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BVM3 Alimentary > Hepatic Disease in Dogs and Cats > Flashcards

Hepatic Disease in Dogs and Cats Flashcards

1
Q

Label this liver!

A
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2
Q

What are the clinical signs of hepatic disease?

A
  • Inappetence/anorexia, vomiting +/- diarrhea
  • Jaundice, depression/lethargy, PU/PD
  • Neurological - encephalopathy
  • Bleeding tendencies - coagulopathies (lack of clotting factors)
  • GI ulceration
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3
Q

What is the timeline of acute vs chronic hepatopathies?

A

Acute - Days to weeks
Chronic - weeks to months

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4
Q

What are the causes of acute hepatopathies in Dogs?

A

Infections/parasites
Toxic/Drug induced
Neoplasia
Genetic

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5
Q

What are the causes of chronic hepatopathies in Dogs?

A

Inflammatory
Cirrhosis
Neoplastic
Drug-Related
Developmental/Congenital

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6
Q

List the infectious (viral, bacterial, parasitic) causes of acute hepatitis in dogs?

A

Leptospira
Canine Adenovirus (CAV-1)
Bacterial endotoxemia/septicemia
Parasitic - liver flukes

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7
Q

What are some toxic/drug-induced causes of acute hepatitis in dogs? How does this differ from the cause of drug-related chronic hepatitis?

A

Acute - phenobarbitone, carprofen, sulphonamides, fungi, alfatoxins, mycotoxins (blue-green algae)
Chronic - glucocorticoids

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8
Q

Which neoplasia is commonly responsible for acute hepatopathies in dogs? What about in cats

A

lymphoma (both)

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9
Q

List some inflammatory conditions associated with chronic hepatopathies in dogs?

A

Idiopathic chronic hepatitis
Chronic progession of acute hepatopathy
Eosinophilic/granulomatous hepatitis
Lobular dissecting hepatitis (hepatic reaction)
Doberman hepatopathy (copper storage? immune mediated?

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10
Q

List some inflammatory conditions associated with chronic hepatopathies in cats?

A

Accute supperative/neutrophilic cholangitis
Common and leads to jaundice (post-hepatic)

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11
Q

What are developmental/congenital causes of acute vs chronic hepatitis in dogs? What are the breed predispositions?

A

Same thing can cause both acute and chronic disease
Copper storage disease a cause of both
Possibly immune mediated
Bedlington terriers, Westies, Dobermans

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12
Q

What is cirrhosis the end stage of? What are the 2 types?

A

End stage of chronic hepatitis
Macronodular and Micronodular

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13
Q

How does hepatic lipidosis occur in cats? What is another (common) name for this disease? Does this cause acute or chronic hepatopathies in cats?

A

Not a disease on its own
Result of overweight cats not eating = changes in fat metabolism → accumulation of fat in liver (fatty liver)
Acute

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14
Q

What are some infectious causes of acute hepatopathies in cats? Which of these can also cause chronic hepatopathies?

A

Bacterial endotoxemia/septicemia
Toxoplasmosis - also chronic
Feline Infectious Peritonitis (FIP) - also chronic

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15
Q

What is the virus which causes FIP?

A

Feline coronavirus

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16
Q

Which drugs can induce acute hepatopathies in cats?

A

Diazepam
Phenobarbitone
Potentiated sulphonamides

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17
Q

Which drugs can induce acute hepatopathies in dogs?

A

phenobarbitone
Carprofen
potentiated sulphonamides

18
Q

Which toxins can induce acute hepatopathies in dogs?

A

Aflatoxins (Fungi on Corn/Maize)
Mycotoxins (Blue-green algae)

19
Q

What are the causes of chronic hepatopathies in cats?

A

Inflammatory
Amyloidosis
Neoplasia
Infectious
Congenital

20
Q

What are the inflammatory causes of chronic hepatopathies in cats?

A

lymphocytic cholangitis
Chronic neutrophilic cholangitis

21
Q

What is the name for cholangitis which also involves the pancreas and gut?

A

Triaditis

22
Q

Which biliary neoplasia is a common cause of chronic hepatopathies in cats?

A

biliary carcinoma

23
Q

What is a congenital cause of chronic hepatopathies in cats?

A

congenital portosystemic shunt

24
Q

What is the challenge with diagnosing hepatobiliary disease in dogs/cats

A

Clinical signs are few and unique

25
Q

What kind of organ is the liver? What does it do when another body system is not functioning well?

A

Reactive organ

26
Q

What are the challenges with clinical pathology assessment (BW)?

A
  • May or may not indicate liver disease is present
  • More difficult to assess in cats than in dogs as changes are more subtle in part due to shorter half life of enzymes
  • Even if blood tests confirm presence of liver disease, they will usually not indicate the type of lesion present
27
Q

Which values do you test on clin path if you suspect liver disease?

A
  • Liver enzymes (ALT, ALP, GGT, AST)
  • Bilirubin, Bile Acids, Albumin/Globulin
  • Cholesterol, Glucose, Urea, Ammonia
28
Q

What does ALT indicate? Why do you need to be careful with interpretation?

A

Alanine Transaminase
Leakage enzyme
Indicates hepatic parenchymal damage
T = TRAUMA
Liver leaks for many reasons (heart failure, gut disease, hemolysis, etc)

29
Q

Which tissue is ALT highest in? How does it get into the blood?

A

Liver
Liver cells release ALT into the bloodstream when they are damaged

30
Q

Which tissue is ALP highest in?

A

Liver and bone

31
Q

Which tissue is AST highest in?

A

heart, muscle, kidney, brain, pancreas, lung

32
Q

Which tissue is GGT highest in?

A

liver, kidney, pancreas and intestine

33
Q

What does ALP/GGT indicate? What does ALP/GGT test?

A

Alkaline phosphatase - ALP tests how much ALP is circulating in the bloodstream
Gamma-glutamyl transferase - GGT tests how much GGT is in bloodstream
Indicates cholestasis (slow down of bile flow) and liver damage

34
Q

What does decrease in Albumin indicate?

A

Decreased levels indicate losses of >80% of hepatic function or renal/gut loss

35
Q

What do globulins indicate? Are they a reliable indicator of hepatic disease?

A

Can be increased or decreased in hepatic disease - Not reliable

36
Q

How do glucose levels change in advanced hepatic failure?

A

Decrease

37
Q

How do urea levels change in advanced hepatic failure?

A

Decrease

38
Q

How do ammonia levels change in advanced liver failure? What other abnormality can change ammonia levels?

A

Increased
Shunts

39
Q

What are the best diagnostic imaging aids for diagnosing hepatobiliary disease?

A

Radiology
Ultrasound
CT Scanning

40
Q

What are the methods for biopsy in hepatobiliary disease?

A

U/S biopsy
Laparoscopy
Exploratory surgery

41
Q

Is “liver disease” a final diagnosis? How do you treat an animal with liver disease if you do not yet know the cause

A

No - need to continue to investigate
Treat symptoms first, but do no harm
Sometimes evidence will allow an informed guess based on species, demographics, age, etc.

42
Q

What can treatment of hepatic disease involve?

A

Supportive treatment (fluid therapy, management of acid/base and electrolyte derangements)
Abx (if needed)
Dietary mgmt/nutritional support
Antioxidants
Ursodeoxycholic acid (used for treatment of chronic cholestasis and jaundice)
Anti-inflammatories (corticosteroids)
Treatment of specific complications:
- Copper chelators, Anti-fibrotics
- Hepatic encephalopathy, gastroduodenal ulceration

BVM3 Alimentary (24 decks)

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