HealthScreen-10 Urine Reagent Strips are comprised of 10 different reagent pads affixed to firm plastic strips. Luckily for most species, diagnostic tests have been refined to the point that they allow us to get a clear picture of the inner workings of animals. As a general rule, if one of your pets values falls outside of the range for this lab, it might mean there is something wrong with your pet on that specific test, but not necessarily.
Keep in mind the blood panel was taken at a specific point in time, and that same sample take hours or days later might have different values. The other part of the CBC is the analysis of the white blood cells, and is closely tied to the immune system.
The next part of the blood panel is called the chemistry panel (chem panel), also called the biochemistry panel (BCP). Some of the tests in the chem panel measure internal organs directly, while others measure them indirectly. Organs that are important for the metabolism of the anesthesia we will be administering are targeted. Red blood cells (RBC’s) to check for anemia, proper oxygen carrying capacity of the red blood cells, and adequate clotting. The standard blood panel, made up of a CBC (complete blood count) and BCP (biochemical profile), is a thorough test of many of your pet’s internal functions. This blood panel is used for pets that seem ill, for older (geriatric) pets, for pets that have a problem discovered during an exam, or when your doctor feels he or she needs a blood panel that is more thorough than the in house pre anesthetic blood panel.
It is sent to one of our outside laboratories that maintain a high level of quality control by using highly automated and advanced laboratory equipment.
To further enhance our ability to find these eggs we use a technique called fecal flotation. It is a painless procedure (the pain is for us trying to keep wiggly pets still for the 5 minutes it takes to obtain a reading) that is obtained with our EKG machine.
We use a special instrument that converts the electrical activity into sounds that are transmitted over the telephone to a cardiologist. One of the densities, called soft tissue, can be difficult to visualize if not surrounded by fat. Metallic density is easy to spot in this dog that was shot in the front legs with a bullet. When a significant disease process is present we occasionally need the help of an ultrasound. Most of us would probably agree that a poke with a needle like this in our abdomen is preferable to the long incision needed during an exploratory surgery. This is an ultrasound picture of an enlarged left adrenal gland, as might be seen in hyperadrenocorticism (Cushing’s Disease). We we perform a surgery or necropsy, or when we take a biopsy of a lesion, we put the sample in formalin for it to be preserved for microscopic analysis by a pathologist.
A relatively new diagnostic modality of increasing importance in veterinary medicine is MRI. Cerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure proteins, sugar (glucose), and other chemicals in the fluid that surrounds and protects the brain and spinal cord. How the Test is Performed A sample of CSF is needed. The final destination of a journey is not, after all, the last item on the agenda, but rather some understanding, however simple or provisional, of what one has seen.
In these modern times, with the plethora of blood-sugar-related diseases, we need tools like GI and GL to help us understand ways to control blood sugar. The self-testing, graphic approach to food testing developed in the balance of the newsletter is a less scientific but a more dynamic way to explore postprandial (post-meal) blood glucose levels (BGLs). GI measures the blood glucose impact of foods eaten in isolation, yet we rarely consume foods this way. GI readings vary with the individual—blood sugar and insulin reactions are more extreme for diabetics, for example (See Charts 2A and 2B). GIs are calculated in the science lab as the day’s first meal after a 12-hour fast and using a fixed serving that includes 50 grams of carbohydrate.  Most of our daily calories, however, are consumed in combination and throughout the day, when our blood sugar is affected by other foods that we have eaten earlier, as well as by our level of activity. Of the following numbered charts, the first three are based upon scientific research journal articles (Charts 1, 2A, 2B), while the last four (Charts 3-6) are constructed from my own self-testing of foods4 using a simple blood glucose monitor.
Chart 1:  Blood Sugar Curves of White Bread Compared to Bread with Added Fiber, Sourdough, and Vinegar. Chart 3:  Instant Oatmeal, Whole Oats (Soaked and Not Soaked), and Whole Oats Combined with a Protein and Fat. To fully appreciate the impact of two back-to-back carbohydrate breakfasts please notice that the scale used for Chart 6 is twice that of Charts 3-5. Resetting the Table–to Control Blood Sugar (For a discussion of other strategies, see April 2011).
Ramekins filled with condiments like nuts and seeds (GI=0).  Nuts and seeds provide healthy fats, fiber, vitamins, minerals, and antioxidants, while they slow digestion and curb blood sugar. Sourdough bread or whole-grain bread with whole kernels; butter from grass-fed cows and organic nut and seed butters such as tahini and pumpkin seed butter. A pitcher of water and glasses for all—sometimes we mistake hunger for what is in fact thirst.  You might flavor the water with a little lemon juice or other flavoring. Because 12-hour fasting, pre-meal blood sugar reading can vary, all data points at time zero prior to the first morning meal were indexed to zero in order to illustrate the change from a neutral starting point. I use the label “traditional” carbohydrates, just as we call unrefined fats, “traditional” fats. Packaged in a plastic bottle with a twist-off cap, each single use disposable strip is stable and ready to use. This has dramatically enhanced the diagnostic process, and even allowed us to check for diseases long before symptoms become apparent. This panel gives us an indication of a pets internal health, and allows us to monitor disease processes and their treatments. Conversely, a normal test of a specific organ on a blood panel, for example a liver enzyme test, does not guarantee the liver is healthy. This is why we often need to follow the blood panel over a series of time to see which direction the trends are following. The total number of WBC’s are noted, giving us an overall indication if a problem might exist. It tends to leave the white and red blood cells alone, and focuses more on the internal organs (although the two are closely related and not easily distinguished in this way-but that’s the art of medicine).
It also checks the general health of the body by measuring parameters like protein, glucose, and calcium.


These tests are interpreted in conjunction with the CBC since the two are so closely related. The first, called the In House blood panel, is performed in our hospital or sent to the lab. It is much more thorough than the in house pre anesthetic blood panel, and consists of over 40 different parameters of internal health. In general, this test is one of the most important ones your doctor can order because it gives us a large amount of information regarding your pet’s internal status.
The results of any blood panel submitted to this lab are faxed to us within 12-24 hours in most cases. Its main goal is to assess the urinary tract (kidneys, ureters, and urinary bladder). It checks for inflammation, infection, specific diseases (sugar diabetes), and kidney function.
Taking another sample of fresh feces, we put it into a solution that causes all of the eggs (sometimes with the exception of tapeworm eggs) to float to the top.
Even though allergies are the most common cause, pets can also get external parasites (called ectoparasites) that cause skin problems. Since some of the parasites burrow into the outer layers of the skin, the scraping has to be done deep enough to cause a minor amount of irritation. This sequenced electrical activity is what allows the heart to beat in a rhythmic way and continuously pump blood to all cells in the body. For routine pre anesthetic EKG’s, the cardiologist faxes the report back within 1 hour, therefore the test can be performed just prior to anesthesia to increase its relevancy.
The ability to take a peak into the internal anatomy of a living organism using x-rays was a watershed in the diagnostic process. This is because you cannot feel an x-ray, along with the fact that negligible radiation is used because of the precision of our x-ray machine and digital readikography. Our machine is inspected every 3 years and certified by the state of California be safe. Air- this appears black on a radiograph, and is commonly seen in the lungs and as gas in the intestines. Soft tissue- this also appears white, and consists of internal organs like the liver, kidney, and intestines. This occurs in young animals due to a lack of abdominal fat, and in older animals that are emaciated by a chronic disease like cancer that has caused them to lose their abdominal fat stores. On occasion, due to unusual findings or complex situations, we request the opinion of a veterinary radiologist.
This is one of the most crucial steps to determine what the lesion is, and whether it is benign or malignant. It is a special stain placed on a microscope slide that contains a small amount of discharge from the ears. A very tiny needle is inserted into the growth and a small amount of cells are aspirated into a syringe. Sometimes the pathologist can give us an idea of what the problem is, and occasionally, the pathologist cannot say for sure what the problem is. This told us that we should aggressively perform surgery to remove the whole mass because of its potential for malignancy. By doing this in a sequential fashion it is able to view the whole brain from front to back. A lumbar puncture, also called a spinal tap, is the most common way to collect this sample.
These two systems need to be understood as they form the fundamentals for homeostasis (how a system stays stable).
The second factor—the postwar shift from traditional to refined carbohydrates—is largely due to the growing role of the commercial food industry and processed, convenience foods.  Convenience foods must have a long shelf-life, so food companies rely upon refined flours and oils, which do not go rancid. Visual pictures of postprandial blood sugar behavior, while less scientific than GI measurements, are nevertheless powerful learning tools, providing a real flavor for how our body reacts when we eat different kinds of foods. This chart illustrates the second meal effect– that what we eat at one meal affects postprandial blood sugar behavior at the next. What we do to our children when we give them a sugary cereal or a Pop-tart for breakfast extends beyond this first meal to affect their blood sugar, hunger, concentration, and desire to overeat throughout the rest of the day.
One of the best herbs and spices to moderate blood sugar.  It can be sprinkled on hot cereals and desserts such as puddings, custards, and stewed fruits. For results, compare the test strip with the colour blocks printed on the label of the bottle. We have to rely on an owner, zookeepers, etc., that care and feed these animals for important information. Many pets do not live long in relation to people, so the ability to diagnose problems before they become firmly entrenched is an important axiom in how we care for pets at the Long Beach animal Hospital. It must be understood that each individual lab has its own set of normal values, which are based on that old bell shaped statical curve we all learned to love (and hate) in school. In measuring the RBC’s we are looking for a low count, called anemia, and a high count, called polycythemia. The RBC’s are counted with a machine that gives us an actual number, usually in the millions per cc. Interpretation of problems in the chem panel is very complex, and must be interpreted in conjunction with the other parameters of the diagnostic process.
For example, if a pet has anemia, and the liver tests are significantly elevated, all other things being equal, it is probable that the anemia is caused by a liver problem. It is used for young pets, apparently healthy pets, and for routine surgeries like spays, neuters, and declaws when we anticipate surgery the same day. The first set of tests is performed with our QBC machine, the second set with our serum chemistry analyzer. It is obtained in our hospital and sent to the same lab that does our standard blood panel. These eggs are then collected with a cover slip and placed on a slide for analysis under the microscope. Except for fleas, these parasites are almost always microscopic in size, and are diagnosed with a skin scraping. The discharge is looked at under the microscope for either the parasite itself or eggs of the parasite. The electrocardiogram can help diagnose a heart that is having a problem but appears normal during a physical exam.
Over the years this has been refined to the point that it is a normal part of diagnostic testing.
This decreases the amount of radiation your pet receives and adds to the information available when our doctors read the radiograph.


It is also difficult to see soft tissue densities in an animal that has fluid in the abdomen, since the fluid obscures the distinct margins between organs.
It has revolutionized veterinary medicine, and replaced exploratory surgery in many cases, or told us surgery is needed immediately in other cases. It is very useful for pets that have significant dental disease because it assesses the heart valves that are commonly injured due to bacterial infection. Below the valves, towards the middle of the picture, is a color rendition of how the blood is flowing through the heart chambers. Since the test is simple to perform, relatively inexpensive, and can be performed without any anesthesia, it is well worth utilizing.
It is particularly useful in neurologic diseases and for the diagnosis of problems in the brain. We will see these loops when we explore hormones and how they work.Positive FeedbackIn a positive feedback loop is designed to enhance and accelerate the output of a stimulus. Sometimes the information we do get is biased or erroneous, leading us down the wrong path. This also confirms the need for routine yearly wellness exams, especially for pets that are middle aged and older.
Finally, we do not interpret blood panels by themselves, we use all of the information available to us in regards to the diagnostic process. Of the two, anemia is much more common, so we will base our explanation on this problem only. Hematocrit is a percent of the red blood cells in the serum, usually near 45% (this varies tremendously with the species).
A low WBC count can be caused by a virus, overwhelming infection, an immunosuppressive disease, or a problem with the bone marrow. In some species, even though the tests are included in the chem panel, they might be useless in determining whether a pet has a disease or not.
It is not this simple though, because an anemic pet with normal liver tests can still have a liver problem as the cause of the anemia. Many of the tests on this Standard Blood Panel can be run in-house for immediate results if an emergency. What we are looking for is the egg of the parasite, not the actual parasite, since the parasite resides in the stomach and intestines, and usually does not come out in the feces (tapeworms and the occasional roundworm are an exception).
In both the direct smear and fecal flotation techniques finding these eggs is a hit or miss approach, and all depends on whether or not the individual female parasite is releasing eggs at the time of the sample. We have pages on sarcoptic mange and demodectic mange, the two ectoparasites commonly diagnosed with a skin scraping. Even after years of this exposure there is negligible radiation due to the minor amount of x-ray power needed with today’s digital radiography.
Many other diseases are diagnosed with radiology, although some of the radiographic changes can be subtle and are open to interpretation. It allows us to look at an internal organ in ways x-rays cannot, and even allows us to biopsy these organs using a small biopsy needle during the ultrasound process. This test must be arranged in advance since we call in a specialist to perform the test in our hospital. Most people with pets assume their dog or cat has ear mites whenever there is an ear problem, which is erroneous in most occasions. Only a few very tiny cells are on this slide, so we are lucky to have skilled pathologists at our disposal that can give us an interpretation.
In some cases, particularly if the report tells us the mass might be malignant, we can plan surgery better to make sure we remove all of the tumor. But the sun is shining too brightly on this particular day and it causes the leaf to lose too much water due to evaporation.
This is why diabetes and obesity often go hand-in-hand (90% of diabetics are either overweight or obese). David Ludwig regarding high-glycemic foods and overeating, cited in the Recommended Reading section at the conclusion of this newsletter. Also, anemia is not a disease, it is a potential sign of a disease, the cause of which should be determined. After the total WBC is determined the WBC’s are broken down into their different types. Obviously, a normal chem panel is highly advantageous, although it is no guarantee that a pet is disease free. This means that a negative fecal report does not guarantee our pet is free of internal parasites.
This depends on how strong the x-ray is, how much time it is given to penetrate the body, how sensitive the x-ray film is, and how dense the body part being x-rayed. This test is critical in diagnosing kidney problems in mammals (including humanoids), but is useless in birds and reptiles. This dye radiograph is called a myelogram for the spinal cord, and an intravenous pyelogram for the kidneys.
These leaves continue to open further as the sun continues to shine on them.Another example is with child birth. The leaf opening is thus regulated to keep water in the plant.A real life example is with glucose and insulin. If anemia is present, other tests are used to determine if the anemia is regenerative or non-regenerative. Changes in the amounts of these different types, whether or not the WBC count is normal, high, or low, also gives us important information. By rechecking we increase the chance that we will be analyzing a sample in which the female parasite residing in the digestive tract is actually releasing eggs into the environment through the feces.
In regenerative anemia’s the body is making more red blood cells to make up for the anemia, in non-regenerative it is not.
These are veterinarians that have graduated from veterinary school and continued their education in just this one area for an additional 5 years. This is an important point from the diagnostic point of view because certain diseases tend to be one or the other. If they pass a special test they are board certified, and truly specialists in radiography. This brings the glucose level back to normal.On the other side if the glucose level is too low, the body will release glucagon.



Blood sugar level 172 after meal uk
Normal blood glucose in toddlers


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