The utility of bile acids in dogs with liver disease | VETgirl Veterinary Continuing Education Podcasts
In this VETgirl online veterinary continuing education podcast, we discuss the utility of bile acid measurements in dogs with various forms of liver disease. Serum bile acids (SBAs) are a common diagnostic test performed in small animal medicine, primarily used to assess liver function. As you know, bile acids are typically measured by performing two separate blood draws. They are first measured with the dog fasted, followed by a postprandial measurement taken 2 hours after eating. The postprandial measurement offers even more sensitive detection of abnormalities, in that clearance of bile acids is challenged by the surge that occurs from eating. When we observe abnormally elevated bile acid levels, there are three broad categories of problems this could indicate. One is liver dysfunction, as bile acids are not being cleared effectively by the liver itself. The second is abnormal blood flow, such as a portosystemic shunt. In this scenario, bile acids are bypassing the liver, and thereby not being cleared from the bloodstream. Lastly, bile stasis for any reason can result in elevated serum bile acids, due to impared excretion. While measurement of SBAs may help identify that a problem is present and offer a sense of the severity of the problem, the assay is less helpful in defining what the underlying problem actually is. So, Pena-Ramos et al sought to compare fasted and postprandial SBAs and to determine their sensitivity and specificity in the context of different types of liver disease in dogs.