Liver Disease in Dogs and Cats

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Questions and Answers

What are the primary functions of the liver in dogs, and how do they relate to overall systemic health?

The liver performs essential roles, including metabolism (carbohydrates, fats, proteins), detoxification of toxins and drugs, bile production for fat digestion, storage of glycogen and fat-soluble vitamins, and synthesis of clotting factors. These functions are critical for maintaining homeostasis and overall health.

Which major blood vessels supply and drain the canine liver?

The liver is supplied by the hepatic artery (oxygenated blood) and the portal vein (nutrient-rich blood from the gastrointestinal tract). The hepatic veins drain blood from the liver into the caudal vena cava.

How does the liver contribute to detoxification and metabolism in dogs?

The liver metabolizes endogenous and exogenous substances through Phase I (oxidation, reduction, hydrolysis) and Phase II (conjugation) reactions, making them water-soluble for excretion. It also processes ammonia into urea and regulates blood glucose by glycogenesis and gluconeogenesis.

What are the most common types of liver disease in dogs, and how do they differ pathophysiologically? (Select all that apply)

<p>Hepatitis: Inflammation due to infection, toxins, or autoimmune conditions. (A), Portosystemic shunts (PSS): Abnormal blood flow bypassing the liver, leading to reduced detoxification. (B), Hepatic lipidosis: Excessive fat deposition disrupting liver function. (C), Cirrhosis: Chronic damage leading to fibrosis and loss of liver architecture. (D)</p> Signup and view all the answers

How does liver dysfunction lead to secondary systemic effects such as coagulopathy or hepatic encephalopathy?

<p>Coagulopathy: Reduced synthesis of clotting factors. Hepatic encephalopathy: Accumulation of ammonia and other toxins affecting the brain.</p> Signup and view all the answers

What is the significance of portal hypertension in canine liver disease?

<p>Portal hypertension occurs due to increased resistance in hepatic blood flow, often from fibrosis or cirrhosis, leading to ascites, gastrointestinal bleeding, and portosystemic shunting.</p> Signup and view all the answers

What are the common infectious causes of liver disease in dogs? (Select all that apply)

<p>Canine adenovirus-1 (CAV-1): Causes infectious canine hepatitis. (B), Leptospirosis: Bacterial infection affecting the liver and kidneys. (C)</p> Signup and view all the answers

How can toxins such as xylitol or aflatoxins lead to liver damage in dogs?

<p>Xylitol: Induces hypoglycemia and acute liver failure. Aflatoxins: Mycotoxins causing oxidative damage and hepatocyte death.</p> Signup and view all the answers

What role do congenital diseases like portosystemic shunts play in liver pathology?

<p>Congenital PSS bypasses liver filtration, leading to systemic circulation of toxins and nutrient imbalances, causing failure to thrive, seizures, and hepatic encephalopathy.</p> Signup and view all the answers

What are the most common clinical signs of liver disease in dogs, and how do they relate to the liver's role in the body?

<p>Common signs include jaundice (impaired bilirubin metabolism), vomiting, diarrhea, anorexia (loss of appetite), ascites (portal hypertension), and neurological signs (hepatic encephalopathy).</p> Signup and view all the answers

How might a dog with liver disease present differently based on whether the condition is acute or chronic? (Select all that apply)

<p>Acute: Sudden onset of vomiting, jaundice, and lethargy. (A), Chronic: Weight loss, intermittent vomiting, polyuria/polydipsia, and progressive lethargy. (B)</p> Signup and view all the answers

Which laboratory tests are most important in diagnosing liver disease in dogs? (Select all that apply)

<p>Albumin, bilirubin, clotting times: Evaluate synthetic function and cholestasis. (A), ALT and AST: Elevated levels indicate hepatocellular damage. (B), ALP and GGT: Elevated levels suggest cholestasis. (C), Bile acids test: Assesses liver function. (D)</p> Signup and view all the answers

What imaging modalities (e.g., ultrasound, CT) are commonly used to evaluate the liver in dogs, and what findings indicate disease? (Select all that apply)

<p>Ultrasound: Visualizes size, shape, echogenicity, and masses. Signs of disease include hepatomegaly, nodules, or ascites. (A), CT: Provides detailed images of vascular abnormalities, like PSS. (B)</p> Signup and view all the answers

What is the significance of liver biopsy in diagnosing specific hepatic diseases in dogs?

<p>Liver biopsy provides definitive diagnosis through histopathology, identifying fibrosis, inflammation, neoplasia, or infections.</p> Signup and view all the answers

What dietary recommendations are typically made for dogs with liver disease, and why? (Select all that apply)

<p>High-quality, easily digestible protein. (A), Increased zinc and antioxidants to reduce oxidative stress. (B), Low protein (to reduce ammonia production in hepatic encephalopathy). (C)</p> Signup and view all the answers

How are hepatoprotective drugs (e.g., SAMe, silymarin) used in canine liver disease treatment?

<p>SAMe: Supports antioxidant defense and glutathione synthesis. Silymarin (milk thistle): Protects hepatocytes from toxins.</p> Signup and view all the answers

What are the indications for surgical intervention in cases of canine liver disease?

<p>Surgery is indicated for PSS correction, removal of liver masses, or abscesses.</p> Signup and view all the answers

What factors influence the prognosis for dogs with chronic liver disease?

<p>Prognosis depends on the underlying cause, degree of liver damage, response to treatment, and development of complications like ascites or encephalopathy.</p> Signup and view all the answers

How does the underlying cause of liver disease impact the long-term outcomes in dogs?

<p>Reversible causes (e.g., infections) have a better prognosis, while irreversible damage (e.g., cirrhosis, neoplasia) worsens outcomes.</p> Signup and view all the answers

How can vaccination and preventive care reduce the risk of liver disease in dogs?

<p>Vaccination against CAV-1 and leptospirosis reduces infectious risks. Routine health checks ensure early detection and management.</p> Signup and view all the answers

What client education strategies are effective for managing dogs with liver conditions?

<p>Educate clients on proper diet, medication adherence, recognizing clinical signs of deterioration, and regular follow-up tests to monitor liver function.</p> Signup and view all the answers

How can toxins such as acetaminophen or plants (e.g., lilies) lead to liver damage in cats?

<p>Cats lack certain liver enzymes (e.g., glucuronyl transferase) needed to detoxify substances like acetaminophen, leading to oxidative damage and hepatocellular necrosis.</p> Signup and view all the answers

Which laboratory tests are most important in diagnosing liver disease in cats (e.g., ALT, ALP, bile acids)? (Select all that apply)

<p>ALP and GGT: Often elevated in cholangitis or biliary diseases. (A), Bile acids and ammonia tests: Assess liver function. (B), Albumin and bilirubin: Evaluate synthetic function and cholestasis. (C), ALT and AST: Elevated levels indicate hepatocellular damage. (D)</p> Signup and view all the answers

Flashcards

Liver function in dogs and cats

The liver plays a critical role in metabolism (proteins, carbohydrates, lipids), detoxification (drugs, toxins), bile production, and immune function (Kupffer cells).

Dog liver disease: Hepatitis

Inflammation of the dog's liver, often caused by infections (e.g., leptospirosis, adenovirus), immune issues or toxins.

Dog liver disease: Portosystemic Shunt (PSS)

Abnormal blood flow bypasses the dog's liver, often having congenital or acquired causes.

Dog liver disease: Hepatic Lipidosis

Fat build-up in the dog's liver due to starvation or metabolic issues.

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Dog liver disease: Neoplasia

Cancers of the dog's liver (hepatocellular carcinoma, bile duct carcinoma).

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Dog liver disease: Copper-associated Hepatopathy

Liver inflammation and damage in dogs due to excess copper.

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Feline liver disease: Hepatic Lipidosis

The most common liver disease in cats, commonly caused by prolonged lack of appetite.

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Feline liver disease: Cholangitis

Inflammation of the bile ducts in cats, potentially caused by bacteria or immune issues.

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Feline liver disease: Feline Infectious Peritonitis (FIP)

A viral disease that can affect the cat's liver, often causing ascites and other issues.

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Clinical sign: Jaundice

Yellowing of the skin and mucous membranes due to liver dysfunction.

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Clinical sign: Ascites

Fluid buildup in the abdomen, often a sign of liver failure.

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Clinical sign: Vomiting

Forceful expulsion of stomach contents, a symptom of various conditions, including liver issues.

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Clinical sign: Innappetence

Loss of appetite, may be a sign of various ailments, including liver disease.

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Clinical sign: Lethargy

Lack of energy or activity, a common symptom in many illnesses, including liver disease.

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Clinical Sign: Hepatic Encephalopathy

Neurological dysfunction resulting from impaired liver function, often leading to altered mental state.

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Clinical sign: Weight loss

Reduction in body weight, often present in animals with liver disorders

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Clinical sign: Diarrhea

Frequent passage of loose stools, may be caused by multiple conditions, including liver issues

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Liver's role in Metabolism

Processes proteins, carbohydrates, and fats.

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Liver's role in Detoxification

Transforms harmful substances into less harmful ones.

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Liver's role in Bile Production

Produces bile for fat digestion and vitamin absorption.

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Liver's role in Immune Function

Filters blood using Kupffer cells, removing pathogens and debris.

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Clinical sign: Coagulopathy

Disorders in blood clotting, often resulting from liver damage.

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Clinical sign: Melena

Dark, tarry stools, indicating bleeding from the upper gastrointestinal tract.

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Clinical sign: Petechiae

Small, pinpoint hemorrhages under the skin.

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Study Notes

Liver Disease in Dogs and Cats

  • Liver disease is a significant concern in veterinary medicine
  • Liver function is critical for various physiological processes, including metabolism of proteins, carbohydrates, and lipids, detoxification, bile production, and immune function.
  • Dogs are susceptible to various liver diseases, including acute and chronic hepatitis, portosystemic shunts (abnormal blood flow), hepatic lipidosis (rare), neoplasia (cancers), and copper-associated hepatopathy.
  • Cats are frequently diagnosed with hepatic lipidosis, cholangitis (inflammation), feline infectious peritonitis (FIP), and neoplasia.

Common Liver Diseases in Dogs

  • Acute/Chronic Hepatitis: Caused by infectious agents, immune conditions or toxins
  • Portosystemic Shunt (PSS): Congenital or acquired, abnormal blood flow bypassing the liver. Signs include small stature, neurological issues, and poor growth.
  • Hepatic Lipidosis: Occurs with severe starvation or metabolic dysfunction.
  • Neoplasia: Cancers (hepatocellular carcinoma, bile duct carcinoma) cause symptoms like weight loss, ascites, and lethargy.
  • Copper-Associated Hepatopathy: Excess copper storage, especially in breeds like Bedlington Terriers, causes liver inflammation and fibrosis.

Common Liver Diseases in Cats

  • Hepatic Lipidosis: Most common cat liver disease, often following prolonged anorexia. Signs include lethargy, icterus (jaundice), rapid weight loss.
  • Cholangitis: Neutrophilic (bacterial) or lymphocytic (immune-mediated), causes fever, abdominal pain, and jaundice.
  • Feline Infectious Peritonitis (FIP): Can involve the liver, causing ascites, lethargy, and poor growth.
  • Neoplasia: Lymphoma or bile duct carcinoma.

Clinical Signs of Liver Disease

  • Clinical signs often overlap between dogs and cats.
  • Common signs include vomiting, diarrhea, inappetence, weight loss, lethargy, jaundice (yellowing), abdominal swelling (ascites), and hepatic encephalopathy (head pressing, seizures).

Diagnostic Approach

  • History and Examination: Prolonged anorexia, toxin exposure, or breed predispositions.
  • Blood Work: Elevated ALT and AST; ALP and GGT elevated in cholestasis; increased bile acids or bilirubin may indicate liver dysfunction
  • Imaging: Ultrasound (assessing liver size, echogenicity, vascular anomalies); radiography (assessing liver silhouette)
  • Advanced Diagnostics: Fine needle aspiration (FNA) or biopsy for histopathology to identify the cause of the underlying disease, leptospirosis serology, copper quantification

Treatment and Management

  • Supportive care: IV fluids, antiemetics, appetite stimulants.
  • Disease-specific treatments: Assisted feeding, copper chelators, low-copper diet, zinc supplementation.

Prognosis and Monitoring

  • Prognosis: Good for early-diagnosed and well-managed cases (e.g., hepatic lipidosis).
  • Follow-up: Regular liver enzyme checks (3-6 months) and monitoring response to treatment

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