Laboratory

LaboratoryOur feline friends cannot (or do not) tell us when they are unwell.  We often use blood and urine tests along with a detailed history and comprehensive physical examination to help us determine if there is a problem internally.  In some respects, the blood and urine tests are helping our patients “speak to us”.  In our experience, our patients typically “look sick” during advanced stages of disease and appear “sick” suddenly despite the fact that disease has been present for weeks to months.  Remember, cats are small and had many predators in the wild.  If they exhibited signs of illness or weakness, they would fall victim to predators.  What does this mean?  This inherent instinct of cats translates into cats showing they are unwell only during advanced stages of disease when they cannot “hide” disease anymore.  By hiding the fact that they are unwell, they avoid detection by predators.  Unfortunately, you are now the “predator” because if your cat tells you that they are not feeling well, you bring your cat to a hospital (as you should!).

Screening


To help counteract this inherent nature of the cat, we recommend annual blood and urine screens.  This concept is called Patient Trending.  Patient trending allows our doctors to do a number of things. Firstly, we are able to establish normal values for your individual cat while they are young and healthy.  Secondly, by comparing the results year after year, we are able to detect changes early.  Not only are we able to detect changes when values fall outside the normal reference range, we are able to spot and monitor changes within the reference range.  If your cat’s kidney values begin to increase but are still within the reference range, we have an opportunity to begin treatment early and monitor the trends more closely.  Patient Trending can be a powerful tool to detect and treat disease early.  Again, the main goal is to ensure our patients lead healthier, longer lives.

Pre-anesthetic screens

Any patient requiring anesthesia will be required to have a pre-anesthetic internal organ screen.  Even though our anesthetic protocols are safe, patients with an internal issue may pose a greater anesthetic risk.  If a problem is detected prior to anesthesia, a protocol can be tailored for your cat to help minimize the risk of anesthesia.  Since we are administering a number of injections for pain and anesthesia, and IV (intravenous) fluids during the procedure, a comprehensive screen is required.  The more information we have prior to anesthesia and IV fluids, the better.

Specific Tests


Our hospital is equipped with an in-house laboratory to provide same day results with common blood and urine tests.  This is particularly useful when your cat is suddenly unwell and needs appropriate treatment quickly.  We also use an outside laboratory for wellness screens and additional specialized tests.  Below are explanations of commonly used blood and urine tests.

Fecal Analysis

We recommend a fecal analysis at least every 12 months for our patients.  Why?  Your pet may be harboring parasites and you may not know it (even indoor only cats).  A number of these parasites are zoonotic or can be transferred to humans.  Young children, the elderly, or immunocompromised individuals are at greatest risk from a zoonotic parasite you cat may beha.  Parasites that we screen for include roundworms, hookworms, tapeworms, Toxoplasma, giardia, coccida, and Cryptosporidium.  Please visit the links below for more information.

CAPC CDC

In addition to fecal testing, we recommend at least annual de-wormings in our patients, especially in certain circumstances:
  • Your cat spends any amount of time outside, even if just on a leash or on a porch.
  • Your cat hunts, even indoor only cats.
  • Children or elderly are in the household.
  • Someone in the household has a weakened immune system or is unwell.
Feline leukemia (FeLV) & feline immunodeficiency virus (FIV)

Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are major causes of illness and death in cats.  Our hospital strictly follows the American Associations of Feline Practitioners (AAFP) Retroviral Testing Guidelines.  All kittens (and cats) should be tested at least twice in their lifetime 2-3 months apart.  All unwell patients need to be tested, even if done previously, as the viruses may “hide” within the body and “come out” at a later date.

Chemistry Panel

These routine blood tests evaluate a number of internal organs and secondary changes when disease is present.  Our chemistry panels provide our doctors with the following important information:

  • Kidney evaluation – Two waste products in the blood, creatinine and BUN (urea), give us a sense if your cat’s kidneys are functioning correctly.

     
  • Liver evaluation – Changes in your cat’s liver enzymes (ALKP, ALT) and bilirubin levels helps us determine how this important organ is functioning.

     
  • Electrolytes & minerals – Many diseases may change or alter your cat’s electrolytes (sodium, chloride, potassium) and minerals (calcium, phosphorus, magnesium).  Patterns of electrolyte disturbances or changes in mineral content in the blood may give important clues to the health of your cat.

     
  • Blood protein levels (albumin, globulin, total protein) – Changes may indicate an inflammatory process, and infectious process, or disease in an internal organ.

     
  • Glucose – Measurement of your cat’s blood sugar helps screen for diabetes.
Complete Blood Count (CBC)

These routine blood panel evaluates bone marrow production and the immune system.  Our complete blood counts provide our doctors with the following important information:

  • White blood cell evaluation – White blood cells help your cat’s body fight off infection.  Changes in specific white blood cells lines (neutrophils, lymphocytes, eosinophils, monocytes, basophils) may give important clues to the health of your cat. Abnormalities may indicate an infection, inflammation or cancer.
     
  • Red Blood cells – Changes in red blood cell parameters may give us a clue about a bone marrow disorder, parasites, chronic disease in an internal organ, or an immune-mediated process.
     
  • Platelets – Platelets are used to form clots and prevent bleeding from blood vessels.  Changes in platelet counts may indicate a problem about your cat’s health.
Thyroid Hormone (T4)

The most common hormone disorder in cats results from an abnormal enlargement in the thyroid gland and an excessive production of thyroid hormone.  Clinically, you may notice weight loss, a ravenous appetite, vomiting, and behavior change.  All cats over 8 years of age should be screened for thyroid disease annually.

Urinalysis

Evaluation of the urine is an important aspect of our above wellness profiles.  Our urinalysis evaluates for the following:
  • Urine concentration (this helps evaluate the kidney function)
  • Urine pH
  • Presence of crystals
  • Presence of bacteria
  • Cells (red blood cells, white blood cells, kidney cells, other abnormal cells)
  • Glucose
  • Protein
  • Ketones
  • Bilirubin
Young Wellness Screens

In an attempt to pursue Patient Trending and establish your individual cat’s normal values, we pursue an annual young wellness screen in our patients less than 8 years of age.  What is included in this screening?

Senior Screens

Age is not a disease; however, we know the diseases that affect our patients in their later years.  At 8 years of age, we pursue an annual comprehensive screening and blood pressure measurement in an attempt to continue the Patient Trending started early in life and to aid our doctors in detecting and treating disease early.  The most common diseases in our older patients include kidney disease, thyroid disease, diabetes mellitus, inflammatory bowel disease (IBD) and cancer. The goal is prevention and early detection. What is included in this screening?
Blood Glucose (BG)Curves

We perform BG curves on our diabetic patients to monitor the response to insulin injections administered at home.  These curves are pursued in new diabetic patients and diabetic patients that suddenly become uncontrolled.  A BG curve determines the blood glucose level every 2-4 hours (depending on the insulin used) throughout the day.  We are able to monitor the blood glucose “highs” and “lows” in response to the insulin administered.  With this information, we are able to make sure your cat is receiving an appropriate dose of insulin (i.e. not too much, not too little).

Outside Laboratory


We use an outside laboratory to provide a more comprehensive evaluation of our patients with tests that cannot be performed in-house.  The turn around time is typically 24 hours.  The use of an outside laboratory allows us to speak directly with a veterinarian specialist if needed.  Some tests we commonly pursue include:

  • Heartworm antibody & antigen tests– These tests help us evaluate our patients for previous and current heartworm infections. This annual blood tests evaluates for antibodies against heartworms in your cat.  A positive heartworm test means your cat had a previous heartworm infection.  A positive heartworm test may also mean an increased risk for anesthesia.  Feline heartworm disease is a serious, life-threatening disease and is 100% preventable with year round protection. There is currently no treatment for heartworm disease in cats, so screening and prevention is key!
  • Fructosamine – For our diabetic patients, this tests helps us monitor our insulin treatment by taking an average of the blood glucose in the previous 2-3 weeks. 
  • Urine C&S (culture and sensitivity) – Urine is submitted to determine if bacteria are present and what antibiotics the bacteria are susceptible to.  This test is used to rule out urinary tract infections (UTIs) and determine the response to treatment if a UTI is documented.  This test may be recommended in patients that are predisposed to urinary tract infections (i.e. kidney patients, diabetic patients, hyperthyroid patients), patients with urinary issues (i.e. bloody urine, frequenting the litter box often, inappropriate urination), changes are noted on a urinalysis (i.e. red blood cells or white blood cells are seen), and when urine is not very concentrated (specific gravity or concentration is less than 1.035).
  • Gastrointestinal Panel (PLI/TLI/B12/Cobalimin) – These pancreas and vitamin tests help our doctors evaluate diseases and changes associated with the digestive tract.  These tests are valuable in patients with a history of vomiting, diarrhea, constipation and/or weight loss. 
  • Cytology – Sometimes, we want a board certified pathologist to give us their opinion on a slide of a blood smear, an impression smear from an area on your cat, or the cells obtained with a fine needle aspirate.  Looking directly at the cells may give more information than the above blood tests can provide. 
  • Histopathology – A board certified pathologist makes very thin slides of tissue samples from a biopsy.  We are able to obtain a wealth of information from this direct evaluation of the tissue.  Together with blood and urine tests, we are able to gain a very accurate picture of the health status of your cat.


 
 
 
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1533 DeKalb Street            Norristown, PA 19401            (610) 279-2287 (CATS)

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