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Urine bile acids to evaluate liver function in cats
Advances
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were collected from 54 cats with hepatobiliary disease, 17 cats with nonhepatic disorders, and 8 healthy cats. Urine bile acids were measured by a quantitative enzymatic colorimetric method, and results were related to concurrent urine creatinine concentration. Results Significantly higher values of USBAto-creatinine, UNSBA-to-creatinine, and (USBA and UNSBA)-to-creatinine occurred in cats with liver disease than in cats without liver disease. Urine bile acid tests with diagnostic performance equivalent to serum bile acids were the UNSBAto-creatinine and the combined test (USBA and UNSBA-to-creatinine). Author Conclusion Ratios of UNSBA-to-creatinine or USBA and UNSBA-to-creatinine are convenient and reliable diagnostic tests for identifying cats with liver disease. Inclusions One figure, 4 tables, 27 references.
Urine Bile Acids to Evaluate Liver Function in Cats Background Urine bile acid tests may correlate with average serum bile acid concentrations and be more practical to obtain than paired serum bile acid samples in cats. Objectives To evaluate the diagnostic utility of urine sulfated bile acids (USBAs), urine nonsulfated bile acids (UNSBAs), or a combined assessment compared to serum bile acid concentrations. Procedure Routine serum biochemistry tests, serum bile acid concentrations, and urine samples
Editor Annotation Urine bile acids represent the average serum bile acid concentration during the time that urine is formed and are influenced less by transient changes in serum bile acid concentrations. Therefore, measurement of urine bile acids and urine creatinine in a single, randomly obtained urine sample may offer a more convenient diagnostic test for hepatic disease in dogs and cats. This proposed liver function test would not require venipuncture, fasting, or challenge with food. Urine bile acids had a significant positive correlation with serum bile acids in this study of cats with liver disease. The diagnostic accuracy (87%) of the nonsulfated bile acid (UNSBA)-to-creatinine ratio and serum bile acids was the same. The urine sulfated bile acids (USBA) plus UNSBA-to-creatinine ratio was only slightly less accurate in detecting liver disease with a diagnostic accuracy of 85%. These results are consistent with findings in dogs as determined by the same investigators in a different study. The only significant positive correlation in sick cats without liver disease was between the UNSBA-to-creatinine ratio and serum aspartate aminotransferase activity.
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Unlike dogs, healthy cats and cats with liver disease preferentially conjugate bile acids by sulfation and excrete larger quantities of USBA. The concentration of USBA was significantly higher in cats with liver disease than in healthy cats and in sick cats without liver disease. The highest concentrations of USBA-tocreatinine were seen with severe cholestatic disease. The highest specificity (94%) and greatest positive predictive value (98%) of liver disease was determined by the USBA-to-creatinine ratio. (MRK) Trainor D, Center SA, Randolph JF, et al. Urine sulfated and nonsulfated bile acids as a diagnostic test for liver disease in cats. J Vet Intern Med 2003;17:145-153.
Advances
Page 5
were collected from 54 cats with hepatobiliary disease, 17 cats with nonhepatic disorders, and 8 healthy cats. Urine bile acids were measured by a quantitative enzymatic colorimetric method, and results were related to concurrent urine creatinine concentration. Results Significantly higher values of USBAto-creatinine, UNSBA-to-creatinine, and (USBA and UNSBA)-to-creatinine occurred in cats with liver disease than in cats without liver disease. Urine bile acid tests with diagnostic performance equivalent to serum bile acids were the UNSBAto-creatinine and the combined test (USBA and UNSBA-to-creatinine). Author Conclusion Ratios of UNSBA-to-creatinine or USBA and UNSBA-to-creatinine are convenient and reliable diagnostic tests for identifying cats with liver disease. Inclusions One figure, 4 tables, 27 references.
Urine Bile Acids to Evaluate Liver Function in Cats Background Urine bile acid tests may correlate with average serum bile acid concentrations and be more practical to obtain than paired serum bile acid samples in cats. Objectives To evaluate the diagnostic utility of urine sulfated bile acids (USBAs), urine nonsulfated bile acids (UNSBAs), or a combined assessment compared to serum bile acid concentrations. Procedure Routine serum biochemistry tests, serum bile acid concentrations, and urine samples
Editor Annotation Urine bile acids represent the average serum bile acid concentration during the time that urine is formed and are influenced less by transient changes in serum bile acid concentrations. Therefore, measurement of urine bile acids and urine creatinine in a single, randomly obtained urine sample may offer a more convenient diagnostic test for hepatic disease in dogs and cats. This proposed liver function test would not require venipuncture, fasting, or challenge with food. Urine bile acids had a significant positive correlation with serum bile acids in this study of cats with liver disease. The diagnostic accuracy (87%) of the nonsulfated bile acid (UNSBA)-to-creatinine ratio and serum bile acids was the same. The urine sulfated bile acids (USBA) plus UNSBA-to-creatinine ratio was only slightly less accurate in detecting liver disease with a diagnostic accuracy of 85%. These results are consistent with findings in dogs as determined by the same investigators in a different study. The only significant positive correlation in sick cats without liver disease was between the UNSBA-to-creatinine ratio and serum aspartate aminotransferase activity.
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Unlike dogs, healthy cats and cats with liver disease preferentially conjugate bile acids by sulfation and excrete larger quantities of USBA. The concentration of USBA was significantly higher in cats with liver disease than in healthy cats and in sick cats without liver disease. The highest concentrations of USBA-tocreatinine were seen with severe cholestatic disease. The highest specificity (94%) and greatest positive predictive value (98%) of liver disease was determined by the USBA-to-creatinine ratio. (MRK) Trainor D, Center SA, Randolph JF, et al. Urine sulfated and nonsulfated bile acids as a diagnostic test for liver disease in cats. J Vet Intern Med 2003;17:145-153.
Advances