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Blood biochemistry: alkaline phosphatase
Synonym(s): ALP, Serum alkaline phosphatase, SAP
Overview
- Numerous isoenzymes produced in a range of tissues.
- Increased plasma levels are derived from liver, bone and intestine.
- ALKP also found in placenta and leukocytes.
- Good indicator of cholestasis - increases before plasma bilirubin.
- Non-specific for liver (hepatobiliary) disease as may rise in extra-hepatic cholestasis, bone disease/fractures, intestinal and renal 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.
Other points
- Growing animals have elevated ALKP.
- Combine with ultrasonography and radiography to evaluate exact nature of hepatic disease or bone abnormalities.
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.
Validity
Sensitivity
- Reported cases of cholestasis in ferrets indicate good sensitivity for this problem.
Specificity
- High values in the absence of bone pathology or growth may be quite indicative of cholestasis, but overall ALKP has low specificity due to the fact that it is produced in several tissues.
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.
- Hein J, Spreyer F & Sauter-Louis C et al (2012) Reference ranges for laboratory parameters in ferrets. Vet Rec 171, 218 PubMed.
- Hall B A & Ketz-Riley C J (2011) Cholestasis and cholelithiasis in a domestic ferret (Mustela putorius furo). J Vet Diag Invest 23 (4), 836-839 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.
- Fudge A M (1999) Laboratory Medicine. Avian and Exotic Pets. W B Saunders Co. ISBN: 0721676790.