Small Animal Liver Flashcards

1
Q

What is the main blood supply to the liver from the GI tract?

A

Hepatic portal vein

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2
Q

What are the important metabolic processes of the liver?

A

Urea Cycle
Glycogen Storage
Protein Synthesis
Cholesterol Processing

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3
Q

How do onions cause liver toxicity?

A

Remove glutathione = oxidative damage
Heinz body anemia

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4
Q

What on the biochemistry panel tells you the liver is not functioning well?

A

Glucose
BUN
Albumin
Cholesterol

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5
Q

What do pre- and post-prandial bile acids tell us?

A

Liver function test

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6
Q

What biochemistry values are indicative of hepatocellular injury/damage/necrosis?

A

ALT (most specific)
AST (mm damage)
NOT loss of function

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7
Q

What causes pre-hepatic hyperbilirubinemia?

A

Low PCV/normal TP
e.g. RBC hemolysis (IMHA)

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8
Q

What causes post-hepatic hyperbilirubinemia?

A

Gall bladder mucocele
EHBO
Pancreatitis

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9
Q

What total bilirubin value is considered hyperbilirubinemia?

A

> 0.2mG/dL

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10
Q

When is a bile acids test redundant?

A

If patient is already hyperbilirubinemic (icteric)

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11
Q

What biochemistry values are indicative of cholestasis?

A

ALP
GGT

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12
Q

What can cause increases in ALP?

A

E. coli
Dental disease
Hyperthyroidism
Cushing’s disease

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13
Q

When are ALP levels induced?

A

Prednisone
Phenobarbital
Canines only

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14
Q

What are causes of a primary hepatopathy?

A

ALT (AST)
Inflammation, infection, necrosis, immune, fibrosis/cirrhosis, neoplasia

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15
Q

What are causes of secondary (reactive) hepatopathy?

A

ALP (GGT)
Medications, inflammation/infection, endocrine, hypoxia

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16
Q

What are radiographic signs of pancreatitis?

A

Soft tissue opacity
Decreased serosal detail
Wide pyloric duodenal angle
Gas-filled duodenum
Corrugated small intestines

17
Q

What are clinical signs of a congenital portosystemic shunt?

A

CNS = hepatic encephalopathy
Urinary = pu/pd, stones
Growth = poor doer
GI = vomiting, diarrhea

18
Q

What on the biochemistry profile is indicative of a congenital portosystemic shunt?

A

Glucose (L)
BUN (L)
Albumin (L)
Cholesterol (L)
ALP (H)
AST (H)
Do not usually develop ascites or turn yellow

19
Q

What on a CBC is indicative of a congenital portosystemic shunt?

A

Key = microcytosis
Normocytic, normochromic nonregenerative anemia

20
Q

What on a urinalysis is indicative of a congenital portosystemic shunt?

A

Low specific gravity (pu/pd)
Ammonium (bi)urate crystals

21
Q

What are key diagnostics for a congenital portosystemic shunt?

A

Bile acids = liver function test, useful when shunt is expected
Abdominal ultrasound

22
Q

What are clinical signs of the “quiet” PSS?

A

Undersized, elevated bile acids
No shunt visible on ultrasound
Histopathology = hepatic changes = shunt

23
Q

What are clinical signs of copper-associated hepatitis?

A

Anorexia, lethargy
Vomiting
Weight loss
Jaundice
Hepatic encephalopathy
Ascites
PU/PD

24
Q

What lab abnormalities are associated with copper-associated hepatitis?

A

ALT (ALP)
T-bili
Clotting times
Decreased PCV

25
Q

Can an abnormal snap PLI be used as a definitive diagnosis of pancreatitis?

A

No

26
Q

What can be a definitive diagnosis of pancreatitis?

A

U/S
Biopsy

27
Q

Chemistry panel shows moderately elevated liver enzymes and t-bili. In this case, you would attribute those abnormalities as being most likely?

A

Reactive hepatopathy and functional biliary obstruction

28
Q

Why can you not give oral diazepam to cats?

A

Fulminant hepatic failure

29
Q

What is the treatment for diazepam toxicity in cats?

A

S-adenosylmethionine

30
Q

What clinical signs are associated with feline cholangitis?

A

Lethargy, anorexia, vomiting, ptyalism
Jaundice, fever, dehydration, cranial abdominal pain
ALT, ALP, t-bili
Thick GB wall, dilated bile ducts

31
Q

What are the components of feline triaditis?

A

Cholangitis
Pancreatitis
IBD

32
Q

What is the normal presentation for feline hepatic lipidosis?

A

Hx of anorexia
PE = overweight + weight loss
ALP&raquo_space; GGT

33
Q

ALP elevation is indicative of what processes?

A

Reactive hepatopathy
Induced
Cholestasis

34
Q

What is the best way to determine the appropriate abx for treating a bacterial infection of the gallbladder?

A

GB fluid culture and sensitivity

35
Q

What is the most important aspect of treating a cat with hepatic lipidosis?

A

Esophageal feeding tube