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

Updated Guidelines for Liver Function Tests

The American College of Gastroenterology (ACG) has recently released new guidelines for blood chemistry tests used to assess liver health. These updated recommendations are aimed at both specialists and primary care physicians, providing specific values for the normal range of liver enzymes and screening algorithms for elevated levels.

One of the most significant changes in the new guidelines is the reduction in the upper limits of normal ranges for liver enzymes, particularly for alanine aminotransferase (ALT). Previously, the upper limit of normal (ULN) for ALT could vary widely between laboratories, ranging from 30-40 international units (IU) per liter to 70-80 IU/L. The new guidelines establish more stringent normal ranges:

• For women: 19-25 IU/L
• For men: 29-33 IU/L

These lower thresholds may result in more patients being categorized as having elevated liver enzymes, potentially creating challenges for healthcare providers. However, the ACG justifies this change by emphasizing that even small increases in ALT can significantly raise the risk of liver disease-related mortality.

The Importance of AST and ALT in Liver Health Assessment

Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are two crucial enzymes used to evaluate liver function. These enzymes are normally found within liver cells, but when the liver is damaged or inflamed, they leak into the bloodstream, causing elevated levels in blood tests.

Why are AST and ALT levels important indicators of liver health? These enzymes serve as early warning signs for various liver conditions, including:

• Non-alcoholic fatty liver disease (NAFLD)
• Chronic hepatitis B and C
• Alcoholic liver disease
• Autoimmune liver disorders
• Drug-induced liver injury

By detecting elevated AST and ALT levels early, healthcare providers can initiate further investigations and interventions to prevent the progression of liver disease.

Interpreting AST and ALT Results: What Do the Numbers Mean?

Understanding AST and ALT test results is crucial for both patients and healthcare providers. Here’s a breakdown of what different levels might indicate:

Normal Range

As per the new ACG guidelines:

• ALT: 19-25 IU/L for women, 29-33 IU/L for men
• AST: Generally similar to ALT, but can vary slightly between laboratories

Mildly Elevated

Levels up to 2-3 times the upper limit of normal may indicate:

• NAFLD
• Early stages of viral hepatitis
• Medication side effects

Moderately Elevated

Levels 3-10 times the upper limit of normal could suggest:

• Chronic viral hepatitis
• Alcoholic liver disease
• Autoimmune hepatitis

Severely Elevated

Levels more than 10 times the upper limit of normal may indicate:

• Acute viral hepatitis
• Drug-induced liver injury
• Ischemic hepatopathy (reduced blood flow to the liver)

It’s important to note that interpreting AST and ALT results should always be done in the context of a patient’s overall health, medical history, and other laboratory findings.

Screening Recommendations for Liver Diseases

The updated ACG guidelines provide comprehensive recommendations for screening various liver conditions. These recommendations aim to improve early detection and management of liver diseases. Some key points include:

Chronic Hepatitis C

How should chronic hepatitis C be screened? The guidelines recommend using anti-HCV antibody testing, with confirmation by HCV RNA nucleic acid testing. Who should be screened for hepatitis C? The following groups are at higher risk:

• Individuals with a history of intranasal or intravenous drug use
• People with tattoos or piercings
• Those who have received blood transfusions
• Individuals engaging in high-risk sexual behavior
• People born between 1945 and 1965

Chronic Hepatitis B

For chronic hepatitis B screening, the guidelines recommend HBsAg testing. Which groups are at higher risk for hepatitis B?

• People born in endemic or hyperendemic areas (HBsAg prevalence > 2%)
• Men who have sex with men
• Individuals with a history of injecting drug use
• Dialysis patients
• HIV-infected individuals
• Pregnant women
• Family members and sexual contacts of HBV-infected persons

Non-Alcoholic Fatty Liver Disease (NAFLD)

Who should be screened for NAFLD? The guidelines recommend ultrasound screening for patients with:

• Elevated BMI
• Features of metabolic syndrome (diabetes mellitus, overweight/obesity, hyperlipidemia, hypertension)
• Mild ALT elevations

Other Important Liver Function Tests

While AST and ALT are crucial indicators of liver health, other tests provide valuable information about liver function and potential disorders. These include:

Alkaline Phosphatase (ALP)

What does elevated alkaline phosphatase indicate? High levels of ALP can suggest:

• Bile duct obstruction
• Primary biliary cholangitis
• Primary sclerosing cholangitis
• Infiltrative liver diseases

It’s important to note that ALP is also present in bones, so elevated levels may be related to bone disorders as well.

Bilirubin

Why is bilirubin important in liver function assessment? Bilirubin is a byproduct of red blood cell breakdown, processed by the liver. Elevated levels can indicate:

• Liver cell damage
• Bile duct obstruction
• Hemolytic anemia
• Genetic conditions like Gilbert’s syndrome

Gamma-Glutamyl Transferase (GGT)

When should GGT be measured? GGT is often used as a confirmatory test when ALP is elevated. It can help differentiate between liver and bone sources of elevated ALP. GGT is particularly sensitive to alcohol consumption and certain medications.

Addressing Alcoholic Liver Disease

The ACG guidelines provide specific recommendations for identifying and managing alcoholic liver disease. How can healthcare providers assess the risk of alcoholic liver disease?

• Consider alcoholic liver disease in women consuming more than 140 g of alcohol per week
• Consider alcoholic liver disease in men consuming more than 210 g of alcohol per week
• Look for AST levels higher than ALT levels, which is characteristic of alcoholic liver injury

What should be done if alcoholic liver disease is suspected? Patients should be advised to stop drinking alcohol completely. Early intervention is crucial in preventing further liver damage and promoting recovery.

Screening for Genetic and Autoimmune Liver Disorders

The updated guidelines also emphasize the importance of screening for less common but potentially serious liver conditions. These include:

Hereditary Hemochromatosis

How should patients be screened for hereditary hemochromatosis? The guidelines recommend:

• Testing iron, transferrin, and serum ferritin levels in all patients with abnormal liver function tests
• Performing HFE mutation analysis in patients with transferrin saturation ≥45% and/or elevated serum ferritin

Autoimmune Liver Disease

Which patients should be tested for autoimmune liver disease? The guidelines suggest screening patients with abnormal AST and ALT levels, especially those with other autoimmune conditions. Tests should include:

• Antinuclear antibodies (ANA)
• Anti-smooth muscle antibodies (ASMA)
• Globulin levels

Wilson’s Disease

When should Wilson’s disease be considered? Screening is recommended for patients with persistently elevated AST and ALT levels, particularly those under 55 years of age. The initial test is serum ceruloplasmin, with further confirmatory testing if levels are low.

By incorporating these screening recommendations, healthcare providers can improve the detection and management of a wide range of liver disorders, potentially improving outcomes for patients with liver disease.

The Future of Liver Function Testing and Management

As our understanding of liver diseases continues to evolve, so too will the approaches to testing and management. What can we expect in the future of liver health assessment?

• More sophisticated non-invasive testing methods to reduce the need for liver biopsies
• Improved biomarkers for early detection of liver fibrosis and cirrhosis
• Personalized medicine approaches based on genetic and environmental factors
• Enhanced imaging techniques for better visualization of liver structure and function
• Integration of artificial intelligence in interpreting liver function test results and predicting disease progression

These advancements hold the promise of earlier detection, more accurate diagnosis, and more effective treatment of liver diseases. As research progresses, healthcare providers and patients alike can look forward to improved liver health outcomes.

The new ACG guidelines for liver function tests, particularly the updated normal ranges for AST and ALT, represent a significant step forward in liver health assessment. By lowering the thresholds for what is considered normal, these guidelines aim to catch liver problems earlier, potentially saving lives and improving overall health outcomes. While this may initially lead to more patients being flagged for potential liver issues, the long-term benefits of early detection and intervention are likely to outweigh the short-term challenges.

As we continue to refine our understanding of liver function and disease, it’s crucial for both healthcare providers and patients to stay informed about these evolving standards. Regular check-ups, lifestyle modifications, and prompt attention to any signs of liver dysfunction remain key components of maintaining liver health. With continued research and improved diagnostic tools, we can look forward to a future where liver diseases are detected earlier, managed more effectively, and perhaps even prevented altogether.

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