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Articles 2020-24 > Hepato > Flashcards

Hepato Flashcards

1
Q

What is Tyzzer’s disease ? (etiology, target population, clinical signs)

A

Clostridium piliforme acute necrotising hepatitis = Tyzzer’s disease
Clostridium piliforme is a Gram-negative, obligate intracellular spore-forming manure- and soil-borne bacterium.
Hepatic lesions predominate in foals, with profound hypoglycaemia and variable increases in hepatic enzymes

Successful management of an outbreak of Tyzzer’s disease on a Thoroughbred breeding farm in central Kentucky; use of sorbitol dehydrogenase to identify sub-clinical cases
EVE 2023

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1
Q

What is the ddx of hepatic failure in neonates ?

A
  • EHV-1
  • Tyzzer’s disease
  • neonatal isoerythrolysis
  • acute iron toxicity
  • congenital biliary atresia
  • hypoxic injury

Successful management of an outbreak of Tyzzer’s disease on a Thoroughbred breeding farm in central Kentucky; use of sorbitol dehydrogenase to identify sub-clinical cases
EVE 2023

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2
Q

What biomarker could be used to identify subclinical or early-onset Tyzzer disease?

A

SDH (Sorbitol deshydrogenase) lacks specificity but might be the most sensitive test available during a Tyzzer’s disease outbreak.

Successful management of an outbreak of Tyzzer’s disease on a Thoroughbred breeding farm in central Kentucky; use of sorbitol dehydrogenase to identify sub-clinical cases
EVE 2023

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3
Q

Which virus is currently suspected of causing Theiler’s disease?

A

Equine Parvovirus Hepatitis (EqPV-H)

First report of equine parvovirus-hepatitis-associated Theiler’s disease in Europe
evj 2020

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4
Q

Which zoonotic virus has been found in donkeys in China? Which genotype ?

A

Detection of hepatitis E virus genotypes 3 and 4 in donkeys in northern China

Detection of hepatitis E virus genotypes 3 and 4 in donkeys in northern China
evj 2020

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5
Q

What are the most liver specific enzymes in horses ?
A- ALKP, ASAT, GGT
B- LDH, GGT, SDH
C- GGT, ALKP, GLDH
D- GGT, SDH, GLDH

A

D- GGT, SDH, GLDH
GGT → biliary disease
SDH, GLDH → hepatocellular damage
SDH → very sensitive and specific marker of liver disease

Pre-analytical stability of sorbitol dehydrogenase in equine heparinized plasma
Vet J 2021

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6
Q

What is the pre-analytical stability of SDH in equine heparinized plasma ?
A- Adequate stability for 72h at -20°C
B- Adequate stability for 4h regardless of storage T° and 24h if stored at 4°C
C- Adequate stability for 4h at 4°C and 24h if stored at -20°C
D- Adequate stability for 4h regardless of storage T° and 24h if stored at -20°C

A

B- Adequate stability for 4h regardless of storage T° and 24h if stored at 4°C

Pre-analytical stability of sorbitol dehydrogenase in equine heparinized plasma
Vet J 2021

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7
Q

What risk factor is associated with active equine parvovirus-hepatitis infection (presence of DNA) ?

A

The risk of active EqPV-H infection increases with increasing age.
Significantly, higher probability of active EqPV-H infection was identified in 16 to 31-year-old horses vs 1 to 8 yo and 9 to 15 yo.

Active equine parvovirus-­ hepatitis infection is most frequently
detected in Austrian horses of advanced age
evj 2022

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8
Q

What methods of horizontal transmission are currently ‘proven’ for EqPV-H? (several possible answers)
A- Oral transmission
B- Nasal transmission
C- Oro-fecal transmission
D- Insect-vectoring
E- Equine origin biologic products

A

B- Nasal transmission
E- Equine origin biologic products

Nasal transmission of equine parvovirus hepatitis
jvim 2022

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9
Q

In which samples EqPV-H DNA could be detected ?

A

In one recent study, EqPV-H DNA was detected in nasal secretions and feces of viremic horses (serum). Also detected in oral secretions in other studies.
Risk of horizontal transmission ?

Subclinical infection and potential shedding routes of equine parvovirus-hepatitis among hospitalized horses in Austria
jvim 2024

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10
Q

What are the characteristics of the new seasonal idiopathic hepatitis syndrome? (several answers)
A- Cyclic fever and anorexia
B- Cyclic fever and colic
C- Hepatocellular necrosis (histology)
D- Megalocytosis (histology)
E- During winter and spring
F- During summer and autumn
G- Fatal disease with liver failure
H- Self-resolving

A

A- Cyclic fever and anorexia
C- Hepatocellular necrosis at histo
E- During winter and spring
H- Self-resolving (with NSAIDs)

A seasonal idiopathic hepatitis syndrome in horses presented to a Midwestern veterinary teaching hospital
javma 2023

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11
Q

In Thoroughbred racehorses, GGT activity increases with :
- racing frequency,
- earnings,
- age,
- cumulative training load,
- distance

A

It has been demonstrated that GGT activity increases with racing frequency and cumulative training load.

Investigating the pathogenesis of high- serum gamma-glutamyl transferase activity in Thoroughbred racehorses: A series of case- control studies
evj 2022

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12
Q

Is viral hepatitis associated with the pathogenesis of high-serum GGT activity in TB racehorses ?

A

We conclude that high GGT syndrome is likely a complex metabolic disorder and that viral hepatitis was not identified as a cause for this syndrome in this cohort of racehorses.

Investigating the pathogenesis of high- serum gamma-glutamyl transferase activity in Thoroughbred racehorses: A series of case- control studies
evj 2022

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13
Q

Is pancreatitis or vitamin E deficiency associated with the pathogenesis of high-serum GGT activity in TB racehorses ?

A

Serum lipase and amylase activity and α-tocopherol concentrations did not differ between groups.

Investigation of high gamma-glutamyltransferase syndrome in California Thoroughbred racehorses
jvim 2022

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14
Q

What is the current hypothesis regarding the pathogenesis of high GGT syndrome in TB and SB racehorses ?
- Genetic disorder
- Vitamin E and selenium deficiency
- Viral hepatitis
- Oxidative stress
- Enhanced glutathione recycling
- Mild cholestasis
- Hepatocellular injury
- Enhanced Reactive oxygen and nitrogen species (RONS)

A

An underlying genetic etiology may exist for high GGT syndrome in racing TB.
Enhanced glutathione recycling by the liver and mild cholestasis are possible explanations.

Investigation of high gamma-glutamyltransferase syndrome in California Thoroughbred racehorses
jvim 2022
Case–control exercise challenge study on the pathogenesis of high serum gamma-glutamyl transferase activity in racehorses
evj 2023

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15
Q

Which mycotoxins are associated with hepatopathy in horses ?
- Fumonisin B1
- Mycophenolic acid
- Roquefortine C
- Zearalanone
- aflatoxin B1 and G1
- Neosolaniol

A

The main groups endangering animal health comprising
alflatoxins, ochratoxins, trichothecenes, fumonisins, and zearalenone.
In one study, the median concentration of fumonisin B1 was significantly higher in case (hepatopathy) versus control samples, consistent with the hypothesis that forage-associated mycotoxicosis may be a cause of outbreaks of liver disease in horses in the United Kingdom

Association between forage mycotoxins and liver disease in horses
jvim 2022

16
Q

What is the clinical significance of increased peritoneal bile acids concentrations ?

A

The hepatic group and the GI ischaemic-inflammatory group had significantly higher PBAC than the control and GI obstructive groups.
The nonsurvivor group had significantly higher median PBAC value than the survivor group.

Peritoneal bile acids concentration in adult horses with hepatic and gastrointestinal disorders
evj 2022

17
Q

A 3-year-old Thoroughbred racehorse in training presents with normal clinical examination but routine bloodwork reveals a serum gamma-glutamyl transferase (GGT) activity of 65 IU/L (reference range 2-36 IU/L). Which of the following is most likely to be observed in further diagnostic testing of this horse?

A) Markedly elevated serum activities of other liver enzymes like AST and SDH
B) Positive PCR results for equine hepacivirus (EqHV)
C) Significantly decreased serum selenium concentration
D) Decreased serum concentrations of taurine-conjugated bile acids
E) Reduced serum abundance of vitamin B6

A

The correct answer is E) Reduced serum abundance of vitamin B6.

Explanation:
Horses with high GGT did not show marked elevations in other liver enzymes like AST or SDH, ruling out option A1
No significant differences were found in the frequency of EqHV or EqPV-H between cases and controls, making option B unlikely1
While selenium concentrations were lower in case horses, they remained within reference intervals, so option C is not the best choice1
The study found increased abundance of taurine-conjugated bile acids in cases compared to controls.
Metabolomic testing revealed reduced abundance of Vitamin B6 in cases compared to controls. This finding is particularly interesting as it aligns with other research suggesting a potential role of vitamin B6 in liver metabolism and steatosis

Investigating the pathogenesis of high-serum gamma-glutamyl transferase activity in Thoroughbred racehorses: A series of case-control studies. 2021

18
Q

A 3-year-old Thoroughbred racehorse in training presents with normal clinical examination but routine bloodwork reveals a serum gamma-glutamyl transferase (GGT) activity of 65 IU/L (reference range 2-36 IU/L). Further testing shows mildly elevated total bilirubin and alkaline phosphatase (ALP) activity, with normal aspartate aminotransferase (AST) and sorbitol dehydrogenase (SDH) activities. Which combination of additional findings is most consistent with the pathophysiology of high GGT syndrome in racehorses as described in this study?

A) Increased serum taurolithocholate, normal selenium levels, and positive PCR for equine hepacivirus (EqHV)
B) Decreased serum pyridoxal (Vitamin B6), low-normal selenium levels, and increased serum L-pyroglutamic acid
C) Normal bile acid profile, elevated selenium levels, and positive PCR for equine parvovirus-hepatitis (EqPV-H)
D) Increased serum palmitoleate, markedly elevated SDH activity, and negative viral PCR results
E) Decreased serum taurochenodeoxycholic acid, normal selenium levels, and increased serum propionyl-carnitine

A

The correct answer is B) Decreased serum pyridoxal (Vitamin B6), low-normal selenium levels, and increased serum L-pyroglutamic acid.

Explanation:
Decreased serum pyridoxal (Vitamin B6) was observed in cases compared to controls in the metabolomics analysis.
Selenium concentrations, although within reference intervals, were lower in case horses in both the pilot and larger studies.
Increased L-pyroglutamic acid was found in cases in the untargeted metabolomics analysis of the larger study.
These findings support the study’s conclusion that high GGT syndrome is likely a complex metabolic disorder involving oxidative stress and cholestasis, rather than primarily viral hepatitis or severe hepatocellular injury.
The other options are incorrect because:
A) While increased taurolithocholate was observed, normal selenium and positive EqHV PCR are not consistent with the overall findings.
C) The study found differences in bile acid profiles, and selenium was lower, not elevated, in cases.
D) Markedly elevated SDH was not a feature of the syndrome; palmitoleate changes were inconsistent across studies.
E) Taurochenodeoxycholic acid was increased, not decreased, and propionyl-carnitine was decreased in only one subset of cases.

Investigating the pathogenesis of high-serum gamma-glutamyl transferase activity in Thoroughbred racehorses: A series of case-control studies. 2021

19
Q

Explain the link between hyperlipemia and AKI

A

vascular thrombosis with fat embolism -> Renal nephrosis -> azotemia inhibits lipoprotein lipase -> inhibition of removal of lipids from blood.
50% of miniature horses in hyperlipemia have azotemia.

REED

20
Q

Equine Parvovirus-Hepatitis (EqPV-H) was found only in Argentina (outside from Europe) and in serum pool?
A. Yes
B. No

A

B; worldwide (eg Brazil as well).

None of the serum pools was positive by qpcr.

Three of the commercial horse serum batches (60 %) contained EqPV-H DNA, detected either by qPCR and/or nested-PCR.

EqPV-H in horses and in horse sera commercially available in Argentina and emphasizes the importance of controlling the biosecurity of commercial equine sera as well as any other blood-derived biological products of equine origin.

First report of Equine Parvovirus-Hepatitis (EqPV-H) in Argentina

Articles 2020-24 (18 decks)

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