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Devriendt et al: Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment
Veterinary Surgery 7, 2022

🔍 Key Findings

  • Fasting ammonia (FA) was the most specific test (100%) for confirming EHPSS closure postoperatively.
  • Serum hyaluronic acid (SHA) and MEGX at 15 minutes post-lidocaine were the most sensitive tests (96.9% and 96.2%, respectively).
  • SHA combined with MEGX T15, or with FA or postprandial serum bile acids (SBA), provided 100% sensitivity with good specificity (72.4–82.8%).
  • SHA levels remained elevated in all dogs with persistent shunting, even when other tests were normal.
  • Paired SBA had moderate sensitivity (90%) and variable specificity (89%).
  • The L/MEGX test at 30 min was less useful than at 15 min for assessing closure.
  • Traditional SBA testing showed reduced utility postoperatively; normal values did not rule out persistent shunting.
  • Blood tests improved when combined, but imaging remains essential to definitively confirm EHPSS closure.

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← Articles

Devriendt et al: Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment
Veterinary Surgery 7, 2022

🔍 Key Findings

  • Fasting ammonia (FA) was the most specific test (100%) for confirming EHPSS closure postoperatively.
  • Serum hyaluronic acid (SHA) and MEGX at 15 minutes post-lidocaine were the most sensitive tests (96.9% and 96.2%, respectively).
  • SHA combined with MEGX T15, or with FA or postprandial serum bile acids (SBA), provided 100% sensitivity with good specificity (72.4–82.8%).
  • SHA levels remained elevated in all dogs with persistent shunting, even when other tests were normal.
  • Paired SBA had moderate sensitivity (90%) and variable specificity (89%).
  • The L/MEGX test at 30 min was less useful than at 15 min for assessing closure.
  • Traditional SBA testing showed reduced utility postoperatively; normal values did not rule out persistent shunting.
  • Blood tests improved when combined, but imaging remains essential to definitively confirm EHPSS closure.

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Multiple Choice Questions on this study

In Devriendt 2022 et al., on EHPSS blood testing, what was a noted **limitation** of the SHA test in clinical practice?

A. Low sensitivity in detecting persistent shunting
B. Requires dogs to eat before testing
C. Limited availability of high-performance liquid chromatography
D. Can only be measured by ELISA, limiting routine use
E. Requires multiple blood samples over 24 hours

Answer: Can only be measured by ELISA, limiting routine use

Explanation: SHA requires ELISA for measurement, limiting its practicality in everyday clinical settings.
In Devriendt 2022 et al., on EHPSS blood testing, which single test had the highest **specificity** for confirming shunt closure after surgery?

A. Fasting ammonia (FA)
B. Serum hyaluronic acid (SHA)
C. Paired serum bile acids
D. MEGX at 15 minutes
E. MEGX at 30 minutes

Answer: Fasting ammonia (FA)

Explanation: FA had 100% specificity, making it the most specific single test to confirm shunt closure.
In Devriendt 2022 et al., on EHPSS blood testing, which **two tests** had the highest sensitivity for detecting shunt closure?

A. Postprandial serum bile acids (SBA) and FA
B. SHA and MEGX at 15 minutes
C. FA and MEGX at 30 minutes
D. SHA and postprandial SBA
E. Paired SBA and MEGX at 30 minutes

Answer: SHA and MEGX at 15 minutes

Explanation: SHA (96.9%) and MEGX T15 (96.2%) were the most sensitive single tests for detecting EHPSS closure.
In Devriendt 2022 et al., on EHPSS blood testing, which **combination** of tests yielded 100% sensitivity for confirming shunt closure?

A. SHA + postprandial SBA
B. Paired SBA + FA
C. FA + preprandial SBA
D. MEGX T15 + GX T30
E. GX T15 + postprandial SBA

Answer: SHA + postprandial SBA

Explanation: Combinations like SHA with MEGX T15 or SHA with postprandial SBA yielded 100% sensitivity with good specificity.
In Devriendt 2022 et al., on EHPSS blood testing, which statement about postoperative SBA values is most accurate?

A. Normal SBA values reliably indicate shunt closure.
B. SBA values consistently normalize within 1 month.
C. Postoperative SBA values have limited utility in ruling out persistent shunting.
D. Postprandial SBA is more reliable than SHA in diagnosing closure.
E. Paired SBA values outperform FA in specificity.

Answer: Postoperative SBA values have limited utility in ruling out persistent shunting

Explanation: Normal SBA values do not guarantee shunt closure; persistent shunting may still be present.

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