Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts

Abstract

Background: Liver function tests do not always normalize despite successful attenuation of extrahepatic portosystemic shunts (EHPSS). Objectives: Assess the lidocaine/monoethylglycylxylidide (MEGX) test to determine liver perfusion after EHPSS closure. Animals: Twenty dogs with EHPSS. Methods: A prospective cohort study was performed and all dogs were tested at diagnosis, 1, 3, and 6 months postoperatively. After collecting a baseline blood sample (T0), 1 mg/kg body weight of lidocaine was injected intravenously. Fifteen (T15) and 30 minutes (T30) later, blood was collected. Plasma concentrations of lidocaine and its metabolites MEGX and glycylxylidide (GX) were determined, using a high-performance liquid chromatography with electrospray ionization tandem mass spectrometry method. Three months postoperatively, transsplenic portal scintigraphy was performed to determine EHPSS closure. Results: At T15, median MEGX concentrations were higher in dogs with closed EHPSS compared to diagnosis (33.73 ng/mL [21.11-66.44 ng/mL] vs 13.74 ng/mL [7.25-21.93 ng/ mL]; P < .001), but were not different (12.

Laparoscopic attenuation of a congenital extrahepatic portosystemic shunt in a dog—a thin-film banding for splenophrenic shunt: A case report

“…Postoperative CTA demonstrated a complete transection of vascular blood continuity, no additional shunt development, and more than two times of hepatic volume expansion in the present case. Recently, measurement of serum hyaluronic acid concentration or injection of lidocaine and measurement of its metabolite, monoethylglycinexylidide, have been proposed as a promising, non-invasive biomarker to determine shunt closure and liver perfusion, and these tests do not require anesthesia ( 29 , 30 ).…”

Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment

“…Limits of detection were .08, .18, and .23 ng/mL, respectively and limits of quantification of lidocaine, MEGX and GX were .25, .50 and 2.5 ng/mL, respectively. Reference limits used for MEGX at T15 and T30 and for GX at T15 and T30 were >23.7, >25.1, >12.4 and >19.8 ng/mL, respectively 16 …”

“…Both might aid the assessment of shunt closure after surgical attenuation of EHPSS in dogs. 16,17 In the L/MEGX test, 1 mg/kg of lidocaine is administered intravenously. 16 The metabolization of lidocaine into MEGX and subsequently into glycylxylidide (GX) is assessed 15 and 30 min after lidocaine administration.…”

“…16,17 In the L/MEGX test, 1 mg/kg of lidocaine is administered intravenously. 16 The metabolization of lidocaine into MEGX and subsequently into glycylxylidide (GX) is assessed 15 and 30 min after lidocaine administration. Lidocaine and its metabolites are analyzed using high-performance liquid chromatography with electrospray ionization tandem mass spectrometry.…”

Serum insulin-like growth factor-1 as a marker of improved liver function and surgical outcome in dogs with congenital extrahepatic portosystemic shunts

“…Frozen leftover serum samples from previous studies involving dogs with cEHPSS and PVH, which were approved by Ghent University Ethical and Deontological committee, were used for this study (EC2012/ 164, 29th November, 2012DC211728/13_21_04, 21st April, 2013;EC2014/179 27th January, 2015DC2015N03 16th March, 2015EC2017/49 7th September, 2017DC2017N06 7th November, 2017Or et al, 2017;Devriendt et al, 2021). The samples were taken between April 2013 and August 2019, remained frozen at − 80 • C after collection and were used for IGF-1 measurement.…”