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My 14 and a half year old collie mix has just been diagnosed with both kidney failure and pancreatitis.

I have four pages of blood test result all together, so I'm only going to type in the parts that showed something wrong.

On the test that found kidney failure:

ALKP 365 U/L (reference range 23-212)

ALT 602 U/L (ref. 10-100)

BUN/UREA 82 mg/dL (ref. 7-27)

CHOL >520 mg/dL (ref. 110-320)

CREA 2.8 mg/dL (ref. 0.5-1.8)

LIPA 2043 U/L (ref. 200-1800)

And for the test that showed pancreatitis:

Pancreatic Lipase Immunoreactivity Fasting >1000 ug/L (control range 0-200)

TLI Fasting 46.1 ug/L (control range 5.7-45.2)

My first question is, can you tell me what "CHOL" and "ALT" stand for? My vet explained the results over the phone but it was before I got them on paper and I had trouble understanding. I don't remember anything about either of those, and now that I have them in front of me I see they are the highest above normal of everything on the test. Whatever "CHOL" is, is there anything I can do to make it go lower?

My second question is, based on these results, do you think we are more likely looking at two unrelated conditions, kidney failure caused by pancreatitis, or pancreatitis caused by kidney failure? My vet was unsure what to think on that.

I would also appreciate any advice you can give on diet, herbal therapies, et cetera. Unfortunately all the books I have on pet care recommend almost opposite diets for kidney failure than they do for pancreatitis, so with her having both conditions I don't know what to do. I can't seem to find any resources that talk about both combined. I will probably post again at some time with more specific dietary questions, but I don't want to ask too many questions at once, so will end it here for now.

Thank you for your time.

CHOL stands for cholesterol, and ALT is a liver enzyme. Your dog has a kidney problem, with some liver involvement. The elevated cholesterol shows me that your dog is likely hyperthyroid, so I would not be surprised if he has skin and ear issues. The pancreatic values are not so bad. I would suggest you address the thyroid issue first, as the other values often improve after that. I would start him on milk thistle for the liver and kidneys. I would also put him on some Chinese herbs, such as Rhemania six and Standard Process Canine renal support.

Thanks for the advice on herbs.

Apparently her thyroid function is normal. My vet had suspected thyroid problems from the beginning because she didn't want to eat, so we had a blood sample sent away to a university lab for a more comprehensive test than they could run on site, but those results came in last Thursday and show that she is neither hyperthyroid nor hypothyroid.

I will start her on milk thistle and look for the other herbs too. Can you recommend an approximate dose on the milk thistle, for a 52 pound dog?

Also, she is getting B vitamins, pancreatic enzymes, tums (to bind phosphorus), probiotics, and occasionally pepto-bismol (just when diarrhea flares up), so please let me know if you are aware of any drug interactions between any of those and the herbs you have recommended. I will of course also keep my vet informed of what I'm giving her, but he doesn't have experience using herbs so probably won't be able to answer that question.

Thanks for your time.

I don't see any drug interactions. Ask your vet what was the value of the dog's T4; it should be at or close to 2.0. Most labs use a standard set much too low (0.8-4.0).

If it is under 1.5, your dog would benefit from thyroid supplementation.