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Laboratory Tests for Liver Disease
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The role of the liver in intermediary metabolism
The liver is involved in many aspects of intermediary metabolism (1). The laboratory testing of liver function usually involves some aspect of the liver’s role in intermediary metabolism.
Carbohydrate metabolism
The liver is at the center of carbohydrate metabolism through its role in maintaining normoglycemia. Carbohydrate stored in the liver as glycogen is hydrolyzed to glucose via glycogenolysis when a need for glucose develops. When the glycogen available is insufficient, glucose is produced from amino acids by gluconeogenesis. Glucose is also produced from glycerol and intermediates of glycolysis, such as lactic acid and pyruvic acid. With inadequate carbohydrate in the diet, blood glucose is maintained at the expense of body proteins. Body lipid stores are also depleted during starvation, although lipids do not participate in the maintenance of blood glucose other than serving as an alternate source of energy, since glucose cannot be synthesized from fatty acids. [...]
Key Points
- The laboratory testing of liver function usually involves some aspect of the liver’s role in intermediary metabolism. A good understanding of the liver’s basic functions will assist interpretation of results.
- In animals with suspected liver disease, the minimum database should include complete blood count, serum chemistry, urinalysis, and fecal flotation.
- Survey abdominal radiography should be performed as part of the minimum database in any animal suspected as having liver disease. Additional laboratory tests and imaging studies (e.g. ultrasound) may be considered following development of the minimum database.
- Acute and chronic liver diseases may be accompanied by a diverse range of other abnormalities including hyperammonemia, elevated bile acids, heavy metal accumulations and coagulopathies.
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