concepts of liver dz + canine and feline liver dz Flashcards
what % of the liver can be injured/ removed without evidence of dysfunction ?
75%
what is the most specific evidence for liver dz?
jaundice
general exam findings with liver dz
- jaundice
- low protein ascites <1.25 (portal hypertension 1-2.5; hypoalbuminemia 0-0.5)
- high protein ascites >1.25 (r. heart failure; caval syndrome)
true / false
ascites is uncommon in a cat with liver dz
true
true/ false
cats get a copper colored iris with liver shunts
true
what is the first sign of liver dz
clin path abnormalities
do liver enzymes indicate function ?
NO
what liver enzymes indicate cell damage ?
ALT (cytoplasm, liver specific)
AST (cytoplasm and mitochondria; liver and muscles)
–> poor correlation between magnitude and severity of dz
what liver enzymes indicate cholestasis/drugs
ALP (bone, liver, steroid inducible in dogs; only 6hr half life in cat)
GGT (mostly liver)
–> both are membrane bound
what are some true liver function tests
- ammonia
- serum bile acids (if already icteric there is NO reason to do it)
what are some pseudofunction liver tests
- bilirubin
- albumin
- BUN (low suggests dysfunction)
- cholesterol (decreased in liver dysfunction but increased in cholestatic dz)
- glucose (gluconeogenesis, glycogen storage)
true / false
the cat has a higher renal threshold then the dog for bilirubin, so bilirubinuria in the cat is always significant
true
clinical signs of acute hepatitis
- inappetance
- lethargy
- vomiting
- abdominal pain
- maybe icterus
acute hepatitis biochem
- INCREASED ALT (magnitude depends on severity of damage)
- ALP to a lower extend
- bilirubin might join the party
true/ false
biopsy is commontly indicated for acute hepatitis dx
FALSE
rarely indicated/ useful
-dx is based on clinical findings
acute hepatitis tx
supportive
antiemetics
antioxidant therapy (silymarin, n-acetylcysteine
what are the most common causes for extrahepatic bile duct obstruction in the dog and the cat
dog: pancreatitis
cat: neoplasia
clinical signs of extrahepatic bile duct obstruction
inappetance, icterus, vomiting
how to dx extrahepatic bile duct obstruction
- increased ALP (usually higher then ALT)
- icterus
- UT
- Confirm DX with laparotomy but might not be needed
chronic hepatitis can be copper associates, what are some breeds that correlate with that
bedlington, doberman, westie, dalmation, lab
biochem for chronic hepatitis
- persistant increase in ALT and ALP ( ALT > ALP)
- decreased: albumin, urea nitrogen, cholesterol
- hyperbilirubinemia
- abnormal bile acids
how to dx chronic hepatitis
BIOPSY can find: -mononuclear inflammation -single cell necrosis -bile duct hyperplasia (trying to repair) -fibrosis -> bridging RHODANINE STAIN if Copper
chronic hepatitis Tx
immunosuppressive for cholestasis to improve
- UDCA (synthetic hydrophilic bile)
- anti oxidants
- anti fibrotics
- zinc if copper related, helps bing to the copper; chelation therapy
what is the end stage of liver dz
cirrhosis
