Feline Hepatic Lipidosis Flashcards

1
Q

what is seen grossly with feline hepatic lipidosis?

A

enlarged, friable, yellow liver

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2
Q

what is the primary cause of feline hepatic lipidosis?

A

negative energy balance, usually caused by anorexia

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3
Q

how can we treat feline hepatic lipidosis?

A

identify and eliminate underlying cause for anorexia
address correctable metabolic disturbances
forced nutrition
control factors that fuel progression
control complications of acute liver failure

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4
Q

what factors fuel hepatic lipidosis in cats?

A

protein/calorie malnutrition
depletion of anti-oxidants in the liver
micronutrient depletion
complications of acute liver failure

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5
Q

what leads to the impaired anti-oxidant defense?

A

fatty liver in pro-oxidant state
decreased hepatic glutathione levels
decreased hepatic vitamin E levels

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6
Q

how can you improve the anti-oxidant defense?

A

feed cat: give glutathione precursors
give vitamin E
avoid pro-oxidant drugs

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7
Q

what micronutrients are depleted in feline hepatic lipidosis?

A

B vitamins
vitamin K
potassium

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8
Q

what are the functions of carnitine?

A

transfer LCFA across mitochondrial membrane
elimination of excess acyl-CoA derivatives
enhances beta oxidation
enhances urea synthesis

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9
Q

what are the complications of acute hepatic failure?

A

coagulopathy
hepatic encephalopathy
cerebral edema
underlying condition

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10
Q

what is seen on cytology of hepatic lipidosis?

A

> 50-80% of hepatocytes vacuolated

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11
Q

do cats with hepatic lipidosis tend to be glucose intolerant?

A

yes

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12
Q

what diet should you feed during hepatic lipidosis recovery?

A

high protein
low carbohydrate

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13
Q

what can you give for glutathione precursors?

A

N-acetyl cysteine
S-adenosylmethionine
start enteral nutrition

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14
Q

what does carnitine supplementation do during hepatic lipidosis?

A

decreases serum ketone and free fatty acid concentrations

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15
Q

what are the best prognostic factors for feline hepatic lipidosis?

A

decrease in bilirubin and beta-hydroxybutyrate in first 7-10 days

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16
Q

what is elevated in feline hepatic lipidosis?

A

ALT, AST, ALP, +/- GGT
bilirubin
+/- cholesterol and triglycerides

17
Q

why should you avoid dextrose infusion in a cat with hepatic lipidosis?

A

aggravates glucose intolerance
potentiates accumulation of fat

18
Q

is there decreased oxidation of fatty acids in feline hepatic lipidosis?

A

no

19
Q

is there increased de novo hepatic lipogenesis in feline hepatic lipidosis?

A

no

20
Q

what are some pro-oxidant drugs you should avoid in feline hepatic lipidosis?

A

too much vitamin K
propofol
iron or copper supplements