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EqMed Q2, Liver Dz II
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C/S of acute hepatitis? 6
Depression
Inappetance
Pica
Jaundice
Photodermatitis
Hepatic encephalopathy
Expected liver enzymes with acute hepatitis?
Def Dx?
Elevations of hepatocellular & cholestatic enzymes
Biopsy
Dietary recommendations for acute hepatitis?
Decrease protein (avoid aromatics)
Increase carbohydrates
Mineral oil/Lactulose/Neomycin to reduce ammonia formation
Is total parenteral nutrition a good option for acute hepatitis patient that is sick?
Other Options?
No, high in fat/protein
Use Dextrose CRI = partial nutrition
Ingestion of pyrrolizidine alkaloids => acute or chronic onset?
Chronic (month to year later) - delayed onset with progressive liver failure
what are 3 PA plants horses eat?
Senecio
Crotalaria
Amsinckia intermedia
Pathogneumonic characteristics of liver histopath after PA toxicity?
Which region is mostly affected?
*Megalocytes*
(cross linked DNA= improper cell division)
Bile duct hyperplasia
Periportal fibrosis
*Portal Triads*
(VS centrilobular w/ acute hepatitis)
highly fatal
which liver enzymes are elevated first with PA toxicity?
GGT and ALP - cholestasis
Is fever more likely associated with theiler's disease/PA toxicity or chronic hepatitis?
chronic active hepatitis
what type of dermatitis is associated with chronic hepatitis?
coronary band exfoliative dermatitis
Expected lab findings with chronic hepatitis? 6
Persistent
GGT
and
ALP
Mild
SDH
and
AST
Bile acids
Bilirubin also increased
What are expected biopsy/histo findings w/ chronic hepatitis
Periportal necrosis
Mononuclear cells predominate
(if lots of Neuts --> culture/sensitivity)
Tx for Chronic Hepatitis if histopath reveals...
++ Lymphocytes?
++ Neutrophils?
Lymphocytes- immune mediated- steroids
Neutrophils - antimicrobials
Most common liver Dz's in the horse?
Cholelithiasis & Cholangiohepatitis
What are some extrahepatic causes of cholangiohepatitis? 3
Abscess formation
Inflammatory Dz near common bile duct
Neoplasia (rare)
what is the classic triad of C/S's associated with cholangiohepatitis?
Colic (one of the only liver diseases that causes colic signs)
Fever
Icterus
Expected lab findings with cholangiohepatitis?
All enzymes elevated (SDH, GGT, AST, ALP)
Bili elevated (Direct)
3 classical C/S's associated with hyperlipemia/hyperlipidemia?
Lethargy
Anorexia
Depression
Serum color seen with...
Hyperlipidemia
Hyperlipemia
Hypertriglyceridemia
Hyperlipidemia
: normal/straw
Hyperlipemia
: creamy/milky
HyperTG
: normal/straw
TG levels in horse with...
Hyperlipidemia
Hyperlipemia
Hypertriglyceridemia
hyperlipidemia
: mild/mod (<500)
hyperlipemic
: moderate (>500) - only one w/evidence of fatty liver
hyperTG
: mod/severe (>500)
Which of the 3 syndromes is most similar to fatty liver in cows or HL in cats?
Which horses are "classically" affected
hyperlipemia
Miniature horses
Donkeys
Ponies
Which of the 3 syndromes is most commonly associated with horses in intensive care?
HyperTG
(anything predisposing negative energy balance can lead to hyperTG)
How is fat stored in the liver?
What form are they in order to be transported out of liver?
Stores: Esterified TG's
Transport: VLDL's
What happens to fat that is brought to the liver?
1
:
Oxidized
- into TCA cycle to make ATP
2
:
Esterified
into TG for storage
3
:
Gluconeogenesis
4:
Made into
ketone bodies
Hyperlipemia is due to...?
NOT Liver Failure
Excess peripheral lipolysis
Goes to liver
Liver functions effectively =
Overproduction of VLDLs in circulation
What happens once liver's ability to process TG's into VLDL's is overwhelmed?
Hepatic lipidosis ensues
and
Fatty infiltrates lead to liver failure
How is insulin therapy helpful in treatment of hyperlipemic patient?
Inhibits Hormone Sensitive Lipase =
Reduced lipolysis =
Less fat put into circulation from periphery
Poor indications for liver Dz P? 6
Hypoalbuminemia
(<2.5) - Endstage b/c Alb has long 1/2 life
Incr.
Glob
Prolonged
PT
Chronic, severe elevation of
GGT
Bridging fibrosis
Severe
acidosis
and diarrhea
Author
HLW
ID
212543
Card Set
EqMed Q2, Liver Dz II
Description
EqMed Q2, Liver Dz II
Updated
4/11/2013, 10:14:46 PM
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