Liver, Kidneys, and Gut – Oh My! – What We Learn from the Chemistry Panel

Last month we discussed what the complete blood count or CBC reveals about your cat’s overall health. This month we’ll discuss the second component of standard lab work called the chemistry panel. The chemistry panel primarily screens organ function and can let us know early signs of disease processes allowing intervention and prevention. Running preventive lab work on your cat is as essential as annual examinations! In catching disease processes early, we can help your cat not only live longer but extend the quality of those years as well.


Chemistry components:

Albumin is a small protein produced by the liver that acts as a sponge to hold water in the blood vessels. Albumin is decreased if the liver is damaged and thus cannot produce enough albumin. Low albumin can also indicate intestinal damage or kidney disease.
Total protein includes albumin and larger proteins called globulins. Total protein can be increased if a cat is dehydrated or if their immune system is being stimulated to produce large amounts of antibodies.

Alkaline phosphatase is an enzyme found in many tissues within the body, but it is most concentrated in the cells that make up liver and bone. In the liver, alkaline phosphatase is found on the edges of cells that compose the bile ducts which drain bile from the liver to the bowels. So an increased alkaline phosphatase can indicate liver disease or gallbladder disease.

ALT is an enzyme produced by the liver cells that can indicate the overall health of the liver, but also can be linked to other disease processes in the body including pancreatitis, intestinal disease, and even thyroid disease.

Amylase, an enzyme produced by the pancreas and intestinal tract, helps the body breakdown sugars. Increased levels can indicate pancreatitis or potentially pancreatic cancer. However, cats can have a normal amylase, but still have pancreatitis making it less of a reliable indicator.

BUN, or blood urea nitrogen, is affected by the liver, kidneys, and dehydration. It’s a waste product produced by the liver from proteins in food and is eliminated from the body by the kidneys. Low BUN can indicate liver disease, while increased BUN is commonly associated with kidney disease.

Calcium in the bloodstream comes directly from the bones. Parathyroid glands secrete hormones that help the body regulate calcium and release it from the bones, gut and kidneys for deposit into the bloodstream. Increased calcium indicates a problem related to the bones, gut or kidneys, but is most commonly associated with cancer.

Creatinine, one you’ll commonly hear us talk about, is a waste product that originates from muscles and eliminated by the kidneys. Increased creatinine is most commonly associated with kidney disease, however it can be affected by dehydration.

SDMA, a new kidney biomarker, is now part of all of our lab work at Just Cats because it can indicate decreased kidney function at 25% as opposed to 75% for BUN. This allows us to find kidney disease sooner and it’s more reliable because it’s impacted by less external factors like body condition or age.


Increased glucose, or blood sugar, is most commonly associated with diabetes. However, glucose can also temporarily increase in the blood with stress and excitement during a blood draw. Low blood sugar occurs less commonly and can indicate a serious condition.

Increased phosphorus is another value we look at for cats with kidney disease. Increased phosphorus is common in cats with chronic kidney disease. Occasionally we’ll recommend a phosphate binder to help restrict the absorption of phosphorus from your cat’s diet.

Potassium increases in cats with acute kidney failure and can be low in patients that are not eating. Low potassium can cause cats to feel weak and develop painful muscles. Potassium can be supplemented during ongoing treatment of the underlying cause.

T4 is a thyroid hormone that is used at the primary indicator for thyroid disease. An increased T4 would indicate hyperthyroidism, which you’ll often hear Dr. Elizabeth say is her “favorite old cat disease” because it’s curable! It’s essential to catch the disease early to prevent damage to other organs.

At your next preventive care visit, no matter your cat’s age, talk to your vet about whether preventive labs are the right decision for your cat.






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