Dr. Conor Brady, Dr. Brendan Clarke, and Dr. Nick Thompson discuss how to read canine blood tests. They cover key markers like albumin and creatinine, how raw versus kibble diets affect results, and why fasting and timing matter for accurate readings.
Chapters
Good evening.
Good evening. Jazz hands.
And Conor's always just in time.
Conor's just behind the curve, but there you go.
Getting my mood lighting sorted.
We all have our crosses to bear. Blue, green.
I don't know what's cooler, light red. No good for the podcasters, but I have a light that changes color behind me, which is useless because who changes? You're never ever going to want to change the color of that light. So it's just a waste of money anyway. That'll be tomorrow's landfill.
So everybody, we are Raw Pet Medics. We have Dr. Brendan Clarke, we have Dr. Conor Brady, and me, Dr. Nick Thompson. And we love talking not very seriously about very serious things and looking broadly at medicine and food and health and happiness. And that's what we do. You can find us on Patreon, and we would love you to join to help us. Just a tiny bit of support every month would be most, most, most appreciated. You can also find us— where else can they find us?
Anywhere.
You can find us on YouTube, patreon.com/warpathmedics. Um, and so yeah, any, any help you can give us is absolutely great, but we are going to do this for free anyway because not everybody has the ability to give that small contribution. So guys, we really, really appreciate it. And everybody who supports us on Patreon, we really appreciate that. We give you a little nugget at the end. If I can get these guys to shut up at 19:45, then we jump over to Patreon to give you a special little 10, 11, 12 minutes of extra spice to just say thank you very much to you. So guys, how have you been in the last week? Brendan, what have you been up to? How are the goats?
Oh, well, yeah, thanks Conor. I have to say thank you because since last week there's been a wonderful Facebook post about my birthday. Thank you very much for everybody who responded. Thank you Conor for those wonderful graphics. Can't wait till your birthday in April.
I laughed at my own post. It's my birthday, Brendan Clarke.
Guys, describe it, describe it for me and for those listening on podcasts. And guys, thank you for supporting us on the podcasts. It's great to have you there. You can listen to us. You can't see the beauty and the marvel of this show, but you can certainly hear what we're up to. Conor, what did you do? What did you do?
I got a picture of Brendan Clarke and I put some cool balloons behind it. Spent ages on this picture, actually. It was a high-end, you know, doodling on your phone. It's not going to lead to exact but I think I got pretty close to an appropriate celebration outside in the field. So yeah, a few balloons, a little hat, and then on the message I put the picture up on Hot Pep Medics and I said, it's my birthday, Brendan Clarke. And half the people guessed this is Conor, isn't it?
Absolutely. Thank you, hands down. I mean, everybody wanted to know, was I smoking a joint? Was I blowing those hooters? Or was I chewing a stick of celery? Yeah, haven't they been at birthday parties?
Have you not seen those party blowers? And that was my effort at it anyway. But yeah, so that was good. How old are you, Brad?
Tell everyone.
Old enough.
Old enough. Bloody hell. What'd you do for your birthday?
Went down to Cornwall. I stayed over in Devon at Maudie Lambert. Thank you, Maudie. A wonderful stay. I actually interviewed a friend of her, Bella, is somebody who's doing regen farming in the neighboring farm. So interviewed her. So I've recorded that. So I'm going to release that as a gem on Patreon for everybody. So we can enjoy that. And yeah, just had a great time. Went on to Cornwall, met up with some friends and a friend of ours got married down on the very southern tip, so we were down there for a long weekend and then I've zigzagged my way back up through Oxford and Gloucester and got myself back here for today. So very nice. Yeah, wonderful.
Nice, nice little easy trip.
Yeah, yeah, yeah, it was great. It was great.
Nice.
Good stuff. So, and you, Conor, what have you been up to?
I'm not sure if I've done anything exciting.
Nothing that he's allowed to tell us.
Yeah, nothing exciting happens anymore. I have been— I'm trying to be good, I'm trying to be healthy for the last 16 days, and it's getting easier. I'm on the other side of it now, so I don't feel— I don't feel the pangs of my red wine at nighttime. That was very, very difficult, I have to say. And I have to say, I broke the sugar thing a few times. That hasn't been absolutely perfect, but I'm not going to give in. I think the temptation is Oh, these orange chocolate Kit Kats, guys. Orange flavor Kit Kats. Oh, they're so good. And they're kind of small. And because before, uh, so Holly on Fridays has a long day doing a thing and she gets a little treat in her lunchbox. Easy peasy. But you can't have those in the house because I will find them. I can smell them a mile away. And, uh, so yeah, as soon as I started finding them— Elaine hides them from me, but I can find them. So a few little hiccups. Besides that, things have been good. Yeah, yeah, things have been good. I have a little bit of self-promotion. I, uh, launched a course over the weekend. I have a new website, drconorbrady.com, and it's where I'm moving all my courses and a few other bits and pieces that I'm going to be doing. And that is a nice little kind of, what you call it, app for running a website. Check it out, guys, if anybody's thinking of doing something similar, it's really cool, but it's very easy to use. So I've got my course up on that. It was an introduction to raw feeding masterclass for 3 hours long, and I gave it out for free, and 2,000 people did it to completion. So I think that kind of backfired because nobody else is going to pay for it now. That's all my fans. And that's that dead in the water for a year. But so yeah, that was the first thing that was happening. And also I'm getting ready for— and I have a new— in that course, you'll see a new product coming out called Power Paste, and that's coming out tomorrow morning. And so you'll hear me talking about that. So I just wanted to tell everybody listening that those two products are available for people, and I do appreciate any support in that kind of respect. So that's what I've been working on, and it keeps you up because you get a flood of little issues that happen and things you don't think about. And Blah, blah, blah. So it's a learn.
Diane has just said she watched it twice. So you've got to take it off once. Yeah, you've got to rub out one of the marks.
Yeah. What about you, Nick? Anything groovy happening?
I have just discovered a podcast by Ahmed Malik, Dr. A-H-M-A-D, Dr. Ahmed Malik. And he is a Glaswegian. He's a Pakistani Glaswegian, which makes things interesting from the start. And he got slightly disillusioned with the NHS, came out. He's a consultant, you know, really gifted foot and ankle surgeon. And he has been on a journey looking into alternative medicine, alternative approaches to preventing disease without putting too fine a point on it and talking to the great and the good. He's a very, very, very good interviewer. And so I've been listening to his podcasts incessantly. I'm on probably number 66. I've only missed out about 6 or 7 of them. Done about—
where do you get the time? It's mad, isn't it? When you find something you like, you just absorb it.
Oh my goodness. Just the interviews he— I started with Nick Hudson, who's a big thinker in very many kind of health spaces. And then I went right back to the beginning. I thought, this guy is so good. And if he's got that level of your brains and, you know, spiritual knowledge and, you know, drive for humanity, everybody's there saying, you know, humanity is having a crisis. What can we do? This is what we need to do. Wake up and all this kind of stuff. And so that's it. So I've done about, must have done about 70 hours in the last 10 days or so, and it's absolutely divine. It's— I'm just mainlining it.
It's like a warm hug when you find somebody, uh, you know, it's just that's kind of speaking a bit of sense that you at least you agree with. Anyway, I suppose everyone thinks the same, you know, no matter what side of the fence you're on about any debate. But it is like a warm comforting hug where you go, yeah, that's right, that's exactly it. Oh, ask him that question. He did. Oh, very good. I did notice that— I don't want to, I don't want to speak about the war here too much, but the very first parliamentary debate was had today on excess deaths. and you can check it out on YouTube. It was had in UK by Andrew Bridgen, and, uh, that's the first time anywhere. So it's the first parliamentary debate and was had today, and it's, uh, there's a lot of great videos on it. You should check out the stats and the figures and 17 MEPs standing beside him. So, uh, oh, it's amazing. It's growing a little bit. Well, that's very interesting, guys. Unless you— Nick, are you finished?
Yeah, no, no, I'm just, just gonna put this up just so that you've got— I just want to stroke his images.
I can't do that.
Let me go like that. Let me go like that.
Oh, are you listening to a podcast?
Yeah, yeah, yeah.
Let me just put that up there. This is him. He's a lovely fella. I just absolutely love him. So can you see that? Doc Malik. And it's called, uh, what's it called? Health.
But we'll be fine.
Yeah, you can't go wrong. Type it in, you'll find it.
Honest Health is the— is the— and it's podcast, but it's on YouTube and everything else. I am going on about it and it's absolutely deliberate. If you like it, you'll love it. And if it's not really your cup of tea, it's not offensive. It really is very clever, you know, clever people talking about clever stuff in a really quite light way. And so there we go.
Let's talk about tonight and yeah, blood tests and standards. So I think really great that Conor, you've brought this up and I'm going to share some graphics so we might disappear off the screen temporarily while we get these graphics up. But I think it's really worth going through this at this point because so many people come to me, Nick, and you, Conor, just I'm sure to so many others with scary bloods that they think are scary, and there's just some elementary things that we need to address. So we're going to go through some bloods tonight. So Conor, do you want to set us up with what this particular case was and, um, and just the setup, and then we'll go through the initial results, and then we'll talk about that.
Yeah, cool. Um, okay, so this was, uh, a little— you can— have you got a bigger picture there?
I have. I'm gonna just—
of the actual units that were involved.
Uh, yeah, so first of all, just say this— so this is the particularly the first test, wasn't it, on the 2nd of January?
I believe so, yeah, yeah, absolutely, 2nd of January. So you've got this, you know, advancing dog, he's 12 years old, Lurcher, and he comes in for— now the dog had been exhibiting a bit more sleeping, a bit more eating, couldn't actually satiate the dog, so seemed to be really, really hungry. That seemed to be the outward clinical sign, and and then drinking a bit but not excessively at all, and there wasn't that many other symptoms really. But she did— the girl's very clued in, and so she took bloods, and these were the first initial bloods that the vet presented her with. And the conclusion was that the dog was possibly in chronic kidney disease and that the food that she was on, raw dog food, probably wasn't suitable for the dog and that the dog now needed a low protein diet. Which, you know, we don't need to get into again. We've done the kidney bit numerous times, but the whole low protein bit, uh, you know, for kidney disease, for chronic kidney disease, if you're not in proteinuria, like, you know, uh, this whole idea of low protein was the information that the vet gave, and then the client kind of said, I don't really agree with that information, and the vet said, okay, well, do something and come back to us in 2 or 3 weeks. So she contacted me and I got these bloods and I'm having a look at these and we can go through each one of these, although they make sense, the bottom ones make sense, some of the top ones are letters that people might poorly understand, but you can see some of these things like urea and creatinine on the bottom of those 4 red ones there, they're just on the high bracket, you know, they're just there and they're in red and the big word high, which is scary, and you go, oh God, urea and creatinine. I'm thinking, okay, this is a raw-fed dog, we know that they would be close enough to the top of that green line, to the right-hand side of that green line, because they eat more protein. Gene Dodds has showed us that if you eat more protein, you have more protein in your blood. Stands to reason that the normal, where these bloods are coming from, are dry-fed dogs who are fed the minimum amount of protein, which is 18-20% protein dry food, so they don't have a whole lot of protein whizzing around their blood, it seems. So raw-fed dogs can be 30% higher in urea and creatinine, which begs the the question, maybe these kind of values and norms and confidence intervals don't actually apply exactly to raw-fed dogs. Where might they be if we had more accurate information? So I said, okay, look, don't panic, don't panic. This initial question is, you know, with the extra— and the albumin is a bit up there. So my initial question will be, you know, were these bloods fasted? Like, what was the distance between the meal, which is full of protein? And she goes, oh, I fed the dog in the morning, it was his birthday. And he got 4 eggs and a big meaty treat 3 hours before the bloods. And I said, well, there's the protein, because you're measuring what he just ate, and he just had a high protein meal. So that calls into massive questions. And then the follow-on question is, okay, there's a few little liver readings that are up, and this gets into veterinary territory, which I poorly understand. All I know is that, you know, if I took a chemical wormer or I did something, I'd go, well, yeah, maybe the liver has to do a little bit of scrubbing, or maybe he's on medication, maybe he's on pain Before we go then therefore too far into, you know, what you did and where we got to, I think we should, you know, just maybe help some guys understand those columns and those rows a little bit more.
And okay, if we maybe go through those, Nick, and yeah, you know, bring in some, some information for everyone there.
So okay, I think, you know, if we maybe, I'm going to just, if we blow up the, if we If, right, I'm just going to go through the top line, okay? I like, as you know, I like Peter and Jane approaches, because if you can't do Peter and Jane, you are not going to be able to read Shakespeare, okay? So I'm going to give you the Peter and Jane approach. If you want more, then, you know, we can, we can go there with part 2 if you fancy. Let's have a look at the total protein, which is within the normal range, okay? So we look, reading from the left-hand side, we've got total protein for this date. We've removed the vets and the dates and what have you. You normally have the dogs and the age and the breed and the owner and the vet who commissioned the result. Oh, very clever, Brendan, well done. So 11-year-old male neutered Lurcher. Ah, we've got a Lurcher puppy and he is— we've called him Damien. No, well, his real name's Jet. I call him Damien. Yeah, okay.
This is 11 years on.
This is 11 years on and I'm sure he's fantastic. And by the time he's 11, Jet's 11, if I'm not in the ground, I will be hugging him with great joy. Okay, lurchers, they, they're quite a thing and they love stealing stuff. But that aside, let's come back to the biochemistry. Blood is divided into two major tests. One is the hematology. These are the cells that float around like carrots in vegetable soup. Okay, and The biochemistry is what's dissolved in the liquid of the soup, if you like. Are you with me? You still with me?
Yeah, yeah, yeah.
If you've got a microscope, you can see the hematology. If you've got a microscope, you can't see the biochemistry— tiny little proteins and enzymes buzzing about. Okay, so that's—
I think just for everybody's, you know, enjoyment, let's say that we're going to leave hematology tonight and we're going to talk about that next month, okay? Because I think there's some important things to go on about for that. So we're going to be very specific, but carry on with the chemistry and the biochemistry.
Yeah, okay. So if we, if we're looking at blood as being a bit like minestrone soup, you know, the thin stuff with the, with the little bit of pasta and a little bit of veggies and peas and God knows what in it, okay, that's a good analogy for blood. At a certain level. Okay, so we are looking what's dissolved in the liquid, right? And this is it. And it's basically just a big long list of things that are dissolved in the liquid. And vets over the years have added these tests so that they can, you know, have a look under the bonnet. So let's just go through total protein initially, and then we'll just go through them. We'll go through them in some way after that. So total protein, The result is 63, and g/L is grams per litre. Okay, that's how much solid material is dissolved per litre of the blood.
Okay, just for all of those joining us from Judy Morgan's, these are UK standard units. Okay, so there are a set of American standard units, and we will probably put a post in so that you can look at what the differences are for the standards between the UK and the Americans, just so that you're—
most give that, that image on the right-hand side, which is fairly, you know, an eyeball representation for the plebs like me, non-vets. We look at that thing on the right, you know, it's a little graph. For people listening on podcasts, it's unfortunate, we're just looking at an Excel file here of blood results. But the image on the right will be the same for American dogs as will be for Irish and UK dogs. We'll get that idea off. He's a bit high.
So really interestingly, it also varies depending on the machine that's used and how they present it. So I do find some of the IDEXX machines, just for those people out there, both the in-house labs and the external labs, if it's high, they still stick the bar in the middle of the high range which scares the bejesus out of many people because they think it's way off the top of the scale. Okay, whereas some machines like this one will grade that level of how off the scale it is. Okay, so just be careful, don't get scared if your line is suddenly, you know, way off the top end. Okay, they just are denoting that it's high, not necessarily—
they don't give you how— they don't give you an idea of how high.
Yeah, very much depends upon on the machine, I've found. So just, you know, bear that in mind. So coming back, guys.
Okay, so just coming back. I'm still on the first line here.
Yeah, the first line of 20.
The first line of 20.
The lot—
the rest will be a lot because, because if I give you the ground rules, you can interpret it. So 63 grams per liter. In the States, it might be different units. Always look at the units because you can't, you can't, uh, uh, measure apples against oranges unless you know you've got apples and you know you've got oranges.
Okay.
If you know what I mean. Okay, so units are really important. And then you've got the idiot's guide over on the right-hand side, you've got the reference interval. Okay, looks complicated, it's not. And then you've got the real idiot's guide, which vets use a lot. I'm the first to admit it. Okay, which gives you kind of an eyeball, as Dr. Conor Brady just said, you've got an eyeball as to, oh, you know, are we in the normal range, or are we a bit too high, a bit too low? So The reference range says that total protein should be between 50 and 72 units. Okay, and then we look across and we go, aha, total protein is 63, which is nicely within 50 and 72 units. So thank you very much. And then we look across at the Real Idiot's Guide and lo and behold, it is a bar right in the middle of the green zone. It's not in the upper zone and it's not in the lower zone. That's to just kind of reinforce it. And vets will use this by they'll just scan down the Idiot's Guide and then they'll look back and they'll look to see what the actual figures are to give them a bit more nuance in their interpretation. So that's the total protein at the top and that's kind of the baseline. Bren, do you want to take on the albumin there and the kind of the significance?
Yeah, I think so. The next part, so it's the albumin, which is effectively the protein within the blood which is used for just keeping the concentration, keeping the fact that it's almost osmotically there to keep fluid in the bloodstream. Okay, as a base layer, does carry some other things. Some things will attach to it at various points, but it is basically the protein that keeps the concentration and the fluids within your bloodstream. If you lose too much of that, i.e., you're on a low, low protein diet, you're unable to make it in the liver, or you're losing too much through the gut or the kidneys, then that may become too low, and that's when you can start to have other fluid problems within the bloodstream. Okay, too high, it can indicate that you may be slightly dehydrated. So if you've not been drinking properly, then your albumin can go up too high. Or as Connor was alluding to, if you're on relatively higher protein meals, you may end up having more protein within your bloodstream. So it is, you know, a base layer of albumin. It's what we often would say you'd find in the egg white. Okay. As an albumin. Yeah, that's why it's called albumin. So it is something to be aware of. And when you see this, this level, it's 41. Okay. So that's just over the range for this machine. These temperatures, that is what they have read between 26 and 40, they would class as standard. And I'd like to just take this opportunity to introduce something to everybody. And everybody's going, oh my God, he's going to talk statistics.
Podcasters are lucky they can't see this one.
So this is what they call a standard deviation curve, a bell-shaped curve. And so a general population would normally fit into this normal distribution. Okay, now what tends to happen is because it all gets a bit messy at the edges and those tails can go on for quite some way, what they do when they design a blood test is that they will look normally around the 2 standard deviations So that is a 2 delta on there. μ equals minus 2 delta or plus 2 delta. And that basically means that they have taken the medium, the midline, which is μ, and they have looked at the deviations apart. Now, at 2 standard deviations, you will roughly have 95.45% of the population. So that is usually what they look at because they're looking at the majority of the population. They will look at that as a figure. Now, that is a standard population in most cases for these bloods of a dry-fed, starved, morning-sampled animal. Okay, and that will then— can actually even be specific for, you know, in this case, a canine, okay, for a dog, and then even more specific for a breed, and even more specific for an 11-year to 12-year-old miniature, okay. So you need to understand that the blood results that you've got— now, there are some companies in the world, and Gene Dogs I know does this certainly for thyroid levels, um, who will have enough data and enough incentive to actually give you something specific for your dog at your age, at your breed, break it out, break it out, break it out. And so those, those levels may change slightly between you and a friend who has a totally different dog at a totally different age, a totally different breed. So do be aware those in the example that we have shown here are based on a canine, not on anything more specific.
Yeah. So what you're saying, Ben, is that if you had— you could have two dogs, two very different dogs, different ages, different lifestyles, you know, and they could be eating the same diet with the same amount of protein, but that does not mean they're going to blow the exact same protein in their blood.
Yeah, absolutely. And the thing that you've got to understand with these is when you've got that variance and you've taken off the top and the bottom of that curve, a normal dog could still be in that bottom or top, okay, within the third standard deviation and still be absolutely normal. For your dog in your situation as an individual. So you need to then take— this is the beauty of taking a standard blood and a healthy individual at another time, is that you have the standard for your dog at that point in time. So if you then have a massive variance from that, and, you know, you can look at this over, you know, 6-monthly or yearly intervals, you know, whatever floats your boat, that actually can give you a brilliant way of having a comparison for if your dog is poorly, and you can then refer back to when it was normal, what did they look like for your dog. Yeah, and that's the beauty when they're in for a procedure of having the pre-anesthetic bloods done, because that's usually when the dog you know, if it's a standard procedure, usually when the dog is relatively healthy and not got anything else going on, they'll have been starved because of the procedure. They will be going in. It's useful to sometimes say, yes, I'll have that, not because they're going to change the anesthetic protocol or anything else, because they should be taking great care with that regardless, but that they will at least have a standard.
You'll have a little anchor for your dog that you can keep on record.
You can ask for those bloods. They're your results. You've paid for them. You can ask for those results, take them home, store them in a file, have them on record so that at any point in the future, if you go to an emergency vet or anything like that, you've got a comparison.
I've got a question. I've got a question here. Okay, so this is grams per liter albumin and globulin, which will be your little globules that Nick was talking about, the bits in his minestrone soup. Okay. And there's a little ratio underneath. And the ratio is a little bit wrong because your albumin is a little bit wrong, so your ratio goes a little bit out. But my question is, we know dry-fed dogs drink more and we know raw-fed dogs wee less. Okay, so we had this in Australia. The dogs are fed— it was actually about 1.5% salt dry food, which is huge, and that's not including iodized salt, not the other bits and pieces. This was sodium chloride, so they drink huge amounts. So we had it in guide dogs that, you know, toilet training was a devil because dry-fed dogs in a desert drink huge amounts of water and they they wee all over the place. So if you're drinking huge amounts of water and weeing all over the place, surely your bloods are going to be different to a raw-fed dog that doesn't drink as much, or a cat, a dry-fed or raw-fed cat. Imagine how different those bloods are, sure, just purely based on the amount of moisture they're taking in. And a cat doesn't drink. Absolutely.
I was going to say, because what's happened is over the years, vets have taken more and more blood samples from more and more healthy dogs, and they just add them to basically a great big database to say this is normal, this is normal. The thing is, over the last 3, 4 decades, most dogs have been kibble-fed, and so those normals are not the normals for a dog. They are for, generally speaking, for a kibble and canned-fed dog. Okay, and so we come along and say, well, actually, we think that feeding raw food is a much better idea. Species appropriate, more physiological, more healthy, and, you know, all that stuff. But actually, as, as we all know, you get a different dog. You get a different dog superficially. Yeah, they've got shinier coat, they've got better poos and all that stuff. But actually, physiologically, it will be different. And Gene Dodds has done studies, uh, and it's worth having a little Google. Bren, can you just throw those, uh, results up there?
The ones that we've got here?
Just here?
Yeah.
Just to show people what we find is that many but not all raw-fed dogs, you see the ALT there, it's about 1, 2, 3, 4, 5, 6 down in black. So in this particular dog, raw-fed dog, the ALT is normal at 50. The speed limit is between 13 and 78 units. Okay. However, he is true to form, and this might be just an effect of having had a meal, but we do find many raw-fed dogs run at a higher urea level. Urea is a byproduct of protein metabolism, so if you're eating loads of amazing protein, you're going to have, you're going to run at normal at having a higher urea. So Just one other little thing. I, when I, because I talk, I try and teach my clients about, about blood tests because they find them pretty daunting. If we go back, just go back to the albumin for one second. If you see, look, if we say the speed limit, these are the reference intervals between 26 and 40, and then you look at the idiot guide and it's like, oh my God, it's high. And then you've got right in the middle, which is interesting why they put it there, in red, in capitals. It's like, hi, oh my God. But exactly. But if I said to you that technically doing 71 miles an hour is a crime on the motorway, this is not, not on a little village, not down past the school, but technically just sticking with the story. Yeah. On a motorway or highway, you guys. In the States. So you're on the highway and you're 1 mile an hour over the limit. Technically, you are breaking the law. But actually, in reality, you're good to go. Yeah, you're driving responsibly, you're only 1 mile an hour over. That's assuming your speedo is accurate.
La la la la la.
Okay, that's the context. So if your albumin is going from 41 to 43 to 47 to 48, that's a whole different story. But if you're just, if you're if you're on one or two results, you're a 41, and sometimes you're not, and it's not going anywhere, that might just be you. As Bren was saying, everybody has slightly different normal parameters. They're usually there or thereabouts. But if you're 10, 5, 10% above in certain parameters and you're healthy, that might be you. So that's just really, it's, it's, it's context context-dependent, and it's really important to do that so that we don't panic, because when you panic, you can't read these things properly.
And I'd love to just bring in at this point, so Jean Dodds interestingly published the urea, and I think albumin particularly too. She's not done a full panel for raw feds. I think there was very much limitations on what she's looked at. And what I was interested in is then there was a conclusion drawn that urea being high for raw-fed dogs would mean that actually there could be a consequential impact for kidney cases. And actually, I'm yet to see the data that this will cause a deterioration in the kidneys.
Totally agree.
A raw-fed dog that's got a slightly higher urea level, I Practically, there's some other aspects. I mean, in this particular case, it is so interesting. This particular machine doesn't run what we call an SDMA level, which looks at kidney damage at earlier points. But if you look at the calcium to phosphorus ratio, that's 2:1 roughly. That's within normal parameters, and that's where we look at long-term kidney aspects. And, you know, just having a high urea creatinine, for me, I question, especially when it's just over. And if the albumin is just over and the creatinine is just over, I look at, is the dog hydrated fully? Is the dog, you know, fasted? And if those two are questionable at all, is it in the morning? Okay, and as we can see from when this sample is shown to be done on the first sampling. I think really interestingly, look at the time, okay, next to the date, and that's an afternoon.
Why would that change? Why would your bloods change from morning to afternoon if there's no food involved?
Well, you see, now you have a circadian rhythm, and so your cortisol levels change. So they should be really high in the morning to wake us up as humans. Okay. And then they drift off towards in the afternoon. Having a hormonal change will change what your organs are doing. Okay. And that means that you can have a change in the metabolism. And if that change in metabolism can be significant enough to show changes in these enzymes revealed into the bloodstream. So that's interesting. Have that same circadian rhythm in dogs generally, slightly different in cats. So you need to understand that there's other issues and we'll come to other stress factors. So things like glucose further down this list in cats particularly, they can be all over the place if you stress the cat prior to journeying in to have a blood test and your cat gets distressed because you drive at 100 miles an hour, not 71, over the speed limit, and you're rallying around the corners, okay, then your cat's glucose could be through the roof purely and simply because you've had a stress event prior to it having a sample taken.
So for a cat or a dog who doesn't want to have their blood taken and it takes you 3 goes to go, that'll change things.
So, so we need to take all of these samples in context, and I would always look holistically. And what I mean by that is looking at all of the parameters as this is the animal in front of you, alongside how ill is it at that point in time, to understand how important those bloods are or what the likelihood is that they are an anomaly. I.e., they're abnormal even in a normal case. It could be, and we haven't discussed yet, lipemia, and we haven't discussed, you know, lysis of the cells, which causes effectively the blood to look a reddish color, the serum to look a reddish color. So if we've got hemolysis, so that's breaking down of the red cells, that's— that will cause this red shift. That can change how the machine sees the result because the machine is looking at a color change in these reactions. So if you've added a red color dye into that, then of course purple starts to look brown because there's more red in it. Yeah, all sorts of things, you know. So you've got to understand that can change it. If you've got an excess of bilirubin in the bloodstream, okay, so that again can change the color. So it can affect the result, not because the organ is damaged, but because there is another color overlying the result.
Yeah, two bits to add to this, and with a follow-on quick question I'll ask Nick here, but the First of all, people will be surprised to see glucose on those readings because this is a raw-fed dog that doesn't eat carbs. And it just goes to show that, you know, these dogs are in a state of producing glucose if and when they need it. So they do have glucose when they need it in their bloods, and it's in a normal range because you don't need to feed them carbs to have glucose in your blood. That's all part of this ketogenesis. But you know what's interesting? Just while we're here, although it wasn't an issue for this dog, what would be the reason— I was told to ask— what would be the reason for an excessive cholesterol reading in an otherwise healthy dog? Well fasted, all that, ticked all those other boxes.
I don't take a lot of stock by mildly increased cholesterol in dogs. People, doctors get very upset, whether they should or not is another matter, but But in the normal dog, if they're perfectly healthy, I'm not too worried about that. It can be indicative of metabolic issues, you know, Cushing's disease will bump it up and other inflammatory issues can affect it. But if you address the primary disease, the IBD, the pancreatitis, something like that, you may see, because cholesterol is the ambulance. Yeah, if you look at— this is the same with humans as well— if you look at damaged blood vessels, for example, in humans, you'll always see cholesterol there. Does that mean cholesterol causes the problem? That's how it's been perceived for decades. But actually, wherever you go see an accident on the road, you'll see an ambulance. Doesn't mean that the ambulance causes the accident. Okay, that's really, really important. So yeah, cholesterol in a nutshell is a bit like somebody coming along with a sticking plaster. That's kind of— it's a healing, it's vastly important cholesterol. You couldn't live without it. Okay, we need to do a show on cholesterol.
Yeah, we can't let you go on because you're going to go on.
But what I would bring in, it's not high cholesterol that's the issue, it's actually the ratio ratio of triglycerides to cholesterol that's important. And if you find that your triglyceride level is on a ratio of less than 2:1 to cholesterol, then actually you are probably more likely to have a good health outcome. It's only when you elevate your triglycerides up to 5:1 to cholesterol that actually you start to see health impacts for humans and it's not the cholesterol that's the problem. It's often that either it's oxidized cholesterol, so it's been damaged, okay, or that you've got an excess of triglycerides to cholesterol ratio. And that's the only ones that they can show there's an impact. For those that have just looking at cholesterol, high cholesterol, they cannot correlate that with disease, not even for heart attacks. So it is actually the ratios that become important. And even more importantly, which type, you know, are they low density, very low density, whether they are oxidized or not. So we're going to come to cholesterol separately. Do not concern yourselves with that in this.
So cholesterol generally not a big deal.
No, most of it's produced by your own body. 80% of your cholesterol that's on the scene is produced by your own body who is trying to help you. The, um, guys, let's— we've only got 3 or 4 minutes here and we've got— I've got some questions here that I've been told to ask you, but I'm going to do that as the teaser to get us into Patreon. Can we just skip to the next readings?
Oh, are we going to skip to the next readings or do they want to watch those on Patreon and see what you did?
I have other bits I want.
All right, okay.
I want to discuss about, um, uh, kind of periods and, and how it affects bloods and that kind of stuff. Uh, I found a bit of cool information on that. It's not just the sexy hormones that change throughout the month. And so I had it, and also I've got some questions I want to ask you guys, but let's just have a look at the readings. I also asked this person, when I saw a slight few issues with maybe with liver readings, I thought, okay, did you give the dog any drugs? Which is a really important question, you know, what drugs is the dog on? Because that will throw your bloods out in ways I don't understand, but that these lads will, that Bren and Nick will and she said that she was giving the dog gabapentin for arthritis and not known to be a huge impactor of the liver. There's plenty online, plenty of case studies to show that gabapentin can have an effect on the liver in some dogs, in some situations, whatever. This dog had gabapentin.
Could I just say, so certainly medications can affect bloods, but just for fear, please do not stop gabapentin as a painkiller for your dog. Without your health professional talking to you carefully and you asking them very honestly about what is the importance of that as a pain relief for your dog. I certainly would agree certain medications prior to bloods can affect them, but let's not necessarily concentrate on gabapentin.
You could give your pain relief the day before, you know what I mean? If you're going in for bloods, don't be putting a worming tablet or gabapentin or whatever anything that might cause a little bit, you know, it's not needed that morning, surely to God. You don't need to take gabapentin every day, do you? Is that the way it goes?
Yeah, looking at, yeah, you've got to look at the pharmacokinetics. That's a big word for meaning how your body uses that drug, how it's absorbed, how it's got rid of. Okay. And therefore you need to understand that there are distinct intervals between dosing that should be maintained. Yes, of course they need to look at any medications that use that and the effects they could have on bloods are not mistaken. You know, let's say a nonsteroidal anti-inflammatory, they may cause the gut to bleed when you've given it. And if they do that, of course, your blood urea nitrogen could be high purely because that blood is seen as protein in the gut and it would be processed and raise the blood urea nitrogen. So That's an example. So let's, let's be understanding that drugs could affect it.
Yeah, yeah, it's not— it's—
yeah, so it's not necessarily in this case.
Yeah, not necessarily. Who knows? All we know is that we asked this dog to fast properly. Uh, in this case, as Bren pointed out, the last bloods are taken at 4 PM. This is at 10 AM, so that's a large discrepancy if you go with this diurnal bit. Turns out zinc is the most effective nutrient, uh, when it comes to diurnal patterns of morning and evening bloods. I was just Googling, but yeah, zinc. And actually, they didn't find much difference in the other minerals, but that's not to say all these other bits won't be affected in protein levels, which I didn't look at. So anyway, this dog has been well fasted and took up loads in the morning, so there was no medications given before, and suddenly all these worrying ratios, all these red lights have turned off. So nothing else has changed, the dog's on the same diet. Now bearing in mind the person had gone out with thinking the dog has chronic kidney disease, he was going to be put on chronic kidney disease dry food, and potentially that's the route the dog was going down then. And you know, now just from some simple kind of changes, like, hang on, fast the hell out of the dog, let's see where we are. The red lights have turned off, the albumin globulin ratio is still a touch little wonky, but that's because the albumin ratio, her albumin is up at the, you know, 38. This dog clearly has a high albumin going through through its blood, and globulin is very low. And so when you do that ratio, it's a tiny bit high. I wouldn't be wetting the bed about it. It doesn't seem too dramatic. And then, you know, everything else seems pretty, pretty okay beyond kind of stressing about it.
So, you know, Conor, just to say, this is the same dog, everything's the same, it's just fasted 2 weeks later. That's it.
2 weeks later. And then the person rings me and goes, bloody hell, because she was so worried, you know, and she's there you go, the dog is— and also a few other little changes in the dog. Like, the dog wasn't drinking water, a whole lot of water in the first one, which you guys alluded to, which is 9 days later. In fact, 9 days, there we go. Yeah. And so it like, there was, there was very little interventions. One little thing or two of the things I was getting them to do was offer the dog fresh water or salty water, see if there's any electrolytes were needed by the dog because they wouldn't know. And, you know, a little bit of algae a little bit of kind of chlorella, which can help top up vitamin levels, and, you know, offered separately. And so there was probably a tiny bit of that on in the background, but food-wise and whatever else, I put their mind at ease because studies show of dogs that have been nephrectomized— so this is where they actually chop off the kidney function of the dogs— representing 70% kidney function loss, 80%, 90%, stage 1, 2, 3, whatever. And the more protein they fed these dogs, the better they did. So even the idea of feeding them low protein food was, was kind of wrong. But this person said, no, I'm going to keep on feeding the normal diet, I'm going to see what second bloods, say, and now they have these second bloods to go by and go, ah, and I wonder, I always wonder what the vet thought when that was presented to them, you know, without trying to rub their face in it, you know, no one's trying to do that, you're just trying to say, bloody hell, you're still saying low protein for dogs with early stage kidney disease, like that's desperate, you know. So that kind of annoyed me a little bit that a pleb like me could give that advice, and you know, why isn't that advice filtering down and you know, you're paying for the advice for people to read these bloods for us because this shit is complicated, you know. And then, you know, are they, are they interpreting the bloods correctly for my raw-fed dog? Well, how can they? Because they don't have the numbers and controls and data, and it's certainly not been fed to them in college. So it's a little bit worrying. I wonder where we are with normals and where do we go from here? How do you get normal blood?
You know, well, we need to get thousands of normal bloods from loads of healthy raw dogs. So that we can sell them.
You need to make sure that it is marked that this is a raw dog so that they can differentiate from this is a kibble-fed dog. I mean, realistically, they should separate out the different kibbles because they will have different protein levels. That's true. You know, there's so many changes in some of those, but generally they're all processed. And I can't wait till we start to move into the functional medicine side of things with these normal parameters. This is so archaic. We've been doing bloods like this for the past 40 years with very little change in veterinary medicine, without looking at inflammatory markers, without looking at, you know, some of the cancer markers that are now available, without looking at hormone metabolism. Without looking at all the vitamin levels that are within the bloodstream.
Yeah.
So all of that is becoming available now for functional medicine practitioners. There's so much information you can gain which outstrips all of this that we're seeing here. And even now, unfortunately, we're still misreading some of the basics that we've had 40 years to get hold of.
Yeah. So can I ask you guys, because I'm just aware we're tight on time here, one person here has got a very interesting question. She says, can I ask, bladder cancer was not detected in my dog who had bloods 3 weeks before her death. She was being treated for a UTI and she had 2 ultrasounds that showed no tumor. So how come bloods not show that? I mean, her bloods were totally normal 3 weeks before her death from bladder cancer.
Many cancers will not show on a blood.
Oh, well, they're not.
If you go fishing for cod, you're not gonna get sardines.
Yeah, and there are two.
Is that a good analogy?
Yeah, and there are two.
Unless you look for sardines, you're not going to find sardines. Okay, yeah, yeah, yeah.
So there are cancer markers, but yeah, there are two new tests that are out there that are now being looked that. Okay, and yeah, the BRAF test, there's NUC, these, but they're specifically saying, okay, we've ruled everything out but we're suspicious of cancer. You need to get those specific tests. They're quite expensive, puts people off. You know, if you're spending £150 to £200 for a test trying to screen cancer, yeah, you, you're gonna be a little bit, you know, oh, do I really want to go down that route? And so, you know, looking at a general bloods is really looking at organ function. And for certain spread, you might find that you have some changes maybe in the liver. Okay, maybe in the kidneys. But generally, majority of cancers, you're not going to see changes unless it's fairly marked and stuff.
Okay. That's disappointing. I kind of thought that you guys would be able to just pop— it would hop off the readings like, you know, platelets platelets will be down, or they'll be like, oh, that's definitely what it is.
Hematology comes into it, it's back to the holistic view. Okay, but then you've got to look at what is the clinical picture, what are you— your examination. So just reading bloods on its own in isolation isn't really what you should be doing. You should be reading them with the patient in front of you. Having urine from that bladder cancer case may have made a massive difference to the diagnostic works, you know, because you can see what's going on with that. So there's loads of other information that can come forth, and you've got to work out— look, they're often— these are a start point.
Yeah.
Then it's a progression of if your dog is ill, maybe it's got weight loss, but the— these initial bloods are normal, follow your vet's advice as to the next set of tests because your dog is not normal. It's losing weight, it's looking poorly, it might be straining to urinate. It's got—
is urine analysis not cheap for detecting, uh, the likes of—
yeah, well, you can certainly pick up, you know, on a dip test, you can, you know, addition to this, maybe as little as £40, you know, even £20 to do that with the lab and to get some more information about if cells coming out in the urine, which if they've got bladder cancer, generally there would be. If there's changes in the biochemistry or the bacterial levels, etc., within that, not to be suddenly mistaken for that there is, you know, a cystitis, a bacterial infection. It could be that there's a secondary infection around the cancer. So, you know, how is that collected? Is it collected by by free catch, which means that all of the lower urinary tract and discharges could be collected in it, or is it by direct sampling from the bladder? All of these have really important methods of understanding for why this turns out.
Veterinary stuff is complicated, who would have thought? I just thought anybody could do it, but I have to say my brain's hurting a bit. Should we jump over to Patreon where I will create— where you can hear 3 men discuss the menstrual cycle? I think—
have you got some teasers? No.
Oh, teasers.
Yeah.
Well, my teaser, my main question is what nutrients— so taking bloods from women and certain times of the month. And so we expect things to change. So the obvious, the low-hanging fruit here would be all the, all the sex hormones. Okay. They're all going to— oh, you don't— oh, Nick's just jumped the gun. Okay, so save your, save your guesses. And I'm looking for 3, actually 4 top nutrients that will fluctuate wildly depending on whereabouts you are in your cycle.
So yeah, but you say that, Conor, but I bet every woman in the audience just went, knows the answer to this.
Okay.
Yeah, we can get a bit more fancy than that. However, I do have to go and put children to sleep, so I'm going to leave you to the lovely boys.
Oh yeah, I hope he meant to bed and not literally, because otherwise people are going to have a very strange view of you, Nick.
Yeah, tell us the temperature in your house at the moment, Nick.
Oh God, it's freezing. Look, look, yeah, look at this. I'm wearing a vest, freezing house in all suites, my God, a jumper and a woolly jumper, and I've got long johns on. And I'm just about right.
Why don't you put the heating on, man? Put light a fire. What is going on?
We've done that all day. It's sub-zero. It's literally sub-zero.
That's why the kids are going to bed at 8 o'clock because they need to wrap up in a quilt to keep warm.
Yeah.
They look like the Inuit going to bed.
All sleeping together in one bed like a Roald Dahl book.
With the dogs. To do sleep in with Ellie. Yeah, for sure.
Very nice.
Heaven forbid you ever go to Canada and it's -20 outside right now.
They call that a three-dog night, uh, Brent. They call it a three-dog night. Yeah, yeah, that's amazing.
Brilliant.
Like that.
All right, Nick, take it easy, guys, and, uh, thank
