Diagnostic and predictive ability of hyperbilirubinemia severity in cats: A multicenter retrospective study

Author:

Salord Torres Xavier12ORCID,Jeevaratnam Kamalan2,Schofield Imogen3,Taylor Samantha1245,Stallwood Jennifer6,Heyes Menai7,Hughes Daniel2,Defauw Pieter12ORCID

Affiliation:

1. Lumbry Park Veterinary Specialists (CVS) Alton UK

2. University of Surrey School of Veterinary Medicine Guildford UK

3. CVS Group CVS House Diss UK

4. Linnaeous Veterinary Limited Shirley UK

5. International Society of Feline Medicine Tisbury UK

6. Bristol Veterinary Specialists (former Highcroft Veterinary Referrals) (CVS) Bristol UK

7. ChesterGates Veterinary Specialists (CVS) Chester UK

Abstract

AbstractBackgroundTotal serum bilirubin concentration (TBIL) can provide useful information on several pathophysiological conditions in cats. Nevertheless, whether the variable severity classification of hyperbilirubinemia can reliably indicate certain disease processes or predict a biliary obstruction (BO) has not been investigated.Hypothesis/ObjectiveDetermine if hyperbilirubinemia of variable severity can assist clinicians to identify BO, which often is considered a surgical emergency.AnimalsTwo‐hundred sixteen client‐owned cats.MethodsData were retrospectively collected from all cats (January 2015‐August 2022) with an increased TBIL (>0.58 mg/dL [>10 μmol/L]) presented to 3 referral centers in the United Kingdom (UK). Presenting clinical features and diagnostic outcomes were collected. The predictive ability of TBIL to indicate BO was evaluated by multivariable binary logistic regression modeling and receiver operating characteristic (ROC) curves.ResultsMedian TBIL was 1.73 mg/dL (range, 0.59‐26.15; 29.5 μmol/L; range, 10.1‐447.1) with severity classification of hyperbilirubinemia categorized as mild (>0.58‐2.92 mg/dL; >10‐50 μmol/L; 68.1%), moderate (>2.92‐5.85 mg/dL; >50‐100 μmol/L; 17.6%), severe (>5.85‐11.70 mg/dL; >100‐200 μmol/L; 9.7%) and very severe (>11.70 mg/dL; >200 μmol/L; 4.6%). Biliary obstruction was present in 17 (7.9%) cats, all of which received recommendation for emergency surgery. Median TBIL in cats with BO (9.69 mg/dL; 165.7 μmol/L) differed significantly from those without obstruction (1.51 mg/dL; 25.8 μmol/L; P < .01). The optimal TBIL cut‐off to discriminate between cats with and without BO was ≥3.86 mg/dL (≥66 μmol/L) with a sensitivity of 94.1% and specificity of 82.4%. Using multivariable logistic regression, as age increased, the odds of BO increased significantly (odds ratio, 1.20; 95% confidence interval, 1.01‐1.42; P = .04).Conclusions and Clinical ImportanceAs part of a thorough clinical assessment, the severity classification of hyperbilirubinemia has the potential to predict the likelihood of a BO and to discriminate between cats that may or may not require surgery for BO at a suggested cut‐off of ≥3.86 mg/dL (≥66 μmol/L). Alongside TBIL, age is also useful when assessing for the likelihood of BO in a cat presented with hyperbilirubinemia.

Publisher

Wiley

Reference25 articles.

1. Laboratory evaluation of the;Lawrence YA;Liver,2017

2. Feline infectious peritonitis

3. The molecular pathogenesis of cholestasis in sepsis

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3