Okay, so all the fecal stuff was negative. That would have been a straight forward answer!!
Does Coop drink much water?
LOL, if you hit QUOTE in your post above, the numbers line up very nicely
The EDTA blood sample is clotted, unable to perform haematology. A
fresh EDTA sample (only) is required to finalise the testing you have
1. Please print and submit THIS NOTICE only with the recollect. This
helps us link haematology results with this episode. If that form is
not received, there is a possibility of additional charge.
2. This submission will be kept open for two weeks and will be closed
if no sample is received during this time.
Please call your vet about this - he should have discussed this with you. This says that they did not prepare or handle the blood correctly, or something happened with the draw, so that you didn't get everything that you paid for. I am wondering if this is the blood counts, or CBC, (red blood cells, etc.), but am not sure. This is what will tell you if there is evidence of infection, etc. If it isn't completed, you should be due at least a partial refund, I would guess. But the CBC can give an indication if there is an infection like lepto, etc., which can affect liver and kidneys.
Albumin 38 g/L (24 - 38)
* T. Bil. 1 umol/L (2 - 15)
These values aren't a concern - high albumin and low bilirubin. I did a quick read and it said something about bilirubin binding to albumin, so maybe that is why they seem to be inversely related, am not sure. Low Alb is a big problem, as is high bilirubin, both of which can be seen in liver disease, which doesn't show here.
* Chloride 119 mmol/L (100 - 115)
I don't understand this. My dogs have usually had high normal or slightly high chloride, so I don't use it to tell me anything, though I'm sure someone out there has an understanding of how it relates to everything else.
GGT 3 U/L (1 - 10)
Alk Phos 23 U/L (10 - 120)
* ALT 84 U/L (5 - 80)
AST 36 U/L (10 - 80)
In addition to bilirubin, these can represent liver function. ALT is a primary representative. However, an increase in a liver enzyme does not necessarily indicate liver disease, it can indicate a process that requires more of that enzyme, as has been explained to me by the biologist on the tick list. My old vet said he doesn't worry about it until the ALT is about 4 times higher than the top number. Certainly not my style, but it may be comforting to know that.
"Mild-moderate increases in ALT (up to four to five times normal) may occur with non-hepatic disorders such as inflammatory GI disease, cardiac failure and haemolytic anaemia." From here: http://www.lowchensaustralia.com/health/liverdisease.htm
Liver panel chart here: http://labtestsonline.org/understanding/analytes/liver-panel/tab/test
They talk about the ALT starting on pg 4 here: http://www.idexx.it/pdf/it_it/smallanimal/vetlab/catalyst/diagnosing-liver-disease.pdf
* Urea 11.4 mmol/L (3.6 - 8.9)
Creat. 127 umol/L (43 - 129)
Kidney parameters, both high or high normal. This can be drug toxicity, but you don't list NSAIDs, which would be my first thought.
Amylase 732 U/L (180 - 1300)
Lipase 20 U/L (< 70)
Typically pancreas. Lipase is at the lower end, common in some GSDs. Thought not to be significant, but may be an indicator of a difficulty to absorb fats. You might try an enzyme for him, but it's not clear how necessary this is.
* Non preserved Glucose 1.0 mmol/L (3.3 - 6.7)
Um, I think this is an issue. Had he eaten a meal before the blood test?
It can be seen with liver disease according to this link: http://labtestsonline.org/understanding/analytes/glucose/tab/test
and, according to the same link, can cause trembling, anxiety, confusion - may be some of the symptoms you are seeing?
I don't know much about this, but once Max had a low glucose reading when I was tyring out a new vet. When I talked to her about it, she waved it off as an artifact with a problem with the blood draw (which is what might be happening here, since there seemed to be some issue). When my regular vet saw it, she was NOT happy that the vet didn't recheck it no charge, since it could be dangerous, though I didn't fully understand exactly what her concern was.
Check any food and/or supplements for xylitol?
Found this: "Hypoglycemia is defined as a blood glucose concentration of < 3.3 mmol/L (1). An initial finding of hypoglycemia should always be confirmed before beginning to work up the problem. Artifactual hypoglycemia is common when there has been a delay in the separation of serum from cells " http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657529/
From that article, it can also be a sign of infection, which is another reason to have the CBC completed.
after his surgery he was on a fentanyl patch, then tramadol and ace.
Off-hand, I don't know if these would be enough to cause these changes? Anyone?
And, yes, starting him on the LSF linked above should improve the blood values. Much much higher values are sometimes seen when treating tick disease, and we use the LSF to bring them down. I know that my dogs' kidney numbers also improved on the LSF.
It is so not fair that Cooper has to go through all of this. How are his stools doing? You will want to keep up the probiotics for a long time, if possible. Give some liver support and monitor, and think about whether you want to try an enzyme.