BCSE
Pathology
Clinical Chemistry – BCSE Study Guide
March 28, 2026
30 min read
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BCSE study guide for Clinical Chemistry. High-yield review with exam-focused content and practice questions.
| Enzyme |
Type |
Location |
Key Points |
| ALT |
Leakage (cytoplasmic) |
Hepatocytes (dogs/cats) |
Most liver-specific in small animals |
| AST |
Leakage (cyto + mito) |
Liver, muscle, RBCs |
Check CK to rule out muscle source |
| ALP |
Induction (membrane) |
Liver, bone, intestine |
C-ALP in dogs only; cats lack this |
| GGT |
Induction (membrane) |
Biliary epithelium |
More sensitive for cholestasis in cats |
| Type |
Mechanism |
Common Causes |
| Prehepatic |
Excess bilirubin production from hemolysis |
IMHA, transfusion reactions, Heinz body anemia, babesiosis |
| Hepatic |
Impaired uptake, conjugation, or excretion by hepatocytes |
Hepatitis, hepatic lipidosis, cirrhosis, sepsis |
| Posthepatic |
Obstruction of bile flow |
Cholelithiasis, pancreatitis, neoplasia, mucocele |
| Mechanism |
Causes |
| Decreased production |
Hepatic failure, chronic liver disease, malnutrition |
| GI loss (PLE) |
IBD, lymphangiectasia, GI lymphoma, parasitism |
| Renal loss (PLN) |
Glomerulonephritis, amyloidosis, familial nephropathies |
| Third spacing |
Effusions, vasculitis, burns |
| Type |
BUN:Creatinine |
USG |
Causes |
| Prerenal |
Increased (greater than 20:1) |
Concentrated (greater than 1.030 dogs, greater than 1.035 cats) |
Dehydration, decreased cardiac output, shock |
| Renal |
Normal to mildly increased |
Isosthenuric (1.008-1.012) or inadequately concentrated |
AKI, CKD, nephrotoxins |
| Postrenal |
Variable |
Variable |
Urethral obstruction, uroabdomen, bilateral ureteral obstruction |
| Stage |
Creatinine (dogs) |
Creatinine (cats) |
SDMA Guidance |
| 1 |
Less than 1.4 mg/dL |
Less than 1.6 mg/dL |
Less than 18 mcg/dL |
| 2 |
1.4-2.8 mg/dL |
1.6-2.8 mg/dL |
18-35 mcg/dL |
| 3 |
2.9-5.0 mg/dL |
2.9-5.0 mg/dL |
36-54 mcg/dL |
| 4 |
Greater than 5.0 mg/dL |
Greater than 5.0 mg/dL |
Greater than 54 mcg/dL |
| Albumin |
Globulin |
Pattern |
Causes |
| Decreased |
Decreased |
Panhypoproteinemia |
Hemorrhage, severe PLE, severe burns |
| Decreased |
Normal |
Selective albumin loss |
PLN, liver failure, PLE (early) |
| Decreased |
Increased |
Inflammation + loss |
Chronic infection, FIP, ehrlichiosis |
| Normal |
Increased |
Hyperglobulinemia |
Chronic inflammation, neoplasia (myeloma) |
| Increased |
Increased |
Dehydration |
All proteins concentrated |
| Result |
Spec cPL (Dogs) |
Spec fPL (Cats) |
| Normal |
Less than 200 mcg/L |
Less than 3.5 mcg/L |
| Equivocal |
200-400 mcg/L |
3.5-5.3 mcg/L |
| Consistent with pancreatitis |
Greater than 400 mcg/L |
Greater than 5.3 mcg/L |
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