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VETM 522 > hepatic > Flashcards

hepatic Flashcards

1
Q

hepatic enzymes

A

ALP- cholestatic enzyme, short half life in cats

ALT- hepatocellular damage, short half life in cats

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2
Q

markers of liver dysfunction

A

cholesterol, BG, bilirubin, ALB

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3
Q

liver function test

A

ammonia, bile acids (not sensitive except in PSS

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4
Q

UA and liver disease

A

cats: low USG bilirubin, urate crystals

dogs: low USG, bilirubin can be normal, urate crystals

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5
Q

CBC/clotting factors

A

anemia, leukocytosis, low platelets, decreased clotting factors

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6
Q

congenital liver disease in dogs

A

portosystemic shunt
lg breeds- intrahepatic
sm breeds- extrahepatic , portal vein hypoplasia

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7
Q

EHPSS C/S, dx, tx

A

one vessel shunting blood away from liver

C/S- ataxia, strange behaviour, PU/PD, seizures, stunting, copper iris in cats

dx- microcytic anemia, low liver function, high liver enzymes
isosthenuria, urate crystals
bile acids-> >100 2h post
abd U/S, CT w contrast

tx- lactulose, metro, omeprazole
surgery (coil, ligation)

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8
Q

portal vein hypoplasia

A

sm breed, no C/S
high ALT/ALP, bile acids 2h post under 100, U/S to r/o EHPSS

no tx

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9
Q

hepatic lipidosis causes

A

secondary to anorexia-> decreased insulin, increased lipase-> fat accumulation in liver

primary- anorexia
secondary- diseases causing anorexia or insulin resistance (GI, pancreatitis, DM, obesity)

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10
Q

hepatic lipidosis dx

A

CBC- anemia
chem- high ALP, bilirubin
high Pt/ptt

big liver on rads, bright on U/S
FNA/biopsy

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11
Q

hepatic lipidosis tx

A

nutrition- NGT, e tube
start at 1/4RER per day and increase gradually
antinausea, vit K, appetite stimulants
K supplement
SAMe

monitor PCV, liver values, electrolytes weekly

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12
Q

hepatic encephalopathy

A

clinical dx
neuro signs- ataxia, head pressing, circling, seizures, coma

tx- IVF, metro, lactulose, enemas

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13
Q

feline cholangitis types

A

inflammation of liver, bile ducts
lymphocytic, neutrophilic, chronic

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14
Q

lymphocytic cholangitis

A

younger cats, not very sick
high globulins, ascites
pancreatitis uncommon
dx- r/o other causes of fever, BW
tx- imunosuppression w pred, ursodiol

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15
Q

neutrophilic cholangitis

A

ascending bacterial infection from gut
older cats, more sick (anorexia, icterus) pancreatitis, IBD (triaditis).
normal globulins, no ascites

dx- liver biopsy/culture, GB centesis
tx- abx (clavamox, metro until culture) 6-8wks, SAMe, vit K, pain meds, nutrition w etube

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16
Q

triaditis

A

concurrent inflammation of liver/pancreas/GI
C/S- anorexia, icterus, fever, abd pain, v+
only 30% have all 3

17
Q

approach to liver cat

A
18
Q

canine chronic hepatitis pathogenesis, C/S, dx

A

inflammation-> hepatic antigens-> inflammatory cells-> necrosis, fibrosis-> liver failure after years

higher risk in cocker spaniel, labs, samoyed, doberman

C/S- reduced appetite, lethargy, icterus, ascites, Pu/PD

dx- high ALT, everything else normal until later, need biopsyc

19
Q

chronic hepatitis tx

A

immune suppression- pred 1-2mg/kg/d
liver protectants- ursodiol, SAMe
supportive care

20
Q

liver medications and uses

A

SAMe- antioxidant, protective for liver insult, helps w liver disease

ursodiol- stimulates bile release, not often used in dogs

NAC- anti inflammatory, replaces cysteine to improve metabolism, given during acute toxicities

21
Q

copper accumulation

A

1/3 of dogs w CH have copper accumulation (bedlington terrier, WHWT, lab, doberman)
- hepatocyte accumulation-> primary copper disease
- periportal accumulation-> secondary to inflammation, cholestasis

if >1000ug/g-> d-penicillamine, low copper diet

22
Q

CH monitoring

A

repeat biopsy at 6m
repeat ALT/copper testing
check for C/S

23
Q

vacuolar hepatopathy

A

fat, glycogen, water
secondary to DM, cushings, chronic pred

dx- ALP elevation, non progressive, nodules on U/S

24
Q

nodular hyperplasia

A

benign lesion, older dogs
high ALP, nodules

25
Q

GB mucocele pathophysiology

A

bile becomes harder-> mucous filled cysts-> pressure necrosis of GB-> bile peritonitis

higher risk w cushing, hypothyroid
sheepdogs, cocker spaniel, pom, beagles

26
Q

GB mucocele C/S, dx

A

C/S from rupture only

dx- ALP»>ALT, POCUS
immature-> sludge buildup
mature-> anechoic rim w fracture lines (stellate)

27
Q

GB mucocele tx

A

surgery-> no accepted timeframe, consider elective

medical->ursodiol 10-15mg/kg q24
SAMe 20mg/kg q2 for liver

28
Q

GB mucocele monitoring

A

repeat U/S q3-6m, check ALT/ALP

29
Q

GB rupture

A

present unstable, shocky
fever, tachycardia
icterus, painful abd, v+, anorexia
dx- free abd fluid, abdominocentesis

30
Q

acute liver injury causes

A

infectious hepatitis (CAV1), lepto, neoplasia, copper storage disease
toxins (tylenol, xylitol)

31
Q

acute liver injury tx

A

supportive care- nutrition, NAC, SAMe, ursodiol

VETM 522 (22 decks)

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