Treatment Of Liver Disease Flashcards
What diet should you use for a patient with PSS?
Protein restricted
High biological value - dairy, vegetables
What diet should you use in a patient with chronic active hepatitis?
Anti-oxidants - vitamin E
Low copper and high zinc
Vitamins A,D,E,K
Cottage cheese to add protein to the diet
Taurine and L carnitine for cats
What antibiotics can be used for hepatic encephalopathy?
Metronidazole, ampicillin, neomycin
What antibiotics should you use for bacterial cholangiohepatitis?
Based on culture and sensitivity
When are corticosteroids indicated?
Lymphocytic chronic active inflammation seen on biopsy
Hepatic fibrosis
Prednisolone at immunosuppressive doses
What can a side effect of long term high dose steroids be?
Steroid hepatopathy
How can you treat copper associated hepatopathies?
Copper chelators - D-penicilliamine
Oral zinc - blocks copper absorption
What adjunctive therapies are there?
Ursodeoxycholic acid - bile salt
- stimulates bile flow and modulates the inflammatory response
S-adenosyl methionine
- glutathione donor - improved redox status
Silybum marianum
- free radical scavenger and increases glutathione
Vitamin E - antioxidant
How should you treat immune mediated processes in the liver?
Prednisolone + Azathioprine
How should you treat fibrosis in the liver?
Prednisolone + dietary management + ursodeoxycholic acid
When is ursodeoxycholic acid indicated?
Biliary tract disease
Hepatocellular disease
Gallstones
When is s-adenosyl methionine indicated?
Paracetamol toxicity
Hepatobiliary disease
Toxicities
When is silybum marianum indicated?
Hepatobiliary disease
What can you use to trap ammonia in the gut in hepatic encephalopathy?
Lactulose
How can you manage ascities and oedema in liver disease patients?
Na+ restricted diets
Spironolactone - diuretic
Paracentesis - avoid - high protein effusions in dogs
