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Total bilirubin

Chemistry ·Also called: TBIL, total bili, bilirubin total, jaundice, icterus

What it is

Bilirubin is a waste product of haemoglobin recycling. The liver takes it up, modifies it, and excretes it in bile. Total bilirubin is what is measured on most panels; a laboratory can split it into direct and indirect fractions to help localise the problem.

Why your vet measures it

Bilirubin is one of the few lab values with a visible counterpart. Once it climbs far enough, the whites of the eyes, the gums and the inside of the ears turn yellow — jaundice. Finding it on a panel before the yellowing is obvious buys time.

What a high result can mean

  • Destruction of red blood cells, such as immune-mediated haemolytic anaemia or a toxin
  • Liver disease severe enough to impair processing — hepatitis, lipidosis, cirrhosis, tumours
  • Obstruction of bile flow by a stone, a mass, or swelling from pancreatitis
  • Sepsis, which can raise bilirubin without a primary liver problem
  • Prolonged fasting in cats

What a low result can mean

  • Not clinically significant

Dogs and cats differ

In cats, jaundice with a history of not eating raises hepatic lipidosis high on the list, and it is an emergency — the liver deteriorates quickly without nutritional support. In dogs, sudden jaundice with pale gums points first at red cell destruction.

Questions worth asking your vet

  • Is my pet's anaemia panel normal — could red cell destruction explain this?
  • Do we need imaging to check for a blockage of the bile duct?
  • Are the gums or eyes visibly yellow yet?

Related terms

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