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Alkaline Phosphatase (SAP), High

A 14-year-old, MN, 13.5 lb Maltese was presented for a possible syncopal episode after going upstairs and breathing heavier. The patient was treated with enalapril 2.5 mgs PO SID and scheduled for an echocardiogram. Physical Exam: Grade 4/5 murmur. Radiograph indciated severe cardiomegaly. BP 117/74 Map 90. CBC: Normal. Chemistry: Alk. Phos 1340.

An 8-year-old, F/S, 77 lb, Pitbull terrier was presented at RDVM for decreased activity level and behavioral changes. Blood work was performed and showed an increase in ALKP. The patient also had a dental cleaning recently where they extracted multiple teeth and put her on oral Tramadol. Owner says that she was “normal” on March 20th but has slowly been declining. Repeat blood work showed an increase in ALKP. Unable to perform physical exam due to hyper response. Owner reported the patient had become very head shy and aggressive with other dogs and had drastically changed in personality. RDVM recommended a brain CT scan and it was decided to include the liver due to increased ALKP.

The patient is a 14 month old M Miniature Australian Shepherd dog who presented with an acute case of vomiting, lethargy and ataxia.  The owner was unaware of any exposure to toxins or ingestion of obstructive material. Physical exam: 10% dehydrated; mm pink but tacky; abdomen tender on palpation; weight wnl. CBC/Chem: WBC 21,120, decreased cholesterol and protein; elevated CK, ALKP, ALT, BUN and ammonia. Lepto negative.

The patient was presented for vomiting 3-4 days prior. Was recently gagging, not urinating often despite normal drinking. The patient had a decreased appetite or was not eating at all and having innappropriate defecation in the house. Blood chemistry showed liver enzyme elevation and low BUN. Bile Acids test results were high at 464.6 umol/L. An abdominal ultrasound was recommended to rule out PSS, liver disease. possible infection- Lepto? (patient from Ontario, Canada), toxin, glomerulopathy, protein starvation, chronic non-obstructive FB, Addison, glomerulopathy, other.

An 11-year-old Cavalier King Charles Spaniel was presented for poor appetite and diarrhea. CBC revealed anemia and a hematocrit of 33. Blood chemistry revealed a low total protein of 3.4, albumin of 1.4, and ALKP of 487.

 12-year-old MN Labrador mixed breed was presented for evaluation of anorexia, vomiting, and lethargy. Abnormalities on CBC and serum biochemistry were severe leukocytosis,neutrophilia, hemococentration, and elevated ALP (600).

An 8-year-old FS mixed breed dog was referred for partial anorexia and mild lethargy. Mild painful cranial abdomen was noted on physical exam. CBC and chemistry panel were unremarkable. Urinalysis revealed 3+ proteinuria with isosthenuria. Blood pressure was 220 mm Hg.