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Exam 4
Feline Liver Dz 1
20
Veterinary Medicine
Professional
04/01/2017

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Cards

Term
What is the most common liver dz of cats?
Definition
-hepatic lipidosis
Term
Is hepatic lipidosis more commonly primary or secondary?
Definition
-primary HL
-secondary HL
Term
Describe FA metabolism.
Definition
-mitochondria for beta-oxidation: requires L-carnitine, ketones used peripherally for E, acetyl-CoA enters Kreb's cycle
-lipid vacuoles in hepatocyts: fats transported to peripheral tissues
Term
What substances are essential for heptic fat metabolism.
Definition
-choline
-methionine
-vitmin B 12
Term
How does the liver become overloaded w/ lipids in hepatic lipidosis?
Definition
-inc lipolysis = more lipid to liver
-insufficient tranport proteins = less lipid leaving liver
Term
How does the urea cycle relate to hepatic encephalopathy?
Definition
-arginine deficiency= unable to convert NH3 to urea
Term
What is the typical signalment of hepatic lipidosis cats? CS?
Definition
-7y fat cat
-originally obese
-anorexia
-lose body weight
-jaundice
-GI signs
-unkempt hair coat
-weakness: dec K (ventroflexion of neck), dec Phos
-easy bruising due to coagulopathy
-hepatic encephalopathy: ptyalism, depression
-hepatomegaly
-jaundice
-dehydration
Term
What do we see on chem w/ hepatic lipidosis in cats?
Definition
-ALP inc
-GGT may be normal (huge inc may suggest bacteria)
-dec BUN/albumin/glucose
-hyperbilirubinemia due to cholestasis
-hyperglycemia: stress
-dec K/Phos/Mg
-non-regen anemia
-inc serum bile acids
-bilirubinuria
-high blood ammonia
Term
What do we see on rads w/ hepatic encephalopathy?
Definition
-hepatomegaly
Term
What do we see on U/S w/ hepatic encephalopathy?
Definition
-hyperechoic & hyper-attenuating
Term
What do we see on FNA that supports dx of hepatic lipidosis? Advantages?
Definition
->80% cells vacuolated
-supports diagnosis
-much less invasive
Term
What is the advantage of using a biopsy for hepatic lipidossis? Why would we do a liver biopsy w/ hepatic lipidosis?
Definition
-confirms diagnosis
-necessary if: inflammation or possible neoplasia seen on cytology, not responding to tx >10d
Term
How do we treat hepatic lipidosis?
Definition
-food
-vitamins, fluids, electrolytes
-hepatoprotectants
-anti-emetics
-antacids
-blood
Term
Which AA do we give to hepatic lipidosis cats?
Definition
-arginine
-taurine
-glutamine: PRIMARY FUEL SRC FOR THE GI TRACT
-L-carnitine
Term
Which vitamins do we supplement w/ hepatic lipidosis cats?
Definition
-vit K
-vit E
-Vit B1 (thiamine)
-vit B12 (cyanocobalamin)
Term
What do we avoid w/ fluids therapy w/ hepatic lipidosis cats?
Definition
-avoid lactate as buffer
-avoid dextrose
Term
What do we add to fluid therapy w/ hepatic lipidosis cats?
Definition
-KCl
-KPhos
-MgCit
Term
What hepatoprotectants do we use w/ hepatic lipidosis cats?
Definition
-N-acetylcysteine (precursor for glutathione)
-S-adenosylmethionine (SAMe) (precursor for methionine)
Term
What appetite stimulants do we use w/ hepatic lipidosis cats?
Definition
-martazapine: noradrenergic & serotonergic activity
-cyproheptadine
Term
What do we give hepatic encephalopathy cats w/ hepatic lipidosis?
Definition
-low protein diet
-oral abx: Amoxicillin, Neomycin
-Lactulose
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