Lapis ISSN 2398-2969

Blood biochemistry: total bilirubin

Synonym(s): Direct and indirect bilirubin, Conjugated and unconjugated bilirubin

Contributor(s): Anna Meredith, Vetstream Ltd, Michael Waters, John Chitty

Overview

  • Peripheral breakdown of red blood cells and myoglobin → unconjugated (indirect) bilirubin → bound to albumin → transported to liver → conjugated with glucuronic acid (direct bilirubin) → excreted in bile.
  • Jaundice, with an increase in total bilirubin, may be primarily due to an increase in direct, or indirect bilirubin or both.
  • Biliverdin is the major bile pigment in rabbits, so elevated levels of bilirubin and icterus (jaundice) are rare in rabbits.
  • Elevations reflect biliary tree disease rather than liver dysfunction.

Sampling

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Tests

Methodologies

  • Van den Bergh method.
  • Measure [total bilirubin] and [direct bilirubin] → [indirect bilirubin] = difference.

Availability

  • Routine test.

Technique (intrinsic) limitations

  • Interpret results in conjunction with other laboratory results.

Technician (extrinsic) limitations

  • Routine test.

Result Data

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Benson K G & Paul-Murphy J (1999) Clinical pathology of the domestic rabbit: acquisition and interpretation of samples. Vet Clin North Am Exotic Anim Pract 2 (3), 539-552 PubMed.

Other sources of information

  • Varga M (2014) Textbook of Rabbit Medicine. 2nd edn. Butterworth Heinemann Elsevier, London, UK.
  • Wesche P (2014) Clinical Pathology. In: BSAVA Manual of Rabbit Medicine. Eds: Meredith A & Lord B. pp 124-137. BSAVA, Gloucester, UK.
  • Saunders R A & Rees Davies R (2005) Notes on Rabbit Internal Medicine. Blackwells, Oxford, UK.
  • Donnelly T M (1997) Basic Anatomy, Pphysiology and Husbandry. In: Ferrets, Rabbits and Rodents - Clinical Medicine and Surgery. Eds: Hillyer E V S & Quesenbery K E. Saunders, Philadelphia, USA. pp 147-159.


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