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DATE of Exam: __________________ Official Name of Dog: _______________________________ CTCA Registration Number: ________ |
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BLOOD CHEMISTRY, Form 3 of 3 |
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July 8th, 2010 |
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The CTCA requires a general, comprehensive blood panel and several additional serum panels to complete this portion of the CTCA Health Test. The general, comprehensive blood panel should test for:
Glucose
Urea Nitrogen
Creatine
Alkaline Phosphatase
Total Protein
Albumin
Bilirubin (total)
ALT (SGPT)
AST (SGOT)
Cholesterol
Calcium
Phosphorus
Sodium
Potassium
Chloride
A/G
Bun/Creatinine
Globulin
Hemoglobin
Hematocrit
WBC
RBC
MCV
MCH
MCHC
Platelet Est
Absolute Polys
Absolute Bands
Absolute Lymphs
Absolute Monos
Absolute EOS
Absolute Basos
We require the following additional panels/test:
- Brucellosis
- Clotting Time
- Bile Acids Test (arrange in advance with your veterinarian)
In your opinion, are there any symptoms exhibited by this dog that would suggest the need for additional tests? If so, please specify:
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Please attach the lab results (fax or print out) to this form. The results should clearly show the name of the dog and the date. If not visible, please write on the form and sign.
Thank you again!
TO THE APPLICANT: Any falsification of these tests may result in your immediate and permanent expulsion from the CTCA, the reclassification of your dogs or possibly the removal of your dogs and their progeny from the CTCA's database.