Digestion & Metabolism 2: Equine Hepatic Dz Flashcards
equine liver is predominantly on WHAT side of the horse? (give a fraction)
has HOW many lobes?
mostly on the RIGHT SIDE, 3/5
has 3 LOBES (right, middle, left)
3 NORMAL functions of the liver?
3 functions?
1. METABOLISM
2. EXCRETION
3. IMMUNE FUNCTION
hepatic INSUFFICIENCY usually shows _____ clinical signs because..
we see failure of _____ to _____ in HEPATIC INSUFFICIENCY
NO clinical signs until 80% of LIVER AFFECTED because REGENERATIVE, but once we DO see clinical signs, LIKELY HEPATIC FAILURE
we see failure of BILIRUBIN to CONJUGATE (be taken up) in HEPATIC INSUFFICIENCY
TWO SPECIFIC signs of liver disease & why we see them
- ICTERUS
–> from INCREASE in BILIRUBIN from HEMOLYSIS - ANOREXIA
–> EATING is VERY IMPORTANT for CONJUGATION/UPTAKE of BILIRUBIN, but if we have TOO MUCH then WANT TO NOT EAT
CHOLESTASIS…
= definition?
often see REDUCED _____ of ____, leading to…
= REDUCED EXCRETION by the BILE DUCTS
often see REDUCED EXCRETION of BILIRUBIN, leading to RESORPTION into the PLASMA
HEPATIC ENCEPHALOPATHY…
often see INCREASED ____
–> what OTHER disease PRESENTS WITH THIS
–> occurs due to….
liver disease can also increase PERMEABILITY of…
clinical signs are ____ & tend to be ____, including…
AMMONIA
–> other disease is INTESTINAL HYPERAMMONEMIA
–> occurs due to LIVER failure to EXCRETE AMMONIA
can INCREASE permeability of BLOOD BRAIN BARRIER
clinical signs are VARIABLE & tend to be NEUROLOGIC, including…
1. YAWNING
2. INCREDIBLY DULL
3. HEAD-PRESSING
4. ATAXIA
5. SEIZURES
PHOTOSENSITIZATION…
this can be a CLINICAL manifestation of ____ ____
commonality?
pathophys? (three)
most common in ____ regions of the body
clinical manifestation of LIVER DISEASE
UNCOMMON
pathophys?
1. due to CHLOROPHYLL in plants/grass getting digested into PHYLLOERYTHRIN that is NORMALLY CONJUGATED IN THE LIVER
- but when LIVER is diseased, it ACCUMULATES IN SKIN
- when skin is EXPOSED TO LIGHT, REACTION occurs and FREE RADICALS AND ENERGY PRODUCED
most common in NON-PIGMENTED regions of the skin
if we see FEVER with HEPATIC DZ, can be what 5 diseases?
- NEOPLASIA = from CHRONIC condition causing CYTOKINE RELEASE
- ACUTE HEPATITIS
- CHRONIC ACTIVE HEPATITIS
- HEPATIC ABSCESS
- OBSTRUCTIVE CHOLELITHLIASIS (gallbladder stones)
3 reasons we can see D+ in LIVER dz?
is D+ a COMMON clinical sign for liver dz?
- PORTAL HYPERTENSION
- ALTERED GI MICROFLORA from ANOREXIA
- ABNORMAL BILE METABOLISM
NOT a common presentation of liver dz
2 reasons we can see COLIC with liver dz?
- BILIARY OBSTRUCTION
- HEPATOCELLULAR SWELLING from INFLAMMATION
4 overall GI signs we can see with HEPATIC DZ?
- D+
- COLIC
- TENESMUS
- STEATORRHEA
5 common clinical signs with HEPATIC DZ?
(put here bc not necessarily in the same category)
which one is RARE in horses?
which one is COMMON IN PONIES?
which one is usually in CHRONIC cases?
- WEIGHT LOSS, especially in CHRONIC cases
- PHARYNGEAL/LARYNGEAL COLLAPSE (common in PONIES)
- HEMORRHAGE
- HEMOLYSIS
- PRURITUS (RARE in horses)
LIVER on US in horse…
mostly tilted to WHAT direction?
where do we stand & how should we hold PROBE to see liver?
what does liver look like?
what lies RIGHT NEXT to it that we might see? why this important for BIOPSY?
mostly tilted to the RIGHT
usually go on RIGHT SIDE between 8th & 11th ICS
HYPOECHOIC with HYPERECHOIC FLECKS
right NEXT to it = LUNG, so need to BE CAREFUL TO NOT PUNCTURE IT WHEN DOING BIOPSY
three reasons why do we do US-guided PERCUTANEOUS BIOPSY of LIVER in horses?
how many biopsies do we usually perform?
- to determine ETIOLOGY in ACUTE cases (VIRAL testing)
- to determine PROGNOSIS in CHRONIC cases
- CULTURE tissue for BACTERIA
we usually perform AT LEAST 3 BIOPSY SAMPLES
if we see an ABNORMAL COAGULATION PROFILE…
this DOES NOT PUT HORSE AT A HIGH RISK FOR BLEEDING
