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Blood work for medications

Blood Work and Urinalysis for Patients with Conditions

Why it is important

  • All senior patients (dogs and cats 8yo) should have annual baseline bloodwork. Pets age faster than we do. Organs such as the kidneys age without us seeing it clinically. Blood tests and other tests such as urine give us this vital information. SHVH needs these values before anesthetics in order to help plan what types of anesthetics need to be used for instance in dental surgeries. Older pets have worse teeth and stay under anesthetics longer because the procedure takes longer.
  • Some pets take medications that can affect the body in ways that we don’t easily see. Veterinary medicine uniformly agrees that monitoring of certain drugs is good medicine.

Fasting and Fatty Blood

The best advice is to fast your dog/cat 12 hours before any blood work. If your dog/cat eats a meal prior to the blood testing then the serum will be fatty and you will have to bring your pet back to the office to be retested. If your dog/cat is fasted and still has fatty serum then there may be another disorder of lipid that will need to be addressed. If you need to give a pill with food then give only the amount needed to get the pill into the patient.

Any Repeat Blood Chemistry that needs to be repeated because of abnormal values will usually need to be drawn on FASTED blood. Failure to fast where it is needed will mean that your pet will have to return to the hospital for a repeat blood draw and you will be subject for a repeat blood draw fee.

Common medications that need blood monitoring; there may be others. This is not an inclusive list. The following routine blood rechecks are for patients that are frequently on the medications below:

1. Apoquel (for itching): CBC COMPREHENSIVE

A CBC is recommended before the medications is started (for a baseline). This medication can lower the WBC count in some pets to an extent that the dose must be lowered. Two weeks after starting the treatment is the first time to check for this reaction. It is recommended that we test the CBC again as well as the serum chemistries every 3 months thereafter. Fasting is required.

2. Bile Acid Testing: BILE ACIDS PANEL

This test is performed in the hospital in response to certain elevated blood chemistry values. Your pet will need to stay in the hospital for 2-3 hours. Fasting is required.

3. Carprofen (Vetprofen) (NSAID for chronic pain/arthritis): ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel

  • A serum chemistry panel is recommended as the baseline bloodwork before starting on this medication. Then, for routine use, we recommend serum chemistry testing performed every 6 months. Fasting is required.

4. Digoxin (for heart failure/blood pressure cases): ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel is typically recommended as the baseline blood work before going on this medication.

  • 4 weeks until levels are stable. The digoxin levels should be checked until the levels are deemed to be stable by the Doctor or when clinical signs present that could indicate drug toxicity.
  • Routine drug levels every 3-6 months thereafter to check the kidneys and the liver while the patient is on this medication. Fasting is required. Important: The blood must be drawn 6-8 hours after you give the pill or liquid.

5. Insulin (for diabetes): Glucose Test (In House), or ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work before going on this medication.

  • Insulin is used to treat diabetic pets. A workup requiring extensive bloodwork is required prior to beginning this drug. Blood glucose monitoring is required to regulate the amount of insulin required to treat the condition. Testing will be determined by the Doctor at to frequency and time of day. Weekly blood glucose tests at certain times of day are often recommended once the blood glucose is being maintained.
  • Glucose curves (multiple blood glucose testing throughout the work day). This test requires that the patient comes to the office for the test and must stay for 8 hours.

Do not fast for blood glucose testing. Diabetics must not be fasted.

6. Levothyroxine, L-thyroxine (thyroid replacement drug): T4 OR SENIOR SCREEN, is typically recommended as the baseline blood work.

After the diagnosis is made, the drug is started and then checked 6 weeks later. Each time a dosage adjustment is made the medicine needs to be checked 6 weeks later. Routine maintenance testing should be done at least every 6 months on stable cases and every 3 months on cases where the values are less stable. Owner gives the pill in the morning and the blood is taken 4-6 hours later. Fasting is required

7. Meloxicam (NSAID for chronic pain/arthritis): ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel.

  • Serum testing is recommended as the baseline bloodwork before going on this medication. Then, for routine use of the drug, we recommend serum chemistry to be performed every 6 months to check the kidneys and the liver. Fasting is required.

8. Phenobarbital (for seizures):PHENOBARBITAL or PHENOBARBITAL + BROMIDE, for routine drug level checks. ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work.

  • Serum phenobarbital levels are monitored until a stable level is maintained within a “safe” range of dosages. The frequency depends upon the particular seizure disorder and the “window”. Once stabilized, we recommend to check the phenobarbital levels every 6 months. Owner gives the pill in the morning and the serum is drawn 6-8 hours later. Fasting is required.

9. Potassium Bromide (for seizures): ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work.

  • Once stabilized, the patient’s bromide levels are checked at the 6th week and then every 3-6 months depending upon conditions. Owner is to give the medication in the morning and the serum is drawn 6-8 hours later. Fasting is required.

10. Trilostane (Cushing’s Disease/ Hyperadrenocorticism): ACTH STIMULATION. ADULT WELLNESS, SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work.

  • Must have ordered in ACTH vial prom Specialty Pharmacy before appointment.
  • Maintaining appropriate levels of the drug requires in hospital testing using the ACTH Stimulation Test. This test requires that the patient comes to the office for the test and must stay for 2-3 hours. This test must be repeated at least every 6 months in stable cases. Unless the patient is also a diabetic, fasting from 8pm the night before must be done.

Other Conditions:

High Liver Values: ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work.

  • Recommended to check values in 1 week, Abaxis SHVH Comprehensive Panel, then, check with a lipid panel if values have not improved.
  • Lipid Profile

Fasting is required

High Kidney Values: ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work.

  • After treatment, recommended follow up blood work 1-2 weeks ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel
  • Every 3 months follow up

Fasting is required

High Pancrease Values: ADULT WELLNESS or SENIOR SCREEN or Abaxis SHVH Comprehensive Panel, is typically recommended as the baseline blood work.

  • Recommended SpecCPL canine or SpecFPL feline, preformed to check pancreatic enzymes specifically.
  • 2-4 week blood work follow up

Fasting is required

Urinary Crystals: Found by standard in annual Urinalysis.

  • Followed with mediation food/low ash diets
  • Recheck urine every 4-6 weeks until the crystal load decreases.
  • Recheck urine every 3 months, 6 months once the patient is stable.
  • Urine samples are best in morning, 1st urine of the day
  • Catch a sample in mid-stream
  • Clean sterile container
  • To be tested 1-2 hours after the free catch or put in refrigerator until you can come in to drop off the sample.

Urinary Tract Infection:Found by a standard urinalysis

  • After antibiotics are finished 5 days later a follow up urinalysis is needed