6. Diagnostics, therapy and prevention of liver diseases Flashcards
(12 cards)
What are some diseases affecting the liver?
- Congenital photosensitivity and hyperbilirubinemia
- Diffuse hepatitis
- Fatty liver / hepatic lipidosis
- Hepatic encephalopathy
- Portosystemic shunt
- Bovine bacillary hemoglobinuria
- Liver abscessation
- Liver tumours
- Parasites - Flukes, Echinococcus, Cysticercus, Toxocara vitulorum
Describe Congenital photosensitivity and hyperbilirubinemia
- Affect Southdown sheeps.
CS: photodermatitis
Dx: Biochemistry - unconjugated/conjugated plasma bilirubin - Histology - pigments in hepatocytes
Tx/Px: Avoid sunlight, exclude chlorophyll from diet, culling as most die within weeks.
Genetic defect in livers ability to excrete bilirubin and phylloerythrin. In affected sheep - liver function is impaired -> bilirubin builds up and phylloerythrin accumulates in bliid –> causing photosensitivity to skin (damage) when exposed to UV-light
Describe Diffuse hepatitis
Occur due to - toxins, endotoxemia, parasites, hepatic abscess, nutritionally - fatty liver.
CS: don’t present itself until 70% of live is damaged –> anorexia, ascites, anemia, hepatic encephalopathy, photosensitization and coagulopathies.
Dx: percussion - pain in right side. USG - hepatomegaly or atrophy in chronic cases. Biopsy + histopathology. Biochemistry - elevated liver parameters (GGT, SDH, LDH, AST, urea, bilirubin, albumin.
Tx: fluids, NSAID (flunixin meglumine, ATB (if infectious), protect from sunlight (if photosensitization), antiparsitic (if parasites), diet correction.
Describe Fatty liver/Hepatic lipidosis
Liver store more lipids, <20% (normal is 5%).
If >20% fat reached liver it may lead to FAT COW SYNDROME = extreme NEB and fat mobilization in early lactation (leading to fat accumulation in liver and impaired liver function).
CS: obesity, drop in milk production, depression, rapid weight loss, weakness, rumen hypomobility, inappetance, jaundice.
Dx: History, CS, blood - increased liver enzymes (AST etc), NEFA, BHB, bilirubin. Decreased glucose, cholesterol, WBC. Biopsy - liver floats in water.
Tx: concurrent disease, supportive (propylene glycol, glucose, CCS - careful), dextrose/glucose IV 500g/day). Correct NEB.
Ususlly poor prognosis.
Px: Avoid over-conditioning during dry period, optimize nutrition PP to decrease effect of NEB, encourage DM intake, minimize stress, add glucose supplements
Describe Hepatic encephalopathy
A consequence of increased NH3 in blood and brain (CNS symptoms) due to liver disease; viral, intofixication, fatty liver, overfeeding urea, porto-caval shunt.
CS:
- Degree 1: apathy, limited activity of ear/tail, normal locomotor system
- Degree 2: obvious delay in reactions, empty eyes, slower in standing and laying down, grinding teeth.
- Degree 3: anorexia, response to external stimuli is almost lost, frequent recumbency, reflexes are lost, long term groaning.
Dx: CS, biochem - elevated liver enzymes, total bilirubin, NH3, NEFA, BHB. Decreased cholesterol and albumin. USG - portosystemic shunt.
Tx: glucose (500g/day), GCC, AA, antagonist of GABA, sedation with a-2-agonist (xylazine, detomidine), mannitol (brain edema), surgical treatment for portosystemic shunt, supportive.
Describe Portosystemic shunt
Allows toxic blood to bypass the liver and not being filtrated/converted -> accumulation of NH3 -> HEP.
CS: poor growth, intermittent neurological signs.
Describe Bovine bacillary hemoglobinuria
Caused by - Clostridium hemolyticum (found in soil) - toxin causing intravascular hemolysis -> destruction to RBC.
Affects mainly cattle.
Occurs from hepatic insult (flukes) or trauma.
CS: sudden death, high fever, depression, tachypnea/dyspnea, anemia, pale/icteric MM, hemoglobinuria (port-wine urine), dark liquid feces.
Dx: CS, PM exam, PCR
Tx: Rarely succesful. Can try blood transfusion and ATB.
Px: Vaccination + fluke control.
Describe Liver abscessation
Occur due to
* Several bacteria - Fusobacterium necrophorum (part of normal rumen flora), Trueperella pyogenes, Streptococcus, Staphylococcus, Bacteroides.
* Conditions like - ruminitis, Omphaloblephitis, Hardware disease.
CS: rarely in cattle but -> fever, anorexia, pain, drop in milk production, weight gain.
Dx: USG - 11th ISC at line from wing of ileum to right elbow), blood - leukocytosis, elevated fibrinogen and globulins.
Tx: Longterm ATB
Px: Prevent ruminitis
Describe Liver tumors cattle/goat
In cattle - adenoma, adenocarcinoma, hepatocellular carcinoma
In goat - hepatic fibrosarcoma, cholangiocarcinoma
CS: weight loss, enlarged abdomen, hypoglycaemia, hepatic failure, icterus.
Dx: USG, liver biopsy
Tx: Usually euthanized (surgery possible, but not really worth it economically I guess)
Name some parasites that could be found in liver
- Fasciola hepatica, F. gigantica
- Dicrocoelium dendriticum
- Echinococcus granulosus
- Cysticercus bovis/ovis (IH to Taenia hydatigena)
- Calf toxocariasis
Describe spp, FH/IH, Infection, Location, CS, Dx and Tx to Fasciola and Dendriticum
= Liver flukes
Fasciola hepatica, F. gigantica
* Chronic in cattle, acute in sheep.
* Infection: Ingestion of metacercaria during grazing
* IH: freshwater snail
* FH: Ru, omnivores, man.
Location –> Juveniles in abdominal cavity and liver parenchyma. Adults in bile duct and gall bladder
*CS: ascites, anemia, sudden death, hemorrhage, chronic diarrhea, WL, infertility.
* Dx: sedimentation method, blood (GLDH, GGT, anemia), ELISA.
* Tx: Triclabendazole (all stages), Albendazole (juveniles in intestines, few days).
Dicrocoelium dendriticum
- Infection: Ingestion ant with metacercaria when grazing
- IH1: snail, IH2: ant
- FH: Ru
- Location –> Juveniles in small bile ducts. Adults in large bile ducts + gallbladder.
*CS: Cholangitis and blockage –> anemia, edema, emaciation. - Dx: sedimentation method, PM.
- Tx: Praziquantel, Albendazole
What can be important to say about Echinococcus granulosus and Cysticercosis?
Both have cyst formation. Found in liver, lung and muscles.
Ru = intermediate hosts.
Dx: PM, USG, ELISA, Western blot.
Tx: NONE
Vaccination against Echinococcus
