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1.
Total serum bile acid assay for the evaluation of liver function has been available for many years but its application has been limited primarily by factors such as methodology, equipment and cost. New and improved methods for bile acid assay such as the radioimmunoassay or the hydroxysteroid dehydrogenase techniques have brought the assay for bile acids into the realm of the clinical laboratory. The efficacy of bile acids for clinical diagnostic use in the evaluation of liver function has not been firmly established. Newer methods using high pressure liquid chromatography to develop a profile of the different bile acids may clarify its usefulness and define its role among the many available tests of liver function in animals.  相似文献   

2.
Current literature in veterinary internal medicine regarding the clinical use of the serum bile acids test to assess hepatobiliary function in dogs and cats is reviewed. The test is best used in cases where clinical signs and routine laboratory tests are suggestive of liver disease. It is a highly sensitive and specific test of hepatic function, and is the best method of assessing liver function available to the private practitioner. Abnormal results do not determine etiology, severity, or prognosis of the disorder. They merely indicate the need for hepatic biopsy. The serum bile acids concentration should always be measured in both a fasting and a two-hour postprandial sample.  相似文献   

3.
OBJECTIVE: To determine whether oral administration of ursodeoxycholic acid (UDCA) to healthy dogs alters the results of the bile acids tolerance test. METHODS: UDCA (15 mg/kg once daily) was administered to 16 healthy dogs for 7 days. Health of the dogs was assessed by clinical examination, haematology, serum biochemistry and a bile acids tolerance test. Normal liver structure was confirmed by histopathology at the end of the study. Bile acids tolerance tests were performed before and at the end of the treatment period, with each dog serving as its own control. For the posttreatment bile acids tolerance test, UDCA was administered at the time of feeding. RESULTS: Pretreatment, the fasted serum total bile acid concentrations ranged between 0 and 9 micromol/L. In the majority of dogs, the postprandial total bile acid concentration was greater than the preprandial value, with a range of 0 to 16 micromol/L. The fasted total bile acid concentration was 0 micromol/L in most dogs (93.75%) after treatment with UDCA. Postprandial serum bile acids also remained within the reference range for the majority of dogs (93.75%) after UDCA treatment. A single dog had a postprandial bile acid concentration above the reference range, but the concentration was within the reference range when the assay was repeated the following day without concurrent administration of UDCA. The pre- and postprandial total serum bile acid concentrations were not significantly affected by UDCA treatment. CONCLUSION: The administration of UDCA does not alter the bile acids tolerance test of normal healthy dogs.  相似文献   

4.
Serum bile acids as an indicator of liver disease in dogs   总被引：1，自引：0，他引：1  
Total serum bile acids were determined in 62 dogs with different primary or secondary liver diseases, using 3α-hydroxysteroid dehydrogenase coupled to nitrobluetetrazolium in a centrifugal analyzer. A reaction time of 4 min was sufficient, yielding a within run coefficient of variation of 7% at 6 µmol/1 and 3% at 27 µmol/1. A reference range of 0–4.4 µmol/1 2 h post prandially was observed. The sensitivity of bile acids as a liver function test was superior to that of alanine and aspartate aminotransferase, alkaline phosphatase, γ-glutamyltransferase and combinations of two of these. The bile acids test detected 36 of 39 patients with a morphological or clinical liver diagnosis. For dogs with heart failure the bile acids test was a markedly more sensitive indicator of secondary liver involvement than alanine aminotransferase or alkaline phosphatase. For secondary liver affections associated with pyometra or epilepsy medication the opposite was the case. Bile acid values in the pooled patient material was not correlated to any of the 4 enzymes measured. For cirrhosis there was positive correlation, however, with the amino transferase values.  相似文献   

5.
S-adenosylmethionine (SAMe), an important hepatic metabolite and glutathione (GSH) donor, has been studied mechanistically in vitro, in humans with clinical liver disease, and in experimental animal models of liver disease. Collective findings encourage its therapeutic use in necroinflammatory and cholestatic liver disorders. A chronic longitudinal study (pre- and posttreatment parameters compared) was undertaken with 15 clinically healthy cats given a stable 1,4-butanedisulfonate (S'S isomer) SAMe salt (enteric coated tablets providing 180 mg SAMe), dosage 48 mg/kg PO q24h, on an empty stomach for 113 days. Routine physical and clinicopathologic assessments, red blood cell (RBC) osmotic fragility, liver function and histology, hepatic concentrations of reduced GSH (RGSH) and its oxidized disulfide form (GSSG), protein, glycogen, and deoxyribonucleic acid, GSH concentrations in RBCs, total bile acids in serum and bile, oxidative membrane products (TBARS) in RBCs and liver, and plasma SAMe concentrations were evaluated. SAMe administered PO significantly increased plasma SAMe concentrations, and peak concentrations usually occurred 2-4 hours after dosing. Chronic SAMe administration did not change peak or cumulative plasma SAMe concentrations and did not [corrected] cause overt signs of toxicity. A positive influence on RBC and hepatic redox status (RBC TBARS reduced 21.1% [P < .002], liver GSH increased 35% [P < .002], liver RGSH: GSSG ratio increased 69% [P < .03]) and improved RBC resilience to osmotic challenge (P < .03) were observed. Results prove that this SAMe PO product is enterically available and suggest that it imparts biologic effects that might be useful for attenuating systemic or hepatic oxidant challenge.  相似文献   

6.
The concentration of total plasma bile acids was measured in normal sheep and in sheep in which liver damage was induced by chronic copper poisoning, ligated bile ducts or induced ketosis. All three treatments produced a rise in total bile acid concentration in plasma which was proportional to the degree of hepatic damage seen histologically and which tended to parallel changes in activity of iditol, and glutamate dehydrogenase and aspartate amino-transferase in plasma. Plasma bile acid concentration was a more sensitive method of detecting these types of liver damage than was the measurement of total plasma bilirubin concentration, and could be used to assess alterations in liver function in sheep.  相似文献   

7.
An intravenous bile acid loading test was performed on 16 goats using various dosages and sampling protocols. A recently developed enzymatic bile acid assay provided an economical and technologically simple method for bile acid analysis. Intravenous injection of bile salts into goats was well tolerated. Clearance times were rapid. A protocol for performance of the test was suggested and a practical reference range for T 1/2 clearance of 4+/-1 minute was determined. Further investigations of this test in the assessment of liver function in the ruminant appear warranted.  相似文献   

8.
A comparative study was made of biliary and liver lipid compositions during the growth and egg laying periods of the broiler bird. The liver lipids showed high concentrations of triacylglycerols at seven weeks old which increased when egg laying proceeded. At seven weeks old the lipids of the bile also showed high levels of triacylglycerols which decreased with the onset of egg laying but increased slightly as egg laying proceeded. At seven weeks old the fatty acid composition of the bile triacylglycerols differed from that of the liver which in turn was different from that of the liver at the onset of egg laying. In particular the bile triacylglycerols had lower levels of oleic but higher levels of arachidonic and docosahexaenoic acids. By the late egg laying period, the fatty acid compositions of the bile and liver triacylglycerols were similar. The unique bile lipid composition and its changes are discussed in relationship to the major features of liver lipid metabolism in the broiler bird and the mechanism of lipid deposition during egg laying.  相似文献   

9.
Serum bile acid concentrations were measured in 41 clinically healthy cattle of different breeds. There was no diurnal variation in values and age and sex had no effect. There was no significant difference between serum and plasma bile acid concentrations in clinically healthy cattle. Serum bile acids were stable on storage at -20 degrees C. The total serum bile acid concentrations, together with other tests of hepatic disease, were evaluated in cattle with various types of hepatobiliary disease (hepatic lipidosis, hepatic abscessation, leptospirosis, biliary calculi, fascioliasis), respiratory, cardiovascular and infectious diseases, and in various other conditions not affecting the liver. Total serum bile acids were the most specific and sensitive indicators of a wide variety of hepatic diseases and were significantly correlated with the degree of clinical illness.  相似文献   

10.
Uric acid was used as a test for liver disease before the advent of enzymology. Three old studies criticised uric acid as a test of liver function. Uric acid, as an end-product of purine metabolism in the liver, deserved re-evaluation as a liver function test. Serum totalbile acids are widely accepted as the most reliable liver function test. This study compared the ability of serum uric acid concentration to assess liver function with that of serum pre-prandial bile acids in dogs. In addition, due to the renal excretion of uric acid the 2 assays were also compared in a renal disease group. Using a control group of healthy dogs, a group of dogs with congenital vascular liver disease, a group of dogs with non-vascular parenchymal liver diseases and a renal disease group, the ability of uric acid and pre-prandial bile acids was compared to detect reduced functional hepatic mass overall and in the vascular or parenchymal liver disease groups separately. Sensitivities, specificities and predictive value parameters were calculated for each test. The medians of uric acid concentration did not differ significantly between any of the groups, whereas pre-prandial bile acids medians were significantly higher in the liver disease groups compared with the normal and renal disease group of dogs. The sensitivity of uric acid in detecting liver disease overall was 65% while the specificity of uric acid in detecting liver disease overall was 59%. The sensitivity and specificity of uric acid in detecting congenital vascular liver disease was 68% and 59%, respectively. The sensitivity and specificity of uric acid in detecting parenchymal liver disease was 63% and 60%, respectively. The overall positive and negative predictive values for uric acid in detecting liver disease were poor and the data in this study indicated uric acid to be an unreliable test of liver function. In dogs suffering from renal compromise serum uric acid concentrations may increase into the abnormal range due to its renal route of excretion.  相似文献   

11.
This study was designed to evaluate serum bile acid measurements as indicatory, of liver function and/or hepatic fat infiltration in dairy cattle. Serum bile acid concentrations were measured in healthy dairy cattle at different stages of lactation after fasting or feeding. Bile acid concentrations were compared with liver fat content and sulfobromophthalein (BSP) half-life (T 1/2). Serum bile acid concentrations were higher in cows in early lactation and with higher daily milk production. Compared with prefasting values, bile acid concentrations were decreased at 8,14, and 24 hours of fasting. Blood samples from fed cows at 1 - to 2-hour intervals had wide and inconsistent variations in bile acid concentration. Because serum bile acids correlated well with BSP T 1/2, it is suggested that both measurements evaluate a similar aspect of liver function. Neither bile acids nor BSP T I correlated with differences in liver fat content among cows. Because of large variability in serum bile acid concentrations in fed cows and the lack of correlation of measured values with liver fat content, bile acid determinations do not appear useful for showing changes in hepatic function in fed cows with subclinical hepatic lipidosis nor serve as a screening test for this condition.  相似文献   

12.
Serum bile acid (SBA) reference intervals were established by use of a radioimmunoassay method for fasting dogs to be 0.2 to 4.3 micro mol/L (n = 60) and for 2 hour postprandial samples to be 0.6 to 24.2 micro mol/L (n = 37). The SBA reference intervals estimated using an enzymatic method were 0 to 8.6 micro mol/L for fasting (n = 26) and 0 to 29.8 micro mol/L for 2 hour postprandial samples (n = 36). The correlation between the two methods including samples from healthy dogs and clinical cases is good (n = 128, r = 0.82, p < 0.0001). The radioimmunoassay method is linear to 50 micro mol/L and the enzymatic method is linear to 100 micro mol/L, thus both methods require serum dilutions to be made in many cases of primary liver disease. The enzymatic method is less expensive and more convenient for use in a clinical laboratory but requires a greater sample volume (400 micro I) than the RIA method (50 micro I). Both methods have adequate precision and accuracy to be useful as diagnostic tests of liver function in dogs.  相似文献   

13.
Plasma bile acid concentrations were measured in normal horses. There was no diurnal variation in values, and age and sex had no effect. There was no significant difference between serum and plasma bile acid concentrations in clinically normal horses. Plasma bile acids were stable on storage for one month at -20 degrees C. The total plasma bile acid concentrations together with total and direct bilirubin concentrations and plasma activities of aspartate aminotransferase, glutamate and iditol dehydrogenase were evaluated in horses with various types of hepatobiliary disease (hepatic necrosis, lipidosis, neoplasia and cirrhosis), gastrointestinal disease, cardiovascular, orthopaedic and various other conditions not affecting the liver. Total plasma bile acids together with plasma glutamate and iditol dehydrogenase activities were the best indicators of liver disease. Total plasma bile acid concentrations were the most sensitive indicator of a wide variety of hepatic diseases but alone were unhelpful in differential diagnosis and were of more value when combined with the other tests of hepatic disease.  相似文献   

14.
Plasma bile acid estimation has recently been shown to be an excellent indicator of hepatic function in the dog. At the moment the only reported quantification method useful for routine clinical purposes in dogs is a direct spectrophotometric enzymatic technique. This article describes a modification of this method which improves its sensitivity. The problem of processing samples with high levels of lactate dehydrogenase (and more specifically of LDH5), and its clinical significance is also discussed.  相似文献   

15.
It has been shown that some dietary plant proteins beneficially influence lipid metabolism in animals. The effect of pea protein in this respect however has not yet been investigated. Therefore, we studied the effect of purified pea protein on the lipid metabolism in rats. Twenty-four rats received diets with either 200 g/kg of casein or purified pea protein for 16 days. Concentrations of triacylglycerols in liver, plasma and lipoproteins did not differ between both groups of rats. However, rats fed the pea protein diet had a lower concentration of total cholesterol in the liver and the very low density lipoproteins (VLDL) fraction than rats fed the casein diet (p < 0.05); cholesterol concentration in plasma, low density lipoproteins (LDL) and high density lipoproteins (HDL) did not differ between both groups. Rats fed pea protein moreover had an increased mRNA concentration of cholesterol-7α-hydroxylase in the liver and an increased amount of bile acids excreted via faeces compared with rats fed casein (p < 0.05). Concomitantly, mRNA concentrations of sterol regulatory element-binding protein (SREBP)-2 and its target genes 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase and LDL receptor in the liver were increased in rats fed pea protein (p < 0.05). The data of this study suggests that pea protein stimulates formation and excretion of bile acids, which leads to a reduced hepatic cholesterol concentration and a reduced secretion of cholesterol via VLDL. An increased gene expression of SREBP-2 and its target genes HMG-CoA reductase and LDL receptor may be a means to compensate for the increased loss of cholesterol for bile acid synthesis.  相似文献   

16.
Urine bile acid (UBA) tests reflecting "average" serum bile acid (SBA) concentrations may have greater practical utility than paired SBA samples in cats. This study evaluated whether urine sulfated bile acids (USBAs), urine nousulfated bile acids (UNSBAs), or a combined approach had a clinical utility equivalent to SBAs. Routine serum biochemistry tests, SBA concentrations, and urine samples were collected from 54 cats with hepatobiliary disease, 17 cats with nonhepatic disorders, and 8 healthy cats. UBAs were measured by a quantitative enzymatic colorimetric method, and results were normalized with urine creatinine (UCr) concentrations. Significantly higher values occurred in cats with liver disease than in cats without liver disease for USBA : UCr, UNSBA:UCr, and (USBA and UNSBA) : UCr, P < .05 each. UBA tests with diagnostic performance (sensitivity [SS], specificity [SP], and positive and negative predictive values [PV+ and PV-]) equivalent to SBAs were the UNSBA : UCr and the combined test (SS: 87, 87 versus 85; SP: 88, 88 versus 88; PV+: 96, 96 versus 96; PV-: 68, 65 versus 68; UNSBA : UCr, [USBA, and UNSBA]: UCr versus SBA, respectively). Clinical applications of the UNSBA : UCr or the combined (USBA and UNSBA) : UCr test should be useful as convenient diagnostic tests for identifying cats with liver disease and high SEA concentrations.  相似文献   

17.
This paper studies the progression of various hepatic function tests (fasting and post prandial plasma bile acids, lactate dehydrogenase [LDH], hydroxybutyrate dehydrogenase [HBDH], LDH isoenzymogram, and 45 minutes sulphobromophthalein retention) in a classic model of canine hepatic injury. Sulphobromphthalein and plasma bile acid determination are excellent indicators of hepatic damage. Post prandial bile acid quantification does not improve the diagnostic capacity of this test. LDH alters only in the first 48 hours after poisoning and the study of the HBDH/LDH ratio makes it possible to differentiate the origin of plasma LDH. LDH isoenzymogram is not a practical test for routine clinical diagnosis.  相似文献   

18.
Endogenous bilirubin uptake from plasma and biliary bilirubin excretion were determined in ponies with chronic biliary T-tube fistulas. Excreted bile was quantitatively recovered. Uptake was calculated from the plasma disappearance of 14C-labeled bilirubin. Biliary bilirubin excretion was determined directly in excreted bile. When bile acid excretion was low (during continuous drainage without bile acid replacment), bilirubin excretion was 37% less than uptake. Uptake and excretion were essentially identical when taurocholic acid was infused to replace bile acids. After depletion of the bile acid pool, replacement of bile acids (by taurocholic acid infusion) greatly increased both bilirubin excretion and its biliary concentration for approximately 1 hour. After this initial increase, bilirubin excretion was maintained at a rate approximately 30% greater than the preinfusion rate. Bile acid excretion was found to be essential for normal, endogenous bilirubin excretion.  相似文献   

19.
OBJECTIVE: To evaluate 3 methods for measuring urine bile acids (UBA) and compare their diagnostic performance with that of the serum bile acids (SBA) test and other routine screening tests in dogs with hepatic disorders. DESIGN: Prospective study. ANIMALS: 15 healthy dogs, 102 dogs with hepatic disorders, and 9 dogs with clinical signs of hepatic disorders that were found to have nonhepatic disorders. PROCEDURES: Blood and urine samples were collected from sick dogs and healthy dogs for serum biochemical analyses, and determination of concentrations of SBA and UBA. Urine samples were obtained from 15 healthy dogs to establish an upper cutoff value for UBA concentrations. The UBA were measured by use of a quantitative-linked enzymatic colorimetric method. Three analytical modifications were evaluated; 1 quantified only urine sulfated bile acids (USBA), 1 only urine nonsulfated bile acids (UNSBA), and 1 quantified both (USBA plus UNSBA). The UBA values were standardized with the urine creatinine concentration. RESULTS: The UNSBA-to-creatinine ratio and USBA plus UNSBA-to-creatinine ratio tests had the best diagnostic performance of the UBA tests; each had a substantially higher specificity, slightly higher positive predictive value, slightly lower negative predictive value, and lower sensitivity than the SBA test. These UBA-to-creatinine values were positively correlated with SBA values. The USBA-to-creatinine ratio had poor sensitivity, indicating a low rate of bile acid sulfation in dogs. CONCLUSIONS AND CLINICAL RELEVANCE: The UBA can be measured in dogs with sufficient repeatability and accuracy for clinical application. The UNSBA-to-creatinine ratio and USBA plus UNSBA-to-creatinine ratio identified dogs with hepatic disorders nearly as well as the SBA test.  相似文献   

20.
Biochemical evaluation of the hepatobiliary system in dogs and cats   总被引：1，自引：0，他引：1  
The causes and clinical signs of hepatobiliary involvement in disease are many and varied and often are not referable directly to this organ system. Laboratory investigation frequently is necessary to rule hepatic disease in or out, to assess the functional impact on the liver, and to decide whether hepatic disease is the patient's primary problem or a complication of something else. The selection and interpretation of laboratory tests to resolve these problems is based on an understanding of relevant functional anatomy and pathophysiology. The mainstay of such assessment is hepatic enzymology, which can detect active disease in both hepatocytes and the biliary system. The hepatocellular pattern of disease is characterized by increases in leakage enzymes such as SDH, GLDH, and ALT and the cholestatic pattern by increases in induced enzymes (ALP and GGT). In general, enzymology does not allow the intensity or functional effect of hepatobiliary disease to be assessed, and quite severe hepatopathies may have only minimal enzyme abnormalities. For this reason, the primary biochemical data base for ruling hepatobiliary disease in or out always should involve some screening tests of hepatic function, such as albumin, protein, bilirubin, glucose, or urea determinations; as well as urinalysis to search for bilirubinuria and urobilinogenuria in hyperbilirubinemic patients and for ammonium biurate crystals when hyperammonemia or hepatic encephalopathy is suspected. Because the liver synthesizes most clotting factors, evaluation of blood coagulation is indicated when surgery is contemplated on patients with liver disease or when bleeding is present. Paired pre- and post-prandial determinations of serum bile acids are the preferred method for assessment of hepatobiliary function in dogs and cats. However, the BSP clearance test continues to be useful in the functional assessment of the liver as long as the dye remains available to veterinarians. Clearance of BSP is delayed in hepatocellular, cholestatic, and portosystemic disease as well as by severe extrahepatic circulatory disturbances, In general, this functional test is less sensitive than serum bile acids or the ammonia tolerance test in the recognition of hepatic encephalopathy caused by portosystemic anomalies. The objectives of biochemical screening of the liver are to establish the type (hepatocellular, biliary, or mixed), duration (acute, chronic), and stage (aggressive, convalescent) of hepatobiliary disease and to assess functional status.(ABSTRACT TRUNCATED AT 400 WORDS)  相似文献   

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