Blood Work Information

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Liver Values

Total Protein

  • increased shows dehydration or blood cancer, bone marrow cancer; decreases indicate malnutrition, poor digestion, liver or kidney disease, bleeding or burns


  • Small protein produced by the liver.
  • Holds water like a sponge in the blood vessels
  • If decreased, the liver pry is damaged and cannot produce an adequate amount.
  • If decreased, albumin may be lost through a damaged intestine or in the urine due to kidney disease
  • Low values, fluid van leak out of the blood vessels and accumulate in body cavities such as the abdomen or tissues as edema. The heart forcing blood through the vessels causes this leak.
  • High levels indicate dehydration and loss of protein.
  • Checks how well the liver and kidney are working
  • Used to see if diet has enough protein
  • Reduced levels of protein can point to chronic liver or kidney disease, or parasitic infection.
  • Albumin helps keep the blood from leaking out the blood vessels.
  • It also helps carries some medicines and other substances.
  • A loss of greater than 70% of liver function is required before hypoalbuminaemia occurs


  • if low, indicate problems with antibodies or risk of infectious disease. if high, may indicate stress, dehydration, blood cancer, allergies, liver disease, heart disease, arthritis, diabetes.
  • Globulin is a protein, building block of cells and tissues. Proteins are basic elements of enzymes and antibodies. Made by the liver.

A/G Ratio

  • Albumin/Globulin ratio - albumin should predominate over globulin. Normally, there is a little more albuin than globulin, and the ratio is greater than 1. A ration of less than or greater than 1 can indicated problems in the body.

AST (SGOT) aspartate transferaase

  • Increases with liver damage, muscle damage, or break down of RBCs, Cushing's, steroids, cancers and some infections.
  • It is an enzyme found in the liver, heart, kidney, sketetal muscel and brain.
  • In the blood stream it has a half life of about 12 - 22 hours, shorter than ALT, so the values of AST tend to drop more rapidly once liver function is resumed.
  • In liver disease, AST and ALT will both tyipcally both elevate
  • AST is also elevated after acute pancreatitis
  • Just a side note: vigorous exercise may elevate AST levels in the body, not to the point where liver issues can be ruled out, but just a note if taking your dog in for a re-test, considering avoiding vigorous exercise 24 hours or so prior. Vitamin A may also cause slight elvations.


  • Enzyme produced by liver cells
  • Liver damage causes ALT to increase
  • The elevation correlates with the number of damaged cells
  • More specific for hepatic (liver) injury/inflammation as it is present mainly in the liver and in low concentrations elsewhere.
  • Rapid increases may indicate an acute process
  • Slow increaes may indicate bile duct obstruction
  • Falling levels may indicate recovery, or a large number of liver cells stop functioning
  • Elevates with liver disease, released from damage liver cells. It is considered liver specific in dogs. It is used to screen for liver disease, but will not diagnose the disease. You may also see an increase in ALT when there is damage to renal cells, skeletal muscles, the pancreas and the muscles of the heart. Hemolytic and Lipemia (fat in the blood, need to fast) can also cause a false high reading.
  • When elevated of ALT, there has been some degree of cell membrane damage to allow leakage of this enzyme into the blood stream.
  • ALT's half-life is 48 hours, meaning that one half of the enzyme should be gone in 48 hours.
    • If ALT levels have decreased by half, then the liver healing.
    • If the ALT levels continue to rise, there is ongoing injury/insult to the liver. Common causes: CAH (chronic active hepatitis), pancreatitis, severe anemia, ischemia (loss of blood flow and oxygen), and sepsis
  • Levels peak two to three days after liver injury and return to normal in one to three weeks if the liver injury resolves
  • "ALT is short for alanine transferase. This is an enzyme that is present in the cells in the liver. In order for it to be found in elevated quantities in the blood stream, liver cells have to be leaking the enzyme. So rises in this enzyme indicate damage to liver cells sufficient to cause them to leak the enzyme. Rises in ALT, even large rises, can occur due to problems that don't cause much change in liver function, though." - Bloodwork - Alkaline Phosphatase levels in Dogs


    In most liver diseases, the AST increase is less than that of ALT (AST/ALT ratio is less than 1)


Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) are two liver enzymes usually tested in conjunction with one another. ALT only occurs in the liver and increases when cells in the organ are damaged. Generally, the amount of increase in ALT is proportionate to the amount of liver damage. However, high levels of transaminases in the blood donít always reveal just how badly the liver is inflamed or damaged. Blood tests measure inflammation and damage to the liver at an one point in time

AST is an enzyme present not only in the liver, but in the heart and brain as well. However, an increase in ALT usually means an increase in AST if liver disease is present. If both enzymes are not elevated, the dog's health problems may be a result of something other than a problem with the liver.

The ratio of AST to ALT can give some extra clues in humans as to the cause, once cirrhosis established AST > ALT (Cirrhosis is a condition where normal liver tissue is replaced by scar tissue). In most liver diseases, ALT is greater than AST.

They are associated with inflammation and/or injury to liver cells(hepatocellular liver injury). Damage to the liver typically results in a leak of AST and ALT into the bloodstream.

ALKP (ALK Phosphatase) (AP)

  • Originates from many body tissues. However, bone and liver sources have a half life long enough to be detected in blood work.
  • Increase causes may be liver disease, bone disease or from drugs such as prednisone.
  • serum alkaline phosphates, increases with liver disease, Cushing's, steroids, some cancers and infections. Normally high in young, growing dogs. ALP in young, growing animals of all species may be 2 to 10 times higher than in adults. Values decrease within 3 months of age and are within adult ranges by 15 months of age.
  • When created by the liver, it produced by the cells lining the ducts which bile flows, and increases indicate bile flow obstruction possibly from fats, stones, infection.

GGT - gamma-glutamyl transferase

  • Found in many tissues, main source is the liver. Highly concentrated in thekidneys and pancreas. It is useed as a sensitive indicator of cholestasis (similar to ALP).
  • GGT does not increase in serum in disorders involving the tissues of the pancreas and gastrointestinal track (it usually sheds into the lumen of these organs). The major proportion in the serum seems to come from the liver.
    • Other sources thou say: Because this enzyme is also found in the kidney and pancreas, it is not always a fair indication of liver disease. Typically, an increased level of the GGT enzyme in the blood indicates there is a problem with the pancreas or kidneys. The testing of the GGT enzyme can still be used, but it has to be used in the context of testing of the other liver enzymes.
  • Can also help detect bile duct injury. GGT is increased in most diseases that cause acute damage to the liver or bile ducts. Large elevations are more commonly associated with pancreatitis and bile duct obstruction
  • Elevatations seem to come from new synthesis (of new proteins) rather than rather than leakage.


Neither Alkaline Phosphate (ALP), nor Gamma Glutamyltransferase (GGT) are liver-specific enzymes. However, they are used in testing for liver disease because they are still good indicators of liver problems when used in conjunction with other tests. ALP levels are sensitive during the first stages of liver disease and will generally rise. GGTs are present in the kidneys and pancreas; in conjunction with other tests, a rise in GGTs can indicate liver disease.

Read more: Increased Liver Enzyme in Dogs |

Total Bilirubin

  • is secreted by the liver into the intestinal tract. High levels lead to jaundice and indicated destruction in the liver and bile duct.
  • by product of the breakdown of hemoglobin. Hemoglobin is found in red blood cells and is responsible for carrying oxygen to the tissues. The liver converts the hemoglobin to bilirubin, and then it is secreted in the bile.

    If an excessive number of red blood cells break down, the liver is overwhelmed and bilirubin accumulates in the blood.

    If the bile duct is blocked, the bilirubin cannot be released into the intestine, and again the blood levels will elevate. An dog with elevated bilirubin may appear jaundiced. The level of bilirubin does NOT indicated where the problem may be, nor is it very useful in determining the prognosis.

Direct & Indirect Bilirubin

  • Direct Bilirubin - conjugated - dissolves in water and is made by the liver
    • Liver disease mainly impairs the secretion of conjugated bilirubin into bile. As a result, conjugated bilirubin is rapidly filtered into the urine, resulting in urine having an orange color
  • Indirect Bilirubin - unconjugated - this form does not dissolve in water. it travels through the bloodstream to the liver, where it is changed into a soluble form (direct)
  • Total Bilirubin and Direct are measured direclty in the blood, indirect bilirubin are derived from the total and direct bilirubin measurements.
  • When bilirubin levels are high, yellow or skin, eye whites and gums may occur, jaundice. Jaundice (icterus) can be caused by liver disease (hepatitis), blood disorder, blockage of bile ducts that allow bile to pass from the liver to small intestine. Icterus can come about after the common bile duct is obstructed, either internally or externally.


  • decreased levels found in hyperactive thyroid, liver failure (low levels), low fat diet, and intestinal malabsorption.
  • elevated levels are seen in a variety of disorders including hypothyroidism, diseases of the liver, kidneys, cardiovascular, diabetes, acute pancreatitis, high fat diet, and stress.
  • Very low may occur with congenital or acquired portosystemic shunts and fulminant liver failure.
  • Increased cholesterol along with jaundiced usually indicates major bile duct occlusion. Pancreatitis, diabetes, hyperadrenocorticism and hypothyroidism may also cause an increase.
  • * this test goes along with the Trigliceride levles, they both combine in lipoproteins

Correct Calcium

  • This level can be calculated when the albumin is abnormal.
  • It makes up for the change in total calcium due to the change in albumin bound calcium.
  • An estimate of what the calcium level would be if the albumin were within normal range

Kidney Values

The BUN and Creatinine levels are associated with the kidney. If these are in normal range, it can help narrow down the diagnosis of pancreatitis.


  • blood urea nitrogen end product of protein metabolism. High levles indicate kidney failure or disease, dehydration, shock, high protein diet, certain toxin ingestions, poor circulation to kidneys and urinary obstruction. Low levels liver disease or starvation.


  • High levels indicate kidney failure or disease, dehydration, shock, high protein diet, certain toxin ingestions, poor circulation to kidneys and urinary obstruction. Low levels liver disease or starvation.

BUN/Creatinine Ratio


  • Originates from bones and is controlled by the same hormone, PTH (parathyroid hormone) which controls blood calcium. Phosphorus is increased in the bloodstream in patients with chronic kidney disease. Like BUN and creatinine, phosphorus increases in these patients when about 75 percent of both kidneys is damaged.

    If low causes could be diet related. Large amounts of carbohydrate cause a high demand for phosphorus cells, removing them from the blood.


  • Kidney diease or conditions can impair or excessively excrete magnesium.
  • Intestinal absorption may be impaired due to a gastrointestinal disorder.
  • Persistent low levels can cause low calcium and potassium.
  • Low levels:
    • gastrointestinal disorders
    • long term diuretic use
    • prolonged diarrhea
    • severe burns
    • uncontrolled diabetes
  • High levels:
    • kidney disorders / failure
    • hypothyroidism
    • dehydration
    • addison's disease

Pancreas Values

Typical test for pancreatitis. If these levels are high, the assumption of pancreatitis is made.

These elevated levels can also indicate kidney disease, perforation of the intestine, and dehydration.


  • Elevation causes:


  • Lipase primary purpose is to break down lipids. A large increase is seen with pancreatitis.
  • Rises 4 to 8 hours from the onset of symptoms and normalizes within 7 to 14 days after treatment.

CPK - creatine phosphokinase (aka CK)

  • enzyme released from damaged skeletal & heart muscle
  • it is used in cell converstion to release energy for muscle contraction, if the muscel tissue is injured, the enzyme is released inot hte bloo streem.


  • measures the function of the pancreas, indicates carbohydrate metabolism. High levels could indicate stress, Cushing's, diabetes, pancreatitis or certain meds. Low levels can indicate liver disease, insulin overdose, sever bacterial infection, hypothyroidism and Addison's disease.


  • he main form of fat in the body, along with cholesterol the triglycerides for plasma lipids. Triglycerides plasma are derived from fats eaten in foods or made in the body from other energy sources such as carbs. If the dog eats too many calories, the triglycerides are stored in their fat cells.
    • can be high from consuming to many calories
    • kidney disease
    • diabetes
    • thyroid problems
    • genetics
  • Symptoms can include seizures, abdominal pain, patches on the skin, yellowish-orange bumps on the skin filled with a greasy liquid. Treatment is a low fat diet. High-quality food is very important along with plenty of exercise.

Potassium (K)

  • Potassium is often supplemented to offset the potassium depletion caused by the pancreatitis.


  • Originates from the bones, hormone levels, blood protein levels, and diet influence levels.
  • Increase is often seen with hypercalacemia, hypoadrenocorticism, primary renal failure, or overdose of vitamin D.
  • Decreased levels are seen in hypocalcaemia, hypoalbuminaemia, malabsorption, or acute pancreatitis.
    • Muscle twitches may occur with decreased levels

Complete Blood Count (CBC)

WBC - White Blood Cells aka Leukocytes

  • Many more RBC than WBC
  • Defends body against invading bacteria, viruses, fungi, etc.
  • Different types
    • Lymphocytes
      • Formed and released by the lymphoid tissue like lymph nodes and spleen. B and T cells. They help destroy viruses and foreign material. When decreased it is referred to as lymphoenia, and is frequently noted in the first stages of infections.
    • Monocytes
      • Are developed and stored in the spleen and bone marrow. Can eat foreign material, such as infectious organisms. The also secrete various protein molecules that help in the clean up of inflamed and irrated tissue.
    • Eosinophils
      • Responsible for combating multicellular parasites and certain infections in vertebrates. They are also helpful with allergies and asthma.
    • Basophils
      • Least common. Appear in inflammatory reactions related to allergic symptoms. Can prevent blood from clotting too quickly. Promote blood flow to tissues. Seen in high numbers from infections such as tick bites. They play a role in parasitic infections and allergies.

RBC - Red Blood Cells

  • Formed in bone marrow
  • Life span is bout 120 days, body works to maintain the number of RBCs in the blood vessels. Replaced at about 1% a day
  • Carries oxygen and carbon dioxide throughout the body
    • Iron deficiency will lower the RBC count
    • Even lower could be from copper deficiency, b-12 deficiency, folic acid deficiency, or hemorrhage
    • Anemia: A condition in which the number of red blood cells present in the blood is lower than normal.
    • Dehydration will cause an increase

HGB - Hemoglobin

  • Measures the ability of the blood to carry Oxygen
  • Fills up the red blood cells and gives them their red color
  • Carries Oxygen

HCT - Hematocrit aka PCV (Packed Cell Volume)

  • This value along with HGB are use dto test if anemia or polycythemia (high red blood cell count).
  • Measures the volume of red blood cells in the blood
  • Value given as a %, ie. if HCT is 47, 47% of the blood's volume is made of red blood cells.

Platelet Count

  • Help blood clot
  • Smallest type of blood cell
  • When bleeding occurs, the platelets swell, clump, and form a sticky plug
  • Low levels, uncontrolled bleeding may occur
  • High levels, chance of hardening of the arteries, and/or blood clot forming in the veins.

Electrolytes (Sodium, Potassium, Chloride)

- these chemicals must be in balance. can be life threatening if not.

Sodium (NA)

NA/K Ratio


**** Many of us are not vets or even close to an expert on these topics. Many articles have come from hours spent online reading and talking with others while trying to figure out what is best. If you have any questions, or information to add, feel free to contact me at

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