Canine Hepatic Disease Chapter 282
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Questions and Answers

What is the outcome of acute hepatitis in dogs?

  • Always results in death
  • Can be rapidly fatal, completely reversible or can lead to chronic hepatitis (correct)
  • Always leads to chronic hepatitis
  • Always leads to liver failure

    • What is a common clinical sign of CAV-1?

  • Seizures
  • Fever and lethargy (correct)
  • Polyuria
  • Vomiting

    • What is the most common isolate from biliary cultures in dogs and cats with liver disease?

  • Clostridium (correct)
  • Leptospirosis
  • Salmonella
  • E. coli

    • What is the primary cause of cyanobacterial microcystin toxicosis?

    <p>Exposure to an algal bloom</p> Signup and view all the answers

    What is a potential cause of chronic hepatitis in dogs?

    <p>Excess copper accumulation</p> Signup and view all the answers

    What is a potential complication of leptospirosis?

    <p>Bronchopneumonia</p> Signup and view all the answers

    What is the typical treatment for aflatoxicosis?

    <p>Supportive care</p> Signup and view all the answers

    What is a potential cause of idiopathic chronic hepatitis in dogs?

    <p>Immune-mediated etiology</p> Signup and view all the answers

    What are the most common organisms cultured from bile in dogs and cats with hepatic inflammation?

    <p>E.coli, Enterococcus spp., Bacteroides spp., Streptococcus spp., and Clostridium spp.</p> Signup and view all the answers

    What is the main cause of granulomatous hepatitis in dogs and cats?

    <p>Infectious agents, including bacteria, fungi, and parasites</p> Signup and view all the answers

    What is the primary treatment for chronic hepatitis in dogs and cats?

    <p>Anti-inflammatory and immunosuppressive therapy</p> Signup and view all the answers

    What is the role of copper in hepatic disease?

    <p>Copper is responsible for most of its hepatotoxicity in the cupric oxidation state (Cu2+)</p> Signup and view all the answers

    What is the characteristic pattern of copper accumulation in hepatocytes in cases where copper is the primary cause of hepatopathy?

    <p>Zone 3 (centrilobular) and regenerative nodules accumulation</p> Signup and view all the answers

    What is the ideal method for quantifying copper levels in the liver?

    <p>Atomic absorption spectroscopy</p> Signup and view all the answers

    What is a common sequela of portal hypertension in dogs?

    <p>Ascites, edema, and ulceration of the GI tract</p> Signup and view all the answers

    What is the goal of dietary intervention in dogs with hepatic encephalopathy?

    <p>To reduce the quantity of protein in the diet, with a focus on plant-based sources</p> Signup and view all the answers

    Study Notes

    Canine Inflammatory/Infectious Hepatic Disease

    Acute Hepatitis

    • Can be rapidly fatal, completely reversible, or lead to chronic hepatitis
    • Nonspecific clinical signs and elevations in ALT and ALP are expected
    • Causes include:
      • CAV-1: presents with fever, lethargy, abdominal pain, and elevated LE and kidney values
      • Leptospirosis: causes vomiting, lethargy, icterus, diarrhea, polyuria/polydipsia, and anorexia
      • Clostridium: commonly isolated from biliary cultures in dogs and cats with liver disease
      • Aflatoxicosis: seen in dogs who ingested contaminated dog food
      • Cyanobacterial microcystin toxicosis: often fatal, but some cases have been treated successfully with supportive care
      • Amanita mushroom: usually fatal, causing hepatic inflammation, necrosis, and failure
      • Carprofen: reports of hepatocellular necrosis in dogs, with elevations in liver enzymes and bilirubin
      • TMS: induced hepatic necrosis and failure is likely an idiosyncratic drug reaction

    Chronic Hepatitis

    • Etiologies:
      • Majority of cases are idiopathic
      • Excess copper accumulation is a common definitive etiology
      • Immune-mediated etiologies also exist
      • Can occur secondary to phenobarbital
      • Infectious causes may contribute, including E. coli, Enterococcus spp., Bacteroides spp., Streptococcus spp., and Clostridium spp.
    • Acute hepatitis caused by drug or infection can progress to chronic hepatitis with time
    • Treatment is mainly anti-inflammatory and immunosuppressive therapy
    • Cupric oxidation state (Cu2+) is responsible for most of copper's hepatotoxicity
    • Bedlington terriers have a primary defect in hepatic copper metabolism, resulting in marked lysosomal copper accumulation
    • Copper accumulation can be primary or secondary to other diseases
    • Breeds affected by copper-related hepatopathy include Labradors, Doberman, Skye Terrier, and WHWT
    • Diagnosis is made using copper-specific stains and quantitative measurement of copper (atomic absorption spectroscopy)

    Sequelae of Portal Hypertension

    • Portal hypertension often occurs in dogs with hypoalbuminemia, leading to ascites, edema, ulceration of the GI tract, and signs of hepatic encephalopathy
    • Treatment of GI signs is nonspecific and supportive, including the use of sucralfate, H2 blockers, and proton pump inhibitors
    • Spironolactone in combination with furosemide can be used to treat ascites
    • Therapeutic abdominocentesis is used in cases where the ascites is causing cardiorespiratory compromise
    • Dietary intervention with a high-quality, low-protein diet, and lactulose treatment are used to manage hepatic encephalopathy

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    Description

    This quiz covers acute and chronic hepatitis in canines, including symptoms, diagnosis, and treatment options. Topics include leptospirosis, CAV-1, and clinical signs such as fever, lethargy, and elevated liver enzymes.

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