Podcast
Questions and Answers
What is primarily indicated by cholestasis?
What is primarily indicated by cholestasis?
Which condition is associated with copper toxicosis?
Which condition is associated with copper toxicosis?
Which of the following is a potential cause of icterus?
Which of the following is a potential cause of icterus?
What is the condition characterized by inflammation of bile ducts?
What is the condition characterized by inflammation of bile ducts?
Signup and view all the answers
Which of the following statements is true regarding hyperbilirubinemia and icterus?
Which of the following statements is true regarding hyperbilirubinemia and icterus?
Signup and view all the answers
What percentage of blood flow to the liver is provided by the hepatic artery?
What percentage of blood flow to the liver is provided by the hepatic artery?
Signup and view all the answers
In which location is the liver primarily found in monogastric animals?
In which location is the liver primarily found in monogastric animals?
Signup and view all the answers
What is the primary function of the portal vein in the liver's blood supply?
What is the primary function of the portal vein in the liver's blood supply?
Signup and view all the answers
What structure is found at the center of a liver lobule?
What structure is found at the center of a liver lobule?
Signup and view all the answers
Which component of the liver lobule allows for the flow of bile?
Which component of the liver lobule allows for the flow of bile?
Signup and view all the answers
What characteristic is true of the capillaries within the liver?
What characteristic is true of the capillaries within the liver?
Signup and view all the answers
What type of entry distribution is associated with hematogenous infections in the liver?
What type of entry distribution is associated with hematogenous infections in the liver?
Signup and view all the answers
Which of the following accurately describes the lobation of the liver?
Which of the following accurately describes the lobation of the liver?
Signup and view all the answers
What is a primary consequence of liver bypass related to metabolic disturbances?
What is a primary consequence of liver bypass related to metabolic disturbances?
Signup and view all the answers
Which of the following best describes lipidosis?
Which of the following best describes lipidosis?
Signup and view all the answers
What can lead to hepatic failure in cats?
What can lead to hepatic failure in cats?
Signup and view all the answers
What is a common presentation of fatty livers in affected animals?
What is a common presentation of fatty livers in affected animals?
Signup and view all the answers
Which condition is associated with high energy demands in livestock?
Which condition is associated with high energy demands in livestock?
Signup and view all the answers
What dietary issue can lead to the development of fatty liver?
What dietary issue can lead to the development of fatty liver?
Signup and view all the answers
What deficiency is related to 'White liver disease' in sheep and goats?
What deficiency is related to 'White liver disease' in sheep and goats?
Signup and view all the answers
Which of the following factors does NOT contribute to lipidosis?
Which of the following factors does NOT contribute to lipidosis?
Signup and view all the answers
What characterizes massive necrosis compared to bridging necrosis?
What characterizes massive necrosis compared to bridging necrosis?
Signup and view all the answers
What is a key feature of zonal patterns in liver lesions?
What is a key feature of zonal patterns in liver lesions?
Signup and view all the answers
Which type of necrosis is particularly associated with the central lobular hepatocytes?
Which type of necrosis is particularly associated with the central lobular hepatocytes?
Signup and view all the answers
What is a common cause of injury to centriloobular hepatocytes?
What is a common cause of injury to centriloobular hepatocytes?
Signup and view all the answers
Which of the following best describes random patterns of lesions?
Which of the following best describes random patterns of lesions?
Signup and view all the answers
What is essential to understand histological changes associated with liver lesions?
What is essential to understand histological changes associated with liver lesions?
Signup and view all the answers
In the scenario described involving a 10-day-old calf, which of the following lesions would most likely be found upon necropsy?
In the scenario described involving a 10-day-old calf, which of the following lesions would most likely be found upon necropsy?
Signup and view all the answers
What is the primary direction of bile flow within the liver lobule?
What is the primary direction of bile flow within the liver lobule?
Signup and view all the answers
What is a characteristic feature of hepatic lipidosis?
What is a characteristic feature of hepatic lipidosis?
Signup and view all the answers
Which condition might lead to excessive glycogen accumulation in the liver?
Which condition might lead to excessive glycogen accumulation in the liver?
Signup and view all the answers
What is the primary type of amyloid associated with primary amyloidosis?
What is the primary type of amyloid associated with primary amyloidosis?
Signup and view all the answers
What common consequence can occur if hepatic amyloidosis affects the kidney?
What common consequence can occur if hepatic amyloidosis affects the kidney?
Signup and view all the answers
How is apple green birefringence observed?
How is apple green birefringence observed?
Signup and view all the answers
Which species is noted for hereditary amyloidosis?
Which species is noted for hereditary amyloidosis?
Signup and view all the answers
What is the significance of the beta pleated sheet formation in amyloidosis?
What is the significance of the beta pleated sheet formation in amyloidosis?
Signup and view all the answers
Which statement is true regarding glycogen storage diseases?
Which statement is true regarding glycogen storage diseases?
Signup and view all the answers
Study Notes
End Stage Liver Disease
- End stage liver disease is characterized by chronic congestion, chronic toxins, chronic inflammation, and copper toxicity (in Bedlington Terriers)
- Copper toxicosis is typically exacerbated by a genetic predisposition to store excess copper in the liver.
Hepatobiliary System Disorders
- Cholestasis is a disturbance in bile flow which can be intrahepatic (within the liver) or extrahepatic (outside the liver, such as a bile duct obstruction)
- Cholestasis can be a cause of icterus (jaundice).
- Cholecystitis is inflammation of the gallbladder.
- Cholangitis is inflammation of the bile ducts, and can be intrahepatic or extrahepatic.
- Cholangiohepatitis is a combined inflammation of the bile ducts and liver tissue.
Modifiers of Liver Disease
- Lymphocytic cholangitis is characterized by an abundance of lymphocytes in the bile ducts and is commonly seen in cats over 4 years old. The etiology is often unknown, with autoimmune causes being a possibility.
- Suppurative cholangitis involves the presence of pus-forming cells (neutrophils) in the bile ducts.
- Bilirubin is a breakdown product of heme (from red blood cells), and can be a useful indicator of liver function.
Gallbladder Terminology
- Hyperbilirubinemia is an increased concentration of bilirubin in the blood, which can be conjugated (attached to a protein) or unconjugated (free).
- Icterus (jaundice) is a yellowish discoloration of tissues due to high bilirubin levels. It can have pre-hepatic, hepatic, or post-hepatic causes.
- While hyperbilirubinemia is an indication of an issue, icterus will only manifest after a period of hyperbilirubinemia.
- Physiologic icterus in horses is a temporary condition caused by inappetence (lack of appetite).
Hepatobiliary Anatomy
- The liver is the largest internal organ in the body.
-
Liver size varies with species:
- Adult carnivores: 3-4% of body weight
- Adult omnivores, small ruminants: 1.5-2% of body weight
- Large herbivores: 1% of body weight
-
Location:
- Central cranial abdomen (monogastrics)
- Right side of the abdomen in ruminants due to the rumen's displacement.
- Lobation: Varies among species.
Blood Supply to the Liver
-
Nutritional supply:
- Hepatic artery: 20-30% blood flow
-
Functional supply:
- Portal vein: 70-80% blood flow (from the gastrointestinal tract)
- This high blood flow from the digestive system exposes the liver to a high concentration of microbes and toxins.
Liver Functional Unit: The Lobule
- The liver is divided into lobes, and lobes are further divided into lobules.
- Each lobule is a hexagonal structure containing:
- Cords of hepatocytes: The functional liver cells.
- Central vein: The central vein of the lobule, where blood is collected.
-
Portal triads: Located at the corners of the lobule, containing:
- Bile ductule
- Portal vein branch
- Hepatic artery branch
- Lymphatics and nerves
Blood and Bile Flow within the Lobule
- Blood flow: Blood enters the lobule through portal triads, flows through sinusoids, and exits via the central vein.
- Bile flow: Flows from the hepatocytes towards the portal triad, in the opposite direction of blood flow.
Histological Perspective of the Liver
- Discontinuous capillaries: The capillaries within the liver are unique, with gaps in their lining to allow for exchange of substances.
- Space of Disse: A space between the hepatocytes and the sinusoids, containing stellate cells (Ito cells) which play a role in liver fibrosis.
Portals of Entry and Lesion Distribution
- Hematogenous lesions: Lesions caused by blood-borne pathogens (viruses, bacteria, fungi, etc.) can enter via the hepatic artery and portal vein.
- Lesion distribution: The initial pattern may be difficult to appreciate if the lesion has been present for a while because the disease can spread from both the hepatic artery and portal vein supply.
Lesion Patterns
- Random patterns: Destruction of hepatocytes can occur without preference for specific regions of the lobule. This can be caused by various etiologies such as viruses, bacteria, fungi, and parasites.
- Bridging necrosis: Lesions that coalesce across multiple lobules.
- Massive necrosis: Complete destruction of an entire lobule or several adjacent lobules.
Zonal Patterns of Liver Injury
-
Zonal patterns: Damage to specific regions of the lobule, resulting in a more distinct gross lobular pattern.
- Periportal: Damage around the portal triads.
- Midzonal: Damage in the middle of the lobule.
- Central lobular: Damage in the central region of the lobule.
Case Study: 10-Day-Old Calf
- Presentation: Pale mucous membranes, distended abdomen, coughing, slow movement.
- Necropsy findings: Bronchopneumonia and pulmonary edema.
- Hepatomegaly: Enlarged liver, possibly due to chronic passive congestion.
Liver Pathology: Hypoxemia and Centrilobular Necrosis
- Hypoxia: A lack of oxygen, often caused by poor blood flow, can lead to centrilobular necrosis, a condition where hepatocytes in the central regions of the lobules die.
-
Centrilobular hepatocytes: These cells are more susceptible to injury due to their:
- High metabolic activity: Highly active in the metabolism of toxins, making them more vulnerable.
- Location: Being at the end of the blood flow within the lobule makes them more susceptible to hypoxia.
Portosystemic Shunt (PSS)
- Portosystemic shunt: A bypass of the liver where blood from the portal vein directly enters the systemic circulation.
-
Consequences of PSS:
- Hepatic encephalopathy: Impaired brain function due to toxins bypassing the liver.
- Hyperammonemia: Elevated levels of ammonia in the blood.
- Ammonium biurate crystals: Crystals observed in urine.
- The bypass of the liver leads to the accumulation of ammonia, which can cause various health issues.
Hepatic Lipidosis (Steatosis)
- Hepatic lipidosis: Abnormal accumulation of triglycerides in hepatocytes.
-
Causes:
- Excessive fat or carbohydrate intake: High-fat diets can overwhelm the liver's capacity to process lipids.
- Increased fat metabolism: Conditions like lactation, starvation, and endocrine disorders can lead to increased fat breakdown and mobilization.
- Abnormal hepatocyte function: Impaired function of liver cells can result in an inability to process and export lipids.
- Decreased apoprotein synthesis: Insufficient production of proteins required for lipid transport.
- Secretory defects: Impaired ability of hepatocytes to secrete lipoproteins.
- Increased glucose/insulin concentrations: High levels can contribute to lipid accumulation.
Fatty Liver: Etiologies and Presentation
- Cobalt/vitamin B12 deficiency: Occurs in sheep and goats, typically presenting with a "white liver disease".
- Ketosis: Metabolic condition in high-energy demand states (obese animals, late gestation, post-partum).
- Bovine fatty liver syndrome: This is associated with high-energy demands.
- Feline fatty liver syndrome: Occurs in obese, anorexic cats.
- Hepatocellular steatosis: Occurs in overweight, pregnant, or lactating donkeys, ponies, and mini horses.
Fatty Liver: Gross Pathology
- Gross appearance: Enlarged, rounded borders, pale, friable, greasy on cut surface.
- Histological findings: Hepatocytes contain lipid vacuoles.
Other Causes of Pale, Enlarged Liver
-
Glycogen: Accumulation of glycogen in hepatocytes, seen in steroid-induced hepatopathy, diabetes mellitus, and glycogen storage diseases.
- Gross appearance: Enlarged, rounded borders, pale, NONGREASY.
- Histological findings: Hepatocytes contain glycogen.
-
Amyloidosis: Deposition of amyloid protein in the liver.
- Gross appearance: Can be difficult to distinguish from other causes.
- Histological findings: Amyloid deposition in Spaces of Disse.
Glycogen Hepatopathy
- Glycogen hepatopathy: Excessive glycogen accumulation in hepatocytes.
-
Causes:
- Diabetes mellitus
- Steroid-induced: Iatrogenic (due to medication), Cushing's disease
- Glycogen storage diseases
Hepatic Amyloidosis
- Hepatic amyloidosis: Amyloid deposition primarily in the liver, but it can also affect other organs.
- Locations: Liver, kidney, nasal mucosa.
- Cause: Can be secondary to prolonged inflammation or genetic predisposition.
-
Types of Amyloid:
- AL amyloid: Found in primary amyloidosis, associated with B cell proliferative disorders.
- AA amyloid: Found in secondary or reactive amyloidosis, a consequence of long-term inflammation.
- β-amyloid: Found in Alzheimer's disease and can be seen in aged dogs.
Amyloidosis: Diagnosis
- Fresh tissue: Iodine staining can be used.
-
Formalin-fixed tissue: Congo red staining is commonly used.
- Apple-green birefringence: Amyloid exhibits apple-green color under polarized light when stained with Congo red.
Amyloidosis: Consequences
- Deposition of insoluble protein: Amyloid cannot be broken down, leading to its accumulation.
- Compression and occlusion: The deposited amyloid can compress spaces and occlude vessels.
- Affected organs: Kidney, liver, spleen, and others.
Copper Toxicosis
- Copper toxicosis: Excessive copper accumulation in the liver.
- Normal copper storage: The liver normally stores copper.
- Predisposition: Some breeds, like Bedlington Terriers, have a genetic predisposition to store excess copper.
- Cause: Exposure to copper-plated zinc products or other sources of copper, often compounded by a genetic predisposition to store excess copper.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on end stage liver disease, including its causes and effects, as well as related hepatobiliary system disorders like cholestasis and cholecystitis. This quiz also covers modifications of liver disease, focusing on conditions such as lymphocytic cholangitis in cats. Challenge yourself to understand the complexities of liver health!
