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Protein-losing enteropathy Cirrhosis Cirrhosis of the liver can occur as the end result of several liverdiseases, which may be why it is hard to find information on this condition as a separate entity. Cirrhosis can occur in copper storage diseases of the liver, as the end result of idiopathic chronic hepatitis also called chronic active hepatitis, chronic canine inflammatory hepatic disease and probably other namesas a breed related disorder several terrier breeds, Dobermans, Labs, cockers and standard poodlesdue to anti-seizure medications and possibly due to carprofen and oxibendazole a dewormer.
It is sometimes the end result of infectious illnesses, especially leptospirosis and infectious canine hepatitis pretty rare now.
Of these conditions, the one that usually shows up without much warning is the idiopathic chronic hepatitis. This condition can sometimes go on for long periods of time with no really obvious clinical signs and affected patients may have markedly decreased liver size and function when the condition finally causes clinical signs.
Even at this point it is often possible to help make patients feel better for some time, though.
In liver disease, at least if copper toxicosis is possible, it is best to avoid Vitamin C supplementation as it can make the copper toxicity worse.
As the diseases mentioned above progress, they slowly destroy liver cells, resulting in scarring and an increase in fibrosis in the liver, or cirrhosis.
Some patients live for extended periods of time even after it is clear that they have reached the stage that liver cirrhosis is occurring. It can be pretty hard to go back at the time that there is cirrhosis and to figure out why it occurred, so when the liver disease is discovered at this stage, it may not be possible to give you information on the underlying disease and thus the diagnosis of cirrhosis, rather than a more specific diagnosis.
Hepatocutaneous syndrome is a disease characterized by degeneration of the skin cells likely as a consequence of a nutritional imbalance, resulting from metabolic abnormalities caused by severe liver dysfunction or a pancreatic tumor. Hepatocutaneous syndrome is a disease that generally affects older dogs with no consistent breed predisposition.
There have been very few reports of cats affected by hepatocutaneous syndrome.
Skin disease is the usual presenting complaint, although some dogs will exhibit systemic illness lethargy, poor appetite, weight loss prior to the skin eruptions.
The skin lesions frequently occur in areas of trauma such as the muzzle, lower legs, and footpads. Lesions can also affect the mouth, ear flaps, elbows, and genitalia. Most lesions consist of crusting, erosions or ulcerations, but blisters may also occur.
Footpads are often severely thickened and fissured and are often painful. Diagnosis is based on supporting history, physical examination, bloodwork abnormalities such as elevated liver enzymes and low protein levelsand skin biopsy results.
In cats, the most common finding is a pancreatic tumor. If a pancreatic or liver tumor is identified and able to be surgically excised, the skin lesions may normalize for an extended period of time, but because these tumors metastasize spread to other areas of the body quickly, surgery is not curative.
In cases of end stage liver disease, surgery is not possible, and the goal of therapy is to increase quality of life and decrease uncomfortable skin lesions with supportive care and addressing the nutritional abnormalities. Supportive care includes supplementing protein and necessary minerals and enzymes through the diet and oral supplements or by weekly intravenous amino acid infusions that are performed in the hospital on an outpatient basis until improvement in the skin is noted.
Unfortunately, despite the supportive care, the disease will progress. As this disease is a cutaneous marker for serious internal disease, the prognosis is poor with a survival time of less than a year in most cases.
Idiopathic Vacuolar Hepatopathy This is a diagnosis frequently observed in older dogs. These cases appear typical of steroid hepatopathies based on histopathologic examination and abnormal serum ALP, but without clinical or laboratory evidence of hyperadrenocorticism.
The liver of these dogs contains excess glycogen, and they have laboratory findings of predominately G-ALP isoenzymes. One is unable to make the diagnosis of hyperadrenocorticism based on lack of typical clinical signs and normal conventional adrenal testing i.
Several dogs recently discovered having vacuolar hepatopathy and increased serum ALP without overt hyperadrenocorticism have abnormal concentrations in some of the other adrenal steroids i. It has been documented that progestin steroids bind to hepatic glucocorticoid receptors and will induce a steroid hepatopathy when given orally to dogs.
There is now speculation that increases in progestin steroid hormones may result in the hepatic changes and serum ALP increase. It appears that most, if not all, of these dogs live a prolonged life without adverse consequences from their liver disease.
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The reason for abnormal progestin levels may be secondary to adrenal adenomas, adrenal enzyme deficiency for converting precursors to cortisol or inapparent adrenal masses. Adrenal adenomas have been shown to secrete high levels of hydroxyprogesterone in dogs. Recently a disproportionate number of Scottish terriers have elevated serum ALP and hepatic vacuolar changes, suggesting a breed predisposition for this condition.
They may have a genetic defect in ALP production. Hepatic Nodular Hyperplasia Nodular hyperplasia is a benign process causing an increase in serum hepatic values and histomorphologic changes that include macroscopic or microscopic hepatic nodules containing vacuolated hepatocytes.
Liver function remains unchanged. Grossly, the appearance may be suggestive of chronic hepatitis or neoplasia. The cause is unknown but appears to be an aging change in dogs; most of those affected are older than 10 years of age. Ultrasound study may be normal or may demonstrate larger nodules many can be only microscopic and not observed on ultrasound study.
Biopsy confirms the diagnosis; however, a wedge section is preferred, as a needle biopsy may not demonstrate the nodules. There is no specific therapy. Gallbladder Mucocele Gallbladder mucocele is seen in an enlarged gallbladder with immobile stellate or finely striated patterns within the gallbladder on ultrasound study.Oct 24, · U.S.
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