clinical biochemistry topics

Calcium allows recognition of hyperparathyroidism and other causes of hypercalcemia (which causes polydipsia and renal insufficiency), glucose may indicate diabetes mellitus and contributes to the pattern characteristic of hyperadrenocorticism, and cholesterol also adds to the appreciation of the “Cushing pattern.” Renal failure is covered by the tests already included in the basic panel. If there is no evidence of small-intestinal disease in such patients, a trial therapy with pancreatic enzymes and reevaluation of serum TLI concentration after 1 mo is indicated. The clinical use of fecal proteolytic activity is limited to species for which more specific assays to estimate pancreatic function are not available and in areas where the more accurate and sophisticated tests are not available. In view of these findings, PLI assays for both dogs and cats have been optimized toward higher concentrations, and the current assays are no longer suitable for diagnosis of EPI in dogs or cats. Instruments are available that can analyze whole blood, although great care must be taken to avoid artifacts due to unappreciated hemolysis. A rapid whole-blood color comparison strip is also available, but these read only up to ~20 mmol/L and are thus of limited use. Investigate the aggregation of B lymphocyte cell line from a chicken and determine its temperature … These yield acceptably accurate results on animal blood, although an unexpected hypoglycemia should be confirmed by a professional laboratory. It decreases due to overhydration, severe congestive heart failure (with edema), protein-losing nephropathy, protein-losing enteropathy, hemorrhage, burns, dietary protein deficiency, malabsorption, and some viral conditions (especially in horses). From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. PLI is also highly specific for exocrine pancreatic function and could be used to diagnose EPI. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. Analysis of other body fluids (eg, urine, ascitic fluids, CSF) is also included. Reflectance photometry methods do not always compare well with the reference method and are best confined to simpler tests such as glucose and urea. It decreases due to hypoalbuminemia, parturient paresis, oxalate poisoning, chronic renal failure (secondary renal hyperparathyroidism), acute pancreatitis (occasionally), surgical interference with parathyroid glands, and idiopathic (autoimmune) hypoparathyroidism. In cats, serum amylase and lipase activities are of no clinical value for diagnosis of pancreatitis. It is also reported to increase in hypothyroidism. Two types are available—those based on transmission/absorbance photometry (wet chemistry) and those based on reflectance photometry (dry-reagent chemistry). Dual-purpose, high-speed microhematocrit centrifuges are favored for in-practice use, because they separate samples more quickly and the same machine can be used to measure PCV. Other tests for diagnosis of pancreatitis in dogs and cats have been evaluated, including plasma trypsinogen activation peptide (TAP) concentration, urine TAP concentration, urine TAP:creatinine ratio, serum α1-proteinase inhibitor trypsin complex concentration, and serum α2-macroglobulin concentration. The reason for this is not known. This is a qualitative judgment but is nevertheless useful, especially in equine patients. Critical care meters are also available that can estimate a variety of analytes, including glucose, urea, and electrolytes; however, these have not been extensively validated on nonhuman blood, and results should be interpreted with caution. Galactose Metabolism. The veterinarian in charge of the laboratory is responsible for all the results issued and incurs a legal liability to prove accuracy and reliability. Further tests may be added to the basic panel, according to the principal presenting signs, to create panels for polydipsic animals, collapsing animals, etc. Better appreciation of the source of the jaundice is gained from bile acid measurements. It is therefore of very limited value in general clinical practice. Clinical biochemistry refers to the analysis of the blood plasma (or serum) for a wide variety of substances—substrates, enzymes, hormones, etc—and their use in diagnosis and monitoring of disease. Most of these methods, particularly the radiographic film clearance test, are unreliable. The new tube must be adequately labeled. At the same time, many dogs and cats with chronic diarrhea and weight loss have mild decreases in serum TLI concentration. One test is very seldom specific to one clinical condition, and basic checklists of factors affecting the most commonly requested analytes are given below. Last full review/revision Jun 2015 | Content last modified Jun 2015, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, This puppy has an extrahepatic portosystemic shunt (PSS), This puppy has copper-associated hepatopathy, This puppy has microvascular dysplasia (MVD). The Merck Veterinary Manual was first published in 1955 as a service to the community. These panels are structured so that the patterns of abnormalities typical of all the likely differential diagnoses applicable to the situation can be discerned.

Triglyceride levels may be visualized in a plasma or serum sample as lipemia.

However, none has been shown to be of clinical usefulness. Decreases are seen in some downer cows and as part of the stress pattern in horses and small animals. Steroid administration can also increase serum lipase activity and cause variable responses in serum amylase activity. However, a small number of these dogs and cats may have EPI.

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A fecal canine elastase concentration assay has been developed and validated but is inferior to the widely used TLI measurement. Copyright © 1996-2020 themedicalbiochemistrypage, LLC, Enzyme Kinetics and Diagnostic Uses of Enzymes, Abbreviations Used in The Medical Biochemistry Page, Glossary of Terms used in The Medical Biochemistry Page, References Used in The Medical Biochemistry Page, Glycolysis and the Regulation of Blood Glucose, Bile Acid Synthesis, Metabolism, and Biological Functions, Bioactive Lipids and Lipid Sensing Receptors, Bioactive Lipid Mediators of Inflammation, Cholesterol: Synthesis, Metabolism, and Regulation, Eicosanoid Metabolism: Prostaglandins, Thromboxanes, Leukotrienes, and Lipoxins, Endocannabinoids in Feeding Behavior and Energy Homeostasis, Ethanol (Alcohol) Metabolism: Acute and Chronic Toxicities, Lipolysis and the Oxidation of Fatty Acids, Lipoproteins, Blood Lipids, and Lipoprotein Metabolism, NADPH: Reductive Biosynthesis and Cellular Redox Control, Omega-3 & Omega-6 Fatty Acid Synthesis, Metabolism, Functions, Sphingolipid Metabolism and the Ceramides, Synthesis of Fatty Acids, Triglycerides, and Phospholipids, Amino Acid Derivatives: Synthesis of Neurotransmitters, Nitric Oxide, and Additional Derivatives, Glycoproteins: Synthesis and Clinical Consequences, Mitochondria: Biogenesis, Functions, and Disease, Oxidative Phosphorylation and Related Mitochondrial Functions, The Pyruvate Dehydrogenase Complex and the TCA Cycle, Fatty Acid, Triglyceride, and Phospholipid Synthesis. If these cannot be guaranteed to the same standard as a referral laboratory, then results should not be relied on without external confirmation. The half-life is 72 hr in dogs but only 6 hr in cats. Glucose meters for use on whole blood are widely available for home use by human diabetic patients. Magnesium level increases are rarely seen, including during acute renal failure. Biochemistry Topics contains all the posts/pages that discuss the biochemistry of the synthesis and catabolism of carbohydrate, lipid, amino acid, and nitrogenous compounds with an emphasis on the medical and clinical relevance. Transmission/absorbance photometry is the reference method on which all reference values and interpretive guidelines are based. This is in contrast to serum lipase activity, which measures the enzymatic activity of all triglyceridases present in the serum, regardless of their cellular origin. In dogs and cats, unless investigating specific muscle disease, increased levels are generally of no clinical significance. Rarely, animals with serum TLI concentrations below the cut-off value for EPI do not have clinical signs of EPI. In healthy animals, only a small amount of trypsinogen is present in serum. In one study of 12 cats with severe forms of pancreatitis, not a single cat had serum lipase or amylase activity above the upper limit of the reference range. It is also valid for protein measurement of ascitic and pleural fluids. Otherwise, the milkiness is caused by triglycerides. Glucose measurement requires fluoride/oxalate plasma. Samples of known composition must be run at least daily for each analyte, in both normal and pathologic ranges; unless these are within the tolerance limits, no patient samples should be tested. Lipase (routine assay) is not a useful indicator of pancreatitis in cats. Phosphate level increases due to renal failure (secondary renal hyperparathyroidism). In small animals, increases in ALT and ALP levels can reach four times normal and still be associated only with fatty change, a nonspecific finding and not, in most cases, a primary liver problem. This can be achieved by using the ketone patch of a urine dipstick, giving a qualitative result. The half-life is 5 hr in dogs and 77 min in cats. In healthy animals, serum TLI is low, but during pancreatitis an increased amount of trypsinogen leaks into the vascular space, which can lead to an increase in serum TLI concentration. Total CO2 (bicarbonate) level increases in metabolic alkalosis and decreases in metabolic acidosis.

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