case_images: PMC8573117_01
case_images: Serial serum creatine kinase (CK) (A), alanine transaminase (ALT) (B), and aspartate aminotransferase (AST) (C) enzyme activity measurements in a subclinical dog over 1,807 days (5 years). Two reference laboratories were used over the 5-year follow-up period (laboratory A; day 1-602; laboratory B, day 1,036-1,807). Reference intervals for laboratory A included CK (10-200 IU/L), ALT (18-121 IU/L), and AST (16-55 IU/L) and laboratory B included CK (59-895 IU/L), ALT (12-118 IU/L), and AST (15-66 IU/L). The dotted red and blue lines denote the upper limit of the reference interval for laboratory A and laboratory B, respectively.
case_images: fvets-08-757294-g0001.jpg
case_images: PMC8573117_01_fvets-08-757294-g0001.jpg
case_images: F1
case_images: A serum biochemical profile was repeated 7-days later, which revealed persistently increased serum CK activity (10,301 IU/L) as well as ALT (409 IU/L) and AST (290 IU/L) enzyme activities (Figure 1). ALT, and AST enzyme activities (Figure 1). A commercial ELISA-based kit (4DX SNAP Plus Test kit, IDEXX Laboratories Inc., Westbrook, ME) was negative for detection of antibodies for Ehrlichia sp., Anaplasma phagocytophilum, Anaplasma platys, Borrelia burgdorferi C6 peptide, and ALT, and AST enzyme activities (Figure 1). All additional diagnostic testing recommendations were declined and the dog was discharged without medications. The serum biochemistry revealed persistence in severe hyperCKemia and mild to moderate increases in ALT and AST enzyme activities (Figure 1). Serum biochemistry revealed an unchanged severe hyperCKemia and persistent mild-to-moderate derangements in ALT and AST enzyme activities (Figure 1). ALT and AST enzyme activities (Figure 1). A complete blood count and urinalysis were unremarkable. A serum biochemistry revealed a moderate hyperCKemia (4,601 IU/L) and mild-to-moderate increases in ALT (225 IU/L) and AST (165 IU/L) enzyme activity (Figure 1).