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Why Is My Dog's Bile Acid Assay Abnormal ?

Why Is My Cat's Bile Acid Assay Abnormal ?



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Ron Hines DVM PhD


The Bile Acids Level In Your Pet’s Blood

Bile acids are formed in your cat or dog ’s liver. As a portion of your pet’s bile, these acids pass through your pet’s gall bladder and bile ducts in the form of bile salts. They then move on into the pet's upper intestine to aid in the digestion of fats.

A large portion of those bile acids are eventually reabsorbed into your pet's body and returned to its liver through the blood stream. They are then re-secreted into the bile in an endless cycle. When your pet's liver cells (hepatocytes) are injured, the level of bile acids in its blood tend to increase.(ref)

So a bile acid determination on your dog or cat’s blood can be a very good way for your veterinarian to detect liver problems, particularly when your pet’s ALT and bilirubin tests are only borderline elevated and difficult to interpret. Two tests are often run, one after your pet has fasted and another two hours after a light meal.

Health Problems That Can Causes Bile Acid Levels To Be Elevated In Your Pet :

Many forms of liver disease, abnormal liver blood flow (portosystemic shunts), impaired gall bladder and bile duct function (cholestasis, biliary obstruction), gallstones, liver cancer, Cushing’s disease, pancreatitis, hepatic encephalopathy (the liver can no longer render your pet's blood ammonia non-toxic) can all cause your pet to have abnormally high bile acid levels.

Cats that have developed hepatic lipidosis because they are not eating often have abnormally high bile acid values due to a taurine deficiency. (ref) The same situation can occur when they are fed unbalanced taurine-deficient vegetarian diets.

Lipemic blood samples can falsely increase bile acid readings.

An abnormal bile acid test is not unusual in toy breeds experiencing hepatic microvascular dysplasia.

Health Problems That Can Cause Bile Acid Levels To Be Low In Your Pet :

Long-standing intestinal disease (such as IBD when the upper portions of your pet's remain inflamed) , poor nutrient absorption (mal- absorption/maldigestion), persistent diarrhea and starvation can all lower blood bile acid readings.

Serum bile acids can also be falsely reported as low if the blood sample was hemolized or lipemic. Low bile acid levels can also result in a fat-soluble vitamin deficiency (A,D,E & K).

Dogs less than 16 weeks old may naturally have lower levels. I do not know if the is also the case in kittens.

Complementary Tests :

AP, GGT, Albumin, BUN, AST, ALT, GLDH, bilirubin, Liver biopsy, after-eating bile acid results compared to fasting test results (dynamic bile acid test), liver ultrasound, blood ammonia level
