Lab diagnosis of liver disease Flashcards
What enzymes indicate hepatocellular damage?
Alanine aminotransferase (ALT) - Aspartate aminotransferase (AST) - Sorbitol dehydrogenase (SDH) - Glutamate dehydrogenase (GLDH)
Which enzyme is used most commonly in small animals to signify hepatocyte damage? What is used in large animals?
ALT - SDH or GLDH
Which two enzymes are not liver specific? Where else can they be derived from?
AST and ALT - muscle
To differentiate between muscle and liver damage what else can you look at?
Creatine kinase levels as it is muscle specific and peaks earlier than AST and ALT
What enzymes indicate Cholestasis? (obstruction of bile flow - biliary substances in blood)
Alkaline phosphate (ALP) and Gammaglutamyltransferase (GGT)
ALP is derived from ____ ____ ______ and ____
Bile duct epithelium - bone
Why is an increase in ALP steroid induced isoform significant in cats?
Not normally present
GGT is derived from ___ ____ _____, a better indicator of cholestasis in _____ animals
Bile duct epithelium - large
What are the 7 substances that measure hepatic function?
Bilirubin - Albumin - Urea - Glucose - Cholesterol - Ammonia - Bile acids
What will the levels of ammonia and urea be during hepatic disease? Why?
Higher ammonia and lower urea - Less conversion of ammonia to urea in the liver
Cholesterol is ______ in liver and _____ in bile. What happens to it during a) cholestasis b) hepatic failure?
Synthesized - excreted
a) increases due to decreased secretion
b) decreases due to less synthesis
What 3 diseases would increase cholesterol? Name another disease which would decrease cholesterol?
Diabetes Mellitus, Hyperadrenocorticism, Hypothyroidism - Hyperthyroidism
In small animals, when do you measure Bile Acid Concentration?
During fasting and post prandial (after eating)
What can cause lower Bile Acid clearance from portal blood?
Decreased functional mass - Portosystemic shunt
What can cause lower Bile Acid excretion via bile?
Obstructive cholestasis
