Increased Bile Acids

Todd Archer, DVM, MS, DACVIM (SAIM), Mississippi State University

ArticleLast Updated July 20231 min readPeer Reviewed
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Following are differential diagnoses for patients presented with increased bile acids: 

  • Abnormal portal blood flow  

    • Microvascular dysplasia 

    • Portosystemic shunts 

    • Other congenital vascular anomalies 

  • Cholestatic disease 

    • Extrahepatic biliary obstruction (hyperbilirubinemia often present) 

    • Fibrosis 

    • Hepatic lipidosis 

    • Inflammation or infection (hepatitis/cholangiohepatitis) 

    • Neoplasia 

    • Toxin or drug hepatopathy 

  • Hepatocellular dysfunction or failure 

    • Fibrosis   

    • Hepatic lipidosis 

    • Inflammation or infection (hepatitis/cholangiohepatitis) 

    • Neoplasia 

    • Toxin or drug hepatopathy 

  • Interference 

    • Bile acids should not be measured in patients with hyperbilirubinemia    

    • Lipemia falsely increases bile acid values 

    • Hemolysis falsely decreases bile acid values