Dog with liver disease and zero ALP

Re: Dog with liver disease and zero ALP

Martin Atkinson — Mon, 22 Jun 2015 08:44:50 GMT

[quote user="robloxley"]

[quote user="Michael Woodhouse"]VetTest[/quote] Sounds like martin has a vetscan.

[/quote]Yup its a Vetscan. Disadvantage I need to run a rota every time, big advantage it gives me electrolytes. And it correlates well with external labs albeit they are NEVER going to be exactly the same for a number of reasons.

Re: Dog with liver disease and zero ALP

John Flynn — Sun, 21 Jun 2015 23:16:18 GMT

[quote user="Michael Woodhouse"]I fell out with our VetTest after it lied to me one too many times.[/quote]

Personally, I consider the VetTest an excellent biochem analyser which has been reliable (and crucially user-serviceable!) for over a decade now. Run samples on serum (NOT plasma) when possible and be aware of the approximate confidence intervals and interferences on the various assays and the information it can provide as a bedside test is invaluable. Economical to run also.

I agree though that for non-emergency/weekend testing I would use an external lab 90% of time.

Re: Dog with liver disease and zero ALP

Rob Loxley — Sun, 21 Jun 2015 23:02:37 GMT

[quote user="Michael Woodhouse"]VetTest[/quote] Sounds like martin has a vetscan.

Re: Dog with liver disease and zero ALP

Michael Woodhouse — Sun, 21 Jun 2015 00:38:59 GMT

When did you last do a quality control against an external lab?

I fell out with our VetTest after it lied to me one too many times.

Re: Dog with liver disease and zero ALP

Martin Atkinson — Fri, 19 Jun 2015 08:45:38 GMT

[quote user="robloxley"]

If it's a VS2 rotor, what does the iQC and Error Report say?

[/quote]That's too clever a question. All I know is that we ran a comprehensive profile followed by a mammalian liver profile. The ALP was zero on both and on the trouble shooting cards as well which is why it is odd but all the other number pretty well matched.. The sample was 1+ haemolysed even though we got a clean jugular sample, 1+ lipaemic and 2+ icteric. These shouldn't affect ALP. The only thing that might is if it was in an EDTA sample and it was in heparin.

Re: Dog with liver disease and zero ALP

Rob Loxley — Thu, 18 Jun 2015 18:26:59 GMT

If it's a VS2 rotor, what does the iQC and Error Report say?

Re: Dog with liver disease and zero ALP

Luca Poddighe — Thu, 18 Jun 2015 17:16:30 GMT

[quote user="Kate Richardson"]

+ another one for lab error.

[/quote]

I agree too

Re: Dog with liver disease and zero ALP

Kate Richardson — Thu, 18 Jun 2015 16:53:56 GMT

+ another one for lab error.

Re: Dog with liver disease and zero ALP

Martin Atkinson — Thu, 18 Jun 2015 16:39:46 GMT

Thanks Mark . It is what I suspected but I would have to run a whole rota so it isn't worth it. I think there's enough information to make a diagnosis I was just curious.

Re: Dog with liver disease and zero ALP

Mark Naguib — Thu, 18 Jun 2015 15:47:51 GMT

Hi Martin,

I seem to recall some colorimetric tests can read 0 when there are extremely high levels. If you still have some blood, I would try running it as a dilution.

Mark

Re: Dog with liver disease and zero ALP

Martin Atkinson — Thu, 18 Jun 2015 13:33:22 GMT

[quote user="Robin Grimmer"]Sounds like a lab error. ALP is a marker of cholestasis and you've obviously got that with such high tbil and cholesterol. My guess is the high tbil is interfering with the assay. Try sending to an external lab?[/quote]Never had a high tbil interfere with ALP before at least not to the extent of giving a zero reading. Its not worth spending money on an external lab tests its pretty nailed on.

[quote user="Robin Grimmer"]Also bile acids are generally not helpful when you've got jaundice.[/quote]I know, but it all comes as part of a liver profile rota!

Re: Dog with liver disease and zero ALP

Robin Grimmer — Thu, 18 Jun 2015 12:25:32 GMT

Sounds like a lab error. ALP is a marker of cholestasis and you've obviously got that with such high tbil and cholesterol. My guess is the high tbil is interfering with the assay. Try sending to an external lab?

Also bile acids are generally not helpful when you've got jaundice.