Detecting Health Issues Early

Music.

Really, the goal is just to use our stories to bring veterinary medicine to life for the pet caretakers of the world. And we're doing it because we believe that educating these caretakers is the most powerful thing that we can do to improve the life quality of all of the pets that we love. Hello, all. Dr. Natalie Keith. Oh. I love us already today. Dr. Josiah Dame. And this is Vet Tales. Vet Tales. I was listening back to our ear podcast we did last time, and I was like, I cut him off a lot.

We're going to be no better today. Not at all. Nope. Not at all. All right. Okay. Did you catch the DuckTales reference? I did. Okay. Yeah, I did. Okay. I mean, I'm a kid of the 80s, so we were all about the DuckTales. Yeah, we should probably interject some more songs throughout the year. Oh, we're going to get copystriked. Oh, yeah. I was going to record this for Facebook, too. Let's just. Copystriked. What?

We're going to get copystriked by Disney. Oh, gosh. Because you are. That's a real thing. What I sang. Oh, my goodness. So beautifully matched the. Yeah. Perfectly. Yes, it did. Yeah. So we're going to have some emails, ugly emails, I'm sure. You can see that. Once Disney finds out that all 45 of our list is reducing thumbnails.

Oh gosh okay for real though i'm gonna lie to this i think the my facebook people are sad that we don't do these anymore so okay today's topic we are going to talk about blood work yeah blood work routine blood work specifically but then like what ends up not being routine about it yeah and why we're asking you to do blood work yeah yeah exactly it's it could be a really expansive topic, but we'll try to kind of keep it. I mean, it's a two semester situation in vet school, so. Us keeping it.

Science is laughable at very best. Okay. All right. So first of all, who are we recommending blood work for?

Yeah. The first time your pet will most likely get blood work is when they get get spayed or neutered. So that will be the first time they kind of see blood work. And it might be the final time if they're healthy until they are seven. When they become geriatric is when we start saying, okay, yearly blood work is recommended. Yeah. Routine annuals, as opposed to just pre-anesthetic, which is kind of what the spay thing is.

But, you know, it's like you have a little dog that needs their teeth cleaned, you know, at four, you know, that's another time. Yeah, we always do blood work before anesthesia, not any different than your human doctors. Because why? Because we want to make sure that organ function is functioning appropriately. We want to make sure that. Platelets help you clot so if we were to move a tooth and

your dog's bleeding a significant amount we're not panicking going we should have done lab work how many platelets does this dog have yeah no doubt yeah it helps us tailor their anesthetic needs and be aware of any challenges we may encounter along the way to minimize side effects or risk you know nobody you know even i had a client yesterday i was talking with this about and she was just has a little frenchie for a neuter and she was like nervous about his anesthesia.

And I'm sitting there telling her, you know, yeah, I get that. I know that statistically it's like somewhere around 0.012% or, you know, like one in 2000 or in that ballpark of complications from anesthesia. But when my dog has to go under sedation for his, you know, he had a little growth on his tummy and And he's had dentals. Like I do not love it. I'm putting off my dog's dental currently a little bit, which is not good. Do as we say, not as we do. Do as we say, not as we do.

Not putting off, putting off. He just came due for it. And I've been like, all right, what day am I going to have a panic attack? Right. Let me pick a convenient day to be completely stressed out. Let me schedule this stressful day because we get it. There are children. Yeah. Yeah. And it's just, it's, it's, I think you could put it in the same

category as like flying for me. Like I know that airplanes are super safe ish. Did you see the door that flew off the bung? I know. And my husband, he knows a lot, a lot of people because he guides white tail deer hunts. And so he meets people from all over the country and, and like through horses and, you know, dentistry and all that stuff.

And he has recently met a. Pilots and he's bringing back these terrifying stories but anyway most people get where they're going right pretty safely and yet still i'm driving safer than driving and i still have a panic attack panic attack so i didn't before i had kids and yeah i like and i was like yolo you know whatever we go down we go down but now you have kids you're like i already had anxiety and then i had a child and it was like this is a next level of anxiety because now i'm

anxious is about me and him yeah exactly what's gonna happen to him i was low-key on the i was on the plane and getting ready to go and my husband it called me you know like okay i mean i'm playing you to do the thing and this isn't a therapy podcast at all but here we go we were at dinner with some of my friends like or you know our mutual friends and their kids and my daughter had like snugged up to the to the wife and and whatever and he's like i can't pull madeline off for her.

She just was like, she'll be okay if I die. Anyway, I made a batch. She's back. She's on Oklahoma soil. So anyway, point of all of that is that we understand that anesthesia is anxiety giving, even though statistically it's very safe. Hey, morning, LJ. Haven't seen you in a while, friend.

Anyway, sorry, sidebar from the Facebook notification. So what we're really trying to do, again, is just mitigate risks and make it as safe as possible so we don't have regrets about what we might have done differently had we known a patient's blood work looked discerningly. Yeah. And when they're coming in at six and 12 months, that's the first time that we've seen those labs. And personally, VetTail, I've had a lot of Yorkies that I've been like,

oh, your liver values are up. We can still neuter you. We need, and you're probably a cryptorchid. Yeah, probably. Because we will want to see you back to investigate maybe if they have a liver shunt. Yeah. And so it catches those diseases earlier when you want to catch them. Yeah. Because you don't want to be eight and then catching a liver shunt because then a lot of the damage has been done. Yeah, absolutely. If you catch it earlier, you can refer for surgery. You can do a lot more.

Yeah. Yeah, and the same goes for some breeds with like clotting issue propensities, like the Great Danes, Great Pyrenees, and Dobermen. We're looking for different reasons why they may not be clotting well. So you never know what you're going to come across. Yeah, yeah. It's so worth it. Yeah, it is. If nothing else, just to say you did, you know, all the things you could do to make it as safe as possible. Exactly. Because, yeah, that's the name of the game.

And, and it creates a beautiful baseline. line. It does.

So as that pet goes down the road of time, we can look back and say, like, there's some dogs, for example, that have a genetic propensity, which you can actually find this on DNA tests. It's a gene code that causes their ALT to be abnormally low.

Yeah. So that's kind of a fun thing. If you're thinking about DNAing your dog, if you go through your veterinarian to do that, we have the capability of doing a bunch of like gene markers and interpreting them in a way that's different than like just like oh my dog is half this and half that and they can tell us like hey this dog's blood work is going to be weird because of this yep and like personally my dog hannah i think i've done i've done lab work on her since she was like two well she got

spayed so we did lab work then but i had done it pretty frequently until recently but i had done it frequently and she always ran high on her bua yeah and i was so freaked out the first time that i saw But then you kind of trend them and watch them throughout their life. And you're like, oh, she just naturally, her BUN is just like three points higher than what it should be. But it never moved. So it's like, okay, maybe she's just, it's just her. her.

Yeah. Max is a similar story in the sense that we had brought in a new piece of equipment that ran what's called an SDMA. For those of you who are not familiar, it's basically a very sensitive kidney test. And they were like, hey, we need a normal dog to check. And then we started like, okay, Max is in the office. Here's my normal dog. He's five. Lol. So he was elevated on his SDMA and his urine specific gravity was quite low, indicating his kidneys weren't functioning properly.

So I put him on a kidney diet. Turns out, I think he's like a mild form of diabetes insipidus, but I monitor his blood work twice a year and he never changes. So we just keep a really close eye on that. Yeah. So baselines are probably the number one reason. And then, you know, we have that stay neutered lab work and then we have our Ehrlichia dogs. except that's a good point and recommend checking yearly and so that's a huge.

Because when they get to the age of 10, they're like 200% more likely to develop kidney disease.

Yeah, 100%. And in the acute stages, you can have all the CBC, you know, infectious clotting issues, platelet things. And so that's why we're like, hey, let's check that once a year just so that if there is a kidney issue, we are catching it early. Right. Yeah. Yeah. Early detection is paramount because so many times that's not the case. Yeah. Yeah. So, yeah. So we've got our Likia dogs that we're checking annually.

We've got pre-anesthetic that we're doing constantly, you know, I mean, anytime before an anesthetic event. And then we also have our geriatric or senior pets and that's a huge shift in the recommendations. So now we're just recommending them every year, you know, either. So like some dogs will come in for their, their wellness exam where they're getting like their vaccines or their heartworm test or their fecal or dewormer, all that stuff. And they may want to do blood work at that time.

Or a lot of times what I actually encourage people to do is have that visit at one time and then six months later do the other because that for one, it's not so much on the dog or cat as it were.

And then the other big thing is that now I'm looking at this pet and weighing this pet and listening to this pet twice a year because diseases happen as the pet ages just like a vehicle you know with more miles starts to break down and so you want to catch things like the heart rumors and the elevation of the kidney enzymes or the the rapid weight loss or whatever the thing is and things can happen so fast like you owners are always like did i miss something and i'm like no,

I'm like, this can happen this quickly where it's just. Yep. And so it's nice to see them more often. Yeah. So another like tale is a situation. So there was like, I think he was only eight and he came in for routine lab work and he was just going to do a senior screen. And when we do those senior screens, we actually throw in some kind of imaging because what does not show up on blood work is cancer. Cancer. It's like, yeah, it's so frustrating. And so we do imaging on them to look for tumors.

So we run the blood work on this dog and he's a little anemic. He had less red blood cells than he should have. And I went, oh, I bet that's a spleen tumor. And so we went to ultrasound and sure enough, there was his gigantic spleen tumor. So we ended up actually being able to take it out before it ruptured. Because a lot of those spleen tumors, there's no symptoms until they're critical, you know, they're bleeding out.

And that's not the time you want to find out that your animal has a tumor is when they're bleeding out in their emergency status. So we were able to remove the spleen and that patient actually did pretty well for several years. It didn't metastasize or anything like that. I have seen them on the flip side of that though, where they come in, they're anemic, Their belly is full of blood because a giant tumor is ruptured.

And there was no signs leading up to that. It's the same for, you know, liver cancer. There's no symptoms until it's really bad. And I mean, you see that in human medicine as well. So it's a really good reason to just like do the routine stuff to, again, to avoid regret of having missed something that was manageable at an earlier stage. Age yeah yeah that's i think the end of that thought yeah and then for a really

commonly i feel like we find kidney disease most of the time when we're checking yearly labs which. You know we're doing it yearly and then if your dog we do find that it has kidney disease that's just going to increase our recommendation of how often we check that definitely so irish staging is this fancy organization that decides, you know, this is how you grade a kidney disease. And so when they're stage one, there's not much to do other than we'll see you back sooner.

Make sure they have fresh water. Yeah, make sure they have fresh water. We'll see you back sooner. It might be like Natalie's dog that's been in stage one, I think for five years. He's almost 12. So yeah, six, seven years.

So that's the dream. But, you know, we're like, okay, you know, of let's recheck in three to six months you know check those kidney values three months is kind of gold standard but we understand yeah that's especially when you first find it because you don't know how fast it's changing when you don't have anything to compare it back to within a recent amount of time you know if that dog hasn't had blood work since it was a puppy then you're basically flying blind as far as how quickly

this could be changing how quickly it'll progress and you know if they're not clinical okay we'll see you back in three months and then And, you know, okay, great. We caught them when they've gone into stage two. Now we're going to do some lifestyle changes. So it's just trying to catch things as they go. And then for the liver stuff, that's another one that I feel like we find commonly find. Yeah. The liver makes me so angry. It could be nothing. It's a brat.

The liver will throw these wild numbers over absolutely nothing because it just got upset one day. And then it can be in complete, like, tumor-ridden status. And the blood work's completely normal. It's just not fair. Or it can go one week, blood work's normal. The next week, completely abnormal. And the animal is critical. Yeah. Yeah. And then sometimes it's reversible. Sometimes it's not. Another tale was a, I met this dog. She'd been on, she's probably 11 year old lab when I met her.

And she had been on carprofen for quite some time. Or Remedil is another name for that drug, if you're familiar with it.

And she came into the clinic in complete liver failure was a referral from another kind of you know clinic in our area and and they sent her to us for critical care and she survived she came out of it and she did great for a couple of years we just had to keep her up insides oh that's another one we didn't even talk about that blood work yeah routine blood work for medication for medication medication management. Yeah. So non-steroidal anti-inflammatories, steroids, venobarbital,

those are the big ones. Yeah. Because we're looking to make sure that the kidney and liver are still in a good place to be handling them. And there is some, it's basically idiopathic liver inflammation that happens specifically, mostly in Labrador retrievers as a response to non-steroidal anti-inflammatories, especially carprofin, less so Daramax, Although I don't think the statistics are like hugely different. Yeah.

So we check them. Yeah. We just check them every six months because above all else, do no harm. Yeah. And so, and then if we notice, you know, creeping values, we'll give you some other options, which now we have a more. Yeah. The galopran is nice in the sense that it's like a non-steroidal anti-inflammatory, but it is processed through the GI tract, not the kidney and the liver. So dogs can be in kidney or liver disease or have kidney or liver disease and still take Gallop Rant Safer.

Yeah. Although Max gets the runs on it. To be honest, he cannot take it. And then we have Labrella. So then Labrella is what Max is on. Yes. Which is not an anti-inflammatory, but it is a pain reliever. Yes. And it's a once a month injection. It's pretty much brand new. Dogs are doing really well on it. And a lot of my dogs that are on it have been able to come off the pills completely. Yeah. which has been cool. It's your favorite class of drugs too. Yeah, it's a monoclonal antibody.

Yeah, it's the monoclonal antibodies have been revolutionary over the past, you know, what, like four or five years, whenever Cytopoint came out, I think was the first one. Yeah, Cytopoint. We currently have a Parvo one. There's Librella and there is a pancreatitis one. And the cat, Salencia. Cat Salencia. Which is Librella, yeah, for arthritis in cats. Because we forget about cats. No. I know. I was like, the kidney is, yeah, nearly all cats.

Although some little old Yorkies and stuff, I have one that has had, this dog is defying all like the textbooks, just throw them out because he just is not going to follow that. He has had, he's iris stage four renal disease, grade five heart murmur, congestive heart failure, and has been that way for probably two years. And I think this dog is like 17. He's just this little bitty kind of, I think he's like a Yorkie plus men pen or something.

I don't know. So he's kind of a deer-like Yorkie. But anyway, that little dog just keeps it going. The energizer buddy. Mm-hmm. And then a couple other medications that we monitor lab work for is going to be hyperthyroidism and hypothyroidism, which is going to be methimazole and levothyroxine. Mm-hmm. And so that's another one that we're going to be monitoring work. Yep. And then the diabetics.

So, you know, it's nice to do the routine lab work because now with cats, if we can catch it early before they're sick. If your cat is developing type 2 diabetes there is an oral liquid that is changing the game we no longer have to rely on injectable insulin to manage these cats and you can actually.

Nearly and some of them actually correct their their type 2 diabetes and put them into what we would call like remission which is the goal which is the goal with cats of everything dogs just It's just tough manners. No. But cats, if you can get them into remission, heck yes. Yeah. And previously there was one particular medication that had a chance of getting them into remission. More likely. Are you talking about Prozinc? Or are you talking about Bexa? Glargine. Oh, I forgot about Glargine.

But now with this new medication, it's cheaper than Glargine. Yeah, because Glargine was like $400 a bottle, which is why I forgot about it. Yeah. It's extremely expensive. And this medication is cheaper when you look at how long it lasts and the potential of it. And it's oral.

It's oral. First time that's ever happened. It works in a totally different mechanism, a whole different kind of, I don't know, mode of action, I guess, in terms of managing the diabetes, which is a little scary at first, you know, just because it changes what we're monitoring. Now, with that, we're actually more likely to be monitoring urine and blood sugar versus, you know, your actual like ketones in the blood. Curbs. and that too.

Yeah, so anyway, if you catch your animals, cats specifically, at that early stage with your routine lab work. Never been on insulin. Yeah, you could save yourself so much heartache. Yeah. If you have a fat cat, we're talking to you. Me. And yes, I'm looking directly at Dr. Damon as a fat cat. My cats are athletes. I think they are. No, I've seen mine. They try to jump over fences and then you're like, oh, you can't get off the ground. Dude, mine will literally plot on baby deer.

They'll sit there and wiggle like they're going to pounce. I'm like, I don't know, guys. But they have brought back some pretty big prey. My cat is so fat. I went home that day and I was like, guess what, buddy? You will get treated if you have diabetes. I won't have to give you injections. That's right. Woo. That's right. So anyway, so that's another really common reason that we're doing blood work.

You know, so I guess just a quick recap, you know, we're looking for infection, inflammation, anemia, clotting disorders, liver disease, inflammation of the pancreas, kidney disease, diabetes. I think I named them in the order from top to bottom when we look at the screen. You did. Yeah. It's just so, so powerful what we can learn about the body from blood. Yeah. Which is wild. Yeah. Yeah. And we, our patients can't be like, I feel exhausted.

Yeah. Can't tell us that. Yeah. We can find that out from context clues and from exam sometimes, but like, they can't like go in and describe how they're feeling to us the way that we described to our doctor. So it's very helpful to have the lab work. Yeah. Yeah. Yeah. The external signs are often not evident until disease is severe, like anemia.

You know you're not going to see it until they're very anemic or if they have liver disease you're not going to see it until they're either vomiting or jaundiced or ichteric as we call it and you know and so on and so for the diabetes you're not going to notice until they've lost 30 percent of their body weight and they're drinking you out of house and home and peeing on your carpet when they've not done that you know so you're going to have really advanced symptoms before.

You're going to be able to see it without lab work yeah so when we recommend it it's because we care and because our job is so much easier if we catch it before they're dying yes to be honest and so yeah we just want your pets to have the best i guess you know opportunity at staying healthy so exactly which is what y'all want yeah the best opportunity at staying healthy yeah because it tends to be cheaper if you catch it early that's no lie it's yeah it's because

financially it is and it seems like a lot up front but it is. Yeah, it really is. And not to mention, like, it's hard to put a value on adding years to your pet's life. So that's important to think about. And you know, blood work, I can't speak for everywhere, by any means. But here, it's about 115 bucks for a full panel. And that's a CBC comprehensive. Your onset clips are like $60. I don't know, but you know, somewhere in those ranges. ranges.

So it's not the end of the world to do that once a year and just budget ahead for it.

Sometimes insurances will cover certain blood work for certain reasons. So depending on your policy and your company and all that jazz, as always, I like to just throw out pet insurance is a great idea. Yep. So the policy advisor. Yes. Yeah. It's like P-A-W. Yeah. Policyadvisor.com. And it's like Travelocity for pet insurance because we're not insurance salespeople.

We don't deal with the policies at all. We just see the relief on our clients' faces when they are dealing with a problem that now they don't have to fit the bill for financially because they have insurance. Yeah, it's worth it. Yeah, veterinary medicines just come so far that it's not just penicillin and steroids anymore. And so if we want to be able to offer them what is available, it can be expensive.

Expensive so again back to routine blood work routine blood work is not that expensive and can save you a lot of heartache down the road yeah anything else no i think we were concise we were concise i was like we're under 30 minutes and i don't think we circled back i don't think we did that might be your first okay all right well uh and we even talked about airplanes i know i had our own mini therapy session all right okay guys i'm going to end

the video first and then then we're gonna sign off. You guys have a good one. If you need us, you know where to find us. Bye. Music.