Investigating Canine and Feline Liver Disease Flashcards

Question

Summarise how billirubin is produced in the body

Answer 1

erythrocytes Transported to the liver and conjugated, secreted into bile, stored in gall bladder and excreted via ducts

Answer 2

Prehepatic - Haemolysis - Increased production exceeds capacity of hepatic excretion Hepatic - Abnormal uptake, defective conjugation or abnormal excretion of bilirubin by hepatocytes Post hepatic - Impaired excretion of bilirubin

Answer 3

Increased PCV

Answer 4

ALP, GGT > ALT, AST Hypercholesterolaemia? Ultrasound biliary system - Assess for obstruction of bile duct, GB rupture Pancreatic assessment- cPLI

Answer 5

Rule out pre and post hepatic aetiology Consider biopsy

Answer 6

Liver failure

Answer 7

Extrahepatic bile duct obstruction Intrahepatic cholestatic diseases Marked hepatic regeneration

Answer 8

Derived from diet and made in the liver Undergoes enterohepatic recycling Bile provides the major excretory pathway

Answer 9

Decreases with severe liver dysfunction due to failure to convert ammonia to urea

Answer 10

Occasionally hypoglycaemia seen with severe hepatic compromise (<30% hepatic function)

Answer 11

bile acids

Answer 12

Mild anaemia Microcytic, hypochromic anaemia with portosystemic shunts

Answer 13

Accumulation of free fluid within the abdominal cavity

Answer 14

Decreased oncotic pressure- Hypoalbuminaemia Increased hydrostatic pressure - Portal Hypertension Leakage from organs (bile) Inflammation (peritonitis) Leakage from vessels (blood)

Answer 15

Minimally invasive procedure Little equipment Sedation Useful for lymphoma, mast cell tumours and hepatic lipidosis Bile samples

Answer 16

Accuracy of cytology limited (30-50% agreement with histology) Does not evaluate hepatic architecture Only cytology Iatrogenic damage gall bladder

Answer 17

Cutting Needle (Tru-Cut)

Answer 18

Larger sample size allows examination of hepatic architecture Avoids laparotomy Sample focal disease

Answer 19

General anaesthesia Specialist equipment Less accurate than surgical biopsies Difficult with small livers or ascites Haemorrhage

Answer 20

Better diagnostic samples. Larger sample size allows better examination of hepatic architecture Can get samples form multiple liver lobes and bile aspirate Can visualise haemorrhage

Answer 21

General anaesthesia More invasive procedure Risks of haemorrhage

Answer 22

Chronic Hepatitis Cholangitis - Neutrophilic Cholangitis - Lymphocytic Cholangitis - Vacuolar Hepatopathies Hepatobiliary Neoplasia

Answer 23

Inflammation of the hepatic parenchyma Often present later stages of chronic hepatitis Treat with immunosuppressives

Answer 24

Inflammation of the biliary duct More common in cats +/- duodenitis, pancreatitis, cholangitis (“triaditis”)

Answer 25

Suppurative inflammation on histology Ascending infection from intestines – anatomical problem in cats Treat with AB

Answer 26

Suspected immune mediated disease Chronic history of vague illness Systemically well – normothermic Treat with immunosuppressive

Answer 27

Histopathology diagnosis Hepatocytes become markedly distended with cytosolic glycogen Associated with glucocorticoid excess: - Glucocorticoid administration - Hyperadrenocorticism Endogenous release of corticosteroids in response to chronic stress, illness, inflammation or neoplasia ALP often increased (dogs)

Answer 28

Distention of gallbladder by an inappropriate accumulation of mucus

Answer 29

“Kiwi” appearance

Answer 30

Inflammatory response of the lining of the abdominal cavity to the presence of free bile