Peer-reviewed veterinary case report
Fasting ammonia and bile acid tests to detect liver shunts in dogs
By Gerritzen-Bruning, M J et al.·Published in Journal of veterinary internal medicine·2006·Department of Clinical Sciences of Companion Animals, Netherlands·View original on PubMed →
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Original publication title: Diagnostic value of fasting plasma ammonia and bile acid concentrations in the identification of portosystemic shunting in dogs.
- Species:
- dog
Plain-English summary
A group of dogs with suspected liver issues underwent tests to check for portosystemic shunting, a condition where blood bypasses the liver. The tests measured fasting plasma ammonia and bile acid levels. Results showed that ammonia levels were very effective in identifying the condition, with a 98% success rate, while bile acids were less reliable. This means that if your dog is diagnosed with liver problems, a high ammonia level could indicate portosystemic shunting, and your vet may recommend further evaluation or treatment based on these results.
People also search for: dog liver disease symptoms · portosystemic shunting diagnosis · high ammonia levels in dogs
Abstract
Portosystemic shunting occurs frequently either as congenital anomalies of the portal vein (PVA) or as acquired shunting (AS) due to portal hypertension secondary to parenchymal liver disease or portal vein thrombosis. The 2 most commonly used screening tests for portosystemic shunting are bile acid and plasma ammonia concentrations. The purpose of this study was to compare the 12-hour fasting plasma ammonia (AMM) and bile acid concentration (BA) as tests for diagnosing portosystemic shunting. Medical records of 337 dogs were used in which AMM and BA were measured simultaneously and in which portosystemic shunting was confirmed or excluded. These dogs were divided into 2 groups (group 1: portosystemic shunting present, n = 153, and group 2: portosystemic shunting absent, n = 184). Group 1 was subdivided into 2 subgroups (group 1a: PVA, n = 132 and group 1b: AS, n = 21). The sensitivity of AMM in detecting PVA was 100% and of BA was 92.2%. For portosystemic shunting in general (PVA or AS), the sensitivity of AMM was 98% and that of BA was 88.9%. The specificity in the total population of AMM was 89.1% and that of BA was 67.9%. If only dogs with liver diseases were included with (n = 153) or without (n = 28) shunting, the specificity of AMM to detect shunting was 89.3% and that of BA was 17.9%. In conclusion, AMM is a highly sensitive and specific parameter to detect PVA and portosystemic shunting in a general population and in dogs with liver disease, whereas BA is somewhat less sensitive and considerably less specific.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/16496918/