Serum hyaluronic acid, a marker for improved liver perfusion after gradual surgical attenuation of extrahepatic portosystemic shunt closure in dogs

Devriendt, Nausikaa; Serrano, Gonçalo; Meyer, Evelyne; Demeyere, Kristel; Paepe, Dominique; Vandermeulen, Eva; Stock, Emmelie; Rooster, H. de

doi:10.1016/j.tvjl.2020.105604

Cited by 7 publications

(14 citation statements)

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“…The main disadvantage of SHA is that it currently can only be measured with an ELISA kit, making it impractical to determine values in individual dogs. 17 Nevertheless, conversion to automated or point-of-care immonoassays can overcome this issue. Furthermore, in this study, a different dilution was used to analyze samples from closed EHPSS versus those with persistent shunting in order to obtain results that would fall within the results of the standard curve.…”

Section: Discussionmentioning

confidence: 99%

“…Serum hyaluronic acid, to the contrary, seems to be already a valuable blood test as soon as 1 month postoperatively to determine shunt closure in dogs after gradual attenuation of an EHPSS. Serum hyaluronic acid solely assesses hypoperfusion of the liver 17 . Although clinical signs in dogs with portosystemic shunting are mainly caused by liver hypoperfusion, some degree of liver dysfunction seems to be present.…”

Section: Discussionmentioning

confidence: 99%

“…Serum samples were used to determine SHA concentrations using a commercial enzyme linked immunosorbent assay (ELISA) kit (Hyaluronan Quantikine, R&D Systems, Abingdon, United Kingdom), according to the manufacturer's instructions. Different dilutions were used for “diseased” samples (samples at diagnosis and postoperative samples of dogs with persistent shunting; 1/20 dilution) and “healthy” samples (all postoperative samples of dogs with closed EHPSS as determined 3 months postoperatively by TSPS; ¼ dilution) 17 . The upper reference limit used for SHA was 55.9 ng/ml 17 …”

Section: Methodsmentioning

confidence: 99%

“…Different dilutions were used for “diseased” samples (samples at diagnosis and postoperative samples of dogs with persistent shunting; 1/20 dilution) and “healthy” samples (all postoperative samples of dogs with closed EHPSS as determined 3 months postoperatively by TSPS; ¼ dilution) 17 . The upper reference limit used for SHA was 55.9 ng/ml 17 …”

Section: Methodsmentioning

confidence: 99%

“…Hyaluronic acid is a linear heteropolysaccharide, which is secreted in various (connective) tissues and rapidly catabolized by hepatic endothelial cells once reaching the blood 20,21 . Consequently, SHA is an endogenous marker that can aid in the determination of the presence of hepatic hypoperfusion 17 …”

Section: Introductionmentioning

confidence: 99%

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Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment

et al. 2022

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Objective: To determine the sensitivity and specificity of different individual and combined blood tests to assess extrahepatic portosystemic shunt (EHPSS) closure after gradual attenuation of EHPSS in dogs. Study design: Clinical prospective study. Animals: Twenty client-owned dogs with EHPSS. Methods: Fasting ammonia (FA), preprandial, postprandial, and paired serum bile acids (SBA), the lidocaine/monoethylglycylxylidide (L/MEGX) test, and serum hyaluronic acid (SHA) were performed at diagnosis, and 1, 3, and 6 months postoperatively. Transsplenic portal scintigraphy was performed to determine EHPSS closure 3 months postoperatively. Their sensitivity and specificity in determining shunt closure postoperatively were calculated.Results: When assessing a single blood parameter, FA had the highest specificity (100%), whereas SHA and MEGX measured 15 min after lidocaine administration (T15) had the highest sensitivity (96.9% and 96.2%, respectively) for determining shunt closure postoperatively. The most promising blood test combinations were SHA (sensitivity 96.9%, specificity 81.8%), combined with the L/MEGX test (MEGX at T15: sensitivity 100%, specificity 72.4%) or the L/MEGX test (MEGX at T15) combined with either FA (sensitivity 100%, specificity 82.8%) or postprandial SBA (sensitivity 100%, specificity 81.5%). Conclusion:Both SHA and the L/MEGX test were sensitive tests for determining shunt closure after gradual attenuation of EHPSS. Test performances could even be improved by combining these tests with each other or with traditional tests such as FA or postprandial SBA.Clinical significance: Although SHA and the L/MEGX test are sensitive blood tests for determining EHPSS closure, especially when combined with traditional blood tests, imaging is still needed to confirm EHPSS closure.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%