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Blood biochemistry: alkaline phosphatase

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Synonym(s): ALP, Serum alkaline phosphatase, SAP

Overview

  • Number of isoenzymes produced in a range of tissues.
  • Increased plasma levels are derived from liver and bone and intestine.
  • Good indicator of cholestasis - increases before plasma bilirubin.
  • Non-specific for liver disease as may rise in extra-hepatic cholestasis, bone disease/fractures, intestinal disease.

Uses

Alone

  • Cholestasis.
  • Bone disease/remodeling.

In combination

  • Liver disease.
  • Intestinal disease.
  • Useful to distinguish liver/bone disease from tissue damage (handling/venipuncture) as ALKP does not rise in these situations whereas CK does.

Sampling

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Tests

Methodologies

  • Method and normal range may vary between laboratories.
  • Electrophoretic or other separation method necessary to measure activity of individual isoenzymes.

Availability

  • Routine test.

Technique intrinsic limitations

  • Test results most significant when interpreted in conjunction with other laboratory results and clinical findings.

Result Data

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource
  • Meredith A & Rayment L (2000) Liver disease in rabbits. Sem Avian Exotic Pet Med 9 (3), 146-152.
  • Benson K G & Paul-Murphy J (1999) Clinical pathology of the domestic rabbit: acquisition and interpretation of samples. Vet Clin North Am Exotic Anim Pract 2 (3), 539-552 PubMed.

Other sources of information

  • Bourne D (2016) Clinical Pathology of Lagomorphs. In: Wildpro. Website: http://wildpro.twycrosszoo.org
  • Wesche P (2014) Clinical Pathology. In: BSAVA Manual of Rabbit Medicine.Eds: Meredith A & Lord B. BSAVA, UK. pp 124-137.
  • Varga M (2014) Laboratory Medicine. Avian and Exotic Pets. W B Saunders Co. ISBN: 0721676790.
  • Fudge A M (1999) Laboratory Medicine. Avian and Exotic Pets. W B Saunders Co. ISBN: 0721676790.