22. acute liver disease in cat, hepatic lipidosis

Question 1

baht to mention

Answer 1

toxicosis: paracetamol, diazepam, clonazepam

Question 2

haptic lipidosis occurence

Answer 2

most common cat hepatopathy
high mortality without treatment
multifactorial: obese cat, prolonged stress, anorexia, idiopathic, secondary to other diseases

Question 3

secondary hepatic lipidosis - causes

Answer 3

FORL, FIP, CKD, hepatopathy, toxins, neoplasm

Question 4

idiopathic hepatic lipidosis

Answer 4

fasting: lipid accumulation
- increased fee fatty acid from fat stores
- decreased lipoprotein production
- triglycerides accumulate in liver and can’t be transported
decreased arginine - urea cycle, NH3 metabolism decrease -> high ammonium levels, hepatic encephalopathy

Question 5

clinical signs of feline hepatic lipidosis

Answer 5

anorexia, depression, dehydration
obese cat loose wight - mostly muscle loss
go signs, hepatomegaly, icterus

Question 6

hepatic lipidosis lab findings

Answer 6

intrahepatic cholestais
ALT, AST, ALP increase
increased NH3
increased glucose (stress- insulin resistance)

Question 7

treatment of hepatic lipidosis

Answer 7

stabilisation: fluid, electrolyte
intesnive forced feeding (avoid referring syndrome)
treat background causes
treat coagulopathy
good quality diet with high protein level, low fat

Question 8

diazepam/clonazepam toxicity

Answer 8

acute, fulminant liver failure, high mortality
idiosyncratic reaction, after several days of drug
centrolobular necrosis
very increased liver enzymes
treat: stop drug, supportive, poor prognosis

Question 9

paracetamol toxicosis

Answer 9

depletion of glutathione stores 
toxic metabolites ->oxidative injury 
erythrocytes: methemoglobinemia 
hepatocytes: hepatic necrosis 
dose dependent hepatotoxicity

Question 10

paracetamol toxicosis signs

Answer 10

cyanosis
brown blood
dyspnoe

Question 11

paracetamol treatment

Answer 11

NAC: n-acetylcystein - ANTIDOTE

SAMe- supportive