Comprehensive Diagnostic Profile (23+7)
A broad veterinary chemistry profile combining 23 measured analytes and 7 calculated indicators to support rapid biochemical assessment of liver, kidney, pancreas, muscle, glucose balance, electrolyte and mineral status, perfusion, and acid-base change in a single run.
High-value clinical uses
Wellness screening, pre-anesthetic workup, emergency triage, internal medicine evaluation, ICU follow-up, endocrine workups, vomiting/diarrhea cases, jaundice, PU/PD, and suspected renal or hepatobiliary disease.
Core coverage
Proteins, hepatocellular leakage, cholestasis, bile acids, renal filtration, pancreatic support markers, glucose, electrolytes, minerals, lactate, and acid-base indicators.
Platform-style workflow
Designed around the Celercare V / Pointcare V chemistry analyzer workflow using rapid disc-based analysis with small sample volume and point-of-care suitability.
What this panel is for
The Comprehensive Diagnostic Profile (23+7) is intended for broad biochemical screening and monitoring in veterinary practice. It is particularly useful when the clinician needs a single chemistry panel that can quickly highlight dehydration, protein loss, hepatocellular injury, cholestasis, impaired hepatic function, azotemia, muscle leakage, pancreatic involvement, glucose imbalance, electrolyte derangement, mineral imbalance, metabolic acidosis, or systemic hypoperfusion.
For day-to-day case management, this kind of profile reduces repeat sampling, improves pattern recognition, and makes serial monitoring easier in medical, surgical, emergency, and geriatric patients.
Measured test items (23)
Calculation items (7)
- GLO: calculated globulin, usually TP minus ALB.
- ALB/GLO: albumin-to-globulin ratio, useful for inflammatory and protein-distribution patterns.
- AST/ALT: contextual clue when trying to separate hepatocellular leakage from muscle leakage.
- BUN/CRE: helps identify disproportion between urea and creatinine change.
- K+/Na+: electrolyte relationship clue; interpret with analyzer reporting format.
- Ca×P: calcium-phosphorus product, clinically useful when mineralization risk is a concern.
- AG: anion gap estimate used in metabolic acidosis workups and shock interpretation.
Sample, workflow, and handling
- Analyzer platform: Celercare V / Pointcare V workflow style
- Typical sample types: lithium heparin whole blood, lithium heparin plasma, or serum
- Typical sample volume: 100 μL
- Run start guidance: begin the test within about 10 minutes after loading the disc
- Whole blood note: gently mix before transfer to keep the sample homogeneous
- Disc storage: sealed pouches at 2-8°C
- Avoid: direct sunlight and temperatures above 32°C
- Damaged pouch rule: do not use discs from torn or compromised pouches
- Specimen quality: review hemolysis, lipemia, and icterus before interpreting results
These operational details are adapted from related Celercare V / Pointcare V IFU documents and are suitable as platform-level guidance. The exact 23+7 disc insert should override any analyzer-specific or disc-specific difference.
Clinical interpretation by analyte group
Protein profile
- TP: total of albumin and globulins; useful for hydration, inflammation, hemorrhage, protein loss, and nutritional or hepatic trends.
- ALB: main oncotic and transport protein. Low albumin supports loss, reduced hepatic synthesis, severe inflammation, hemorrhage, or dilution. High albumin usually suggests hemoconcentration.
- GLO: helps detect chronic antigenic stimulation, inflammation, infection, or gammopathy.
- ALB/GLO: low ratio favors globulin excess or albumin loss; high ratio favors relatively low globulins.
Hepatocellular injury, cholestasis, and hepatic function
- ALT: key hepatocellular leakage enzyme in small animals. Indicates injury, not actual liver functional reserve by itself.
- AST: rises with hepatic or muscular injury. Always review with CK.
- GGT and ALP: cholestatic markers that help raise suspicion for biliary disease, obstruction, cholangitis, gallbladder disease, or steroid/drug induction.
- TBIL: helps assess bilirubin production, hepatic uptake/conjugation, and biliary excretion.
- TBA: strong hepatic function and portal-circulation marker; useful in hepatic insufficiency or portosystemic shunting, although cholestasis itself can also increase it.
- CHOL: often adds weight to cholestatic, nephrotic, endocrine, or chronic hepatic interpretations.
Renal and hydration assessment
- CRE: key filtration marker for azotemia and renal monitoring, but influenced by muscle mass.
- BUN: affected by renal function, hydration, dietary protein, catabolism, GI bleeding, and hepatic urea production.
- BUN/CRE: useful when urea is changing out of proportion to creatinine.
Muscle, pancreas, metabolism, and perfusion
- CK: strongest routine chemistry clue for muscle leakage, trauma, seizures, rhabdomyolysis, or IM injection effect.
- AMY and LPS: supportive pancreatic markers; interpret with clinical findings and consider species-appropriate pancreatic-specific assays where needed.
- GLU: central for diabetes, stress hyperglycemia, sepsis, hypoglycemia, and emergency decision-making.
- LAC: important in shock, sepsis, trauma, hypoperfusion, and critical-care monitoring.
Electrolytes, minerals, and acid-base balance
- K+, Na+, Cl-: essential for hydration, renal, adrenal, urinary obstruction, GI-loss, and acid-base interpretation.
- Ca, P, Mg: relevant in renal disease, endocrine disease, growth, mineral disorders, neuromuscular dysfunction, and tissue mineralization risk.
- tCO2: chemistry estimate of the metabolic bicarbonate component.
- AG: useful in high-anion-gap metabolic acidosis such as lactic acidosis, ketoacidosis, toxin exposure, and severe renal failure.
Quick high / low interpretation guide
| Analyte | If high, it may suggest | If low, it may suggest |
|---|---|---|
| TP | Dehydration, inflammation, gammopathy | Protein loss, hemorrhage, severe hepatic dysfunction, dilution |
| ALB | Usually hemoconcentration | Protein-losing nephropathy/enteropathy, hepatic synthetic failure, inflammation, hemorrhage |
| ALT | Hepatocellular injury or leakage | Usually limited direct significance |
| AST | Liver injury or muscle injury; compare with CK | Usually limited direct significance |
| GGT / ALP | Cholestasis, biliary disease, steroid/drug induction, growth (ALP) | Often limited direct significance |
| TBIL | Hemolysis, impaired hepatic handling, cholestasis | Usually not clinically important |
| TBA | Hepatic insufficiency, shunting, cholestasis | Usually not clinically important |
| CRE / BUN | Azotemia, dehydration, renal disease, postrenal causes | Low muscle mass (CRE), hepatic dysfunction or low protein intake (BUN) |
| CK | Muscle trauma, seizures, rhabdomyolysis, injections | Usually not clinically important |
| AMY / LPS | Pancreatic disease suspicion, reduced clearance, nonpancreatic abdominal disease | Often limited direct significance |
| GLU | Stress, diabetes mellitus, endocrine insulin resistance | Sepsis, insulin excess, severe hepatic disease, juvenile/starvation states |
| CHOL | Cholestasis, nephrotic syndrome, hypothyroidism, diabetes, hyperadrenocorticism | Hepatic dysfunction, malabsorption, inflammatory disease, shunting |
| K+ | Urinary obstruction, Addisonian pattern, severe renal disease, hemolysis artifact | GI loss, diuresis, poor intake, insulin effect, alkalosis |
| Na+ | Water deficit / hypertonicity | Sodium loss, dilution, adrenal disease patterns |
| Cl- | Relative hyperchloremic acidosis or saline effect | Vomiting, metabolic alkalosis, free-water excess |
| Ca | Malignancy, renal disease, hyperparathyroidism, vitamin D excess | Hypoalbuminemia, eclampsia, pancreatitis, renal loss |
| P | Renal disease, hemolysis, growth, cell injury | Hyperparathyroidism, refeeding, insulin shifts |
| Mg | Reduced excretion, some renal or endocrine states | GI loss, poor intake, refractory electrolyte issues |
| tCO2 | Metabolic alkalosis or compensation pattern | Metabolic acidosis |
| LAC | Hypoperfusion, shock, sepsis, seizures, severe metabolic stress | Usually limited direct significance |
Pattern-based diagnostic scenarios
1) Dehydration / prerenal trend
Common pattern: TP↑, ALB↑ or high-normal, BUN↑ out of proportion to CRE, Na+ variable, sometimes lactate↑ if perfusion is poor.
Interpretation: supports hemoconcentration and prerenal azotemia, especially when clinical dehydration or concentrated urine is present.
2) Hepatocellular injury
Common pattern: ALT↑, AST↑, with CK normal or only mildly changed.
Interpretation: favors hepatocellular leakage or injury rather than primary muscle leakage.
3) Cholestatic / biliary disease
Common pattern: ALP↑, GGT↑, TBIL↑, CHOL↑, sometimes TBA↑.
Interpretation: raises suspicion for cholestasis, biliary obstruction, cholangitis, gallbladder disease, or steroid/drug influence.
4) Hepatic insufficiency or shunting
Common pattern: TBA↑, BUN↓, CHOL↓, ALB↓, sometimes GLU↓.
Interpretation: supports reduced hepatic functional reserve or abnormal portal circulation.
5) Renal compromise / azotemia
Common pattern: CRE↑, BUN↑, P↑, K+↑ in more advanced or obstructive cases, tCO2↓ in acidotic patients.
Interpretation: supports renal or postrenal disease, especially when paired with urinalysis abnormalities.
6) Muscle injury
Common pattern: CK↑ markedly, AST↑, potassium may appear high in severe muscle injury.
Interpretation: shifts suspicion toward muscle leakage, trauma, seizures, or rhabdomyolysis rather than primary liver disease.
7) Pancreatic disease suspicion
Common pattern: LPS↑ and/or AMY↑, with dehydration or azotemia sometimes present; glucose, calcium, and liver-associated enzymes may also change.
Interpretation: supportive for pancreatitis or pancreatic involvement, but should be integrated with clinical signs and more specific tests if available.
8) Addisonian-style electrolyte concern
Common pattern: K+↑, Na+↓, altered K+/Na+ relationship, sometimes azotemia and hypoglycemia.
Interpretation: electrolyte pattern can support suspicion for hypoadrenocorticism, but it is never diagnostic by itself.
9) High-anion-gap metabolic acidosis
Common pattern: tCO2↓, AG↑, LAC↑, and sometimes K+ change.
Interpretation: supports lactic acidosis, ketoacidosis, toxin exposure, or severe renal failure depending on the case context.
10) Mineralization risk
Common pattern: Ca×P markedly increased, often with Ca↑ and/or P↑.
Interpretation: indicates higher concern for soft tissue mineralization, especially in renal disease or vitamin D-related toxicity.
Reference intervals and performance notes
Useful analyzer-family reference intervals and assay performance characteristics are available for the overlapping analytes documented in the related Comprehensive Diagnostic Profile (20+7) IFU. These include TP, ALB, ALT, AST, GGT, ALP, TBIL, TBA, CRE, BUN, AMY, GLU, CHOL, LPS, K+, Na+, Cl-, Ca, P, and tCO2. For the final live product page, the exact 23+7 disc insert should be the primary source for CK, Mg, LAC, and any panel-specific reference interval or dynamic-range claim.
| Overlapping analyte | Dog reference interval | Cat reference interval |
|---|---|---|
| TP | 5.2-8.2 g/dL | 5.4-8.9 g/dL |
| ALB | 2.2-4.4 g/dL | 2.2-4.5 g/dL |
| ALT | 10-140 U/L | 8.2-123 U/L |
| ALP | 20-150 U/L | 10-90 U/L |
| TBIL | 0.1-0.9 mg/dL | 0.1-0.9 mg/dL |
| CRE | 0.3-1.7 mg/dL | 0.3-2.5 mg/dL |
| BUN | 7-32 mg/dL | 10-43 mg/dL |
| GLU | 70-143 mg/dL | 74-159 mg/dL |
| CHOL | 110-320 mg/dL | 65-225 mg/dL |
| AMY | 200-1800 U/L | 200-1800 U/L |
| K+ | 3.7-5.8 mmol/L | 3.7-5.8 mmol/L |
| Na+ | 138-160 mmol/L | 142-164 mmol/L |
| Cl- | 106-130 mmol/L | 100-126 mmol/L |
| Ca | 7.9-11.8 mg/dL | 7.8-11.8 mg/dL |
| P | 2.5-6.8 mg/dL | 3.1-8.5 mg/dL |
| GGT | 0-7 U/L | 0-2 U/L |
| TBA | 0-20 µmol/L | 0-15 µmol/L |
| AST | 8.9-55 U/L | 9.2-60 U/L |
| tCO2 | 12-27 mmol/L | 15-24 mmol/L |
| LPS | 0-258 U/L | 0-143 U/L |
Interference and reporting cautions
- Physiologic interferents such as hemolysis, lipemia, and icterus can materially affect reported concentrations.
- On the documented platform family, results can be suppressed or replaced by sample-quality flags such as HEM, LIP, or ICT when interference exceeds accepted limits.
- For related Celercare V / Pointcare V chemistry assays, potassium measured in anticoagulated plasma may run about 0.2-0.5 mmol/L lower than potassium measured in serum from the same sample.
- Unexpectedly high potassium in a patient with extreme muscle trauma or very high CK should be confirmed by another method if the number does not fit the clinical picture.
- If a result exceeds the assay range, confirm with an approved alternate method or a referral laboratory rather than simply diluting and rerunning.
Why this profile is valuable
The biggest advantage of the Comprehensive Diagnostic Profile (23+7) is that it gives clinicians a broad biochemical snapshot without forcing them to order multiple small groups separately. That speeds triage, improves pattern recognition, and makes serial monitoring practical for real-world veterinary workflow.
Examples of high-yield combinations include ALT with normal CK pointing more strongly toward liver injury, AST with high CK shifting concern toward muscle, ALP or GGT with bilirubin and cholesterol supporting cholestasis, creatinine with phosphorus supporting renal compromise, and low tCO2 with elevated lactate or anion gap supporting metabolic or perfusion-related deterioration.
References
Primary product / IFU references
- Celercare V / Pointcare V chemistry analyzer IFU. Used here for analyzer-family sample, storage, interference, reference interval, and performance details for overlapping analytes.
- Related Celercare V / Pointcare V chemistry analyzer IFU. Used only as supporting platform-level guidance where transferable.
This page is written for professional product education and should not replace case-specific clinical judgment. Final diagnosis should always integrate history, examination, CBC, urinalysis, imaging, and species-specific context.