Fast Lab Results: Sometimes they can save a Life

Fast Lab Results:
Sometimes they can save a Life

By Dr. Ed Mapes
Stonebridge Animal Hospital
McKinney, Tx

I never had laboratory equipment that could test for blood levels of electrolytes – sodium, chloride, potassium, and calcium – until now that is. There are some medical conditions for which we need to know electrolyte levels to either diagnose or to assist in treatment; without that vital information we’re left to making educated guesses while the blood is sent to outside labs for testing. That’s not the best way to practice medicine.

Figure 1: Modern suite of laboratory equipment

Figure 1: Modern suite of laboratory equipment

The modern suite of laboratory equipment in Figure 1 allows us to perform tests in-house that had to be sent to reference labs before. This fast, accurate information always comes in handy, but sometimes the fast information is a matter of life or death.

Rosco is a 13-year old German shepherd mix dog. On his first visit to our hospital recently, he summoned just enough energy to walk from the car into one of our exam rooms; and then he collapsed to the floor. He was weak, had a sub-normal temperature, and his heart rate was less than normal. Rosco had been “slowing down” recently, but nothing this slow; his owner and I were very concerned and we needed answers.

Rosco had a malignant tumor removed from his arm nine months previously, and we wondered whether the cancer had spread; or were we dealing with a new problem entirely?

I had to start narrowing down the list of possible diagnoses as soon as possible, because Rosco was in trouble. I had learned as much as possible from questioning the owner and doing a thorough examination, and now needed more information – and I needed it fast.

Chest X-rays showed no indication of tumor spread to the lungs. We drew blood for testing, and thanks to the lab equipment we were able to do it in-house in just a few minutes. It’s a good thing we got it so quickly too, because the results revealed that Rosco had a condition known as hypoadrenocorticism (Addison’s disease), and we needed to start treatment immediately to prevent serious heart problems that can be fatal.

In this disease, the body loses too much sodium, chloride, and sometimes calcium, while the concentration of potassium builds to very high levels. Blood cortisol is often low as well, and this proved to be the case in Rosco. These imbalances cause the muscular weakness Rosco experienced, and produce other symptoms such as low blood sugar levels, depression, anorexia, loss of balance, dehydration, and coma – but it can also cause fatal heart abnormalities. Rosco’s Potassium level was at 8.6, and I’ve seen patients in comas with levels lower than that.

We started intravenous saline solution, gave him a large dose of IV cortisone and some other medications, and monitored his blood and EKG closely. By the next day, Rosco was markedly stronger, he began eating, went for a walk outside to urinate, and I promised him he could go home that day.

We also started him on injections to supply the hormones that his adrenal gland can no longer produce. He’ll need that injection about every 25 days, and he should be able to live a pretty normal life.

Without the lab equipment that yielded the electrolytes and blood cortisol, I probably would have started Rosco on the IV saline and given the cortisone, but it would have been a guess and I could have been wrong. I’ve taken that leap of faith in the past when we did not have the ability to run these more specialized tests in-house, but it’s a real comfort to know that from now on we’ll have hard evidence before starting a life-or-death treatment. In medicine, knowledge and information are power, and I’ll take all the power I can get when managing sick patients.

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