Hepatobiliary 1 Flashcards
How is the blood supply entering the liver arranged?
The liver is supplied by the hepatic artery and hepatic portal vein
The most specific blood marker for indicating hepatocellular damage in dogs and cats is
ALT
You are presented with a dog with notable jaundice on his mucous membranes and sclera. What is the most appropriate first test to do in order to progress your case workup?
PCV- to rule in or out pre-hepatic jaundice
where does the hepatic portal vein come from
from the gastrointestinal tract- can contain infectious agents and toxic substances
List 5 clinical signs of liver disease
lethargy
anorexia
weight loss
PUPD
V+/D+
Very non-specific
what is portal hypotension
increased intrahepatic resistance to portal blood flow
- so blood backs up basically if there is inflammation
Describe what you can see with hepatic encephalopathy
Waxing and waning; non-localising on neuro exam
Hyperactive &/or depressed/dull/clumsy
Circling, pacing, central blindness
Salivation, especially cats
Seizures —> coma
T/F it is always abnormal to see bilirubin in cat urine
True
where should liver normally sit on radiograph
Liver should sit behind the last rib
which is US good for looking for in the liver
mass lesion
nodular disease
significant change in echotexure
describe what you normally see of the liver on US
moderately and uniformly echoic- less echoic than spleen (“kidney, liver, spleen”)
coarsely granular parenchyma
uniform texture
List 8 possible causes of secondary hepatopathies
GI disease
Pancreatitis
endocrine disease- e.g. cushings
RHF
hypoxia
toxaemia
sepsis/ bacteraemia
drug induced in dogs
List 5 broad causes of acute liver disease in dogs
toxic/drug induced
infectious
sepsis/endotoxaemia
congenital causes
metabolic
describe how to sample liver
ultrasound guided FNA
surgical biopsy
Describe the 5 main aspects of managing liver disease
supportive- very important
treat the cause
treat hepatic encephalopathy
manage coagulopathy as necessary
liver support