Bile acids Flashcards
What are bile acids
Major contributors to bile and a product of cholesterol degradation that is absorbed through the sinusoids and excreted out the canaliculi
Role of bile acids
Facilitate excretion of lipid based compounds and absorption of lipids from gut
Circulation of bile acids
Remain within enterohepatic circulation and very little in systemic circulation
BA
Cholesterol derived anionic acids (cholic acids) and their dissociated anions (bile salts)
Serum bile acids analysis
Enterohepatic circulation is the basis for the test and has the portal venous circulation and hepatic function
Increased bile acid concentration
- Decreased BA clearance from portal blood
- Decreased BA excretion via bile
Decreased BA clearance from portal blood
-Decreased functional hepatic mass
-Portosystemic shunt
Decreased BA excretion via bile
-Obstructive of functional cholestasis
-Sepsis associated cholestasis
Performing a serum bile acids test
Paired samples in red or green top. One before a small meal and one 2hrs after the small meal. Only indicated for non icteric dogs and cats
Why do you want them to eat a small meal before SBA
Get cholecystokinin production release and cause gall bladder contraction but not enough to produce lipemia
Test interferences
Lipemia and hemolysis
What indicates hepatic insufficiency or shunt
fasting BA WRI
Post BA is increased
What can cause falsely low post BA
-Meal doesnt cause gall bladder to empty
-Delayed intestinal transit
-Rapid intestinal transit
-Malabsorption
Pre BA> post
Spontaneous gall bladder emptying before small meal
Random BA
Increased BA provides proof of liver dysfunction and if marked no need for SBA
