CC: Lipidosis Flashcards
What were the lab abnormalities?
Low PCV (anemia) High ALT (liver or muscle) High AP (liver or bone)
Signs point toward hepatopathy
What was the diagnostic plan?
Abdominal ultrasound (take a peak)
Liver function test - bile acids
Coagulogram
Hepatic Aspirate/Biopsy (most invasive, want to hold off unless absolutely necessary)
What were the diagnostic results we were interested in?
Elevated Pre- and Post-prandial Bile Acids
Hepatic aspirate showed hepatocytes heavily vacuolated, multiple vacuoles, no inflammatory cells
What was the therapeutic plan?
PEG Tube
Enteral nutrition
How did they treat?
Day 1: 1/3 of calculated daily energy requirement
Day 2: 2/3 of calculated daily energy requirement
Day 3: total calculated daily energy requirement
Day 4: discharged with instruction how to feed
What is hepatic lipidosis?
Massive accumulation of lipid within the liver/hepatocytes.
Most common hepatic disease of CATS.
Decreased hepatic function.
Most common in 2-8 years of age.
Follows periods of anorexia: Stress, Idiopathic, Secondary
What are clinical signs of hepatic lipidosis?
Anorexia Weight loss Icterus Hepatomegaly Vomiting Signs of Primary Disease
What is pathophysiology of hepatic lipidosis?
Anorexia leads to lipolysis –> overwhelms livers ability to process lipids –> fatty liver
What stressors can cause hepatic lipidosis in cats?
Moving New Pet New family member Diet Change Construction Boarding or house sitter Owner absence
What are lab abnormalities associated with hepatic lipidosis?
Elevated Alkaline Phosphatase (AP) Elevated Alanine Aminotransferase (ALT) Hyperbilirubinemia Anemia Microcytosis Neutrophilia Elevated Bile Acids
(usually not ketoacidotic)
What is the prognosis of hepatic lipidosis?
Depends on the underlying disease.
Idiopathic: 50%-75%
Relapses are uncommon. Most recover.
