Interpreting abnormal CBC and chemistry values in dogs and cats
A reference for veterinarians on what a high or low result on a dog or cat CBC, chemistry panel or urinalysis can point to, what can shift it artificially, and the next test, with a citation for each.
Analyte index
Liver enzymes
Azotemia and kidney values
Hyperkalemia and electrolytes
Low PCV and red cell values
Thrombocytopenia and platelets
Hypercalcemia and calcium
Reading a value against the reporting lab's own interval
A reference interval is an estimate of the distribution of values in healthy, comparable animals, and decisions to pursue a diagnosis are often triggered by a value outside it1. Laboratories determine their own intervals or validate intervals transferred from another source, such as an analyzer manufacturer, for the method they actually run1. The ACVIM panel on canine hyperadrenocorticism made the same point for endocrine tests, recommending that reference ranges be re-established as test technology changes2.
That is why this site publishes no numbers. Check your lab's range, printed beside the result, and read every value on these pages as above, within or below that interval. A value just outside the interval in a well patient is a prompt to look at the rest of the panel and, often, to repeat it, since a single time point is less reliable than a series3.
When the sample moved the number
Some abnormal results describe the tube rather than the patient. Platelet clumping in EDTA is a common cause of a falsely low platelet count in dogs and cats4. Akitas and several other East Asian breeds can carry red cells rich in potassium, so their serum potassium can read high without disease5,6. Ionized calcium is most reliable when the sample is handled anaerobically7. Each topic page lists the artifacts for its own values under Can shift it artificially.
Lab values from a photo
Vetinuity built this site. Vetinuity is a veterinary clinical assistant. Take a picture of a chemistry or CBC printout and it reads out every flagged result, adds those results to the chart, and reworks its list of likely causes, next tests and treatment considerations around them. With an owner who speaks another language, it interprets the visit live in 80+ languages.
The first 14 days are free: see vetinuity.ai.
Frequently asked questions
How do I interpret a dog or cat CBC and chemistry panel?
Value by value against the reporting lab's own interval, then as patterns across related values, with the sample's quality and the patient's drugs and breed in mind1,3.
Why does this site not list normal ranges?
Intervals are set or validated by each laboratory for its own method and population, so a number from one lab can mislead on another lab's report1.
What does it mean when a value is barely outside the interval?
Often little on its own. Intervals describe healthy animals, so the rest of the panel and a repeat measurement usually decide whether it matters1,3.
Sources
- Friedrichs KR, Harr KE, Freeman KP, et al. ASVCP reference interval guidelines: determination of de novo reference intervals in veterinary species and other related topics. Vet Clin Pathol. 2012; 41(4):441-53. PMID: 23240820. DOI: 10.1111/vcp.12006.
- Behrend EN, Kooistra HS, Nelson R, et al. Diagnosis of spontaneous canine hyperadrenocorticism: 2012 ACVIM consensus statement (small animal). J Vet Intern Med. 2013; 27(6):1292-304. PMID: 24112317. DOI: 10.1111/jvim.12192.
- Center SA. Interpretation of liver enzymes. Vet Clin North Am Small Anim Pract. 2007; 37(2):297-333, vii. PMID: 17336677. DOI: 10.1016/j.cvsm.2006.11.009.
- Williams TL, Archer J. Effect of prewarming EDTA blood samples to 37°C on platelet count measured by Sysmex XT-2000iV in dogs, cats, and horses. Vet Clin Pathol. 2016; 45(3):444-9. PMID: 27391303. DOI: 10.1111/vcp.12378.
- Conrado FO, Oliveira ST, Lacerda LA, et al. Clinicopathologic and electrocardiographic features of Akita dogs with high and low erythrocyte potassium phenotypes. Vet Clin Pathol. 2014; 43(1):50-4. PMID: 24405428. DOI: 10.1111/vcp.12112.
- Battison A. Apparent pseudohyperkalemia in a Chinese Shar Pei dog. Vet Clin Pathol. 2007; 36(1):89-93. PMID: 17311201. DOI: 10.1111/j.1939-165x.2007.tb00188.x.
- Schenck PA, Chew DJ. Calcium: total or ionized?. Vet Clin North Am Small Anim Pract. 2008; 38(3):497-502, ix. PMID: 18402876. DOI: 10.1016/j.cvsm.2008.01.010.