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51 Cards in this Set
- Front
- Back
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how much of your liver has to fail before you start seeing signs of dz
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75%
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when is icterus common in horses
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in acute stages
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hepatic encepalopathy can be caused by what two things
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liver dz and GI dz (ammonia being produced)
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how common is hepatic encephalopathy?
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very common
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what is the most frustrating thing to treat with a horse with liver dz
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anorexia
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what causes photosensitization
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phyloeryrthrins from plants. when the liver is sick, the phyloerthryins go to the skin, if they horses are in the sun and they have this they will get some bad ass dermatitis on the light skin
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what will some horses develop with liver dz, its a horse think horse
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colic
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what liver enzymes are you going to check for hepatocellular injury
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cytosolic enzymes
SDH AST ALT- no reliable in lg animals |
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what is the most specific liver enzyme to look at for hepatocellular damage?
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SDH
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what can cause an increase AST
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liver, muscle, ruptured RBC's
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when do you start caring about SDH increase
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when it is about 2.5 times. normal is 30 so you care when its about 80
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what are the cholestatic enzymes you can test for when you have issues with the biliary system?
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GGT
ALP |
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which choleostatic enzyme is more specific for horses
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GGT
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where can ALP be found in?
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liver, bone, colostrum
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when do you start caring about increase in choleostatic enzymes
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when they are 3x
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iver fxn best
* means will find on CHEM panel |
albumin*
bun* bilirubin (1/2 life is 19 days)* glucose* bile acids serum ammonia coagulation tests |
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what can you see in horses that are hypoalbumemic
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ascites
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what is detoxified to make BUN
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urea
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biliary obstruction, what will increase indirect or direct bilirubin?
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direct
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can horses have an increase in bilirubin when horses fast?
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yes but it should only be the indirect component
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what do you have to rule out when you see an increase in bilrubin on your chem?
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fule out hemolysis
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ligandin wtf is it?
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resonsible in assisting in congugation process of bilirubin. if this is absent, then you will have a bunch of uncongugated bilirubin in your blood.
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when you have elevated bile acids specific or sensitive?
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they are highly specific for liver dz
NOT specific for the type of liver dz |
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what should normal results of bile acids be
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< 20 umol/L
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do you have to fast a horse prior to taking blood for bile acids
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no they have no gallbladder
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what else can you check for liver dz
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ammonia
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what is the most common CS of hepatoencepahlopahty
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headpressing
aggressive falling down seizures |
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what do you do immediately after taking blood to test for ammonia
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put it on ice and test immediately
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does the degree of elevation of ammonia correlate with clinical signs?
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no
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visualization of the liver
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ultrasound
size echogenicity parenchyma detail |
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where is the liver in respect to ICS
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ventral to lung margins
left 7th-9th ICS right 6th-15th ICS should remain within costochondral junction |
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what can you see with the liver with fibrosis in ultrasound
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the liver and the spleen will have the same echogenicity
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liver biopsy will tell you what
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presence of fibrosis. if you have a horse with fibrosis thats bad news they gonna die
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where do you perform a liver bipsty
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on right side
draw a line from tuber coxae to the point of the shoulder and other from the tuber coxae to the back of the elbow then 11th-14 ICS |
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are you going to do a liver biopsy with a pcv less than 30
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fuck no, leave them alone. they can bleed to death
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hepatic encephalopathy
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exact mechanism is unknown
abnormal protein metabolism by the diseased liver NH3+ is toxic to tliver |
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what is the initial therapy for HE
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abolishing abnormal behaviors to prevent the horse from endangering itself and others
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can you use use benzodiazepenes for HE
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no
GABAergic effects on inhibitory neurons |
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what can you use to sedate the horses with HE to get control of them?
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detomidine
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what is the goal for HE?
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to reduce the amount of NH3+ within the GIT
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what can be done to help calm down the NH3+ being produced that is controversial?
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alter colonic microbial population
oral neomycin +/- oral lactulose and acetic acid |
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what is the conservative choice to help with NH3+ production
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diet and additional supportive therapies
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again, what is the huge pain in treating horses with liver dz
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they don't want to eat
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aromatic acids cause what in the brain
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sedative effects. tryptophan in turkey makes you want to sleep
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what do you want to provide in the diet as far as amino acids
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BRANCHED- CHAIN AA
so give then beet pulp, oats, and grass hay, milo, and sorghum force feeding may be necessary |
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what is the bottom line about force feeding horses
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it is more imporatant for horses to eat something even if its not the ideal low-protein diets.
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what kind of hay do you want to avoid in horses with liver dz
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alfalfa
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which liver dz.'s warrant abx
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chronic active hepatitis
cholangioheptatits |
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what ar the most common types of bacterial infections in the equine liver?
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gram negative
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what are the abx you should use that will concentrate in the liver or binary tract
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penicillin/ gentamicin
enrofloxacin chloramphenicol trimethoprim sulfa +/- metronidazole (only if indicated on culture) |
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what are the anti-inflammatories/ anti-oxidants you can use for liver dz in horses
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flunixin meglumine
pentoxifyllin S-adenosylmethinine (SAMe) appears to have protective effects against oxidative hepatic injury DMSO- free radical scavenger also potentially dissolves biliary stones and sludges |
