ferret - Articles
Blood biochemistry: total bilirubin
Synonym(s): Direct and indirect bilirubin, Conjugated and unconjugated bilirubin
Overview
- Peripheral breakdown of red blood cells and myoglobin → unconjugated (indirect) bilirubin → bound to albumin → transported to liver → conjugated with glucuronic acid (direct bilirubin) → excreted in bile.
- Unconjugated bilirubin is the most clinically significant fraction because it is the form that is most likely to cause tissue damage.
- Jaundice, with an increase in total bilirubin, may be primarily due to an increase in direct, or indirect bilirubin or both.
- Elevations reflect biliary tree disease rather than liver dysfunction.
Uses
In combination
- With direct bilirubin:
- Hemolytic crisis.
- Internal hemorrhage.
- Intra-hepatic and post-hepatic biliary obstruction.
Other points
- If levels are high, consider complete blood count, chemistry panel, urinalysis, bile acids Blood biochemistry: bile acids, and abdominal radiography/ultrasound.
Sampling
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Tests
Methodologies
- Van den Bergh method.
- Measure [total bilirubin] and [direct bilirubin] → [indirect bilirubin] = difference.
Availability
- Routine test.
Validity
Sensitivity
- Increased bilirubin level in the ferret is not reliable for significant liver damage and jaundice is found only occasionally.
Specificity
- Serum bilirubin depends on functionality of liver parenchyma and alteration of the biliary tract.
Technique intrinsic limitations
- Interpret results in conjunction with other laboratory results.
Technician extrinsic limitations
- Routine test.
Result Data
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Vilalta L, Espada Y & Majó N (2016) Liver lobe torsion in a domestic ferret (Mustela putorius furo). Journal of Exotic Pet Medicine 25 (4), 321-326 VetMedResource.
- Kaye S W, Ossiboff R J, Noonan B et al (2015) Biliary coccidiosis associated with immunosuppressive treatment of pure red cell aplasia in an adult ferret (Mustela putorius furo). Journal of Exotic Pet Medicine 24 (2), 215-222 VetMedResource.
- Hein J, Spreyer F, Sauter-Louis C et al (2012) Reference ranges for laboratory parameters in ferrets. Vet Rec 171, 218 PubMed.
- Hauptman K, Tichy F & Znotek Z (2001) Clinical diagnostics of hepatopathies in small mammals: evaluation of importance of individual methods. Acta Vet Brno 70, 297-311.
Other sources of information
- Mayer J & Donnelly T M (2013) Clinical Veterinary Advisor: Birds and Exotic Pets. Elsevier, USA. pp 752.