Term
| What is the most common liver dz of cats? |
|
Definition
|
|
Term
| Is hepatic lipidosis more commonly primary or secondary? |
|
Definition
|
|
Term
|
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
|
|
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
|
|
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 |
|
|
