Gastroenterology - Pancreas and Liver Flashcards
What are zymogens?
digestive enzymes released in the inactive form
- prevent enzymes from digesting origin cells
Describe the pathology of pancreatitis
- zymogen activation in pancreatic tissue
- inflammation and necrosis of pancreatic cells
- clinical signs caused by cell death and inflammation
What is the pathology of pancreatitis?
auto-digestion of the pancreas
- edema, hemorrhage, necrosis, inflammation
What are the common clinical signs of pancreatitis?
- vomiting, diarrhea
- abdominal pain
- lethargy
- inappetence
What are the clinical signs of acute pancreatitis?
- “ADR”
- vomiting, diarrhea, abdominal pain, lethargy, inappetence
- “prayer position” or “meatloaf”
- cats may present with only anorexia
What are the inciting causes of pancreatitis in the dog?
- dietary indiscretion, high fat diet
- organophosphate toxicity
- hypertriglyceridemia
- drugs
- trauma and/or hypoperfusion
- neoplasia
- hypercalcemia
What are the inciting causes of pancreatitis in the cat?
- infections
- neoplasia
- organophosphate toxicity
- concurrent GI disease or liver disease
What is seen on CBC with pancreatitis in the dog and in the cat?
dog: leukocytosis with left shift, thrombocyotosis/penia
cat: heinz body anemia, same as dogs
What is Pancreatic Lipase Immunoreactivity?
- measures lipase of specific pancreatic origin
- released into blood in higher quantities with pancreatic inflammation
- increases with inflammation and necrosis
What is the most definitive test for pancreatitis?
pancreatic biopsy
How is pancreatitis treated?
supportive and symptomatic therapy
What are the therapies used for pancreatitis?
- fluids
- pain management
- antacids
- antiemetics
- prokinetics
- anti-clot
- antibiotics
- vasopressors
- gastric decompression
- supplemental enzymes
What are the possible findings associated with liver disease?
- lethargy
- peritoneal effusion
- acholic feces
- hepatic encephalopathy
- pain
What are the diagnostics for liver disease?
- CBC/Chem
- Urinalysis
- liver function tests
- imaging
- biopsy
What is indicated by increased and decreased cholesterol?
increased - cholestatic disease
decreased - shunts and liver dysfunction
What is indicated by increased and decreased BUN?
increased - GI bleed
decreased - shunting or liver dysfunction
What is indicated by decreased albumin?
shunts and liver dysfunction
What is indicated with hypoglycemia in regards to the liver?
75% or more hepatic dysfunction
- some shunts
What breed is predisposed to copper hepatopathy?
Bedlington Terrier
- deletion of exon 2 in COMMD1 gene
How is canine copper hepatopathy treated?
- D-Penicillamine: mobilizes copper from tissues. increases urine secretion, and increases metallothionein
- Zinc: increases metallothionin
- Trientine HCl: increases urine excretion
What is vacuolar hepatopathy?
excess glycogen accumulation in the liver often secondary to excess glucocorticoid exposure
What is hepatocutaneous syndrome?
pronounced skin lesions associated with primary hepatic disease
What are the two forms of cholangitis/cholangiohepatitis syndrome?
suppurative - neutrophilic, associated with bacteria
non-suppurative - lymphocytic/lymphoplasmacytic
Which antibiotics are used to treat cholangitis/cholangiohepatitis syndrome?
- amoxicillin/clavulanic acid
- metronidazole and enrofloxacin
What are the lab changes associated with hepatic lipidosis?
- heinz body anemia
- increased ALP
- increased bilirubin
- +/- hypokalemia
- bilirubinuria
