Renal panel and urinalysis—Lady is moderately azotemic. This partially reflects a prerenal component as she was clinically dehydrated when the sample was collected. Although the urine is concentrated, a 1.027 specific gravity in the face of dehydration and in an oliguric or anuric animal suggests impaired concentrating ability and possible renal failure. Thus, a renal component is also present. Granular and waxy casts are nonspecific indicators of renal tubular damage.
Electrolytes and acid-base panel—The mild electrolyte changes are consistent with diuretic therapy; however, the unexplained high chloride compared to sodium is similar to the first chemistry profile. This typically would be seen in an animal with metabolic acidosis, but there is no decrease in tCO2 representative of a secretional metabolic acidosis. The low anion gap is related to the decreased albumin.
Protein panel—The hypoproteinemia and hypoalbuminemia have worsened since Lady’s original presentation; interpretation is the same.
Liver panel—The increased GGT, compared to the original chemistry profile, is supportive of cholestasis, which is further supported in the finding of 2+ bilirubinuria within a urine sample with only a 1.027 specific gravity. The very mild elevation in ALKP may be due to the cholestatic process or glucocorticoid induction.