Hepatology

Question 1

Answer 1

Question 2

Answer 2

• Compare effect of hepatic diet, hepatic diet + lactulose, hepatic diet and metronidazole on dogs 36 dogs with cEHPSS assessing clinical signs, fasting ammonia and CRP
• Hepatic diet + lactulose was effective in pre surgical control of clinical score
• addition of metronidazole did not improve clinical score
• medical management reduced fasting ammonia
  Conclusion: Hepatic diet and lactulose provides a good reduction in clinical score in dogs with cPSS

Question 3

Which pre-surgical treatment(s) resulted in a significant improvement in clinical score in dogs with EHPSS prior to shunt attenuation
a) Hepatic diet
b) Hepatic diet + lactulose
c) Hepatic diet and metronidazole
d) Metronidazole only

Answer 3

B - Hepatic diet and lactulose

Question 4

Answer 4

Question 5

Answer 5

• Currently CT angiography, transplenic portal scintigraphy or visualization are required to identify MAPSS
• Increased spec CPLI has been identified in dogs with portal hypertension and normal pancreatic histo.
• Assess if spec cPL post surgical attenuation of cEHPSS was higher in dogs with MAPSS
• No changes in spec CPL over time identified in any group
• Half life of spec cPL is <2hrs
  Conclusion: Spec cPL not useful marker for development/presence of MAPSS

Question 6

Answer 6

Question 7

Answer 7

• Perioperative mortality in dogs with EHPSS is 3-10%, statistical models that predict outcome would be useful
• Post attenuation seizures possibly associated with age and hepatic encephalopathy
• 85 dogs, 5 developed post attenuation seizures
• variable associated with seizures: higher age, lower WBC count, genes dHGFact and dLYSMD
• Variable predictive of recovery: pre-op albumin, CTGF (associated with liver fibrosis/role in regeneration), WBC, expression of MAT2alpha (gene associated with cell proliferation)
  Conclusion: Pre operative higher albumin is associated with clinical and complete recovery post PSS closure

Question 8

Which preoperative factors were found to be associated with clinical recovery in dogs post EHPSS ligation
a) Age, MAT2a expression and bilirubin
b) Albumin, WBC count, and MAT2a expression
c) Resting bile acids, albumin and CTGF expression
d) Albumin, ages and DHD expression

Answer 8

B - Albumin, WBC count, and MAT2a expression