Patterns of hepatobillary and pancreatic disease

Question 1

What is intrahepatic shunt

Answer 1

Abnormal blood vessels IN liver
Located in left hepatic division
Persistent patent fetal ductus venosus

Question 1

What is extrahepatic shunt

Answer 1

Splenomesenteric blood drains into a systemic vein, bypassing the liver through a complete or partial extrahepatic shunt.
Shunting from portal vein/major tributaries
Shunting to caudal vena cava

Question 2

Breed predisposed to extrahepatic shunt

Answer 2

Small breed dogs
Maltese, small terries

Question 3

Breed predisposed to intrahepatic shunt

Answer 3

Large breeds
Bernese mountain dogs, Retreiver

Question 4

Breed predisposed to congenital shunts

Answer 4

Irish wolfhound, Maltese, Yorkshire terrier

Question 5

Canine Adenovirus 1 (CAV-1) is a DNA virus with tropism for what cells?

Answer 5

Endothelium, mesothelium and hepatocytes

Question 6

Clinical presentations of CAV1

Answer 6

Pyrexia
Abdominal pain
Vomitting and Melena
Corneal opacity/ or blue
Sudden death

Question 7

Breed predisposed to chronic hepatitis

Answer 7

English Springer Spaniel

Question 8

Breed predisposed to copper associated liver disease

Answer 8

Bedlington Terrier

Question 9

Copper associated liver disease

Answer 9

Copper accumulation in liver causing liver fibrosis and necrosis

Question 10

Example of Toxic causes of liver disease

Answer 10

Xylitol
Iatrogenic
Toxins- mushrooms

Question 11

What is suppurative cholangitis

Answer 11

Inflammation and degeneration of bilary and bile ducts progressing to hepatic fibrosis

Question 12

Are dogs or cats more susceptible to suppurative cholangitis

Answer 12

Cats

Question 13

Cause of Exocrine pancreatic insufficiency in dogs

Answer 13

Juvenille pancreatic atrophy
pancreatic acinar atrophy
Chronic pancreatitis

Question 14

Cause of Exocrine pancreatic insufficiency in cats

Answer 14

Chronic pancreatitis

Question 15

Diagnosis of Exocrine pancreatic insufficiency

Answer 15

Low levels of Trypsin like Immunoreactivity (TLI) serum levels

Question 16

Clinical features of Exocrine pancreatic insufficiency

Answer 16

Diarrhoea and chronic weight loss despite voracious appt

Question 17

Breed predisposed to Juvenille pancreatic atrophy

Answer 17

German shephard

Question 18

Pathogenesis of Acute pancreatic necrosis

Answer 18

Activation of trypsinogen to trypsin within acinar cells
Activation of pancreatic proenzymes
Autodigestion of organ
Severe inflammation in acute pancreatitis can lead to vascular damage, including microvascular thrombosis and ischemia (reduced blood flow) to pancreatic tissue. Ischemia further exacerbates tissue injury and necrosis.

Question 19

Difference between Acute pancreatic necrosis (Local/Systemic)

Answer 19

Systemic
- Release of activated enzymes into systemic circulation
- Systemic inflammatory response
- Hypotention, Hypovolaemic shock, DIC
- Multiorgan failure

Local:
- Trypsin activates enzymes that damage walls of local blood vessels
- Oedema, Haemorrhage and thrombosis
- Pancreatic damage

Question 20

Biomarkers for canine pancreatitis

Answer 20

Canine pancreas specific lipase (cPSL)
- Marker for acute pancreatitis (>400ug/l)
Canine pancreatic elastase-1 (cPE-1)
- 17.24ng/ml

Question 21

What is Triaditis

Answer 21

Cats > Dogs
Concurrent inflammation of the pancreas, liver and small intestine
Primary trigger is SI inflammation leading to reflux of bacteric content into pancreaticbilloary duct