Increased Serum Transaminases in the Dog Flashcards
what are the bacterial hepatobiliary infectious diseases?
leptospirosis
opportunistic: enteric organisms
what is a hepatic and/or bile FNA good for?
neoplasia especially round cell
vacuolar change
identify/culture infectious organisms
is bile or liver better to culture?
bile
what are the contraindications for a hepatic biopsy?
high probability of hemorrhage
suspicious of an abscess
severe ascites- to percutaneous only
what is the presentation of chronic hepatitis?
many asymptomatic
vague signs
clinical pathology and imaging changes
how are bedlington terriers predisposed to primary copper hepatopathy?
autosomal recessive
DNA test available
what can you stain with for copper?
rhodamine
what are the causes of primary copper hepatopathy?
genetic
increased intake
decreased excretion from cholestatic disease: not in dogs
how can you treat hepatic copper toxicosis?
limit copper intake
anti-oxidants: SAMe, vitamin E
chelate copper
decrease absorption of copper
monitor
when should you use immunosuppressive therapy in immune chronic hepatitis?
hepatic biopsy shows chronic hepatitis with significant lymphoplasmacytic or granulomatous inflammation
evidence of extrahepatic immune disease- raree
elimination of infectious/toxic etiologies
what are the pros of using corticosteroids for immunosuppressive therapy?
anti-inflammatory
mild choleretic
appetite stimulant
what are some hepatoprotectants?
N-acetylcysteine
S-adenosylmethionine
ursodeoxycholate
vitamin E
silymarin
what is the most significant finding for diagnosing a congenital portosystemic shunt?
elevated serum total bile acids
what drugs can be associated with acute liver failure?
diazepam in cat
potentiated sulfonamides in dog
carprofen in dog
acetaminophen when overdosed in dog and cat
what are some environmental toxins?
cycad seeds
amanita mushrooms
blue green algae
xylitol
alfatoxin
copper
which endocrinopathies can cause an elevated ALT?
diabetes mellitus
hyperadrenocorticism
hyperthyroidism: cats
what GI diseases can cause ALT to be elevated?
pancreatitis
inflammatory bowel disease
what viral disease can cause hepatobiliary disease in dogs?
canine adenovirus
what is a hepatic and/or bile FNA bad for?
inflammation
fibrosis
bile cytology typically normal with primary hepatic disorders
what size needles should you use for hepatic biopsies?
canine: 16G
feline: 18G
what should you expect from a hepatic biopsy?
identify category
identify extend and severity
provide material for special testing
not etiology in every case
what would indicate your animal is at increased risk for bleeding?
PT and PTT >1.5xprolonged
platelet count <80,000/ul
what are the etiologies of canine chronic hepatitis?
idiopathic: most
toxic
immune
infectious: rare
how can you eliminate the causative agent of chronic hepatitis?
stop all hepatotoxic drugs
test for copper and chelate
test for autoimmune disease: no good tests
test for infectious disease
where is copper seen in copper hepatopathy?
high grade
centrilobular
what are the cons of azathioprine?
maintenance not induction of remission
bone marrow suppression
hepatotoxic
what are the hepatic vascular diseases?
congenital portosystemic shunts
microvascular dysplasia
what are the clinical signs of congenital portosystemic shunts due to?
hepatic encephalopathy
hepatic atrophy
who is predisposed to microvascular dysplasia?
yorkies
cairns
other small breeds
what are clinical signs of microvascular dysplasia?
usually none
no treatment necessary
what is acute liver failure?
recent onset of hepatic disease with hyperbilirubinemia and coagulopathy
+/- development of encephalopathy
