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e-Article

Diagnostic and predictive ability of hyperbilirubinemia severity in cats: A multicenter retrospective study
Document Type
article
Source
Journal of Veterinary Internal Medicine, Vol 38, Iss 2, Pp 1043-1050 (2024)
Subject
biliary
bilirubin
icterus
jaundice
liver
obstruction
Veterinary medicine
SF600-1100
Language
English
ISSN
1939-1676
0891-6640
Abstract
Abstract Background Total 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/Objective Determine if hyperbilirubinemia of variable severity can assist clinicians to identify BO, which often is considered a surgical emergency. Animals Two‐hundred sixteen client‐owned cats. Methods Data 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. Results Median 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