What are the new normal ranges for AST and ALT. How do these liver enzymes indicate liver health. What causes elevated AST and ALT levels. When should you be concerned about abnormal liver function test results.

Understanding AST and ALT: Key Indicators of Liver Health

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are enzymes primarily found in liver cells. When liver cells are damaged, these enzymes leak into the bloodstream, causing elevated levels in blood tests. Monitoring AST and ALT levels is crucial for assessing liver health and detecting potential liver diseases.

The American College of Gastroenterology (ACG) has recently updated its guidelines for interpreting liver function tests, including AST and ALT. These new recommendations aim to improve early detection of liver problems and promote better overall liver health.

New Normal Ranges for ALT

The ACG has established new, lower thresholds for normal ALT levels:

• Women: 19-25 IU/L
• Men: 29-33 IU/L

These updated ranges are significantly lower than previous guidelines, which often considered upper limits of 30-80 IU/L as normal. The change reflects growing evidence that even slight elevations in ALT can indicate increased risk of liver disease and mortality.

Causes of Elevated AST and ALT Levels

Elevated AST and ALT levels can be caused by various factors, including:

1. Non-alcoholic fatty liver disease (NAFLD)
2. Chronic hepatitis B and C
3. Alcoholic liver disease
4. Autoimmune liver diseases
5. Hereditary hemochromatosis
6. Wilson’s disease
7. Medications and supplements
8. Obesity and metabolic syndrome

Understanding these potential causes is essential for proper diagnosis and treatment of liver conditions.

Interpreting AST/ALT Ratios: A Diagnostic Tool

The ratio of AST to ALT can provide valuable insights into the underlying cause of liver dysfunction. An AST/ALT ratio greater than 1 may suggest alcoholic liver disease, while a ratio less than 1 is more commonly seen in viral hepatitis and other chronic liver conditions.

AST/ALT Ratio Guidelines

• AST/ALT < 1: Typical of viral hepatitis and NAFLD
• AST/ALT > 2: Suggestive of alcoholic liver disease
• AST/ALT > 1 but < 2: May indicate cirrhosis of various etiologies

It’s important to note that these ratios should be interpreted in conjunction with other clinical findings and not used as standalone diagnostic criteria.

Screening Recommendations for Liver Disease

The ACG guidelines provide specific recommendations for screening various liver diseases based on AST and ALT results:

Chronic Hepatitis C

Testing for chronic hepatitis C should be done using anti-HCV antibodies, with confirmation by HCV RNA nucleic acid testing. Individuals at higher risk include those with a history of drug use, blood transfusions, and high-risk sexual behavior, as well as people born between 1945 and 1965.

Chronic Hepatitis B

Screening for chronic hepatitis B is performed using HBsAg testing. High-risk groups include individuals born in endemic areas, men who have sex with men, injection drug users, dialysis patients, and HIV-infected individuals.

Non-alcoholic Fatty Liver Disease (NAFLD)

Patients with elevated BMI, diabetes, hyperlipidemia, or hypertension who show mild ALT elevations should undergo ultrasound screening for NAFLD.

When to Be Concerned About Abnormal Liver Function Tests

While minor elevations in AST and ALT may not always indicate severe liver disease, persistent abnormalities warrant further investigation. Consider the following scenarios:

• AST or ALT > 3 times the upper limit of normal
• Persistent elevation for more than 6 months
• Accompanying symptoms such as jaundice, abdominal pain, or fatigue
• Presence of risk factors for liver disease

In these cases, consulting a hepatologist or gastroenterologist is advisable for comprehensive evaluation and management.

Lifestyle Modifications to Improve Liver Health

For individuals with mildly elevated AST and ALT levels, lifestyle changes can often help improve liver function:

1. Maintain a healthy weight
2. Limit alcohol consumption
3. Exercise regularly
4. Follow a balanced diet rich in fruits, vegetables, and whole grains
5. Avoid unnecessary medications and supplements
6. Manage underlying conditions like diabetes and high cholesterol

These modifications can significantly impact liver health and may help normalize AST and ALT levels in some cases.

Advanced Diagnostic Techniques for Liver Disease

When initial liver function tests reveal abnormalities, further diagnostic procedures may be necessary to determine the underlying cause and extent of liver damage:

Imaging Studies

• Ultrasound: Non-invasive and cost-effective, useful for detecting fatty liver, cirrhosis, and tumors
• CT scan: Provides detailed images of the liver structure and can identify advanced liver disease
• MRI: Offers high-resolution images and can detect subtle liver abnormalities
• Fibroscan: Measures liver stiffness to assess fibrosis and cirrhosis

Liver Biopsy

A liver biopsy involves extracting a small sample of liver tissue for microscopic examination. This procedure can provide definitive diagnosis of various liver conditions and assess the severity of liver damage. While invasive, it remains the gold standard for diagnosing many liver diseases.

Genetic Testing

For suspected hereditary liver conditions, genetic testing may be recommended. For example, HFE mutation analysis is used to diagnose hereditary hemochromatosis in patients with elevated transferrin saturation and ferritin levels.

Emerging Biomarkers in Liver Disease Assessment

While AST and ALT remain crucial indicators of liver health, researchers are exploring new biomarkers to enhance liver disease diagnosis and monitoring:

Cytokeratin-18 (CK-18)

CK-18 fragments in the blood can indicate the degree of liver cell death, potentially differentiating between simple fatty liver and more severe forms of NAFLD.

Enhanced Liver Fibrosis (ELF) Score

This blood test combines three markers of liver fibrosis to assess the risk of advanced fibrosis in patients with chronic liver disease.

Mac-2 Binding Protein Glycosylation Isomer (M2BPGi)

This novel biomarker shows promise in assessing liver fibrosis progression and the risk of hepatocellular carcinoma in patients with chronic liver diseases.

These emerging biomarkers, while not yet widely used in clinical practice, may offer more precise and non-invasive methods for assessing liver health in the future.

Special Considerations in AST and ALT Interpretation

Interpreting AST and ALT results requires consideration of various factors that can influence these enzyme levels:

Age and Gender

AST and ALT levels tend to be higher in men than in women and may increase slightly with age. The new ACG guidelines account for these differences by providing gender-specific normal ranges.

Ethnicity

Some studies suggest that AST and ALT levels may vary among different ethnic groups. For example, some Asian populations may have lower baseline levels compared to Western populations.

Muscle Mass and Exercise

Intense exercise or muscle injuries can temporarily elevate AST and ALT levels, as these enzymes are also present in muscle tissue. This factor should be considered when interpreting results in athletes or individuals who recently engaged in strenuous physical activity.

Medications

Certain medications, including some common over-the-counter pain relievers and statins, can cause transient elevations in liver enzymes. A thorough medication review is essential when assessing abnormal AST and ALT results.

Understanding these factors helps healthcare providers make more accurate interpretations of liver function test results and avoid unnecessary interventions or missed diagnoses.

The Future of Liver Health Assessment

As our understanding of liver disease continues to evolve, so do the methods for assessing liver health. Several promising developments are on the horizon:

Artificial Intelligence in Liver Imaging

Machine learning algorithms are being developed to analyze liver imaging studies, potentially improving the accuracy and efficiency of liver disease diagnosis.

Metabolomics

This emerging field studies the unique chemical fingerprints left by cellular processes. Metabolomic profiles may offer new insights into liver function and disease progression.

Liquid Biopsy

Techniques to detect circulating tumor DNA and other molecular markers in blood samples could provide non-invasive methods for early detection of liver cancer and assessment of treatment response.

Personalized Medicine Approaches

Integrating genetic, environmental, and lifestyle factors may lead to more individualized interpretations of liver function tests and tailored treatment strategies.

These advancements hold the potential to revolutionize liver health assessment, moving beyond traditional enzyme tests to more comprehensive and personalized evaluations.

As research progresses, healthcare providers and patients alike must stay informed about the latest developments in liver health assessment. The evolving landscape of liver disease diagnosis and monitoring promises more accurate, non-invasive, and patient-friendly approaches in the years to come.

How to interpret ALT, AST, Bilirubin, Alkaline Phosphatase Tests

The American College of Gastroenterology (ACG) has released updated guidelines for blood chemistry tests used to assess liver health

New guidance is targeted at both professionals and primary care physicians.

This document provides specific values ​​for the normal range of alanine aminotransferase (ALT) levels, as well as stepwise screening algorithms for elevations in ALT, aspartic aminotransferase (AST), alkaline phosphatase, and bilirubin. In comparison with the documents of previous editions, the new recommendations contain reduced limits of the norm. Those. previous recommendations have considered upper limit values ​​(URL) as the norm, which can vary significantly between laboratories, ranging from 30-40 international units (IU) per liter in some institutions and up to 70-80 IU/l in others. According to the new guidelines, the normal range for ALT will be 19-25 IU/L for women and 29-33 IU/L for men.

Cirrhosis of the liver. Questions and answers

The authors noted that they are aware that due to the decrease in the limits of the norm, many patients will fall into the category with elevated rates and that this will create certain difficulties for doctors.

However, the authors consider the use of lower starting points justified, pointing out that sometimes even the smallest increase in ALT significantly increases the risk of death due to liver disease.

The authors point out that elevated ALT helps identify people with chronic liver diseases such as non-alcoholic fatty liver disease and chronic hepatitis C and B. over time, its level does not return to normal. The authors hope that, over time, practitioners will become accustomed to these new levels, and this will lead to improved liver health for all, as well as general health.

Key recommendations

1. Before starting to assess liver function abnormalities, repeat the laboratory panel and/or perform a clarifying test (eg, GGT test if serum alkaline phosphatase is elevated) to confirm that the blood chemistry for liver actually are not normal. (Strong recommendation, very low level of evidence).
2. Chronic hepatitis C testing is done with anti-HCV and confirmation is done with HCV RNA by nucleic acid testing. Risk factors for hepatitis C include a history of intranasal or intravenous drug use, tattoos, piercings, blood transfusions, and high-risk sexual behavior. Also at risk are people born between 1945 and 1965. Testing for acute hepatitis C is done with anti-HCV and HCV RNA by nucleic acid testing. (Strong recommendation, very low level of evidence).
3. Testing for chronic hepatitis B is done with HBsAg testing. Testing for acute hepatitis B is associated with HBsAg and anti-HBc IgM.
   The following groups are most at risk: people born in endemic or hyperendemic areas (HBsAg prevalence > 2%), men who have sex with men, ever injecting drug users, dialysis patients, HIV-infected individuals, pregnant women and family members, family members and sexual contacts of HBV-infected persons. (Strong recommendation, very low level of evidence).
4. Testing for acute hepatitis A (IgM HAV) should occur in patients with acute hepatitis and suspected fecal-oral exposure. Acute hepatitis E (IgM HEV) testing should also be done in those returning from endemic areas who test negative for acute hepatitis A, B, and C. (Strong recommendation, very low level of evidence).
5. Patients with elevated BMI and other features of the metabolic syndrome, including diabetes mellitus, overweight or obesity, hyperlipidemia, or hypertension with mild ALT elevations, should undergo ultrasound screening for non-alcoholic fatty liver disease (NAFLD). (Strong recommendation, very low level of evidence).
6. Women consuming more than 140 g of alcohol per week or men consuming more than 210 g per week who have AST>ALT should be considered at risk for alcoholic liver disease and should be advised to stop drinking alcohol. (Strong recommendation, very low level of evidence).
7. All patients with abnormal liver function tests in the absence of acute hepatitis should be tested for hereditary hemochromatosis with iron, transferrin, and serum ferritin levels. HFE mutation analysis should be performed in patients with transferrin ≥45% and/or elevated serum ferritin. (Strong recommendation, very low level of evidence).
8. Patients with abnormal AST and ALT levels, especially those with other autoimmune conditions, should be tested for autoimmune liver disease including ANA, ASMA, and globulin levels. (Strong recommendation, very low level of evidence).
9. Patients with persistently elevated AST and ALT levels, especially those under 55 years of age, should be screened for Wilson’s disease with a serum ceruloplasmin test. If low ceruloplasmin is found, confirmatory testing with a 24-hour urine copper test and slit-lamp eye examination for abnormalities (Kaiser-Fleischer mosaic rings) is recommended. (Strong recommendation, very low level of evidence).
10. Patients with persistently elevated AST or ALT should be screened for alpha-1 antitrypsin deficiency (A1AT) with the alpha-1 antitrypsin phenotype. (Strong recommendation, very low level of evidence).
11. Doctors should ask patients with abnormal kidney tests about their medications and medications, including those they take on their own, without a doctor’s recommendation. It is also worth considering dietary or herbal supplements that may be associated with DILI. (Strong recommendation, very low level of evidence).
12. Liver biopsy may be considered when serological testing and imaging fail to reveal a diagnosis, interpret the condition, or when multiple diagnoses are possible. (Strong recommendation, very low level of evidence).
13. An increase in alkaline phosphatase should be confirmed by an increase in GGT. Given the lack of specificity for liver disease, GGT should not be used as a screening test for underlying liver disease in the absence of other abnormal liver findings. (Strong recommendation, very low level of evidence).
14. Patients with elevated alkaline phosphatase with or without elevated bilirubin should be tested for PBC (previously called primary biliary cirrhosis) with antimitochondrial antibody testing. (Strong recommendation, very low level of evidence).
15. Patients with alkaline phosphatase elevation with or without bilirubin elevation should be tested for PSC by MR cholangiography or ERCP with IgG4. (Strong recommendation, very low level of evidence).
16. In patients with ALT and/or AST levels <5X ULN, laboratory investigations should evaluate the possibility of viral hepatitis B and C, alcoholic and NAFLD, hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, autoimmune hepatitis and consider the possibility of drug poisoning and related with them liver damage. (Strong recommendation, very low level of evidence).
17. In individuals with an ALT and/or AST level of 5-15X ULN, acute hepatitis A, B, and C should be considered in addition to all etiologies. (Strong recommendation, very low level of evidence).
18. In individuals with ALT and/or AST > 15X ULN or massive ALT elevation > 10,000 IU/L, acetaminophen toxicity and ischemic hepatopathy (liver shock) should be considered. (Strong recommendation, very low level of evidence).
19. A patient with acute hepatitis with elevated prothrombin time and/or encephalopathy requires immediate referral to a hepaologist. liver specialist. (Strong recommendation, very low level of evidence).

ALT, alanine aminotransferase; ANA, antinuclear antibodies; ASMA, anti-smooth antibody; AST, aspartate aminotransferase; BMI, body mass index; DILI, drug-induced liver injury; GGT, gamma-glutamyl transferase; HAV, hepatitis A virus; HBc, hepatitis B major antigen; HBsAg, hepatitis B surface antigen; HCV, hepatitis C virus; HEV, hepatitis E virus; HFE, hereditary hemochromatosis; IgM, immunoglobulin M; MR, magnetic resonance; NAFLD, non-alcoholic fatty liver disease; PBC, primary biliary cholangitis; PSC, primary sclerosing cholangitis; ULN, upper limit of normal

Contributors to the guidelines:

Division of Gastroenterology/Hepatology, Department of Medicine, Stanford University School of Medicine Palo Alto, California, USA; Digestive Health Institute, University Hospitals Cleveland Medical Center and Division of Gastroenterology and Liver Disease, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA; Yale Viral Hepatitis Program, Yale University School of Medicine. New Haven, Connecticut, USA. Correspondence: Paul Y. Kwo, MD, FACG, Division of Gastroenterology/Hepatology, Stanford University School of Medicine, 750 Welch Road, Suite 210, Palo Alto, California 94304,USA

Source http://acgblog.org/

Tags diagnostics recommendation

Price list

Biochemistry is one of the most informative methods for diagnosing the state of the organism. It allows you to identify pathologies that cannot be determined visually, using palpation or other methods.

It is possible to take biomaterial around the clock and evaluate the parameters of blood biochemistry in a cat at the best price in the laboratory of the network of veterinary clinics “Svoi Doktor”. Our experts in the shortest possible time (from 12 hours to a day) will give a full detailed conclusion. This will help the veterinarian to quickly diagnose the disease and prescribe adequate treatment. With this analysis, you can also determine if the diet is suitable for your pet.

Scientists have long established the numerical values ​​of indicators of various chemical elements and compounds in the blood, corresponding to the vital activity of a healthy organism. The deviation of quantitative coefficients from the norm indicates the presence of certain problems. It is these discrepancies that allow the veterinarian to determine the presence and degree of pathology.

The functioning of all systems of the animal’s body implies a continuous chain of chemical reactions occurring as a result of the interaction of various enzymes. The most active enzymes are:

• ALT (alanine aminotransferase) – takes part in amino acid metabolism. Normal level 10 – 80 (unit/liter):
  • increased levels – liver toxicity of any etiology, heart failure, shock, trauma,
  • decrease – cirrhosis or necrosis of the liver, lack of vitamin B6;
• AST (aspartate aminotransferase) – causes the transfer of amino groups within cells. Norm 10 – 80 (unit / l):
  • exceeding the indicator – hepatitis, pancreatitis, physical overwork, heart failure,
  • low level – severe course of the disease (any), liver rupture;
• CPK or CK (creatine phosphokinase) – is involved in the processes occurring in the heart, muscles, thyroid gland. The normal level is 150 to 798 units/litre;
• ALP (alkaline phosphatase) – plays an important role in metabolic processes. Standard from 39up to 55 (u/l):
  • increase – bone disease, hyperparathyroidism, lymphogranulomatosis, liver problems, tumor of the biliary tract, pulmonary or kidney infarction, vitamin C overdose,
  • decrease – anemia, deficiency of zinc, magnesium, vitamin C, B12;
• Alpha-amylase is a digestive enzyme produced by the pancreas. Normal level 580 – 1720 (u/l):
  • increase – pancreatitis or other pancreatic diseases, acute peritonitis, kidney problems.

What do deviations from the norm of some other biochemical parameters show:

• urea – norm 6 – 12 (mmol / liter):
  • excess indicates heart failure, kidney disease, impaired urine outflow, oncology, shock, intestinal obstruction,
  • decrease below the minimum level – about a violation of the liver, poisoning with toxic substances;
• creatinine – standard numbers 40 – 130 (µmol / l):
  • magnification indicates renal insufficiency, hyperthyroidism,
  • decrease – malnutrition and loss of muscle mass;
• phosphorus – norm 1.1 – 2.3 (mmol / l):
  • excess indicates bone destruction, kidney disease, acidosis (blood acid-base imbalance), cirrhosis,
  • decrease – about rickets, periodontal disease, hypercalcemia, hyperparathyroidism, hyperinsulinemia;
• calcium – normal range 2 – 2. 7 (mmol/l):
  • increase may indicate cancer, dehydration, kidney failure,
  • decrease – for rickets, osteodystrophy, pancreatitis, liver disease;
• total protein (total concentration of albumin and globulin fractions) – the norm is 54 – 77 (g / l):
  • excess indicates an acute infectious disease, oncology, dehydration,
  • decrease below the standard range – about pancreatitis, diseases of the liver, intestines, kidneys, cancer, fasting.

For more information about your pet’s health problems, visit your veterinarian after a vein biochemistry test.

Biochemical analysis of blood in cats is performed strictly on an empty stomach. The accuracy of the results depends on many factors. Among them are the quality of the reagents used, the temperature regime, accounting for statistical errors, etc. The employees of our laboratory are certified specialists, and the research is carried out using modern equipment. Therefore, you can be sure of the high accuracy of our diagnostics.

Biomaterial is taken from a vein with sterile instruments. If the animal behaves calmly, then it is enough if the owner holds it during the procedure. If there is a chance that the cat will break out, then it is fixed on its side so that it does not injure the doctor. The puncture area is shaved from wool. As a rule, this is the front paw. For diagnosis, 1 ml of venous blood is sufficient. After manipulation, the paw is tightly bandaged. You can remove the bandage after 1 – 1.5 hours.

The sample is sent to the laboratory. After carrying out all the necessary studies, the formalized result will be provided to the attending physician.

Biomaterial sampling implies compliance with certain rules. Otherwise, the information about the analyzed indicators will be incorrect and may lead to the appointment of treatment that is ineffective in a particular case.

Preparation

What you need to do to donate blood biochemistry to a cat correctly:

• do not feed the animal 8 hours before the clinic visit;
• do not exercise excessively 2 days before the study;
• tell your doctor if your pet is taking any medication. Perhaps the specialist will cancel the drug for several days or adjust its dosage.

How much does blood biochemistry cost for a cat depends on the number of parameters studied. The following research options are possible:

• selective – in this case, certain elements are evaluated that are of interest to the doctor in a particular situation;
• complex (profile) – a complex of elements is analyzed in order to identify the state of functioning of a certain system of the body. For example, this may be the diagnosis of renal, hepatic or cardiac parameters.

The price of laboratory diagnostics is increased by 50% if the result is required urgently (cito).

Cost of services

Name of services	Standard deadlines*	Price for 1 study	Price Cito +50%
HEMATOLOGY AND HEMOPARASITES
CBC BASIC (A + automatic leukoformula)	12-24 hours	550	825
CBC STANDARD (A+L+ESR)	12-24 hours	900	1350
CBC ADVANCED (CBC+RTC+ESR)	12-24 hours	1000	1500
AUTOMATIC CELL COUNTING (A) without leukoformula	12-24 hours	500	750
ESR	12-24 hours	220	330
RETICULOCYTES (RTC)	12-24 hours	450	675
LEUKOFORMULA (L)	12-24 h	350	525
BABESIOSIS 1 (peripheral blood smear)	3-6 h	550	825
BABESIOSIS 2 (automatic + test tube blood smear for babesiosis)	3-6 h	750	1125
DIROFILARIOSIS COMPLEX (Knott + IC method)	Up to 24 hours	2000	3000
DIROFILARIOSIS DIAGNOSIS (Knott method)	Up to 24 hours	800	1200
Dirofilaria immitis (Express)	1 hour	1500	no
Cytoparasitic complex (A+mycoELISA+ChlamIFA)	up to 5 days	2200	no
Blood typing in dogs and cats	3-6 h	2200	no
Blood compatibility	1 hour	550	825
PRIMARY EXAMINATION (8 indicators: total protein, glucose, AST, ALT, total bilirubin, urea, creatinine, alkaline phosphatase)	12-24 hours	1000	1500
OPTIMAL MINI (13 indicators: Total protein, Albumin, Globulin, Glucose, AST. , ALT, Total bilirubin, Direct bilirubin, Urea, Creatinine, Alkaline phosphatase, Cholesterol)	12-24 hours	1500	2250
OPTIMAL (18 indicators: Total protein, Albumin, Globulin, Glucose, AST., ALT, Total bilirubin, Direct bilirubin, Urea, Creatinine, Alkaline phosphatase, Cholesterol, P, Ca i, K, Na, Cl)	12-24 hours	1800	2700
MAXIMUM (25 indicators: Total protein, Albumin, Globulin, Glucose, LDH, Amylase, AST., ALT, Total bilirubin, Direct bilirubin, Urea, Creatinine, Alkaline phosphatase, GGT, Cholesterol, CPK, P, Ca , Ca i, K, Na, Fe, Mg, Cl, triglycerides)	12-24 hours	3000	4500
RENAL (13 indicators: Total protein, Albumin, Globulin, Glucose, Urea, Creatinine, P, Ca, Ca i, K, Na, Mg, Cl,)	12-24 hours	1250	1875
LIVER (13 indicators: Total protein, Albumin, Globulin, Glucose, AST. , ALT, Total bilirubin, Direct bilirubin, Urea, Alkaline phosphatase, GGT, Cholesterol, Triglycerides)	12-24 hours	1250	1875
SURGICAL (14 indicators: Total protein, Albumin, Globulin, Glucose, AST, ALT, Total bilirubin, Urea, Creatinine, Alkaline phosphatase, Ca i, K, Na, Cl)	12-24 hours	1500	2250
ELDERLY ANIMAL (13 indicators + T4: Total protein, Albumin, Globulin, Glucose, AST., ALT, Total bilirubin, Direct bilirubin, Urea, Creatinine, Alkaline phosphatase, Cholesterol)	12-24 hours	2500	3750
PREOPERATIVE COMPLEX (Surgical+A+Coagulogram)	12-24	2800	4200
CARDIAC (12 indicators: LDH, AST., ALT, Urea, Creatinine, CPK, Ca, Ca i, K, Na, Mg, Cl)	12-24 hours	1250	1875
EasyStat Blood gases and electrolytes ( Na+, K+, Cl-, PH, PCO2, HCO3-, tCO2, Anion gap. )	1 hour	1650	2475
BIOCHEMISTRY
IONIC COMPOSITION (Na+K+Cl+iCa)	12-24 hours	450	675
Selected indicators: urine, creat, ob.bil, av.bil, AST, ALT, AP, GGT, LDH, glitch, ob.bel, alb, glob, cholest, Ca, P, Fe, Mg, triglycerides	12-24 hours	190	285
Selected indicators : Amylase, CPK, Lipase	12-24 hours	400	600
LIPASE, PANCREATIC (species-specific)	12-24 hours	2550	3825
Canine CRP Express	until 12 noon	1600	no
Express Feline Serum Amyliod A (C-reactive protein)	until 12 noon	1600	no
Express Cat/Canine Brain Natriuretic Propeptide (NT-proBNP)	until 12 noon	2200	no
SDMA	until 12 noon	2500	3750
Troponin	until 12 noon	2200	3300
Fructosamine	12-24 hours	450	675
Ammonia	12-24 hours	700	1050
COAGULOGRAM
Coagulogram (APTT, prothrombin time, thrombin time, fibrinogen)	12-24 hours	1700	2550
DIAGNOSTIC COMPLEXES
DISPENSERIZATION OF DOGS (Optimal mini+Automatic+General urinalysis+I/g complex and protozoa+Dirofilariasis Knott method)	12-24 hours	3300	no
CAT DISPENSERIZATION (Optimal mini+Automatic+Complete urinalysis+I/g complex and protozoa)	12-24 hours	3000	no
ENDOCRINOLOGY: ELISA***
ELISA. T4	up to 5 days	1400	no
Express T4	until 12 noon	1700	no
T3 ELISA	up to 5 days	1400	no
Canine TSH ELISA	up to 5 days	1400	no
Express TSH	until 12 noon	1700	no
triple T3+T4+TTG	up to 5 days	3300	no
T4 free ELISA	up to 5 days	1400	no
ELISA. Cortisol	up to 5 days	1400	no
Express Cortisol	until 12 noon	1700	no
Luteinizing hormone	up to 5 days	1400	no
Estradiol	up to 5 days	1400	no
ELISA. Progesterone	12-24 hours	1700	no
Progesterone Express	until 12 noon	1700	no
Testosterone	up to 5 days	1400	no
Small/Large Dexamethasone Sample	up to 5 days	2500	no
Express D-Dimer	until 12 noon	1900	no
DERMATOLOGY
Dermatophytes (wool microscopy)	12-24 hours	700	1050
Ectoparasite scraping (deep skin scraping)	12-24 hours	700	1050
Dermatological complex (wool microscopy + deep skin scraping)	12-24 hours	1100	1650
Otodectosis swab	12-24 hours	700	1050
Imprint smear with microscopy of stained slide	12-24 hours	700	1050
Wool microscopy + ringworm culture without antimycotic susceptibility	14-21 days	1550	no
Ringworm culture without antimycotic susceptibility	14-21 days	1000	no
CYTOLOG. RESEARCH. AFFECTED AREA (deep scraping)	3-5 days	1100	no
URINE
Urinalysis, incl. sediment microscopy	12-24 hours	800	1200
Urine protein to creatinine ratio	12-24 hours	400	600
COMPLEX (Complete urinalysis + White / Crea ratio)	12-24 hours	1000	1500
Nephrocomplex (URI TCA + Gram stain)	3-5 days	1500	no
Urinary cortisol to creatinine ratio	3-5 days	1100	1650
Gram stain	3-5 days	800	no
REPRODUCTION
Mating day determinations (Progesterone+Vaginal Pap Cytology)	12-24 hours	2200	3300
COPROLOGY
I/G+PROTOSE COMPLEX (native smear+Fülleborn flotation method)	12-24 hours	800	1200
GENERAL fecal analysis (including i/g and protozoa by native smear method)	12-24 hours	1100	1650
ELISA
MYCOPLASMOSIS IgG with TITER	up to 5 days	1400	no
CHLAMYDIOSIS IgG with TITER	up to 5 days	1400	no
TOXOPLASMOSIS IgG with TITER	up to 5 days	1400	no
CORONAVIROSIS IgG with TITER	up to 5 days	2200	no
LEUKEMIA ELISA with TITER	up to 5 days	2200	no
ELISA ELISA with TITER	up to 5 days	2200	no
Detection of IgG immunoglobulins for parvovirus, distemper and adenovirus (hepatitis) (with Titer) (DOGS)	up to 5 days	2800	no
CALYCIVIROSIS, HERPES, PANLEUCOPENIA with Titer (CATS)	up to 5 days	2800	no
IHA
Dogs
Parvovirus infection of carnivores (Ag)	12-24 hours	1100	no
Canine distemper (Ag)	12-24 hours	1100	no
Canine coronavirus (Ag)	12-24 hours	1100	no
Influenza (CIV h4 Ag)	12-24	1350	no
Adenovirus (CAV Ag)	12-24 hours	1350	no
Borreliosis (Ab) – Lyme	12-24 hours	1350	no
4-D: Anaplasmosis, Dirofilariasis, Borreliosis, Ehrlichiosis	12-24 hours	2200	no
Cats
Feline panleukopenia (Ag)	12-24 hours	1100	no
Feline coronavirus (Ag)	12-24 hours	1350	no
Feline Coronavirus (Ab) – Feline Viral Peritonitis	12-24 hours	1350	no
Feline leukemia virus (Ag)	12-24 hours	1100	no
Feline immunodeficiency virus (Ag)	12-24 hours	1100	no
General
Dirofilariasis (Ag)	12-24 hours	1500	no
Leishmaniasis (Ab)	12-24 hours	1500	no
Ehrlichiosis (Ab)	12-24 hours	1500	no
Giardiasis (Ag)	12-24 hours	1100	no
PATHOMORPHOLOGY
POINT STUDY, IMPRESSION, SCRAPING	3-5 days	1200	no
FLUID	3-5 days	1200	no
SYNOVIAL FLUID	3-5 days	1200	no
BLOOD CYTOLOGY	3-5 days	1200	no
TRANSUDATE AND EXSUDATE STUDY	3-5 days	1600	no
VAGINA CYTOLOGY (pathomorphology)	3-5 days	1200	no
PATHOMORPHOLOGY LABOCLEAN
Histological examination by a Russian pathologist (tumors – up to two locations, endoscopic/punch biopsies – up to 3 locations) – new	7 – 10 days	2800	no
Histological examination by a Russian pathologist (tumors – more than two locations, endoscopic/punch biopsies – more than 3 locations) – new	7 – 10 days	3900	no
Histological examination by a Russian pathologist (consultation on ready-made histological preparations) Issued only by our doctor at the appointment	3 – 5 days	2000	no
Cytology	1 – 3 days	1700	no
Cytology of effusion (including evaluation of cytosis)	1 – 3 days	1700	no
Cytological examination of skin scrapings/smears	1 – 3 days	1700	no
Vaginal cytology	1 – 3 days	1700	no
Synovial fluid cytology (no cytosis/protein assessment)	1 – 3 days	1700	no
Tracheal/bronchoalveolar lavage cytology	1 – 3 days	1700	no
Urine cytology (Gram stain)	1 – 3 days	1700	no
Bone marrow cytology	1 – 3 days	3500	no
Additional staining of preparations with supplemented pathologist’s conclusion (toluidine blue, CHIC, etc. Leave a Reply Cancel reply Your email address will not be published. Required fields are marked * Comment * Name * Email * Website