Hepatic Flashcards
agonal liver changes
congestion
diffuse reddening
heavy with oozing
exacerbated by barbiturates
post mortem liver changes
autolysis - pale, soft, friable, mucosal linings sloughing off, swollen cells, cytoplasmic and nuclear details lost
putrefaction - blown up carcas, gas bubbles, pseudomelanosis, bacteria on histo
no inflammation on either
nutmeg liver
congestion
heart failure –> low oxygen delivery to hepatocytes –> cell swelling
chronic anemia - effect on histo
loss of centrilobular heaptocytes
telangiectasia
cows
benign distension of siusoids
diaphragmatic hernia effect on liver
compromises blood flow to liver
portosystemic shunt
blood bypasses liver
congenital or secondary to chronic liver disease
congenital - one vessel
acquired - multiple vessels
intra hepatic in large breeds, extra hepatic in small
ammonium biurate crystals in alkaline urine
nonregenerative anemia
viral infection
multifocal random necrosis
herpes - foetus and neonates, viral inclusion bodies
adenovirus - canine infectious hepatitis, also in chickens
bunyavirus - rift valley fever
flavivirus - wesselbron disease
bacterial infection
GIT or hematogenous
tyzzers disease - clostridium pilliforme, from GIT
hematogenous - salmonella, listeria, clostridia, yersinia
mycobacteria - pyogranulomatous
leptospirosis - hepatic or renal or both, icterus depending on level of hepatic necrosis, fever, PUPD, inappetence, vomiting, abdominal pain
campylobacter
helminths
target organ - trematodes and cestodes
migration - nematodes
liver fluke
fasciola hepatica
acute - sheep - large migration through liver –> extensive hemorrhage –> sudden death
chronic - sheep and cattle - adults in bile ducts –> anemia, weight loss, impact on fertility and production
black disease and bacillary hemoglobinuria - migration of immature flukes through liver –> activate clostridium spores –> toxins –> liver necrosis and death
cestodes
echinococcus granulosas - from dogs, carcass condemnation at slaughter
echinococcus mulltilocularis - dog-rodent lifecycle - liver covered in cysts
fungal infection
histoplasmosis
protozoa
toxoplasmosis
toxins
liver affected by most toxins - centrilobular hepatocyte necrosis as most not toxic until metabolised by CYP450
periportal necrosis
plants - blue-green algae, ragwort, amanita mushrooms, mycotoxins
chemicals/drugs - xylitol, carprofen, paracetamol
sopper
chronic low grade toxicosis - regenerative nodules and fibrosis due to liver repair
copper toxicity
acute - death due to hemolytic crisis and liver necrosis, icterus, liver necrosis, gunmetal blue kidneys
chronic - bedlington terriers, defect in copper transport gene
fatty liver disease
fatty liver/ketosis/twin lamb diease/steatosis
lipid deposition in liver
accumulation of triglycerides - more made than mobilised
usually when mobilising adipose tissue as energy source - negative energy balance
reversible
gall bladder mucocoele
border terriers
idiopathic
neoplastia of liver
heptocytes - hepatocellular adenoma/carcinoma
bile ducts - cholangiocellularcarcinoma
lymphoma metastasis
signs in horses
weight loss - reduced metabolism and nutrient utilisation - from impaired glycolysis/gluconeogenesis, fatty acid metabolism and bile acid excretion
jaundice - retention of bilirubin - from impaired excretion
neurological signs - increased circulating toxins and ammonia - from impaired detoxification of blood and elimination of ammonia
oedema, coagulopathies - hypoalbuminema and decreased clotting factors - from impaired production of plasma proteins
lethargy
inappetence
weight loss
colic
photsensitisation
encephalopathy
diarrhoea
70% function loss before signs occur
horse liver enzymes
AST - hepatocellular injury
ALP - billiary disease or drug induction
GGT - biliary disease, drugs, primary hepatic neoplasia - good indicator of chronic liver disease
GLDH - most specific for liver disease - hepatocellular injury
serum bile acids - highly specific for liver disease
not ALT in herbivores
prognosis indicators of equine liver disease
fibrosis
irreversible cytopathology
inflammatory infiltrate
hemosiderin accumulation
biliary hyperplasia
scored based on severity of each that is present
therapeutic options for treating equine liver disease
applied on basis of biopsy - specific diagnosis
fibrosis - steroids, vitamin E, benxapril
inflammatory infiltrate - steroids, vitamin E, antimicrobials
nutritional support - only needed if liver is failing, vitamin A, K, D, E. Low protein but high quality protein
leptospirosis - leptospires by species
dog - pomona and grippotyphosa
cattle - canicola, pyrogenes, grippotyphosa
horses - canicola and grippotyphosa
canine leptospirosis
direct spread through contact or indirect through urine
signs -
subclinical - no signs but infectious
peracute - death, shock presentation of shock and DIC
acute - fever, vascular injury, haemorrhage, anorexia, shock, renal failure, jaundice, diarrhoea, muscle tenderness, reluctance to move, death
chronic - multisystemic failure, chronic hepatitis, renal failure, anterior uveitis
pathophysiology - acute renal failure, liver impairment, leptospirosis pulmonary haemorrhage syndrome
leptospirosis - signs in ruminants
pyrexia
hemolytic anemia
hemoglobinuria
jaundice
drop in production
abortion
still birth
death
leptospirosis - signs in horses
uveitis
abortion
