5. Diagnostics and treatment of liver diseases in ruminants. Flashcards
Ruminant energy supply?
Ruminant energy supply
• The blood glucose is lower than in monogastric species because most of the energy supply comes from the
rumen (VFA).
• During gluconeogenesis in the liver glucose is formed. A lot of the produced glucose goes to the udder to
form milk glucose in dairy cattle. After calving there can be insulin resistance
Measurement of insulin resistance?
Measurement of insulin resistance
• Gold standard
o Hyperinsulinemia euglycemic (HEC) test
§ The gluconeogenesis of the liver can be supressed at 100-120uU/ml insulin concentration
- Intravenous glucose tolerance test
- Intravenous insulin tolerance test
NEFA in the liver?
NEFA in the liver (non-esterified fatty acids)
2-6 weeks after calving there is a major negative energy balance. The cow will burn its body fat stores, BCS
decreases. In the blood we measure non-esterified fatty acids, they go to the liver and 3 things can happen:
1. They join gluconeogenesis (best)
2. Ketone body formation (hyperketonaemia)- Beta- hydroxy butyrate, acetoacetate, and acetone. In high
amounts they appear in the urine and milk
- If the liver is unable to utilise it, it will become re-esterified triglycerides, leading to fatty infiltration
(worst)
Jaundice haemolytic icterus causes?
Jaundice
Haemolytic icterus
- Leptospirosis (calf), babesiosis, anaplasmosis
- Food (cabbage, onion)
- Copper-toxicosis (sheep)
Hepatic icterus?
Hepatic icterus
• Common in sheep (toxic hepatopathies), rare in cattle
Obstructive icterus?
Obstructive ileus
- Obstruction of the bile duct (extrahepatic)- very rare
- Intrahepatic bile capillary compression (e.g., fatty liver): more frequent
Clinical signs and diagnosis?
Clinical signs
- Yellow sclera, MM, and skin
- Dark urine
o Bilirubinuria and/or haemoglobinuria
• Increase in plasma Br rarely results in clinical icterus in ruminants
o TBr > 3mg/dl
Diagnosis
• Liver Enzymes in Cattle
o AST can come from the RBCS, brain and muscles- it is less specific in Ru
Liver enzymes in cattle?
Total bile acids?
Total bile acids (TBA)
• Normal
o <90umol/L
• Fatty liver
o 1.5-2 x increase
- High variability between individuals
- No importance of pre- and postprandial level
Dry chemistry NH3 analyser: blood ammonia checker
Dry chemistry NH3- analyser: blood ammonia checker
• Reference value
o 25-50umol/L
• Energy deficiency, protein overload
o 50-80umol/L
• Severe fatty liver, coma hepaticum
o >100umol/L
Summary of clinical diagnostics in liver diseases?
Summary of clinical diagnostics in liver diseases
• Plasma/ sera
o AST, ALT, ALKP, GLDH, bilirubin, ammonia, BHB, NEFA
• Urine
o Acetic acid, acetone
- Ultrasound
- Biopsy
o TL, TAG
Clinical diagnosis of subclinical and clinical ketosis?
Clinical diagnosis of subclinical and clinical ketosis
On farm ketone body measurement
• Beta-hydroxy butyrate (BHB)
o Blood from tail vein (v. coccygea)
o Clinical ketosis
§ >2.5mmol/L
o Subclinical ketosis
§ >1.2-1.4mmol/L
Ultrasound in ruminants?
Liver is on the right side, can scan it through the ICS, there is no criteria in cows for hepatomegaly
• In normal animals it is triangle shaped. Caudal vena cava thrombosis can occur in seriously septic conditions
blood clots in the caudal vena cava
Liver biopsy in cattle?
Liver biopsy in cattle
• In upper 3rd of 11th intercostal space (13 ribs and 12 ICS in total) there is the puncture place of the blind
liver biopsy
• Use special biopsy needles
Non- Purulent hepatitis?
Non-purulent hepatitis
• Metabolic
o Energy deficiency- fatty liver
• Toxic
o Cu, P, As, CCl4
o Cabbage
o Lupinosis: phomopsin
o Plant toxins
o Poor quality silage, mycotoxins
• Infectious
o Bacterial
§ Cl novyi, salmonella, enteriditis
o Hepatic fascioliasis
§ Acute hepatitis, cholangitis
