# The Diagnostic Value of Serum Amyloid A and Other Laboratory and Clinical Variables in Cats with Increased Liver Enzyme Activity

## TL;DR

This study shows that Serum Amyloid A (SAA) levels can help distinguish between different causes of elevated liver enzymes in cats, including trauma and severe hepatic lipidosis.

## Contribution

The study demonstrates that SAA is a useful biomarker for differentiating between clinical disease categories and cytological findings in cats with elevated liver enzymes.

## Key findings

- Cats with trauma had higher SAA levels compared to those with other diseases.
- Cats with severe hepatic lipidosis had lower SAA and were younger than those with other cytological findings.

## Abstract

In this retrospective medical record study, we evaluated if certain diagnostic variables, including Serum Amyloid A (SAA), could differentiate (1) between various clinical disease categories and (2) between cytological findings of severe hepatic lipidosis and other cytological findings in cats diagnosed with increased liver enzymes at a Swedish animal hospital. Grouping into four clinical disease categories (primary liver diseases, trauma, extrahepatic diseases, and other non-specified diagnoses) was based on clinical diagnosis or information from medical records. Serum Amyloid A was found to be higher in the group of cats with diagnoses supporting trauma. Cats with cytological findings supporting severe hepatic lipidosis had lower SAA and were younger, compared to cats with other cytological findings.

Distinguishing inflammatory from non-inflammatory liver disease in cats may impact management. The study aim was to evaluate if certain diagnostic variables, including Serum Amyloid A (SAA), differ (1) between various clinical disease categories (Primary liver disease, Extrahepatic, Trauma and Inconclusive) and (2) between cytological findings of severe hepatic lipidosis and other cytological findings in cats with increased liver enzymes. Medical records from 5042 cats, where SAA had been measured, were reviewed, and 566 cats fulfilled inclusion criteria consisting of increased liver enzymes and available biochemical panel results. SAA was higher in cats diagnosed with trauma compared to other diseases (p = 0.008). Cytology results were available in 85 cats, and cats with severe lipidosis had lower serum SAA concentration (p < 0.0001) and were younger (p < 0.0002) compared to cats with other cytological findings. The study shows that SAA was higher in cats diagnosed with trauma compared to cats with other causes of increased liver enzymes and that SAA may be useful to distinguish cats with cytologic evidence of hepatic lipidosis from cats with other liver pathologies. Serum Amyloid A may be a valuable complement to liver cytology when investigating cats with increased liver enzymes.