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31 Cards in this Set
- Front
- Back
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What can be assessed when diagnosing problems with the liver?
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hepatocellular injury
cholestatis liver failure |
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What causes leakage enzymes?
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Injury to cell membranes or organelles
it does not require production of ensymes |
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Do we see enzyme increase a a result of injury or death?
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no the increase as a result of increased production
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T/F
ALT is liver specific. |
True
it is also increase due to hepatocyte death or injury or severe muscle injury |
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When should increases in ALT be looked into?
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When the ALT levels are 2x the normal interval or it is persistently increased
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What does increase in ALT in older dogs suggest? younger dogs?
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chronic hepatitis
portocaval shunt |
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Is AST liver liver specific?
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no but it can be increased because of muscle
Run a CK test to confirm muscle origin |
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What test should you not run in larger animals?
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ALT
Because they have more ALT in muscle than in the liver |
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What kind of lab changes do you see in focal hepatic necrosis? Diffuse?
What percentage of liver damage will cause abnormal lab results? |
None
Increase in leakage & induced enzymes and inc. in bile acids 60-80% |
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Where does alkaline phosphate come from?
What induces Alk Phos? But not in what animal? |
1) Osteoblasts in growing animals
2) Liver induced by cholestasis Corticosteroids Cats |
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If you see an increased Alk Phos without hyperbillirubinemia, what should you suspect?
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Steroid or anticonvulsant medication induction
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What test is a better indication of cholestasis in cats?
What is the exception? |
GGT
Hepatic lipidosis |
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What are the four causes of cholestasis?
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1) Cholangitis
2) Cholangiohepatitis 3) Bile duct Obstruction 4) Hepatic lipidosis |
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Are leakage enzymes increased with cholestasis?
Induced enzymes? Serum bilirubin? Bile acids? Other liver function tests? |
Mildly
Marked Moderate/marked Moderate/marked Normal |
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What is the cytology of the liver best used for diagnostically?
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1) Hepatic lipidosis
2) Vaculoar hepatopathy 3) Cholestasis 4) Inflammation |
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If bile acids are increased what should you follow up with?
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Radiograph, ultrasound, FNA
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What are the four substances removed by the liver?
What are the four substances synthesized by the liver? |
Bilirubin, Bile Acids, Cholesterol, Ammonia
Albumin, Urea, Cholesterol, Coagulation factors |
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What are the three causes of an increase in bilirubin?
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1) Increased production due to increased RBC destruction
2) Decrease uptake or conjugation by the liver 3) Blockage of bile flow |
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What is good test to run if you suspect liver disease ot portocaval shunt?
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bile acid test
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In chronic liver disease, what percentage of dogs are hypoalbuminemic?
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60% or greater
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Do you see an increase of decrease in cholesterol with cholestasis?
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increase in cholesterol
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In liver failure do you see an increase or decrease in cholesterol?
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decrease in cholesterol
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What is necessary for the absorption of Vitamin K dependent factors?
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The flow of bile
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What mineral is bound to albumin?
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calcium
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What is the formula for determining if calcium is normal without the loss of albumin?
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calcium - albumin + 3.5 = corrected Ca
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What type of crystals are characteristic for portosystemic shunt?
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ammonium biurate
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What are the signs for early portosystemic shunt?
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normal or increased enzyme activity
increase bile acids possible microcytic anemia |
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What are the signs for late portosystemic shunt?
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marked increase in bile acids
possible cholestasis microcytic anemia |
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What two test that are increased are indicative of cholestasis?
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ALP and GGT
these are induced enzymes |
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What is the common liver disease in dogs?
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Chronic diffuse hepatitis
seen in dobermans |
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What are the causes of chronic diffuse hepatitis?
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copper toxicity
infectious (lepto, ICH) drugs genetic idiopathic **end result is cirrosis** |
