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Blood biochemistry: bile acid stimulation test
Synonym(s): Bile salts, BST, Bile acids
Overview
- Cholic and chenodeoxycholic acids (primary bile acids) synthesized in liver from cholesterol → conjugated with taurine (preferred) or glycine and excreted in bile as their sodium salts (bile salts).
- Discharged at time of eating to small intestine where they assist in fat digestion.
- Only 2-5% of total bile acids are lost in faces each day - remainder resorbed, pass to the liver where extracted and re-excreted (enteropathic circulation).
- Small proportion reach general circulation - it is these that are measured.
- Sensitive indicator of liver function and of integrity of liver, biliary and intestinal circulation.
Uses
Alone
- Liver function Liver function assessment.
Post-prandial bile acid concentration reported to have the highest sensitivity of any single test for the diagnosis of feline liver disease. - Portosystemic shunt Congenital portosystemic shunt (CPSS).
Sampling
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Tests
Methodologies
- Enzymatic: more common (and accurate).
- Radio-immunoassay (RIA) (uncommon in veterinary laboratories).
Availability
- Commercial laboratory.
Technique intrinsic limitations
- Measurements of total serum bile acids (TSBA) not indicated when jaundice is present because hyperbilirubinemia is present and increased affecting TSBA.
- TSBA may be warranted in icteric animal if hemolysis cannot be ruled out. If hemolytic disease is the cause of jaundice TSBA are expected to be within normal limits.
- RIA method less accurate.
- Interpret results in conjunction with other laboratory results (liver enzymes) and/or liver biopsy.
Technician extrinsic limitations
- Depends on methodology.
Result Data
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Further Reading
Publications
Refereed papers
- Recent references from VetMedResource and PubMed.
- Center S A, Erb H N & Joseph S A (1995) Measurement of Serum Bile and Concentrations for Diagnosis of Hepatobiliary Disease in Cats. JAVMA 207, 1048-1054.
- Sutherland R J (1989) Biochemical evaluation of the hepatobiliary system in Dogs and Cats. Vet Clin North Am Small Anim Pract 19 (5), 899-927.
- Center S A, Bladwin B H, Erb H & Tennant B C (1986) Bile acid concentrations in the diagnosis of hepatobiliary disease in the cat. JAVMA 189 (8), 891-896.
- Center S A, Bladwin B H, King J M & Tennant B C (1983) Hematologic and biochemical abnormalities associated with induced extrahepatic bile duct obstruction in the cat. Am J Vet Res 44 (10), 1822-1829.
Other sources of information
- Ettinger S J & Feldman E C (2000) Eds. Textbook of Veterinary Internal Medicine. 5th edn. W B Saunders & Co, USA.
- Kaneko J J, Harvey J W & Brass M L (1997) Eds. Clinical Biochemistry of Domestic Animals. 5th edn. Academic Press, USA.
- Duncan J R, Prasse K W & Mahaffey E A (1994) Veterinary Laboratory Medicine. Clinical Pathology. 3rd edn. Iowa University Press, USA.