My dog's blood test has high WBC and liver enzymes. What's next?

Thank you for sharing Millie's bloodwork results. She has VERY high white blood cell counts which may be indicative of a severe infection, autoimmune disease, or even cancer. I would have her evaluated for the underlying cause which may require radiographs, an ultrasound, and or a blood smear evaluation by a pathologist.

Poor Meddy! I am sure you are very worried about him. I wish i could tell you what is going on with him but from the medications you list it sounds like something is wrong with his liver. If he received a blood transfusion then this means he was anemic (low red count). The pictures you show are of a common intravenous fluid solution to maintain hydration, an antibiotic, and a sugar solution (which is often given if the blood sugar is low). It sounds like your vet is working hard to help him. As all of these are supportive medications the really important thing will be finding out why this is happening. I assume you took him to the vet because he was sick and he was placed on these medications to treat him. If this is not the case and he developed sickness after starting a medication then report this to your vet right away. It sounds like Meddy needs more tests to figure this out. Do you have access to any veterinary specialists in your area, such as an internal medicine specialist? If not, you could talk to your vet about he or she getting a phone consult with a specialist to help with the case. I hope this helps and the Meddy feels better soon! Thank you for using Petco Pet Education Center, formerly Petcoach.

There are many different causes that would include hepatitis (which can be bacterial or sterile), cancer, or an issue with his gallgladder. The next step I would recommend is an abdominal ultrasound with fine needle aspirate (FNA) to try to get some information about what is going on in the liver, and possibly a biopsy of the liver after that. The other courses of action is to try treating him to various medications to see if anything helps -- however this doesn't really make sense if he has no signs of illness. Or finally, doing nothing and checking again in 2 months to see if they are rising or staying the same. Sometimes we decide not to get to the bottom of something when there are no clinical signs.

I'm sorry Meddy is sick. I am trying to understand exactly what is going on with him. It sounds like your vet is suspicious of an immune mediated disease (where Meddy's own immune system is malfunctioning and destroying her platelets (as well as possibly her red blood cells and/or white blood cells). A blood transfusion may have been required help Meddy survive. Let me briefly review the medications you've listed: *Zip vit- I am not familiar with this, but it seems to be a vitamin supplement. *I suppose "sucroll" may be the drug sucralfate, which is a medication that helps to decrease bleeding in the stomach and intestine. *Livotas is not something used in the US and I cannot find any information on it. *Thrombup is an herbal that may be beneficial when platelets are low (I don't have any experience with this one, and it is not generally used in the US) *Lisybin is a supplement for liver health. *Alamin R Forte is not something I have experience with but appears to be used for a number of different indications in India. *I assume Doxypet is doxycycline, which is an antibiotic commonly used to treat possible underlying infection that results in immune mediated cell destruction. Doxycycline also has some anti-inflammatory properties that can be helpful. *udiliv300 is ursodiol, which helps with bile flow from the gallbladder and through the liver *Venol is not a drug used in dogs in the US, so I am not sure what the purpose of this mediation would be for Meddy. *azathioprine suppressed the immune system and helps treat immune mediated diseases. Azathioprine can have negative side effects on the liver, so the liver protective medications listed may be to help try to minimize these negative effects on the liver. * I do not know what you mean by NS DNA D10. Regarding the pictures you've attached : The first picture is shows small spots of bleeding under the skin, which would commonly be seen with low platelet counts. The second picture looks like what is an amino acid supplement that can be given as an injection. I am not sure of the purpose of this medication for Meddy, but I don't see a reason it would cause harm. The third picture of the lab findings- shows the red cell count a little low (mild anemia), and there is no number for either the platelets or the total white blood cell count. Generally that means those counts are very low--too low for the machine to read. To try to answer your questions: I am not highly suspicious that this is liver cancer, but it is possible. We can see immune mediated cell destruction AS A CONSEQUENCE of cancer, so it may be that liver cancer, or another type of cancer, is the underlying cause. It is possible that the liver value abnormalities on the lab work are a side effect from the medication. You can talk to your vet about potentially having an abdominal ultrasound (sonogram of the belly) performed. This may help identify a tumor in the liver or elsewhere that may be the underlying cause of disease. The picture that you took with the spots on the skin-- this would be seen from low platelets. I suspect that the medications were all started BECAUSE of low platelets. It takes time to get that platelet count up, so bleeding will continue while platelets are low. So more bleeding will occur until the meds are working. I do not think that this is reaction to medications. (Having said that, unfortunately sometimes patients just do not respond well to treatment and we cannot get the platelet count up despite our best efforts). Regarding the jaundice that you've seen after the medication was given-- again I doubt this was a result of the medication. If his red blood cells are being destroyed by his immune system, this will result in jaundice. Additionally, following transfusion (even from a known blood source) jaundice is common. I hope that information helps, I can try to help more with a consult. Thank you for asking Petco Pet Education Center, formerly Petcoach!

Blood results always have to be interpreted with the results of a hands-on exam and medical history in mind. Numbers alone cannot give a diagnosis. Your veterinarian should have explained those results to you as he also did a clinical exam and knows why you went to the vet with your dog. That said I can give you a general idea: The lab was looking for blod parasites, but did not find any. This can mean that your dog is blood parasite free or just that in the sample they had, there were no parasites visible. This is not proof that your dog is parasite free, it just means they did not find any. The PCV is high, that means your dog is likely somewhat dehydrated. He also has too many neutrophils and too few lymphocytes which is most often a sign of infection. Your veterinarian should explain to you what he suspects your dog is suffering from. The blood parameters alone are just a small part of diagnosis and in your dog's case not very specific.

In looking at the bloodwork you attached, I would not be concerned about the total White Blood Cell value being slightly lower than normal. After the total WBC value, the bloodwork breaks it down into individual white blood cells, like neutrophils and lymphocytes, none of which are too low. In fact, neutrophils, the body's first responders to infection or inflammation, are a little higher than the normal range. White blood cells are the fighters of the immune system, and it appears that Mary still has plenty in case she needs them. There is nothing you can do raise them other than keep her in good health. However, I do see that both BUN and Creatinine are also elevated. This can happen for many reasons, including severe dehydration, kidney insufficiency or failure, kidney infection, among others. These are the more concerning numbers that I see, and I am sure your vet has discussed a plan of action for these values.

Hello, the elevations of the cells is very mild. It appears that she may have a mild infection, given that his eosinophils are high, the most likely cause may be associated with parasites. The medications should not cause the white blood cells to go up, instead, it should help decrease their number. Speak with your veterinarian about checking his stool for parasites and consider deworming him as well. Also check for heart worm disease. Hope this helps and best of luck.