Canine Liver Disease Flashcards
What breeds are predisposed to chronic hepatitis? (7)
Cocker spaniels (American and English) Terrier (Bedlington, Cairn, Skye, Westie) Dalmatian Doberman Great Dane Labrador Samoyed
What is the pathological consequence of chronic hepatitis?
Portal hypertension
What are the 3 typical clinical signs of portal hypertension?
Ascites
GI ulceration
Hepatic encephalopathy
What is the pathophysiological consequence of portal hypertension?
Splanchnic congestion
Gut wall edema and
Ascites
What is the common presentation of idiopathic chronic hepatitis?
Middle aged dog with high ALT for several months
If significant liver mass is lost due to idiopathic chronic hepatitis, what are typical clinical signs?
Vomiting and diarrhoea
Anorexia
PU-PD
In idiopathic chronic hepatitis, what is a negative prognostic indicator at presentation?
Ascites
How is idiopathic chronic hepatitis definitively diagnosed?
Histopathology
If idiopathic chronic hepatitis is suspected but not confirmed, what are the treatment suggestions?
Liver diet (possibly added protein)
SAME (anti inflammatory)
Ursodiol (choleretic)
If idiopathic chronic hepatitis is confirmed with biopsy, what extra treatment options are available?
Glucocorticoids
Antifibrotics (colchicine)
Antibiotics
What is the copper storage disease predisposed population of dogs?
Young dogs
Bedlington terrier
What is suggestive of copper storage disease?
Persistently high ALT
How is copper storage disease managed after biopsy confirmation?
Low copper: high zinc diet
Chelating agents
Antioxidants
Retesting every 3 months
What are the common triggers of acute hepatitis in dogs?
Canine adenovirus
Leptospirosis
Paracetamol Phenobarbital Carprofen TMPS Lomustine
How do dogs present with acute hepatitis?
Vomiting Hepatic encephalopathy Fever Jaundice Coagulopathy
What is necessary for treatment of acute hepatitis?
Fluids
Antibiotics if pyrexic
Monitoring BG and electrolytes
Addressing GI ulceration
How does a congenital portosystemic shunt present?
Young dogs
Neurological/GI/Urinary signs
What are the biochemical abnormalities associated with congenital PSS?
High bile acids (and ammonia)
Low urea
Low USG
How is a congenital PSS diagnosed?
Usually microhepatica with a single abnormal vessel is visualised with US or CT
What is the management for PSS?
Stabilise before surgery and continue for 8 weeks afterward with dietary management, antibiotics and lactulose
What is the difference in portal venous pressure between congenital PSS and microvascular dysplasia?
High pressure with microvascular dysplasia
Low pressure with PSS
What are the consequences of portal hypertension due to a lack of intrahepatic or extrahepatic portal vein branches?
The same as those of chronic hepatitis-
Gut wall edema
Ascites
What dogs are predisposed to microvascular dysplasia?
Yorkshire terriers
Cairn terriers
How do dogs with portal vein hypoplasia or microvascular dysplasia present?
Hepatic encephalopathy
Ascites
GI bleeding
How is microvascular dysplasia diagnosed?
Rule out congenital PSS- absence of a grossly demonstrable shunting vessel
Biopsy- intrahepatic portal vein hypoplasia
What are the classical signs of biliary tract disease in dogs?
Jaundice
Vomiting
Depression
What are the biochemical abnormalities associated with biliary tract disease?
Hyperbilirubinaemia, AP GGT Bile acids and cholesterol increase.
How is a biliary obstruction confirmed?
US shows distended bile duct and the obstruction
What are the common causes of biliary obstruction symptoms?
Pancreatic mass
Cholelith
Gall bladder mucocele
Bile peritonitis
