Peer-reviewed veterinary case report
Using lidocaine blood test to check shunt closure in dogs
By Devriendt, Nausikaa et al.·Published in Journal of veterinary internal medicine·2021·Small Animal Department·View original on PubMed →
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Original publication title: Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts.
- Species:
- dog
Plain-English summary
A group of 20 dogs with extrahepatic portosystemic shunts (EHPSS), a condition affecting liver blood flow, were monitored after surgery to see if their liver function improved. Researchers used a blood test involving lidocaine to measure liver perfusion at different times after the surgery. They found that dogs with successful shunt closure had significantly higher levels of a specific metabolite (MEGX) in their blood compared to when they were first diagnosed. This test could help veterinarians quickly determine if the surgery was successful and if the dog's liver is functioning better.
People also search for: dog liver function test · extrahepatic portosystemic shunt treatment · lidocaine test for dogs
Abstract
BACKGROUND: Liver function tests do not always normalize despite successful attenuation of extrahepatic portosystemic shunts (EHPSS). OBJECTIVES: Assess the lidocaine/monoethylglycylxylidide (MEGX) test to determine liver perfusion after EHPSS closure. ANIMALS: Twenty dogs with EHPSS. METHODS: A prospective cohort study was performed and all dogs were tested at diagnosis, 1, 3, and 6 months postoperatively. After collecting a baseline blood sample (T0), 1 mg/kg body weight of lidocaine was injected intravenously. Fifteen (T15) and 30 minutes (T30) later, blood was collected. Plasma concentrations of lidocaine and its metabolites MEGX and glycylxylidide (GX) were determined, using a high-performance liquid chromatography with electrospray ionization tandem mass spectrometry method. Three months postoperatively, transsplenic portal scintigraphy was performed to determine EHPSS closure. RESULTS: At T15, median MEGX concentrations were higher in dogs with closed EHPSS compared to diagnosis (33.73 ng/mL [21.11-66.44 ng/mL] vs 13.74 ng/mL [7.25-21.93 ng/mL]; P < .001), but were not different (12.28 ng/mL [10.62-23.17 ng/mL] vs 13.74 ng/mL [7.25-21.93 ng/mL]) in dogs with persistent shunting. Sensitivity to determine shunt closure for MEGX at T15 was 96.2% (95% confidence interval [CI]: 78.4-99.8) and specificity 82.8% (95% CI: 63.5-93.5). CONCLUSIONS AND CLINICAL IMPORTANCE: The lidocaine/MEGX test is a promising, rapid, and noninvasive blood test that seems helpful to differentiate dogs with closed EHPSS and dogs with persistent shunting after gradual attenuation.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33432666/