Everything You Need to Know About Blood Work From a Veterinarian

Getting blood work done is never a waste, even when it results in good news.

By Dr. Debora Lichtenberg, VMD Apr 11, 2018

A complete blood count tells veterinarians about a pet’s red blood cells, white blood cells and platelets.

“Blood work, shmud work! Why is my vet always asking me to do blood tests?”

I hear this complaint — or a reluctance to pay for blood tests — frequently. Veterinarians often defend themselves about recommending blood work.

•  “Why do you have to do blood work?” asks a client with an 8-year-old Cocker Spaniel who needs dental work.

• “What will it tell you?” complains the human of a 4-year-old cat who has not been eating for several days.
• “Just take off the lump without the blood work,” says the price-shopping person with a young dog with a skin tumor.

Basic blood work from a veterinarian — a complete blood count (CBC) and a chemistry profile — are completely noninvasive tests that tell us a great deal about the general health of your pet, young or old, sick or healthy.

Vets are so happy we can do highly reliable blood work in a matter of minutes rather than days and at a reasonable cost.

If people really understood how much a CBC and a chemistry can tell us, I think they’d show less reluctance.

Blood Work From a Veterinarian

In a complete blood count, a small amount of your pet’s blood is taken from a vein and placed in a lavender-top tube. The blood draw takes about 10 seconds.

The CBC informs us about red blood cells, white blood cells and platelets.

Red Blood Cells

• If the red cell count (hematocrit or PCV) is low, your pet is anemic. Then your vet has to find out why your pet is anemic.
• If the red cell count is high, your pet is most likely dehydrated. Rarely, a high red blood cell count suggests a disease called polycythemia.

Are the red blood cells healthy? A simple CBC tells us much about your pet’s actual red blood cells, which is like a window into your pet’s bone marrow, spleen and kidneys.

White Blood Cells

There are a number of different white blood cells in your pet’s peripheral blood.

The kind of white cells and the relative numbers of these cells help your vet decide whether your pet might be suffering from an infection, bacterial or viral, inflammation or cancer.

Although the white cell count does not give us specifics about where an infection might be, where the inflammation is coming from or if your pet actually has cancer, it can lead us in a specific diagnostic direction.

Platelets

Platelets are proteins that help pets make a blood clot. A low platelet count is a worry and should be addressed, particularly before any surgery.

The Chemistry Profile (or Panel)

Once we’ve learned how your pet’s blood cells are doing with a CBC, we turn to your pet’s serum, the fluid in your pet’s blood.

This blood is taken in that same 10-second blood draw as the CBC and placed in a second red-top tube. We don’t need much of your pet’s blood to do a battery of tests.

Many enzymes and elements are found in the serum that tell us tons about your pet’s organs, metabolic state and electrolyte status.

Liver, Kidneys, Gallbladder

While the basic chemistry panel can’t give us specific answers as to what liver disease, gallbladder condition or kidney disease your pet might be suffering from, increases in specific enzymes are red flags and tell us we need to look deeper or monitor certain organs.

The chemistry allows us, for example, to pick up early (or advanced) kidney disease, injury to the liver or possible gallbladder problems.

Electrolytes

Alterations in electrolytes like sodium, potassium and chloride are serious. They can:

• Signal endocrine diseases, like Addison’s
• Help us measure dehydration
• Aid in what kind of IV fluid supplementation your animal needs if there has been vomiting, diarrhea, kidney disease or other illness
• Help us complete a medical picture in a pet with diabetes, GI, pancreatic, kidney or endocrine disease

Blood Glucose

An elevated blood glucose (blood sugar) suggests diabetes. A low blood sugar indicates other syndromes such as insulinoma, starvation or hypoglycemia of young puppies.

Misconceptions About Blood Work

Heartworm Test

The annual heartworm test, or 4dX test, for dogs does not include other blood work. The test determines if there is evidence of heartworm or other tick-borne diseases.

Your vet must specify that she’d like to do a CBC/chem or “blood panel” or “comprehensive blood work” to look for things beyond the heartworm test.

Limitations of Blood Tests

Blood tests give important diagnostic information, not necessarily a diagnosis. The diagnosis, however, cannot ultimately be made without the blood tests.

“Will the blood test tell us if my pet has cancer?” is an all-too-frequent question.

No, the CBC/chemistry panel does not diagnose cancer. However, if the pet is anemic, shows atypical cells in the CBC, has high liver enzymes, etc., the panel can point us in a certain diagnostic direction or help us flush out the overall picture.

Blood Work Has a Shelf Life

Blood work must be repeated if your pet’s health status is changing or if we are staging or tracking a chronic disease.

If a pet has recently lost a lot of weight or has begun to drink a lot of water, I will definitely recommend blood work.

The client might say, “But they had blood work done 6 months ago and it was fine.”

But clearly the pet’s health status has changed if they have lost significant weight, or if thirst or appetite have changed dramatically. The blood work should be repeated.

If we have diagnosed a chronic problem, like kidney, liver or diabetes, then serial blood work is one of the best ways to monitor whether the disease has improved or worsened.

Basic Blood Work Costs.

There are many, many other blood tests and “comprehensive panels” that include other tests. Obviously, these tests carry an additional price tag.

A retroviral panel, for example, will include Felv/FIV/FIP for a sick kitty. Thyroid testing is very common in both dogs and cats. Make sure to communicate clearly about costs because these life saving blood tests can be expensive, but well worth it.