Interpretation of bile acids challenge test: Submit both tubes to Gribbles with the completed request form.

Two hours after feeding, collect the second sampleВ and label with patient name and вЂњ2 hrвЂќ.

Note that a high-fat diet is NOT necessary, and can sometimes contribute to unwanted sample lipemia if given in excess. FeedВ a small amount (2-4 tablespoons)В of canned maintenance-type diet.

Collect theВ first blood sample,В and label the tube with patient name and вЂњ0 hrвЂќ.

Sample haemolysis and lipemia can interfere with bile acids measurement and should be avoided by fasting, using aВ large gauge needle, jugular venepuncture, and separation of the serum after clotting. When used as a screening test in puppies from breeds that are predisposed to congenital portosystemic shunts, it is recommended to delay testing until after 16 weeks of age, as bile acid concentrations may be falsely lower in puppies younger than 16 weeks.In patients with pre-hepatic icterus (haemolysis), a bile acids challenge test can help rule out hepatic aetiology, if not readily apparent. Testing is NOT indicated if the patient is icteric from hepatic or post-hepatic cholestasis, as bile acids will inevitably be high and not provide additional information.Bile acids challenge testingВ should be performed when there are clinical and biochemical findings that suggest liver dysfunction or portosystemic shunting.This increased load can better вЂњchallengeвЂќ the liverвЂ™s ability to clear the increased bile acids presented to it. Feeding stimulates gall bladder contraction and the release of bile acids into the intestine and eventual portal circulation. While biochemical changes including elevated ALT, AST, ALK,В bilirubin with decreased albumin, urea, glucose, and cholesterol,В and prolonged coagulation timesВ may suggest liver failure, these analytes may be in normal reference interval with various liver conditions or be altered by non-hepatic diseases.В They are not reliable primary indicators of liver function compared to bile acids measurement.ДЄ bile acids вЂњchallengeвЂќ test with both a pre- andВ two-hour post-prandial blood collection is recommended over a single fasting or random sample (in dogs and cats) because it has substantially higher sensitivity for detecting disease. This test does not differentiate these underlying types of liver disease.

Serum bile acids concentrations may be elevated in diseased states leading to decreased functional liver mass, with obstructive cholestasis, and with congenital or acquired portosystemic vascular shunts.

Bile acids are derived from cholesterol in the liver, released into the intestineВ after eatingВ to aid in fat absorption, then enter theВ portal circulation to be cleared by the liver and re-excreted into bile. Bile acids measurement is a highly sensitive assay to assess hepatobiliary function.

Changing breeds scids