Clin Med - Food Animal Liver

drraythe's version from 2016-03-15 12:26

(General) know things unique to FAs

Question Answer
Do rumis have gall bladders?YES
Do camelids have a gall bladder?No
Where is the liver located in the cow?Mostly on the R side (rumen on L so push everything else to the right)
Explain some fans the liver does when it is Acting as a filter(1) Kuepfer cells for immune fxn (they are MACs)
(2) Convert ammonia → urea
(3) Filters toxins & neurotoxins
(4) Bilirubin excretion
What are some things which are stored in the liver?Vitamins (A, D, B12)
Heavy metals (Iron, **Copper & Cobalt)
also fat & glycogen
What are the main Vitamins stored in the liver?A, D, B12
Which metal being stored in the liver has the potential to cz problems?COPPER is often accumulated slowly & then if there is insult to the liver, a large amount is released (czs probs)
Are cows likely to get fatty liver syndrome?YES! (Fat cats n cows) (Ruminants are not good at exporting VLDLs → buildup of fat in liver, then get fatty liver)
What does a fatty liver look like?Kinda pale-suggests it has more fat stored in it. Also the corners are more rounded. If cut off & put in water, the fatty liver would float
What are the 2 major things the liver produces?(1) Proteins (albumin, coag factors, acute phase proteins, transport proteins)
(2) Bile (bilirubin, bile acids, cholesterol, lecithin, water & electrolytes)
Purpose of bile?Control of fat metabolism & handling of blood break down products
Explain the production of conjugated bilirubinMyoglobin+Hb eaten by macrophages & turned into. Biliverdin quickly breaks into free unconjugated/indirect bilirubin. However, this is in the bloodstream & the unconjugated/indirect bilirubin binds to ALBUMIN (still unconj, just bound to alb). The bili+albumin moves to the liver through the blood stream, where the hepatocytes conjugate it into conjugated bilirubin → bile → bile ducts → GI
The liver can make products of metabolism, such as... (6 examples)ATP
What 3 things can the liver metabolize?(1) CARBS (VFAs & GLUCOSE)
(2) Protein
Hepatic injury does not necessarily mean...Liver failure
What kinda CS would you expect in liver failure?Icterus
Chronic Weight Loss
Sun burn/hepatic photosensitization encephalopathy
Ascites / pendulous abdomen w/ fluid wave
What are 2 reasons you'd see edema in liver failure?Unable to make protein/ hepatic portal hypertension
***What is the MOST COMMON clinical sign seen w/ liver dz?CHRONIC WEIGHT LOSS
How are sugar levels affected w/ liver failure?Hypoglycemia
How is BUN affected by liver failure?↓ BUN
How is albumin affected by liver failure?Hypoalbuminemia
What are bilirubin levels like w/ liver failure? Bile acids?↑ total bile, ↑ bile acids
How is cholesterol affected w/ liver failure?Hypocholesterolemia
What are ammonia levels like in liver failure?↑ ammonia
***What is the most sensitive marker of hepatic damage in the food animal (cow I assume)Sorbitol Dehydrogenase
What is SDH? What does it tell you? What is its half-life? How sensitive is it?Sorbitol Dehydrogenase-THE MOST SENSITIVE MARKER FOR HEPATOCELLULAR DAMAGE it has a short half-life & is very sensitive
What is GLDH? What does it tell you?Glutamate Dehydrogenase, which indicates ACUTE (not chronic) liver dz. It is good for indicating the DEGREE of hepatic necrosis in food animals
What is GGT? What does it tell you? What is the half life? At what level is it considered significant levels?Gamma Glutamyl Transpeptidase - It is chiefly used as an indicator of HEPATOBILIARY DZ-BUT! GGT activity is relatively ↑ in the livers of large animals & so is a more useful indicator of cholestasis! It can also be elevated in hepatic lipidosis. (However, it can be found in any duct system, like the mammary glands) If has a long half-life, so anything past 2xs normal is considered starting to be significant.
What is AST? What is the half life? What is a significant change in it?AST can also indicate liver damage, if there is an elevation of 2-3xs normal (since it has a longer half-life than SDH). However, it also originates in mm & RBCs (so not as specific for liver)
What is ALP? What is a sig value? What does it indicate?There can be WIDE fluctuations of normal values. It can indicate CHOLESTASIS, HEPATOCYTE DAMAGE & can indicate bone activity as well (young growing stock)
Explain the pathophysiology of grain overload & how it affects the liverBegins in rumen (too many carbs, lots of VFAs, ↓ pH, kill flora, more VFAs & other flora make lactate...low pH czs ulcers) → ulcers cz hematogenous route for bacteria to go to liver...from the liver to the lungs
What is the most common bacteria involved in grain overload?Fusobacteria necroforium
What are some ways you could dx grain overload?Observe Hemoptysis (coughing blood), looking for chronic liver abscesses or acute severe liver abscesses (ultrasound)
What is a more common clinical presentation of liver abscesses in cattle?CHRONIC WEIGHT LOSS
How could you treat grain overload w/ liver complications?ABIOPSY! Usually use Penicillin (anaerobes are the bact usually at fault & this works on them)
How can you prevent grain overload from a herd perspective?↓ grain in rations
What is SARA?Subacute rumen acidosis-means not acute-chronic-low grade acidosis in rumen & goes on for a long time. Might have rumen wall damage
What are you worried about w/ umbilical abscesses?Umbilical vein goes to the liver-so can creep up umbilical vein & go to liver (outside portal straight from world to liver)
If there are cattle which are not performing as expected (not growing enough) & there is a pond in the pasture, what are you worried about? (Ddx?)LIVER FLUKES (Fasciola hepatica.) - IH is snails which cows can accidentally eat as they are on the grass around the pond. ((Ddx: mycotoxins)
How many eggs per gram/feces of Fasciola hepatica would you need to have seen before you suspect economic impact from this?1-3 EP2g
What are some other flukes you might concurrently see w/ Fasciola hepatica?F. hepatica
F. magna
Paramphistomum (in rumen)
When are Fasciola hepatica migrating & where? When do you see the most CS?3-4 days after infestation, migrate in liver. CS for migratory phase less common...after 6-8 weeks they penetrate the bile duct & bile ducts begin to calcify ~20 weeks after infestation.
What's the 1 bright side to if you have a problem w/ F. hepatica flukes?Cattle can gain resistance :)
What are 2 dzs that are linked to Fasciola hepatica infestations in cattle? (Why?)They migrate through the liver leaving places for infxn to take hold-esp. our buddy Clostridium
(1) Red water (aka bacillary Hburia) czd by Clostridium novyi type D
(2) Black leg dz czd by Clostridium novyi type b
Red water dz (basically Hburia) is czd by what, what is a predisposing dz?Fasciola hepatica live flukes might predispose - Red water = Clostridium novyi type D
Blackleg is czd by what, what is a predisposing dz?Fasciola hepatica live flukes might predispose-black, Clostridium novyi type b
(Didn't get to in class) What can be a big problem for cows after giving birth?Fatty liver syndrome (cows overconditioned at calving are most likely to develop this)
(Didn't get to in class) How can you rule in/out fatty liver syndrome?Liver biopsy
(Didn't get to in class) How can you try to treat fatty liver syndrome?Tx is the same as prevention; attempts should be made to avoid negative energy balance & to minimize fatty acid mobilization from adipose tissue (Reducing severity & duration of negative energy balance is crucial in the prevention of fatty liver). Can giver propylene glycol to reduce the NEFAs in the blood stream which reduces the severity. Giving glucose provides energy & release of insulin which ↓ fat use.
(Didn't get to in class) What are the risks of giving propylene glycol?(I had trouble w/ this......maybe hyperglycemia? an article says PG has some side effects including ataxia, salivation, hyperventilation & depression.)
(Didn't get to in class) How does insulin help fatty liver syndrome?Insulin ↓ fat mobilization
(Didn't get to in class) Would you wanna use steroids for fatty liver syndrome?(also had to look up...not sure, but I think steroids ↑ serum lipids which would be bad)
(Didn't get to in class) Chronic weight loss in liver failure is due to...Metabolic impairment
(Didn't get to in class) Edema in liver failure is NOT just due to poor albumin production - (what else)Also portal hypertension
(Didn't get to in class) How common is it to see a coagulopathy in liver failure in cattle?Uncommon
(Didn't get to in class) Why might you see diarrhea in liver failure?Portal hypertension & gut edema?? See straining