12/13/14: Liver

Question 1

What liver disease do cats NOT get?

Answer 1

Cirrhosis

Question 2

Which liver disease are cats especially susceptible to?

Answer 2

Lipidosis

Question 3

Which enzyme do cats not have?

Answer 3

Steroid-induced ALP

Question 4

What are clinical signs like in cats in liver disease?

Answer 4

Non-specific - vomiting, pyrexia, hepatomegaly (50%), anorexia, weight loss

Question 5

What is “triaditis” in cats?

Answer 5

Liver and pancreas and IBD

Question 6

What are the clinical signs like in hepatic lipidosis?

Answer 6

Comatose, encephalopathy

Question 7

Why is it hard to tell FIP from lymphocytic cholangitis?

Answer 7

Both cause high-protein ascites

Question 8

What should you do as soon as you are certain of primary liver disease?

Answer 8

BIOPSY ASAP, but check platelets and coagulation first

Question 9

Which kind of lvier biopsies are more and less dangerous?

Answer 9

Wedge biopsy less dangerous, US-guided trucut more dangerous

Question 10

Why is laparotomy for liver biopsy better?

Answer 10

Can deal with haemorrhage

Question 11

What should you do before a liver biopsy?

Answer 11

Pre-treat with vitamin K for 12-24 hours

Question 12

Where do you take an emergency liver FNA?

Answer 12

Blind on LHS

Question 13

In which dogs are raised liver enzymes very common?

Answer 13

Older, in chronic hepatitis or pancreatitis

Question 14

Why do you not put an old dog onto a hepatic diet?

Answer 14

Old dogs need protein

Question 15

Causes of secondary hepatopathy?

Answer 15

CHF, anaemia, toxaemia or sepsis (esp dental), pancreatitis, steroids, diabetes, hyper-lipidaemia

Question 16

How do steroids affect liver parameters?

Answer 16

High ALP, increased ALT, AST, bile acids

Question 17

Which liver conditions can look normal on ultrasound?

Answer 17

Many e.g. cirrhosis

Question 18

WHich is the only condition that needs a hepatic diet?

Answer 18

Copper storage disease

Question 19

Causes of chronic hepatitis?

Answer 19

Copper, toxins e.g. neutraceuticals, infectious e.g. Lepto, autoimmune

Question 20

In which liver conditions are steroids indicated?

Answer 20

Lympho-plasmacytic inflammation and fibrosis

Question 21

What do you give in liver disease if unknown cause?

Answer 21

Destolit, antioxidants, spironolactone

Question 22

When is the only time you should give copper chelators?

Answer 22

After biopsy

Question 23

How much of the pancreas can you lose before diabetes?

Answer 23

80%

Question 24

What is the significance of whether a disease is acute or acute on chronic?

Answer 24

Not important for immediate treatment, but does affect long-term management