Chapter 115- Hepatitis and cholangiohepatitis Flashcards
Any inflammatory infiltrate within the hepatic parenchyma
Hepatitis
Extension of inflammation from the hepatic parenchyma to include the intrahepatic bile ducts
Cholangiohepatitis
Acute hepatitis is characterized by what?
Inflammation, hepatocellular apoptosis, necrosis, +/- regeneration, LACK OF FIBROSIS
Chronic hepatitis is characterized by what?
Presence of fibrosis, proliferation of ductular structures, regenerative nodules, PLUS inflammation, apoptosis +/- necrosis
T/F: A short duration of clinical signs indicates acute disease
F- the liver has a large reserve capacity
More likely acute or chronic hepatitis?
- Abdominal pain-
- Ascites-
- Fever-
- Hepatomegaly-
- Abdominal pain- Acute
- Ascites- Chronic
- Fever- Acute
- Hepatomegaly- Acute
Why are hepatocytes especially susceptible to anoxia?
The liver receives a mixture of venous and arterial blood
Experimental work in mice suggests that what plays a role in the initiation and perpetuation of hepatitis?
TNF-a
TNF-a is produced secondary to what two co-stimulatory molecules on what types of cells?
CD154 on T-cells and CD40 on hepatocytes and Kupffer cells
What does TNF-a do to the hepatocytes and how does it do it?
Stimulates apoptosis via the Fas-Fas ligand pathway
What is the difference between acute and chronic neutrophilic cholangitis?
Edema and neutrophilic inflammation extend to the portal regions, mixed inflammatory infiltrate may be noted in the portal areas along with varying degrees of fibrosis and bile duct hyperplasia
What are some common bacterial species found in cats with cholangitis?
E. coli, Enterococcus, Clostridium, Staph
What are some sequelae of neutrophilic cholangitis?
Bile duct obstruction, acute necrotizing pancreatitis, sepsis, MODs
Name some causes of bacterial cholangitis in dogs and cats (11-2, depending on your count).
- Lepto
- Bartonella
- Tyzzers (C. piliforme)
- Salmonella
- Tularemia
- Brucella
- Yersina
- Helicobacter
- Mycobacteria
- Septicemia
- “Feline cholangitis complex”
T/F: Lymphocytic cholangitis in cats is most likely an immune mediated disease.
T
T/F: Canine chronic hepatitis is perpetuated by an immune mediated process.
T
Name some breeds predisposed to chronic hepatitis (bonus points if you know if suspected/ proven copper associated hepatopathy) (10):
- American cocker
- Bedlington*
- Dalmation*
- Doberman*
- English cocker
- Springer
- Lab*
- Skye terrier*
- Standard poodle
- Westie *
* Denotes copper associated hepatopathy
What drug may delay progression of hepatic fibrosis.
Colchicine
Name 2 drugs that may helped with elevated copper levels noted in a liver biopsy
D-penicillamine, trientine
In what percentage of cases does Lepto cause liver involvement?
20-35%
What 2 serovars of Lepto are more likely to cause hepatic involvement?
Icterohaemorrhagiae, Pomona
What drug is used to specifically eliminate the leptospiremic stage?
Penicillin
What drug is the antibiotic of choice for treatment of Bartonellosis?
Azithromycin
How does SAMe work to support the liver?
It increases glutathione levels which may increase antioxidant and repair abilities
