The Icteric Cat and Dog

Question 1

where does heme come from?

Answer 1

red blood cells: hemoglobin, myoglobin, cytochrome

Question 2

what percentage of septic cats have an increase in serum bilirubin?

Answer 2

63%

Question 3

what infections can cause hemolytic anemia in cats?

Answer 3

mycocplasma
FeLV

Question 4

what medications can cause hepatic icterus in cats?

Answer 4

oral diazepam
methimazole

Question 5

what is the prevalence of lipid vacuoles in hepatic lipidosis?

Answer 5

> 50-60% of hepatocytes

Question 6

what should you supplement in cats with idiopathic hepatic lipidosis?

Answer 6

glutathione
vitamin K
+/- vitamin B1
+/- carnitine

Question 7

when is the prognosis of idiopathic feline hepatic lipidosis good?

Answer 7

if bilirubin decreases in first 5-7 days

Question 8

what are the signs of acute neutrophilic cholangitis?

Answer 8

anorexia, lethargy, vomting
big three: fever, icterus, abdominal pain

Question 9

what are the histologic patterns that cholantitis/cholecystitis can be?

Answer 9

acute neutrophilic cholangitis
chronic neutrophilic cholangitis
chronic lymphocytic cholangitis

Question 10

what can lymphocytic cholangitis be hard to distinguish from?

Answer 10

small cell lymphoma

Question 11

how can you treat lymphocytic cholangitis?

Answer 11

immunomodulation
hepatoprotectives
dietary: vitamin B12

Question 12

what can cause post-hepatic icterus in a dog?

Answer 12

pancreatitis
gallbladder mucocele
cholelithiasis
cholecystitis

Question 13

what is hyperbilirubinemia?

Answer 13

unusually large concentration of bilirubin in the blood
poor prognostic indicator in hepatobiliary and non-hepatobiliary disorders

Question 14

how does sepsis cause cholestasis?

Answer 14

release of cytokines
down-regulation of hepatic transport proteins

Question 15

is prehepatic icterus more common in dogs or cats?

Answer 15

dogs

Question 16

what is abnormal in CBC, chem, abdominal effusion of hepatic lipidosis?

Answer 16

chem: increase liver enzymes, GGT slightly
abdominal effusion only if concurrent pancreatitis

Question 17

what is lymphoma like in the liver on ultrasound?

Answer 17

big, can be bright, dark, or nodular
increased lymph nodes
splenomegaly

Question 18

what does fine needle aspirate of the liver over diagnose?

Answer 18

vacuolar disease

Question 19

how can you treat small cell lymphoma in cats?

Answer 19

prednisolone
chlorambucil

Question 20

is an FNA diagnostic for lipidosis?

Answer 20

yes

Question 21

what is seen on laboratory tests for feline idiopathic hepatic lipidosis?

Answer 21

moderate to marked increase in ALP
mild to moderate increase in ALT
mild increase in GGT

Question 22

what should you avoid giving a cat with feline idiopathic hepatic lipidosis?

Answer 22

propofol anesthesia for extended periods
corticosteroids

Question 23

what should you feed cats with feline idiopathic hepatic lipidosis?

Answer 23

high calorie density
highest protein tolerated

Question 24

how is cholangitis/cholecystitis defined?

Answer 24

by histological pattern: acute neutrophilic cholangitis, chronic neutrophilic cholangitis, chronic lymphocytic cholangitis

Question 25

what is seen in laboratory testing with acute neutrophilic cholangitis?

Answer 25

mild to moderate neutrophilia +/- left shift hyperbilirubinemia increased ALT, AST, GGT, ALP

Question 26

what is best to perform aerobic and anaerobic cultures of for acute neutrophilic cholangitis?

Answer 26

gallbladder wall

Question 27

how can you treat acute neutrophilic cholangitis?

Answer 27

eliminate/treat predisposing factors antibiotics for 6 weeks hepatoprotectants and/or choleretics

Question 28

what are clinical signs with chronic neutrophilic cholangitis?

Answer 28

middle aged to older chronic waxing/waning for years episodic, vomiting, weight loss, hyporexia icterus and hepatomegaly

Question 29

what is seen on laboratory testing with chronic neutrophilic cholangitis?

Answer 29

increased enzymes, ALP, GGT, ALT, AST increased bilirubin

Question 30

what are signs like with lymphcytic cholangitis?

Answer 30

like chronic neutrophilic cholangitis, more chronic may not be icteric until the end older

Question 31

what is lymphoblastic lymphoma like?

Answer 31

involves other structures middle aged to older FeLV negative heterogenous ultrasound

Question 32

what can cause post-hepatic icterus in a cat?

Answer 32

pancreatitis neoplasia cholelithiasis cholecystitis flukes