Feline Hepatic Lipidosis Flashcards
what is seen grossly with feline hepatic lipidosis?
enlarged, friable, yellow liver
what is the primary cause of feline hepatic lipidosis?
negative energy balance, usually caused by anorexia
how can we treat feline hepatic lipidosis?
identify and eliminate underlying cause for anorexia
address correctable metabolic disturbances
forced nutrition
control factors that fuel progression
control complications of acute liver failure
what factors fuel hepatic lipidosis in cats?
protein/calorie malnutrition
depletion of anti-oxidants in the liver
micronutrient depletion
complications of acute liver failure
what leads to the impaired anti-oxidant defense?
fatty liver in pro-oxidant state
decreased hepatic glutathione levels
decreased hepatic vitamin E levels
how can you improve the anti-oxidant defense?
feed cat: give glutathione precursors
give vitamin E
avoid pro-oxidant drugs
what micronutrients are depleted in feline hepatic lipidosis?
B vitamins
vitamin K
potassium
what are the functions of carnitine?
transfer LCFA across mitochondrial membrane
elimination of excess acyl-CoA derivatives
enhances beta oxidation
enhances urea synthesis
what are the complications of acute hepatic failure?
coagulopathy
hepatic encephalopathy
cerebral edema
underlying condition
what is seen on cytology of hepatic lipidosis?
> 50-80% of hepatocytes vacuolated
do cats with hepatic lipidosis tend to be glucose intolerant?
yes
what diet should you feed during hepatic lipidosis recovery?
high protein
low carbohydrate
what can you give for glutathione precursors?
N-acetyl cysteine
S-adenosylmethionine
start enteral nutrition
what does carnitine supplementation do during hepatic lipidosis?
decreases serum ketone and free fatty acid concentrations
what are the best prognostic factors for feline hepatic lipidosis?
decrease in bilirubin and beta-hydroxybutyrate in first 7-10 days
what is elevated in feline hepatic lipidosis?
ALT, AST, ALP, +/- GGT
bilirubin
+/- cholesterol and triglycerides
why should you avoid dextrose infusion in a cat with hepatic lipidosis?
aggravates glucose intolerance
potentiates accumulation of fat
is there decreased oxidation of fatty acids in feline hepatic lipidosis?
no
is there increased de novo hepatic lipogenesis in feline hepatic lipidosis?
no
what are some pro-oxidant drugs you should avoid in feline hepatic lipidosis?
too much vitamin K
propofol
iron or copper supplements
