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Hepatobiliary Disease > Feline Liver Diseases > Flashcards

Feline Liver Diseases Flashcards

1
Q

What are the two presentations of hepatic lipidosis?

A

Primary disease in a fat stressed anorexic cat

Secondary in a normal car with anorexia + pancreatitis, IBD, DM or neoplasia

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2
Q

How is hepatic lipidosis defined?

A

An acute reversible loss of function due to hepatocyte swelling

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3
Q

What are the symptoms of hepatic lipidosis?

A

A very sick cat with a palpably enlarged liver, jaundice and hepatic encephalopathy

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4
Q

How can Hepatic lipidosis be confirmed?

A

They are too sick for anaesthesia, so FNA with 22g needle shows marked swelling of hepatocytes

(compared to lipid accumulation in an anorexic cat)

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5
Q

What biochemical abnormalities are seen with hepatic lipidosis?

A

Hyperbilirubinaemia, ALT, ALP (low ggt with primary), low urea, haemostatic abnormalities

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6
Q

What should stimulate a search for an underlying cause to hepatic lipidosis?

A

In secondary hepatic lipidosis, GGT will be high

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7
Q

What treatment is required for lipidosis?

A 
Fluids
Food
Antiemetic
Vitamin K
Vitamin E
a-adenosylmethionine
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8
Q

What is the pathology of Neutrophilic Cholangitis?

A

An ascending infection of the bile duct causing bile stasis and sepsis-
recognised as a young hot yellow cat

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9
Q

How is neutrophilic cholangitis confirmed?

A

Bile cytology, culture & sensitivity.

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10
Q

What clinicipathological findings are seen in neutrophilic cholangitis?

A

High neutrophils, bilirubin and ALT

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11
Q

What is the treatment for neutrophilic cholangitis?

A

IV fluids
4-6 weeks of antibiotics
Prevent lipidosis from occurring- feline intestinal diet

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12
Q

What is the pathology of Lymphocytic Cholangitis?

A

A waxing and waning disease of older cats, with lymphocytes infiltrating the portal tract

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13
Q

What are the clinical features of Lymphocytic Cholangitis?

A

Jaundice, weight loss and in some cases a high protein ascites (must be differentiated from FIP)

Yellow old thin cat

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14
Q

How is Lymphocytic Cholangitis diagnosed?

A

US shows dilation of the bile ducts, confirmed with biopsy (bile aspiration not required unless acute onset)

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15
Q

Treatment of lymphocytic cholangitis?

A

Cholerectic/anti inflammatory ursodeoxycholic acid

Antioxidant SAME and Vit E

Feline intestinal diet

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16
Q

What is the mechanism of Extrahepatic Bile Duct Obstruction?

A

Combination of extraluminal compression and intraluminal obstruction

17
Q

What conditions are associated with EBDO in cats?

A

Inflammation of the biliary tree, duodenum and pancreatitis (triaditis)

Or

Neoplasia of the biliary tree or pancreas

18
Q

What are the typical signs of cholestasis seen in EBDO?

A 
Icterus
Anorexia
Depression
Vomiting
Hepatomegaly
19
Q

How can EBDO be medically managed? Why?

A

Cholerectic - ursodeoxycholic acid

Antioxidant - s-adenosylmethionine

Surgical intervention required with acholic faeces but carries a poor prognosis

20
Q

What is the presentation for Congenital PSS?

A

Poor growth, waxing and waning neurological symptoms

21
Q

How is PSS treated?

A

Surgery

Stabilise with antibiotics, lactulose and liver diet pre- and 2 months post-op

22
Q

What clinicopathological abnormalities are seen with PSS?

A

Low urea
Microcytosis
High ammonia or bile acids

23
Q

What is hepatic amyloidosis?

A

Formation of inflammmatory amyloid either secondary to an underlying inflammatory process or familial in Siamese or Abyssinian cats

24
Q

How does Amyloidosis present?

A

Anaemia and hypotension related to rupture of liver capsule after jumping. Rarely any specific signs of liver disease

25
Q

What is the appearance of amyloidosis with ultrasound?

A

Lymphoma, lipidosis, amyloidosis are difficult to distinguish.

26
Q

How is Amyloidosis managed?

A

Eliminate underlying inflammatory disorder
Antioxidants
Vitamin K
Prognosis is poor

27
Q

What are typical signs of primary malignancies?

A

Older cats with liver disease- lethargy, vomiting, weight loss, ascites, jaundice

28
Q

What is the most common primary tumour in cats?

A

Biliary carcinoma

29
Q

What are common secondary tumours?

A

Lymphoma, histiocytic, mast cell tumours

30
Q

What should be checked before biopsy?

A

Coagulation profiles

31
Q

If there are coagulation abnormalities how should they be managed?

A

Vitamin K

In Lymphoma or MCT use FFP

Hepatobiliary Disease (6 decks)

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