Treatment of liver disease Flashcards
(18 cards)
When treating chronic active inflammation of the liver, what mineral and protein balance should the diet have?
Low copper - to prevent accumulation
High zinc
High protein
Anti-oxidants (vit E)
For a patient with hepatic encephalopathy, how much protein should the diet have?
Limited
Restrict protein
What antibacterials can be used in hepatic encephalopathy?
Ampicillin
Metronidazole
What should be done before administering antibacterials for cholangiohepatitis?
Culture and sensitivity
When there is chronic inflammation and fibrosis of the liver, what group of drugs should be given?
Steroids
(Prednisolone 1st choice)
Consider adding cyclosporin, azathioprine and mycophenolate to aid withdrawal
What are the advantages of glucocorticoid use in liver disease?
Improves well being Stimulates appetite Anti-inflammatory Immunosuppression Anti-fibrinotic
What are the disadvantages of glucocorticoid use in liver disease?
Steroid hepatopathies
Predisposes to infection
Fluid retention
Catabolism
What breeds are commonly affected by copper associated hepatopathies?
Bedlington terrier, WHWT, Skye terrier
Dalmatian
Lab
Dobermann
Give examples of decoppering agents
Oral zinc
Penicillamine
Trientine
Why is oral zinc used to treat copper associated hepatopathies? When should oral zinc be given?
Zinc is a copper absorption blocker
Give 1 hr before food
What is UDCA? What is it used to treat?
A hydrophilic bile salt that stimulates bile flow
Used to aid biliary tract and hepatocellular disease
What is a contraindication of using UCDA?
Complete biliary obstruction
UCDA stimulates bile flow
What is SAMe used to treat?
Paracetamol toxicity in dogs
Steroid hepatopathies
Give examples of adjunctive therapy that can be used in liver disease
UCDA
SAMe
Milk thistle
Vitamin E
Give examples of liver disease complications
Hepatoencephalopathy (and coma)
Ascites and oedema
Haemorrhage and anaemia
How is hepatic encephalopathy treated in liver disease?
Reduce ammonia concentrations
Low protein diet, lactulose, ampicillin or metronidazole antibiotics
What type of enema can be used for a coma caused by liver disease?
Lactulose retention enema
How is haemorrhage and anaemia treated in liver disease?
Vit K and B injections
Blood transfusions
H2 blockers (ranitidine) if GI haemorrhage
