Liver disease

Question 1

Liver failure is when what percent of liver function is lost?

Answer 1

> 70%

Question 2

Liver disease clinical signs include pain, inflammation, , jaundice, anorexia, haemolytic, sepsis, weight loss, depression and CNS signs. Photosensitisation also occurs - due to what?

Answer 2

Phylloerythrin accumulation

Question 3

Why can ALT not be used to diagnosed liver disease in horses?

Answer 3

Large muscle mass - inaccurate

Question 4

Which liver enzymes are cholestatic?

Answer 4

ALP and GGT

Question 5

What test to diagnose liver disease in horses also correlates with severity?

Answer 5

Bilce acids test (>50umol/l)

Question 6

What can be measured to predict hepatic encephalopathy?

Answer 6

Blood ammonia levels

Question 7

Acute hepatitis is associated with which viruses, toxins and parasites?

Answer 7

Theiler’s disease associated virus, hepacivirus, parvovirus
Aflatoxins
Liver fluke

Question 8

Chronic active hepatitis is any progressive, inflammatory hepatitis. It is often immune mediated. How is it diagnosed?

Answer 8

Biopsy

See if plasmocytic or lymphocytic immune mediated

Question 9

How is chronic active hepatitis treated?

Answer 9

Corticosteroids

Immunosuppressives (azathioprine)

Question 10

What are the risk factors/animals more at risk for hyperlipaemia/hyperlipidaemia?

Answer 10

Ponies/donkeys
Females - esp lactating (NEB)
Obesity
Underlying disease/stress
Starvation

Question 11

Hyperlipaemia/hyperlipidaemia has non-specific clinical signs. How is it diagnosed?

Answer 11

Blood serum - cloudy
TG 1.5-5 mmol/l = hyperlipidaemia
TG >5 mmol/l = hyperlipaemia

Question 12

How is hyperlipaemia/hyperlipidaemia treated?

Answer 12

Treat underlying cause
Positive energy balance
Correct dehydration/electrolytes/acidosis 
Get out of box rest
Insulin therapy

Question 13

Animals with hyperlipaemia/hyperlipidaemia are at risk for developing which condition?

Answer 13

Laminitis

Question 14

The prognosis for horses with hyperlipaemia/hyperlipidaemia is guarded-poor. In what situations is the prognosis worse?

Answer 14

Other organ involvement
If female
Poor initial response to treatment
Failure to eat

Question 15

What plants can cause pyrrolizidine alkaloid toxicity?

Answer 15

Ragwaort (Senecio jacobaea)
Patterson’s curse
Fireweed

Question 16

What is the pathology of pyrrolizidine alkaloid toxicity?

Answer 16

Anti-mitosis - megalocytosis, fibrosis, toxic effect

Liver failure - can be delayed up to 1 year after exposure

Question 17

Plants that cause pyrrolizidine alkaloid toxicity are highly palatable. What % of BW ingestion can be lethal?

Answer 17

5%

Question 18

Pyrrolizidine alkaloid toxicity can show general clinical signs such as weight loss, behavioural changes/CNS signs, anorexia and jaundice. What are some more specific clinical signs?

Answer 18

Inspiratory dyspnoea (laryngeal paralysis)
Gastric impaction colic
Photosensitisation
Haemorrhage

Question 19

How are pyrrolizidine alkaloid toxicities treated?

Answer 19

Supportive therapy
Reduce hepatic encephalopathy - low protein diet
Antibiotics - neomycin, metronidazole

Question 20

Which 2 liver enzymes are crucial for diagnosing liver disease in horses?

Answer 20

AST
GGT
(AP
GLDH)