09 - liver disorders continued Flashcards

1
Q
A
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2
Q
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3
Q

(Feline hepatic lipidosis)

  1. most common liver disease in cats
A
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4
Q

(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?
A
  1. prolonged anorexia

(pronounced weight loss in previously obese cats is common)

  1. uncommon
  2. 20%
  3. middle aged to older cats
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5
Q

(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?
A
  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
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6
Q

(feline hepatic lipidosis - treatment)

1.

A
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7
Q

(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?
A
  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!
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8
Q

(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?
A
  1. cause glycogen accumulation and hepatomegaly
  2. ALP
  3. no specific therapy for liver. treat underlying or decrease glucocorticoids
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9
Q

(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?
A
  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)

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10
Q

(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
A
  1. ALT and ALP
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11
Q

What is the second most common liver disease in cats?

A

feline inflammatory liver diseases

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12
Q

(feline inflammatory liver dz)

  1. what is the most common form?
  2. caused by what?
  3. Cx?
  4. commonly associated with what?
A
  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)
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13
Q

(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?
A
  1. ALT and bilirubin
  2. liver bx
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14
Q

(feline inflammatory dz)

(neutrophilic cholangitis)

  1. tx?
  2. prog?
A
  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

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15
Q

(feline inflammatory dz)

(lymphocytic cholangitis)

  1. infiltration of what into portal areas?
  2. what cats may be predisposed?
  3. treatment is similar to what?
A
  1. lymphocytes -> bile duct proliferation, fibrosis
  2. persians
  3. neutrophilic cholangitis
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16
Q

(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?
A
  1. chronic hepatic failure
  2. 5x
  3. KBr
17
Q

(hepatic amyloidosis)

  1. reactive amyloidosis (2° to chronic inflammatory, infectious, or neoplastic disorders) affects what 4 organs?
  2. familial in what breeds?
A
  1. liver, kidneys, spleen, and adrenal glands
  2. Shar pei dogs and abyssian cats
18
Q

(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
A
  1. more modest increase
  2. liveer bx
19
Q

(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?
A
  1. hepatocellular carcinoma
  2. biliary carcinomas and adenomas
  3. labrador retrievers
  4. surgical excision (chemo not effective)
  5. poor
20
Q

(hepatic nodular hyperplasia)

  1. cause unknown, common in what?
  2. Cx?
  3. tx?
A
  1. older dogs
  2. none
  3. none required
21
Q

(hepatic cysts)

  1. congenital or acquired (trauma, neoplasia, bartonella)
  2. Cx absent unless what?
  3. dx?
  4. tx?
A
  1. cysts compress adjacent tissue
  2. imaging
  3. sx
22
Q
A