Clinical Epidemiology - Liver Enzyme Testing

Introduction

There is limited literature on sensitivity, specificity and predictive values for liver enzyme activity testing. Canine alanine aminotransferase (ALT) activity testing has been reported to have a sensitivity ranging from 45-100%, depending on the liver pathology (acute or chronic hepatopathy, etc.) (1). The predictive value cited for ALT activity testing in this paper was 18%, i.e., an elevated ALT activity testing was predictive for liver disease in 1 of 5 patients. Specificity for canine alkaline phosphatase (ALP) ranged from 44-90% depending on the liver disease in question; its predictive value was 21%, about the same as ALT activity testing. In general, these tests are not ideal for establishing a definitive diagnosis, and follow-up with more specific tests is essential. In this paper we describe Banfield database results for liver enzyme testing, specifically for pets that are reported to be healthy when presented to the veterinarian. [...]