within normal range</p> Signup and view all the answers

    How does urine osmolality correlate with specific gravity?

    <p>There is usually a linear relationship</p> Signup and view all the answers

    What might be inferred if a dog has elevated serum phosphorus levels?

    <p>Kidney function is compromised</p> Signup and view all the answers

    What can be a consequence of cachexia regarding serum creatinine concentrations?

    <p>Decreased serum creatinine concentrations</p> Signup and view all the answers

    Which value best represents the gold standard for measuring glomerular filtration rate (GFR)?

    <p>Inulin clearance</p> Signup and view all the answers

    Which crystal type is associated with alkaline urine and is commonly found in normal animals?

    <p>Struvite crystals</p> Signup and view all the answers

    What condition leads to hypertonic dehydration?

    <p>Loss of more water than solute</p> Signup and view all the answers

    Which type of crystals is specifically associated with acidic urine and commonly linked to a particular breed?

    <p>Uric acid crystals</p> Signup and view all the answers

    What physiological change is observed in isotonic dehydration?

    <p>Equal losses of water and solute</p> Signup and view all the answers

    Which statement describes the compensation for hypertonic dehydration?

    <p>Slower change in urinary acidification</p> Signup and view all the answers

    Which crystal type is NOT typically found in alkaline urine?

    <p>Uric acid crystals</p> Signup and view all the answers

    What clinical signs are associated with severe dehydration of 13% to 15% body weight?

    <p>Vascular collapse and renal failure</p> Signup and view all the answers

    Which statement regarding species specific responses to dehydration is accurate?

    <p>Dogs and cats produce hypotonic sweat.</p> Signup and view all the answers

    Which enzyme levels indicate liver injury in dogs and cats when the ratio of ALT to AST is greater than 1?

    <p>↑ ALT is greater than ↑ AST</p> Signup and view all the answers

    When comparing AST and CK levels in horses, which results would likely indicate solely liver injury?

    <p>↑ AST with no ↑ CK</p> Signup and view all the answers

    What would be expected in a dipstick test of urine that is positive for hemoglobin and has a red serum?

    <p>Hemoglobinuria is likely present</p> Signup and view all the answers

    What distinguishes the result of ammonium sulfate precipitation when evaluating hemoglobin in urine?

    <p>Hemoglobin precipitates, resulting in a negative test</p> Signup and view all the answers

    Which condition is implicated when elevated CK levels are found alongside elevated AST?

    <p>Combined liver and skeletal muscle injury</p> Signup and view all the answers

    In the evaluation of lipids, what type of lipid primarily serves as an energy source for cells?

    <p>Triglycerides</p> Signup and view all the answers

    Which enzyme is used to evaluate muscle injury when it is present in higher levels than ALT and AST?

    <p>CK (Creatine Kinase)</p> Signup and view all the answers

    Which substance would continue testing positive for hemoglobin after ammonium sulfate precipitation if myoglobinuria is present?

    <p>Myoglobin in supernatant</p> Signup and view all the answers

    Which test is considered a sensitive and specific indicator for pancreatitis in cats?

    <p>Fecal muscle fiber analysis</p> Signup and view all the answers

    What does the failure of turbidity to occur in a fat absorption test indicate?

    <p>Impaired intestinal absorption</p> Signup and view all the answers

    What is the main purpose of conducting a fecal flotation test?

    <p>To identify parasitic ova and oocysts</p> Signup and view all the answers

    After a 12-hour fast, what is administered to evaluate lipid absorption in the fat absorption test?

    <p>Corn oil</p> Signup and view all the answers

    How is serum TLI levels affected in animals suffering from exocrine pancreatic insufficiency (EPI)?

    <p>Decreased in both dogs and cats</p> Signup and view all the answers

    What is indicated if turbidity occurs in a fat absorption test after preincubation with pancreatic enzymes?

    <p>Absorption is adequate, digestion is poor</p> Signup and view all the answers

    Which of the following statements about the sensitivity of the fat absorption test is true?

    <p>The sensitivity of this test is poor.</p> Signup and view all the answers

    In the context of fecal tests, which method is best for detecting Strongyloides and Coccidia?

    <p>Direct smear</p> Signup and view all the answers

    Which of the following conditions is commonly associated with polyclonal gammopathies?

    <p>Chronic antigenic stimulation</p> Signup and view all the answers

    What is the most accurate method for measuring globulin concentration in serum?

    <p>Subtracting serum albumin from total protein</p> Signup and view all the answers

    Which factor might lead to a false elevation in plasma protein concentration when using refractometry?

    <p>Dehydration</p> Signup and view all the answers

    Which of the following components is typically included in the beta-globulin fraction?

    <p>Transferrin</p> Signup and view all the answers

    What condition is linked to an increase in hyperfibrinogenemia?

    <p>Dehydration and inflammation</p> Signup and view all the answers

    Which of the following immunoglobulins might be inaccurately measured due to refractometry not being reliable in foals?

    <p>IgG</p> Signup and view all the answers

    Which immunoglobulin condition is characterized by monoclonal gammopathies?

    <p>Multiple myeloma</p> Signup and view all the answers

    What diagnostic method allows for the accurate measurement of immunoglobulins in serum?

    <p>Serum protein electrophoresis</p> Signup and view all the answers

    What characterizes a metabolic acidosis?

    <p>A decrease in HCO3 levels</p> Signup and view all the answers

    Which condition is associated with a decrease in PCO2?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    What change occurs in compensation for chronic respiratory alkalosis?

    <p>Decreased HCO3 levels</p> Signup and view all the answers

    How is base excess calculated?

    <p>From blood gas parameters</p> Signup and view all the answers

    What does an increase in total CO2 levels indicate?

    <p>Metabolic alkalosis</p> Signup and view all the answers

    What does the anion gap calculation help estimate?

    <p>Changes in unmeasured anions and cations</p> Signup and view all the answers

    What primary parameter indicates respiratory disorders?

    <p>Change in PCO2 levels</p> Signup and view all the answers

    What is suggested if HCO3 measurement is not available?

    <p>Estimate using total CO2 from a chemistry profile</p> Signup and view all the answers

    What effect does decreased glucose uptake by the liver have on glucose levels?

    <p>It may increase glucose levels.</p> Signup and view all the answers

    What condition is indicated by the presence of myoglobin in urine?

    <p>Myoglobinuria</p> Signup and view all the answers

    In cases of liver failure, what happens to blood ammonia concentration?

    <p>It increases considerably.</p> Signup and view all the answers

    Which of the following correctly describes myoglobinuria?

    <p>It can cause urine to appear dark brown to red-brown.</p> Signup and view all the answers

    What can be inferred about cholesterol levels in a patient with cholestasis?

    <p>Cholesterol levels may be increased.</p> Signup and view all the answers

    During end-stage liver disease, what percentage of liver mass is typically lost?

    <p>60% to 80%</p> Signup and view all the answers

    Which statement about lipoproteins (LPs) is correct?

    <p>LPs can be classified according to their density.</p> Signup and view all the answers

    What is the primary characteristic of chylomicrons?

    <p>They are cleared quickly by the liver after meals.</p> Signup and view all the answers

    What commonly happens to coagulation factors in dogs with liver failure?

    <p>They decrease.</p> Signup and view all the answers

    How does lipoprotein electrophoresis function?

    <p>It separates lipoproteins based on their charge and size.</p> Signup and view all the answers

    How does decreased gluconeogenesis affect glucose levels during liver failure?

    <p>Glucose levels are likely to decrease.</p> Signup and view all the answers

    In chronic liver disease, which enzyme activity is typically observed?

    <p>Induced enzymes may be mildly increased.</p> Signup and view all the answers

    Which factor can lead to hyperchylomicronemia?

    <p>Decreased activity of lipoprotein lipase.</p> Signup and view all the answers

    Which of the following statements about myoglobin is correct?

    <p>Myoglobin is rapidly excreted by the kidneys.</p> Signup and view all the answers

    What laboratory finding is expected in patients with early portosystemic shunts?

    <p>Normal leakage enzyme levels.</p> Signup and view all the answers

    Which element is NOT a major component of lipoproteins?

    <p>Nucleic acids</p> Signup and view all the answers

    What does the appearance of serum resembling whole milk typically indicate regarding triglyceride levels?

    <p>Triglyceride concentrations range from 2500 to 4000 mg/dL.</p> Signup and view all the answers

    Which test can be performed to evaluate the presence of chylomicrons in serum?

    <p>Refrigeration test</p> Signup and view all the answers

    What condition can lead to extreme hyperglycemia in cattle due to decreased peripheral glucose use?

    <p>Proximal duodenal obstruction</p> Signup and view all the answers

    Which of the following statements about chlomicron layers after refrigeration is true?

    <p>If serum remains turbid after refrigeration, excess VLDLs or LDLs are present.</p> Signup and view all the answers

    Which drugs are commonly known to affect glucose metabolism?

    <p>Glucocorticoids and xylazine</p> Signup and view all the answers

    Hypolipidemia may occur as a result of which condition?

    <p>Liver failure</p> Signup and view all the answers

    What effect does insulin overdose have on glucose levels?

    <p>Causes severe hypoglycemia.</p> Signup and view all the answers

    Which of the following conditions is associated with increased insulin production leading to hypoglycemia?

    <p>Pancreatic tumor</p> Signup and view all the answers

    What is the typical centrifugation speed for urine samples during sediment preparation?

    <p>1000 to 1500 rpm</p> Signup and view all the answers

    Which type of cast is indicated by white cell casts?

    <p>Pyelonephritis</p> Signup and view all the answers

    What condition is commonly associated with red cell casts in urine?

    <p>Acute glomerulonephritis</p> Signup and view all the answers

    What might excessive numbers of RBCs in urine indicate?

    <p>Hematuria from multiple causes</p> Signup and view all the answers

    Which cast is associated with severe tubular injury?

    <p>Granular casts</p> Signup and view all the answers

    What is the implication of finding renal epithelial casts in urine?

    <p>Acute tubular necrosis or severe tubular injury</p> Signup and view all the answers

    What describes hemoglobin casts?

    <p>The hemoglobin color is retained in the cast.</p> Signup and view all the answers

    What can cause hematuria in urine samples?

    <p>Trauma and neoplastic diseases</p> Signup and view all the answers

    Which statement is most accurate regarding the metabolism of bilirubin?

    <p>Bilirubin is produced from the breakdown of heme in macrophages.</p> Signup and view all the answers

    What is the expected effect of a portosystemic shunt on bile acid concentrations?

    <p>Postprandial concentrations are significantly elevated.</p> Signup and view all the answers

    What distinguishes normal liver function from conditions such as cholestasis or cirrhosis?

    <p>Both cholestasis and cirrhosis can lead to increased bile acids in fasting samples.</p> Signup and view all the answers

    Which statement is true regarding the metabolism of bile acids?

    <p>Fasting bile acid concentrations are usually lower than postprandial concentrations.</p> Signup and view all the answers

    What is the typical presentation of bilirubin in animals with significant liver disease?

    <p>Bilirubin levels may increase because of enhanced production or reduced clearance.</p> Signup and view all the answers

    Which condition is most likely to cause hypophosphatemia due to chronic metabolic acidosis?

    <p>Redistribution between ICF and ECF</p> Signup and view all the answers

    What factor is NOT associated with primary hypoparathyroidism?

    <p>High parathyroid hormone levels</p> Signup and view all the answers

    Which of the following statements about ionized calcium is correct?

    <p>Ionized calcium is unaffected by dietary calcium intake</p> Signup and view all the answers

    Excessive ingestion of phosphate binders primarily causes which condition?

    <p>Hypophosphatemia</p> Signup and view all the answers

    Which of these conditions could increase the risk of hypocalcemia?

    <p>All of the above</p> Signup and view all the answers

    What physiological response is likely associated with acute acidosis regarding calcium levels?

    <p>Increased ionized calcium concentration</p> Signup and view all the answers

    Chronic renal dysfunction may lead to secondary hyperparathyroidism through which mechanism?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a characteristic of hyperphosphatemia in patients with renal failure?

    <p>Redistribution of phosphate from ICF to ECF</p> Signup and view all the answers

    What occurs to the anion gap when unmeasured anions increase?

    <p>It increases</p> Signup and view all the answers

    What primarily accounts for unmeasured cations in the body?

    <p>Calcium and magnesium</p> Signup and view all the answers

    Which factor would lead to an increase in osmolal gap?

    <p>Increase in osmotically active particles not accounted for</p> Signup and view all the answers

    What is the most significant effect of metabolic acidosis on bicarbonate levels?

    <p>Bicarbonate levels decrease significantly</p> Signup and view all the answers

    How does the concentration of bicarbonate change during respiratory alkalosis?

    <p>Bicarbonate levels decrease</p> Signup and view all the answers

    What effect does salt poisoning have on osmolality?

    <p>It causes an increase in osmolality</p> Signup and view all the answers

    Which of the following statements is true about metabolic alkalosis?

    <p>Bicarbonate levels are significantly elevated</p> Signup and view all the answers

    What is the formula for calculating osmolality?

    <p>1.86 [Na (mmol/L)] + [glucose (mg/dL)/18]</p> Signup and view all the answers

    What is the primary cause of myoglobinemia?

    <p>Release from dead muscle cells into the blood</p> Signup and view all the answers

    Which of these best describes the coloration of urine in myoglobinuria?

    <p>Dark brown to red-brown</p> Signup and view all the answers

    How are lipoproteins classified?

    <p>According to their density</p> Signup and view all the answers

    Which lipoprotein is primarily composed of triglycerides that are transported after a meal?

    <p>Chylomicrons</p> Signup and view all the answers

    What happens to chylomicrons after they are formed?

    <p>They are cleared rapidly by the liver</p> Signup and view all the answers

    What is indicated if a urine dipstick is positive for hemoglobin while serum appears colorless?

    <p>Myoglobinuria may be present</p> Signup and view all the answers

    What is the main analytical method for separating lipoproteins based on their charge?

    <p>Lipoprotein electrophoresis</p> Signup and view all the answers

    What is the least dense lipoprotein that can float in serum containing excess chylomicrons?

    <p>Chylomicrons</p> Signup and view all the answers

    Study Notes

    Urine Color

    • Red or reddish-brown urine is due to red blood cells, hemoglobin, or myoglobin
    • Dark brown to black urine likely indicates the conversion of hemoglobin to methemoglobin
    • Yellow-brown to yellow-green urine can be due to bilirubin
    • Green urine may be caused by Pseudomonas infection or bilirubin oxidation to biliverdin

    Urine Appearance

    • Dog urine is normally clear, but it may be cloudy in approximately 20% of cases
    • Cloudy urine often indicates an increase in cells, crystals, mucus, or casts
    • Horse urine is frequently cloudy due to mucus
    • Rabbit urine is white and opaque because of the high concentration of calcium carbonate

    Urine Odor

    • Chloride usually accompanies sodium to maintain neutrality

    Ethylene Glycol Toxicity

    • Ethylene glycol is a small osmotically active molecule that may increase the osmolal gap in urine
    • The osmolal gap correlates well with ethylene glycol concentration in serum

    Sodium

    • Sodium is the primary cation in extracellular fluid (ECF)
    • It plays a crucial role in fluid movement across epithelial surfaces

    Hyponatremia

    • Pseudohyponatremia can occur with hyperlipidemia or hyperproteinemia
    • In these cases, the plasma sample is diluted by excessive lipid or protein, leading to a falsely low sodium measurement

    Potassium

    • Potassium is the primary cation within intracellular fluid (ICF)
    • It influences resting cell membrane potential

    Hypokalemia

    • Hypokalemia (often linked to alkalosis) can result from decreased intake, translocation between ECF and ICF, or increased loss
    • Decreased intake may be caused by factors like anorexia, dietary deficiency, or administration of potassium-free fluids

    Bilirubin

    • Most bilirubin in horses is in an unconjugated form
    • Once within hepatocytes, bilirubin is conjugated, and mostly secreted into bile
    • A small amount of conjugated bilirubin, also known as direct bilirubin, passes back into the blood
    • Bilirubin levels increase with increased hemoglobin production (due to red blood cell breakdown), reduced uptake and conjugation by hepatocytes, and decreased outflow of conjugated bilirubin (cholestasis)
    • Bilirubin is not reliably elevated in conditions like hepatic lipidosis, steroid hepatopathy, and neoplasia

    Bile Acids

    • Bile acids are produced in hepatocytes and play a role in fat digestion
    • An increase in circulating bile acids is often associated with one of four disorders: congenital portosystemic shunting, hepatic microvascular dysplasia, intrahepatic cholestatic disease, or extrahepatic bile duct obstruction

    Liver Function Tests

    • Alkaline Phosphatase (ALP) is an enzyme commonly used to assess liver function, especially in cases of cholestasis
    • Increases in ALP are usually due to cholestasis, but other factors such as bone growth and metabolism can also cause elevations
    • Elevations in ALP are typically more pronounced in animals with cholestasis than in horses
    • The increase in ALP in horses with cholestasis is significantly less than in other species

    Gamma-Glutamyl Transferase (GGT)

    • GGT is an enzyme considered to be induced; however, acute injury can also lead to elevated levels
    • Elevated GGT is primarily associated with cholestasis
    • It can also be induced by various factors like glucocorticoids and anticonvulsants
    • GGT is a more reliable indicator of cholestasis compared to ALP in horses and ruminants
    • Calves and sheep consuming colostrum have extremely high levels of GGT due to its presence in high levels in cattle and sheep colostrum

    Ammonia Concentration

    • Ammonia levels usually increase in individuals with portosystemic shunts or when over 60% of liver mass is lost

    Albumin

    • Albumin levels decrease when 60% to 80% of liver function is lost

    Globulins

    • Globulin levels may be elevated, particularly in horses

    Glucose

    • The liver converts glucose to glycogen
    • Glucose levels may increase if there is reduced glucose uptake by the liver
    • Glucose levels may decrease if there is decreased gluconeogenesis or glycogenolysis

    Urea

    • Urea is synthesized in the liver from ammonia
    • Blood urea nitrogen (BUN) levels decrease with liver failure
    • Blood ammonia concentration increases with liver failure

    Cholesterol

    • Cholesterol levels may decrease if there is reduced synthesis of cholesterol in the liver
    • Cholesterol levels may increase in the case of cholestasis, preventing the excretion of cholesterol in bile

    Coagulation Factors

    • Coagulation factors are commonly reduced in dogs experiencing liver failure

    Liver Disease Changes

    • Portosystemic shunts can cause liver disease changes based on severity. In severe cirrhosis, end-stage liver disease changes are expected, while early shunts don't significantly impact hepatocytes, so leakage enzymes are usually not elevated.

    Steroid Hepatopathy

    • Most common in dogs
    • Leakage enzymes are mildly increased
    • Induced enzymes are markedly increased
    • Bilirubin may be mildly increased

    Biliary Disorders

    • Induced enzymes are remarkably increased
    • Leakage enzymes may be mildly increased due to hepatocyte injury from cholestasis
    • Bilirubin and bile acids are typically increased

    Chronic Liver Disease

    • Leakage enzymes might be elevated based on the extent and rate of progression of the disease
    • Induced enzymes are typically mildly to moderately elevated
    • Bilirubin concentration is usually normal to mildly elevated in advanced stages
    • In end-stage liver disease, many individuals have increased ammonia, decreased BUN, decreased albumin, and abnormal coagulation tests.

    Pancreas

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