Clinical Chemistry

We offer a variety of chemistry group tests (e.g. small and large animal panels) for both mammalian and non-mammalian species. Some of our chemistry tests are not incorporated as panels and have to be requested individually. We prefer serum (red top tube) for chemistry testing (all our reference intervals are based on serum), with the exception of stat samples and samples submitted after 3 00 pm. The latter samples should be submitted in heparin (green top tube). Please refer to Sample Submission for more information on the required samples for chemistry tests. There are some differences in reference intervals for some analytes in serum versus heparinized plasma. Please refer to our Reference Intervals for more information.

We use an automated wet chemistry analyzer, the Roche Mod P, for our chemistry tests. As well as performing chemistry tests themselves, the Hitachi provides useful information about interferences in the sample. This is shown on our chemistry reports as special chemistry tests, the lipemic, hemolytic, and icteric indices. Some of our tests are also performed using other instrumentation. For example, patients on bromide therapy have artefactually high chloride (because bromide and chloride are both measured in the assay) with the Hitachi, but our bench instrument, the chloridometer, is less affected by this artefact. For this reason, it is always good practice to inform the laboratory of any medication the patient may be on so that we can modify our methods (if necessary). This is especially important in samples drawn after administration of hemoglobin-based oxygen carriers (e.g. oxyglobin), which are colored compounds that affect the results of many chemistry tests.

All of our chemistry tests that are components within panels can be ordered individually, rather than as group tests. This is useful for research samples.

Group Tests

To view our reports for certain tests below and to obtain more information about the individual components of each test, click on the test name below. For those tests that do not have links, most of the information can be gleaned from the other panels which include the same tests. Refer to the chemistry section of our teaching resource, eClinPath.

Panel Includes Specimen Required Comments
Bilirubin Panel Total, Direct, Indirect 2 ml clotted or heparinized blood Total bilirubin may be over-estimated in under-filled heparin tubes
Electrolyte Panel Na, K, Cl see above Lytes can be run quicker if heparinized blood is submitted
Iron Panel Iron (Fe), TIBC, % saturation see above
Large Animal Panel Na, K, Cl, Bicarb, Anion gap, Urea, Creat, Ca, P, Mg, Total Protein (TP), Alb, Glob, A/G ratio, Gluc, SDH, GLDH, AST, GGT, Tot. Bili, Dir. Bili, Ind. Bili, CK, Fe, TIBC, % sat. 3-5 ml clotted or heparinized blood
Large Animal Liver Panel TP, Alb, Glob, A/G ratio, Triglycerides, CK, SDH, AST, GLDH, GGT, Tot. Bili, Dir. Bili, Ind. Bili 3-5 ml clotted or heparinized blood
Large Animal Renal Panel Na, K, Cl, Bicarb, Anion gap, Urea, Creat, Alb, Ca, P 3-5 ml clotted or heparinized blood
Lytes Plus Panel Na, K, Cl, iCa 1 to 3 ml heparinized blood, preferably in syringe >NO MICROTAINERS!
MUST STAY ANAEROBIC
SUBMIT ASAP!!
Performed on blood gas machine
Metabolic Profile Panel BHB, NEFA, Urea, Albumin, AST non-anticoagulant (red top) tube For transition dairy cows.
Mineral / Lytes Panel Na, K, Cl, Bicarb, Anion Gap, Ca, P, Mg 3 to 5 ml clotted or heparinized blood
Non-mammalian Panel Na, K, Cl, Uric Acid, Ca, P, TP, Gluc, CK, AST, GLDH, Bile Acids Minimum 1 ml blood collected in heparinized microtainer. NO RED TOP MICROTAINERS!!!
Pre-anesthesia Panel (Large Animal) Na, K, Cl, Bicarb, Anion gap, Creat, Ca, Gluc, SDH 3-5 ml clotted or heparinized blood
Pre-anesthesia Panel (Small Animal) Na, K, Cl, Bicarb, Anion Gap, Creat, Ca, Gluc, ALT see above
Small Animal Panel Na, K, Cl, Bicarb, Anion gap, Na:K, Urea, Creat, Ca, P, Mg, TP, Alb, Glob, A/G, Gluc, ALT, AST, AP, GGT, Tot. Bili, Dir. Bili, Ind. Bili, Chol, CK, Amylase, Fe, TIBC, % Sat. see above
Small Animal Liver Panel Alb, AST, Glu, ALT, Urea, Alk Phos, GGT, Tot. Bili, Chol see above
Small Animal Renal Panel Na, K, Cl, Bicarb, Anion gap, Urea, Creat, Alb, Ca, P see above
Total Protein Panel TP, Albumin, Globulin, A/G Ratio 2 ml clotted or heparinized blood
Transition Cow Energy Profile Test Panel BHB, NEFA 2 ml clotted blood

Individual Tests

All the chemistry tests that are components of our panels can be ordered individually. There are also some tests that are not included in the panel, which must be ordered as individual tests. These are indicated below. Click on certain tests to obtain more information. Please refer to our Chemistry Module for additional information about the tests, including disease associations.

Bile acids:

Bile acids provide useful information about the portal venous circulation and hepatic function.

Bile acids aid in fat absorption and modulate cholesterol levels. They are produced from cholesterol in the liver and are stored in the gall bladder. Gall bladder contraction with feeding releases bile acids into the intestine. Bile acids undergo enterohepatic circulation, i.e. they are absorbed in the intestine and taken up by hepatocytes for re-excretion into bile. Bile acids increase in circulation under the following conditions:

Cholestasis: bile acids (along with conjugated bilirubin) regurgitate back into blood. Bile acids do not provide any additional information about hepatic function in the presence of cholestasis.
Liver disease: Bile acid extraction from portal blood is impaired, resulting in increased blood levels.
Portosystemic shunts: Congenital and acquired vascular shunts allow an increased proportion of portal blood to bypass the liver.
Measurement of bile acid concentrations is, therefore, a good indicator of hepatobiliary function, but is not specific for the type of underlying disease. In addition, extrahepatic diseases (e.g. metabolic diseases like hyperadrenocorticism) can elevate bile acid concentrations.

In small animals, measurement of both fasting and post-prandial bile acids is useful. Feeding stimulates gall bladder contraction which releases bile acids into the intestine and portal circulation (after intestinal absorption). This increases the load of bile acids that must be extracted from blood by the liver and increases the sensitivity of the procedure to hepatobiliary or vascular defects. Note that horses lack gall bladders and only fasting or random bile acid concentrations are measured in these species. Furthermore, the range of bile acid concentration in healthy ruminants is quite large, decreasing its diagnostic utility.

Bile Acid Interpretation.

For more information to bile acids, refer to the specialized chemistry test section.

Cholinesterase:

Measurement of cholinesterase activity in serum or plasma is a quick screening test indicated for animals with a history of possible exposure to organophosphate or carbamate compounds and/or that show clinical signs compatible with exposure. Remember that erythrocytes are rich in cholinesterase, therefore hemolysis invalidates the results.

Ionized calcium:

Total calcium (provided on the standard chemistry panels) consists of free or ionized calcium (50%), calcium bound to protein (40-45%), mainly albumin, and calcium complexed to anions (5-10%), e.g. citrate, lactate, bicarbonate. The total calcium concentration does not give an indication of what is available at the cellular level. Ionized calcium (iCa) is the form of calcium that is readily available to cells and actively regulated by the body. Measurement of iCa is a more accurate reflection of the physiological calcium state. The ionized calcium is performed on the ABL-800 Flex. Unlike total calcium, ionized calcium is unaffected by albumin concentration, but is affected by acid-base balance. ICa increases when the sample becomes more acidic. This occurs when there is delayed separation of plasma/serum from cells allowing increased production of acidic cellular metabolic byproducts. ICa is run on serum only and should be submitted in a plain red top tube. EDTA or citrate samples cannot be used (these anticoagulants chelate calcium). Heparinized plasma (green top tube) also results in a falsely decreased iCa, and is not recommended. The sample should be refrigerated and shipped overnight in an insulated container with freezer packs. If more than a 48 hour delay, the serum should be frozen and shipped on dry ice. For more information, see eClinPath.

LDH:

Lactate dehydrogenase catalyzes the conversion of lactate to pyruvate. It is not tissue-specific, being found in a variety of tissues, including liver, heart and skeletal muscle. There are at least 5 different isoenzymes, which are found in varying proportions in different tissues. Because LDH is so non-specific and isoenzyme measurement is not routinely available, its measurement does not confer any additional information about skeletal muscle or hepatic disease in domestic animals, than that provided by enzyme assays routinely used for this purpose (i.e. CK for muscle and SDH and ALT for liver).

Lipase:

Lipase hydrolyzes triglycerides and is used primarily as an indicator of pancreatitis in dogs. Lipase concentrations are variably increased in cats with pancreatitis, so it is less useful in this species.

Non-essential fatty acid (NEFAs), B-hydroxybutyrate (BHB) and metabolic profile testing in cattle:

NEFAs are performed to evaluate the energy balance of prepartum dairy cows, in particular. BHB testing is performed to determine the incidence of sub-clinical ketosis in dairy cows post-calving. These tests should never be interpreted on an individual cow basis and are only meaningful when interpreted on a herd-basis. For this reason, we recommend a minimum of 12 samples be submitted from each herd for this testing (these samples can be submitted whenever suitable cows can be tested and do not have to be submitted simultaneously - they should, however, be interpreted together). We also offer a metabolic profile test in dairy cows post-calving. This test includes BHB, NEFAs, Urea, albumin and AST. We will provide guidelines on interpretation with the test results.

Osmolality:

Serum and urine osmolality is affected by the number of osmotically active particles in solution and is unaffected by their molecular weight and size. For this reason, osmolality is superior to specific gravity, which is affected by particle weight and size.We measure osmolality with a freezing point depression osmometer; 1 osmol (defined as 1 mol of a nondissolving substance in 1 kg H2O) will decrease the freezing point by 1.86°C. Normal serum or plasma osmolality is between 290 and 330 mOsm/kg and is determined principally by sodium, which together with glucose, is an effective osmol. Urine osmolality is useful for evaluating urine concentrating ability, e.g. water deprivation tests, and is more accurate than measurement of urine specific gravity in this regard. Serum or plasma osmolality provides valuable information in suspected hyperosmolar states, e.g. hyperosmolar diabetic ketoacidosis or ethylene glycol poisoning. In the latter condition, an osmolal gap can be calculated from the measured osmolality minus the calculated osmolality. A very high osmolal gap (> 25) supports a diagnosis of ethylene glycol poisoning. Calculated osmolality is determined as follows:

Calculated osmolality = 2 x (Na + K) + (glucose ÷ 18) + (BUN ÷ 2.8),
where values for glucose and BUN are in mg/dL and values for Na and K are in mEq/L

SDH:

Sorbitol dehydrogenase is found in highest concentration in the liver. It is a cytoplasmic enzyme with a short half life (12-24 hours). It is a very specific indicator of liver disease in all species, with increases occurring within 24 hours of liver injury. SDH is the enzyme of choice for detecting hepatocellular injury in large animals and is included in our large animal chemistry panel.

Triglycerides:

Triglycerides are found in high concentrations in chylomicrons (CM) and very low density lipoproteins (VLDL). CM carry lipid absorbed after eating from the GI tract for uptake by adipose tissue and skeletal muscle. VLDL are produced in the liver from free fatty acids and are the main carrier of triglycerides in the fasting state, transporting triglycerides and cholesterol from the liver to peripheral tissues. Increased triglycerides can be seen secondary to increased CM (e.g. post-prandially) or increased VLDL (diseases, such as pancreatitis, diabetes mellitus, Cushing's etc). Visible lactescence (lipemia) in a blood sample is due to increased triglycerides.

Uric acid:

Uric acid is formed in the liver from the catabolism of the nucleic acids, adenine and guanine. Certain dog breeds, e.g. Dalmatians, have a defect in uric acid metabolism, resulting in supersaturation of the urine with uric acid. This predisposes this breed to urate urolithiasis (see uric acid under our urine tests). Uric acid is also used to assess renal function in birds (see non-mammalian chemistry panel). It can be measured in urine or blood.

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