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!Small Animal Medicine > K9 hepatic dz > Flashcards

K9 hepatic dz Flashcards

1
Q

Acute K9 heaptic dz presenting complaint

A

Acute onset anorexia, depressed attitude, V/D

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2
Q

Possible hepatotoxins

A

Blue green algae
Death cap mushroom
Alfala toxin (gets into food)
Sago palm
NSAIDs

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3
Q

Viral (infectious) causes of hepatic dz

A

K9 adenovirus
Coronavirus
Herpesvirus

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4
Q

Bacterial (infectious) causes of hepatic dz

A

Leptospirosis
Enteric organisms
Mycobacterium
helicobacter

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5
Q

Fungal (infectious) causes of hepatic dz

A

Histoplasmosis
Blastomycosis
Coccidioidomycosis

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6
Q

Parasitic and protozoan (infectious) causes of hepatic dz

A

Trematodes
Toxoplasma, Leishmaniasis, cytauxzoon
Rickettsial dz

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7
Q

Other causes of acute hepatic damage

A

Congenital/ acquired hepatic shunts
Pancreatitis
Acute hemolytic anemia
Heatstroke
Anesthesia/ sx hypotension
Liver lobe torsion
Sepsis
Abdominal trauma

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8
Q

CS of acute hepatic dz

A

Icterus
hepatic encephalopathy
Hepatic necrosis/ failure
Petechiae/ ecchymosis

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9
Q

Icterus/ jaundice

A

> 2 mg/dl
Yellow discolor: gums, hard palate, sclera, ear pinna, ventral abdominal skin

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10
Q

Icterus differentials

A

Acute hepatitis/ chr. endstage hepatitis (primary or secondary)
Infiltrative hepatic neoplasia

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11
Q

How to tx icterus

A

Fluid therapy (BR toxic to kidneys)
Ursidiol
Tx underlying dz

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12
Q

CS of hepatic encephalopathy

A

Dull mentation, wide base stance, circling, pacing, ataxia, head pressing, vocalizing, seizure

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13
Q

Hepatic encephalopathy

A

Hepatic dz (acute hepatitis, porto shunt, chr. hepatitis)
CNS dz (hydrocephalus, infectious, inflamm, neoplasia)

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14
Q

Which dz does petechiae/ ecchymosis occur in?

A

Acute or chr. hepatitis
Ehrlichiosis, babesiosis
Sepsis, heatstroke, rodenticide poisoning, VWD

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15
Q

Signs of hepatotoxin

A

Target cells, spur cells or poikilocytes

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16
Q

Hepatic necrosis

A

Hepatocellular damage and swelling: ↑ ALT, AST, GGT, ALP
Cholestasis: ↑ BR (and same as above)

17
Q

Hepatic failure

A

Lack of albumin production
Lack of breakdown: proteins (BUN), fat (cholesterol), CHO (glucose)

18
Q

Specific hepatic function tests

A

Bile acid assay (functioning liver mass- 20= hepatopathy, 5-= liver dz, 100= hepatic failure)
Serum ammonia levels (ability to detoxify)

19
Q

Liver sampling

A

Fine needle aspirate (cytology)
Liver bx (US or laparotomy)
Histopath: hepatic necrosis

20
Q

Liver dz management

A

Tx infection: abx, antifungal or antiparasitic
Remove toxin: activated charcoal, induce vomting, fluid therapy

21
Q

Tx HE: dietary management

A

Protein from diet: ammonia
Emergency tx: NPO and fluid therapy
Low protein diet

22
Q

Tx: removal of colonic bacteria

A

Cleansing enema (povidone iodine)
Retention enema (neomycin + lactulose)
If no V or seizure: oral latulose or oral abx

23
Q

Stabilizing and supportive therapy of HE

A

IV balanced fluids and anti-emetics (V/D)
Potassium to fluid (hypokalemia)
Dextrose to fluids (hypoglycemia)
Antacids (gastric ulcers)

24
Q

Coagulopathy tx

A

Vit K if needed
Fresh whole blood for excessive bleeding

25
Q

Chr. K9 hepatitis CS + differentials

A

Waxing/ weaning, V/D for >2 w (GI dz)
PU/PD (renal dz/ failure or addisons)
WL (protein losing dz, neoplasia)
Thin. cachetic. depressed
Icterus (IV hemolysis, hepatic, cholestasis)
Enlarged abdomen (CHF, protein losing enteropathy)
HE

26
Q

Clin path for chr. hepatic dz

A

↓ ALP, ALT, AST, GGT (low, norm then high)
↓ BUN, glucose, albumin, cholesterol, globulin
↑ resting ammonia, pre and post BA, BR
Isothenuria, alkalinuria, bacteruria
Abdominal fluid analysis

27
Q

Rads for chr. hepatic dz

A

Microhepatica
Loss of abdominal viscera detail (from ascites or ↓ abdominal fat)

28
Q

Sonograph findings for chr. hepatic dz

A

Small hyperechoic liver
Fluid in abdomen
Extra-hepatic shunt vessels (acquired)

29
Q

Liver histopath for chr. hepatic dz

A

Peicemeal or bridging necrosis and active cirrhosis
Excess copper per gram of tissue

30
Q

Slow progression of chr. hepatic dz (inflamm)

A

Anti-inflamms or immunosuppressive to ↓ neutros and lympho activity
ex: pred, azathioprine, cyclophosphamide

31
Q

Slow progression of chr. hepatic dz (↓ fibrosis)

A

Fibrosis can lead to biliary stasis, icterus and ascites
ex: colchicine, pred and D-penicillamine

32
Q

Antioxidants for chr. hepatic dz

A

Free radical scavengers to ↓ inflammation
ex: s-adensyl methionine, vit E, zinc, silymarin

33
Q

Chr. K9 heaptic dz/ Copper associated hepatiz dz CS

A

Mild Cu levels (↑ ALT, asymptomatic)
Moderate Cu levels (V, lethargy, anorexia)
Marked levels (“,” poor BCS, failure; icterus, ascites, HE and CLF)

34
Q

Copper associated hepatiz MOA

A

↑ uptake
Defect in copper metabolism
Altered biliary excretion

!Small Animal Medicine (14 decks)

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