Yes, it is absolutely fine to tag me and I’m glad you did.
Still a huge red flag is that phosphorus number and her calcium. She is really, really at risk of tissue calcification and that high of a P should be making her feel bad. The P x Ca should be below 70. She is also at risk for secondary parahyperthyroidism which is different than hyperthyroidism.
It is really rare to see basophils elevated. If basophils and eosinophils are elevated, it’s likely an allergic response. Here is what Dr. Ron Hines (he has a great website which interprets labs) says about elevated basophils:
The basophil is one of your dog or cat ’s white blood cells. It is a very uncommon cell in most pets - often none are seen. An over abundance of basophils (basophilia) is quite rare. When your pet's basophil numbers are above normal, it is often in conjunction with an increased number of eosinophils, another of your pet’s white blood cells that is associated with allergies. Like their cousins ,the mast cells that are found scattered throughout your pet's body tissue, basophils contain histamine, a compound intimately involved in allergic reactions.
In the rare cases where too many basophils are present, and your pet's eosinophil count is normal, bone marrow problems involving the cells that give rise to basophils (hematopoietic stem cells) are sometimes involved. Those problems can be cancerous.
When increased basophil numbers are found in association with higher than normal eosinophils, internal parasites, fleas and allergies can be the cause. Basophil numbers occasionally go up in liver disease , as well as due to the things that cause persistently high triglyceride levels in pets.
Here is his analysis of high neutrophils:
High levels of neutrophils occur in many infections. But other forms of inflammation, such as wounds and surgery can elevate their numbers as well.
Sudden stress that stimulates your pet’s adrenal glands to liberate corticosteroid and epinephrine also raise neutrophil numbers (stress leukogram).
Autoimmune and allergic reactions can liberate chemicals (inflammatory cytokines) that cause high neutrophil numbers as well.
Corticosteroid medication (eg prednisone) can also elevate neutrophil numbers.
On rare occasion, a pet's continuing high neutrophil numbers are due to a tumor of the stem cells that produce them in the bone marrow (myelogenous leukemia).
The common thread in those two is an issue with the bone marrow and she has had an issue of continuing high neutrophils. I’m not a vet and so I can’t tell you what’s going on but it’s worthy of a discussion with your vet. I’d take her the above info and see what she has to say about it.
BTW, it is very common that kidney infections will not grow anything on a C&S. In fact, my CKD kitty, Gus (now GA), had two kidney infections and his cultures were clean as a whistle. Amoxicillin is not enough of an AB to address kidney infections if that is potentially what is going on. Her creatinine took a pretty good jump from Oct to now.
While you are talking to your vet about the basophils and the neutrophils, you
absolutely must get the P down. It is directly correlated with longevity and a P of 9 is just way, way too high. Her P level should be more along the lines of 4-4.5. Are you using a phosphorus binder?
