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

Author
Organization
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 (12.28 ng/mL [10.62-23.17 ng/mL] vs 13.74 ng/mL [7.25-21.93 ng/mL]) in dogs with persistent shunting. Sensitivity to determine shunt closure for MEGX at T15 was 96.2% (95% confidence interval [CI]: 78.4-99.8) and specificity 82.8% (95% CI: 63.5-93.5). Conclusions and Clinical Importance: The lidocaine/MEGX test is a promising, rapid, and noninvasive blood test that seems helpful to differentiate dogs with closed EHPSS and dogs with persistent shunting after gradual attenuation.

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MLA
Devriendt, Nausikaa, et al. “Evaluation of Serum Lidocaine/Monoethylglycylxylidide Concentration to Assess Shunt Closure in Dogs with Extrahepatic Portosystemic Shunts.” Journal of Veterinary Internal Medicine, 2021, doi:10.111/jvim.16030.
APA
Devriendt, N., Serrano, G., Croubels, S., Stock, E., Vandermeulen, E., Paepe, D., … De Rooster, H. (2021). Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts. Journal of Veterinary Internal Medicine. https://doi.org/10.111/jvim.16030
Chicago author-date
Devriendt, Nausikaa, Gonçalo Serrano, Siska Croubels, Emmelie Stock, Eva Vandermeulen, Dominique Paepe, Jennifer von Luckner, and Hilde De Rooster. 2021. “Evaluation of Serum Lidocaine/Monoethylglycylxylidide Concentration to Assess Shunt Closure in Dogs with Extrahepatic Portosystemic Shunts.” Journal of Veterinary Internal Medicine. https://doi.org/10.111/jvim.16030.
Chicago author-date (all authors)
Devriendt, Nausikaa, Gonçalo Serrano, Siska Croubels, Emmelie Stock, Eva Vandermeulen, Dominique Paepe, Jennifer von Luckner, and Hilde De Rooster. 2021. “Evaluation of Serum Lidocaine/Monoethylglycylxylidide Concentration to Assess Shunt Closure in Dogs with Extrahepatic Portosystemic Shunts.” Journal of Veterinary Internal Medicine. doi:10.111/jvim.16030.
Vancouver
1.
Devriendt N, Serrano G, Croubels S, Stock E, Vandermeulen E, Paepe D, et al. Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts. Journal of Veterinary Internal Medicine. 2021;
IEEE
[1]
N. Devriendt et al., “Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts,” Journal of Veterinary Internal Medicine, 2021.
@article{8686987,
  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 (12.28 ng/mL [10.62-23.17 ng/mL] vs 13.74 ng/mL
[7.25-21.93 ng/mL]) in dogs with persistent shunting. Sensitivity to determine shunt closure
for MEGX at T15 was 96.2% (95% confidence interval [CI]: 78.4-99.8) and specificity 82.8%
(95% CI: 63.5-93.5).
Conclusions and Clinical Importance: The lidocaine/MEGX test is a promising, rapid,
and noninvasive blood test that seems helpful to differentiate dogs with closed
EHPSS and dogs with persistent shunting after gradual attenuation.},
  author       = {Devriendt, Nausikaa and Serrano, Gonçalo and Croubels, Siska and Stock, Emmelie and Vandermeulen, Eva and Paepe, Dominique and von Luckner, Jennifer and De Rooster, Hilde},
  journal      = {Journal of Veterinary Internal Medicine},
  language     = {und},
  title        = {Evaluation of serum lidocaine/monoethylglycylxylidide concentration to assess shunt closure in dogs with extrahepatic portosystemic shunts},
  url          = {http://dx.doi.org/10.111/jvim.16030},
  year         = {2021},
}

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