The Icteric Cat and Dog Flashcards
where does heme come from?
red blood cells: hemoglobin, myoglobin, cytochrome
what percentage of septic cats have an increase in serum bilirubin?
63%
what infections can cause hemolytic anemia in cats?
mycocplasma
FeLV
what medications can cause hepatic icterus in cats?
oral diazepam
methimazole
what is the prevalence of lipid vacuoles in hepatic lipidosis?
> 50-60% of hepatocytes
what should you supplement in cats with idiopathic hepatic lipidosis?
glutathione
vitamin K
+/- vitamin B1
+/- carnitine
when is the prognosis of idiopathic feline hepatic lipidosis good?
if bilirubin decreases in first 5-7 days
what are the signs of acute neutrophilic cholangitis?
anorexia, lethargy, vomting
big three: fever, icterus, abdominal pain
what are the histologic patterns that cholantitis/cholecystitis can be?
acute neutrophilic cholangitis
chronic neutrophilic cholangitis
chronic lymphocytic cholangitis
what can lymphocytic cholangitis be hard to distinguish from?
small cell lymphoma
how can you treat lymphocytic cholangitis?
immunomodulation
hepatoprotectives
dietary: vitamin B12
what can cause post-hepatic icterus in a dog?
pancreatitis
gallbladder mucocele
cholelithiasis
cholecystitis
what is hyperbilirubinemia?
unusually large concentration of bilirubin in the blood
poor prognostic indicator in hepatobiliary and non-hepatobiliary disorders
how does sepsis cause cholestasis?
release of cytokines
down-regulation of hepatic transport proteins
is prehepatic icterus more common in dogs or cats?
dogs
what is abnormal in CBC, chem, abdominal effusion of hepatic lipidosis?
chem: increase liver enzymes, GGT slightly
abdominal effusion only if concurrent pancreatitis
what is lymphoma like in the liver on ultrasound?
big, can be bright, dark, or nodular
increased lymph nodes
splenomegaly
what does fine needle aspirate of the liver over diagnose?
vacuolar disease
how can you treat small cell lymphoma in cats?
prednisolone
chlorambucil
is an FNA diagnostic for lipidosis?
yes
what is seen on laboratory tests for feline idiopathic hepatic lipidosis?
moderate to marked increase in ALP
mild to moderate increase in ALT
mild increase in GGT
what should you avoid giving a cat with feline idiopathic hepatic lipidosis?
propofol anesthesia for extended periods
corticosteroids
what should you feed cats with feline idiopathic hepatic lipidosis?
high calorie density
highest protein tolerated
how is cholangitis/cholecystitis defined?
by histological pattern: acute neutrophilic cholangitis, chronic neutrophilic cholangitis, chronic lymphocytic cholangitis
what is seen in laboratory testing with acute neutrophilic cholangitis?
mild to moderate neutrophilia +/- left shift
hyperbilirubinemia
increased ALT, AST, GGT, ALP
what is best to perform aerobic and anaerobic cultures of for acute neutrophilic cholangitis?
gallbladder wall
how can you treat acute neutrophilic cholangitis?
eliminate/treat predisposing factors
antibiotics for 6 weeks
hepatoprotectants and/or choleretics
what are clinical signs with chronic neutrophilic cholangitis?
middle aged to older
chronic waxing/waning for years
episodic, vomiting, weight loss, hyporexia
icterus and hepatomegaly
what is seen on laboratory testing with chronic neutrophilic cholangitis?
increased enzymes, ALP, GGT, ALT, AST
increased bilirubin
what are signs like with lymphcytic cholangitis?
like chronic neutrophilic cholangitis, more chronic
may not be icteric until the end
older
what is lymphoblastic lymphoma like?
involves other structures
middle aged to older
FeLV negative
heterogenous ultrasound
what can cause post-hepatic icterus in a cat?
pancreatitis
neoplasia
cholelithiasis
cholecystitis
flukes
