09 - liver disorders continued

Question 1

Question 2

Question 3

(Feline hepatic lipidosis)

1. most common liver disease in cats

Question 4

(feline hepatic lipidosis)

1. Cx suggest hepatic dz. what is the most consistent sign?
2. how common are signs of hepatic encephalopathy?
3. overt bleeding occurs in what percentage of cases?
4. what age cats are most commonly effected?

Answer 4

1. prolonged anorexia

(pronounced weight loss in previously obese cats is common)

2. uncommon
3. 20%
4. middle aged to older cats

Question 5

(feline hepatic lipidosis)

1. px may reveal what?
2. how are chem increases?
3. coag tests affected?
4. biopsy usually not done, FNA shows what?

Answer 5

1. hepatomegaly, jaundice, and muscle wasting
2. serum ALP higher, normal GGT (unlike other hepatic diseases in cats)
3. yes, are often abnormal
4. foamy, vacuolated hepatocytes

Question 6

(feline hepatic lipidosis - treatment)

1.

Answer 6

Question 7

(feline hepatic lipidosis - tx)

1. with aggressive therapy, what percentage of cats recover?
2. when can you remove the fedding tube?
3. how common is recurrence?

Answer 7

1. 60 to 85%
2. only when the cat is eating on itws own for at least a week
3. rare - and no evidence of residual hepatic damage!

Question 8

(Canine vacuolar hepatopathies)

(glucocorticoid hepatopathy)

1. occurs in dogs only (not cats)
2. glucocorticoids affect liver how?
3. What ^ chem value most common?
4. tx?

Answer 8

2. cause glycogen accumulation and hepatomegaly
3. ALP
4. no specific therapy for liver. treat underlying or decrease glucocorticoids

Question 9

(hepatic copper accumulation and chronic hepatitis)

1. normal hepatic copper concentration?
2. copper accumulation causes significant damage when concentration reaches what?
3. copper is normally excreted how?

Answer 9

1. less that 400 ug/g
2. 2,000 ug/g
3. in bile

(therefore, hepatic copper accumulation can be secondary to any cholestatic hepatic disorder)

Question 10

(idiopathic chronic hepatitis)

1. characterized by chronic portal inflammation, necrosis, fibrosis, and frequently progresses to cirrhosis
2. Cx: anorexia, depression, PU/PD, ascites, jaundice, wt loss, vomiting
3. what chem values are markedly elevated?
4. hyperbilirubinemia and bilrubinuria are common
5. tx with glucocorticoids, ursodiol, antioxidants, and possibly azathioprine

Answer 10

3. ALT and ALP

Question 11

What is the second most common liver disease in cats?

Answer 11

feline inflammatory liver diseases

Question 12

(feline inflammatory liver dz)

1. what is the most common form?
2. caused by what?
3. Cx?
4. commonly associated with what?

Answer 12

1. neutrophilic cholangitis
2. ascending bacterial infection from the intestine into the biliary tract
3. vomiting, anorexia, lethargy, wt loss
4. IBD and pancreatitis (triaditis)

Question 13

(feline inflammatory liver dz)

(neutrophilic cholangitis)

1. onset usually acute in young, chronic in old
2. liver enzyme variable - usually see increases in levels of what though?
3. what is required for definitive dx?

Answer 13

2. ALT and bilirubin
3. liver bx

Question 14

(feline inflammatory dz)

(neutrophilic cholangitis)

1. tx?
2. prog?

Answer 14

1. supportive care, abx, prednisolone in chronic cases, ursodiol
2. acute form may resolve with tx, or may progress to chronic

chronic form requires life long tx

Question 15

(feline inflammatory dz)

(lymphocytic cholangitis)

1. infiltration of what into portal areas?
2. what cats may be predisposed?
3. treatment is similar to what?

Answer 15

1. lymphocytes -> bile duct proliferation, fibrosis
2. persians
3. neutrophilic cholangitis

Question 16

(phenobarbital associated hepatic disease)

1. clinical signs are consistent with what?
2. increases in ALT and ALP may indicated dmg rather than jsut induction?
3. if possible switch to what?

Answer 16

1. chronic hepatic failure
2. 5x
3. KBr

Question 17

(hepatic amyloidosis)

1. reactive amyloidosis (2° to chronic inflammatory, infectious, or neoplastic disorders) affects what 4 organs?
2. familial in what breeds?

Answer 17

1. liver, kidneys, spleen, and adrenal glands
2. Shar pei dogs and abyssian cats

Question 18

(hepatic cirrhosis and fibrosis)

1. irreversible end stage of chronic hepatic injury
2. Cx are characteristic of generalized hepatic dysfunction
3. how do increases in serum liver eznymes compare to acute dz?
4. what is required for definitive dx?
5. tx is mainly supportive to control complications

Answer 18

3. more modest increase
4. liveer bx

Question 19

(hepatobiliary neoplasia)

1. what is the most common primary tumor in dogs?
2. in cats?
3. what dog breed may have an increased risk for biliary carcinoma?
4. Cx and lab data are consistent with liver dz
5. what is the tx of choice for solitary masses?
6. prog for masses affecting multiple lobes?

Answer 19

1. hepatocellular carcinoma
2. biliary carcinomas and adenomas
3. labrador retrievers
4. surgical excision (chemo not effective)
5. poor

Question 20

(hepatic nodular hyperplasia)

1. cause unknown, common in what?
2. Cx?
3. tx?

Answer 20

1. older dogs
2. none
3. none required

Question 21

(hepatic cysts)

1. congenital or acquired (trauma, neoplasia, bartonella)
2. Cx absent unless what?
3. dx?
4. tx?

Answer 21

2. cysts compress adjacent tissue
3. imaging
4. sx