pancreas and liver disease

Question 1

what are the clinical signs of pancreatic disease

Answer 1

abdominal pain
anorexia
vomiting

weakness, diarrhoea, lethargy

Question 2

what is the test used to check for pancreatic disease

Answer 2

pancreatic lipase test

Question 3

what is the treatment for pancreatic disease

Answer 3

no treatment!
supportive therapy only option
(eg. diet therapy, znalgesia, enzyme supplementation. anti emetics)

Question 4

what is the three stages of pancreatic diet therapy

Answer 4

1. once vomiting stops feed liquid diet through feeding tube
2. low fat meals with water given at small but frequent doses from days 3-28
3. long term diet therapy following this

Question 5

regarding analgesia what shouldnt be given to a patient with pancreatic disease

Answer 5

NSAIDs!!

Question 6

what is the main pancreatic disease seen

Answer 6

acute pancreatitis

Question 7

what are the THREE causes of exocrine pancreatic insufficiency

Answer 7

1. pancreatic acinar atrophy
   heritable, common in GSD
2. pancreatic hypoplasia
   rare, congenital
3. chronic pancreatitis
   rare, more common in cats

Question 8

clinical signs of exocrine pancreas insufficiency

Answer 8

large volumes of foul smelling greasy poo
appetite changes, animal become ravenous
poor coat condition
vomiting

Question 9

what is the test used for exocrine pancreatic insufficiency.
what do the results tell us

Answer 9

trypsin like immunoreactivity
low TLI=EPI
very high TLI=acute pancreatitis

Question 10

what is the treatment for exocrine pancreatic insufficiency

Answer 10

enzyme supplementation
easily digestible diet
cobalamin supplementation

Question 11

what are the liver specific enzymes and the cholestatic specific enzymes

Answer 11

hepaTocellular=AST, ALT
cholestatic=ALP, GGT

Question 12

signs of liver disease

Answer 12

icterus, ascites, abdominal pain

Question 13

what are the four adjunctive theraputics used to treat liver disease

Answer 13

1. ursodeoxycholic acid
2. S-adenosyl methionine
3. milk thistle
4. vitamin E

Question 14

what is the treatment used for cholestatic liver disease

Answer 14

ursodeoxycholic acid
(hydrophobic biles salt, reduces cholestrol saturation in bile and increases flow)

Question 15

what is the MOA of s-adenosyl methionine

Answer 15

glutathionine donor
used to detoxify

Question 16

milk thistle (silymarin) MOA

Answer 16

free radical scavenger
inhibits inflammation

Question 17

vitamin E MOA

Answer 17

antioxidant with anti inflammatory and anti fibrotic properties

Question 18

Treatment for hepatic encephalopathy

Answer 18

protein restriction and lactulose

Question 19

chronic active in flammation treatment

Answer 19

low copper high zinc high quality protein diet with anti oxidants

Question 20

treatment for any liver immune mediated process or fibrosis

Answer 20

prednisolone

Question 21

copper accumulation treatment

Answer 21

trientine, penicillamine

Question 22

what are disadvantages of prednisolone to treat hepatic disorders

Answer 22

predispose to infection and cause fluid reterntion.
Also causes steroid hepatopathy

Question 23

what are the pre, hepatic and post causes of jaundice

Answer 23

pre=haemolysis
hepatic=dysfucntion, intrahepatic cholestasis
post=extra hepatic cholestasis

Question 24

how can liver disease lead to bleeding and clotting disorders

Answer 24

vitamin k malabsorbtion!
portal hypertention often leads nto GI bleeding

Question 25

what do all form of chronic hepatitis end in

Answer 25

cirrhosis liver shrunken

Question 26

between which vessles are acquired shunts usually formed

Answer 26

portal vein and caudal vena cava lead to portal hypertention and ascites