Expert Veterinary Internal Medicine and Endocrinology Consulting Services
Article of the Week
We will be posting commentaries on articles relating to internal medicine and endocrinology that we think are of interest.
May 6th, 2021
Resting and postprandial serum bile acid concentrations in dogs with liver disease
Despite the fact that concentrations of SBAs are measured frequently in dogs, there is limited data on their ability to differentiate between different causes of liver disease. Moreover, little data exists to determine the sensitivity and specificity of SBAs for the diagnosis of individual diseases according to WSAVA histological criteria. Using non-standardized histological criteria, previous studies reported that resting and postprandial SBA concentrations had a sensitivity of greater than 65% for the diagnosis of different liver diseases. In addition, resting and postprandial SBA concentrations greater than 30 μmol/L had specificities greater than 90% for the diagnosis of liver disease in dogs.
The aims of this study were, therefore, (a) to compare resting and postprandial SBA concentrations in different liver diseases in dogs, and (b) to assess the sensitivity and specificity of these tests for different liver diseases classified according to the WSAVA classification
Background: Serum bile acids (SBAs) are frequently measured in dogs. However,
there is limited data comparing SBAs in different liver diseases diagnosed according
to standardized histological criteria.
Objectives: To compare resting and postprandial SBAs, and determine their sensitivity
and specificity, for various liver diseases in dogs.
Animals: Three hundred and forty-one client-owned dogs with suspected liver disease
that had a liver biopsy and SBAs measured.
Methods: Multicenter retrospective study. Cases were classified according to standardized
histological criteria. The sensitivity and specificity of resting and postprandial SBAs for the diagnosis of each liver disease, and all liver diseases combined, were calculated.
Results: The median resting SBAs were highest in dogs with cirrhosis (98.8 μmol/L; range, 6-135) and congenital circulatory anomalies (CCa; 79.45 μmol/L; 0.3-705). The highest median postprandial concentrations were found in CCa (126 μmol/L; 0-726) and chronic hepatitis (CH; 54.3 μmol/L; 0-260). Using the cut-off value of 10 μmol/L, the highest sensitivities of resting SBAs were recorded in dogs with CCa (87.5%; 95% confidence interval, 76.8-94.4) and CH (81.1%; 71.5-88.6). The sensitivities of postprandial SBAs were the highest in cholangitis (100%; 47.8-100.0) and CCa (91.1%; 78.8-97.5). The specificities of resting and postprandial SBAs for all diseases were 49.3% (37.6-61.1) and 29.7% (15.9-47.0), respectively.