Clin Med- Food Animal Liver

kelseyfmeyer's version from 2015-11-30 13:45

(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 functions the liver does when it is acting as a filter(1) Kupfer cells for immune fn. (they are macs) (2) convert ammonia-->urea (3) filters toxins and neurotoxins (4) bilirubin excretion
what are some things which are stored in the liver?Vitamins (A, D, B12), Minerals, Heavy metals (Iron, **copper and cobolt) ….also fat and gycogen
what are the main vitamins stored in the liver?A, D, B12
which metal being stored in the liver has the potential to cause problems?COPPER is often accumulated slowly, and then if there is insult to the liver, a large amount is released (causes probs)
are cows likely to get fatty liver syndrome?YES! (fat cats n cows) (ruminants are not good at exporting VLDLs--> build up 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 and put in water, the fatty liver would float
what are the two major things the liver produces?(1) Proteins (albumin, coag factors, acute phase proteins, transport proteins...) (2) Bile (bilirubin, bile acids, cholesterol, lecithin, water and electrolytes)
purpose of bile?control of fat metabolism and handling of blood break down products
explain the production of conjugated bilirubinMyoglobin+hemoglobin eaten by macrphages and turned into. Biliverdin quickly breaks into free unconjugated/indirect bilirubrin. However, this is in the bloodstream, and the unconjugated/indirect bilirubrin binds to ALBUMIN (still unconj, just bound to alb). The bili+albumin moves to the liver through the blood stream, where the hepatocyctes conjugate it into conjugated bilirubin-->bile--> bile ducts-->GI
the liver can make products of metabolism, such as... (6 examples)ATP, CO2, gluconeogenesis, ketogenesis, VLDLs, urea....etc
what three things can the liver metabolize?(1) CARBS (VFAs and GLUCOSE) (2) protein (3) LIPIDS
hepatic injury does not necessairly mean...liver failure
what kinda clinical signs would you expect in liver failure?Icterus, Edema, Coagulopathy, Chronic Weight Loss sun burn/heaptic photosensitization encephalopathy, Diarrhea, Ascites / pendulous abdomen with fluid wave
what are two reasons you'd see edema in liver failure?unable to make protein/ hepatic portal hypertension
***what is the MOST COMMON clinical sign seen with liver dz?CHRONIC WEIGHT LOSS
how are sugar levels affected with liver failure?hypoglycemia
how is BUN affected by liver failure?low BUN
how is albumin affected by liver failure?hypoalbuminemia
what are bilirubin levels like with liver failure? bile acids?inc total bili, inc bile acids
how is chlosterol affected with liver failure?hypochlosterolemia
what are ammonia levels like in liver failure?inc 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 and 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 high in the livers of large animals and 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 and 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, and can indicate bone activity as well (young growing stock)
(LOOK AT CASES)her and her cases....
explain the pathophysiology of grain overload and how it affects the liverbegins in rumen (too many carbs, lots of VFAs, dec pH, kill flora, more VFAs and other flora make lactate...low pH causes ulcers)--> ulcers cause 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 with liver complications?ABX! usually use penicillin (anaerobes are the bact usually at fault and this works on them)
how can you prevent grain overload from a herd perspective?dec grain in rations
what is SARA?subacute rumen acidosis- means not acute- chronic- low grade acidosis in rumen and goes on for a long time. might have rumen wall damage
what are you worried about with umbilical abscesses? umbilical vein goes to the liver--- so can creep up umbilical vein and go to liver (outside portal straight from world to liver)
if there are cattle which are not performing as expected (not growing enough) and 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 with fasciola hepatica?F. hepatica, F. magna, Paramphistomum (in rumen)
when are fasciola hepatica migrating, and where? when do you see the most clinical signs?3-4 days after infestation, migrate in liver. CS for migratory phase less common...after 6-8 weeks they penetrate the bile duct, and bile ducts begin to calcify ~20 weeks after infestation.
what's the one bright side to if you have a problem with F. hepatica flukes?cattle can gain resistance :)
what are two diseases that are linked to fasciola hepatica infestations in cattle? (why?)they migrate through the liver leaving places for infection to take hold-- esp. our buddy clostridium. So-- (1) red water (aka bacillary hemoglobinuria) caused by clostridium novyi type D. (2) black leg dz caused by clostridium novyi type b
red water dz (basically hemolobinuria) is caused by what, what is a predisposing dz?fasciola hepatica live flukes might predispose-- red water= clostridium novyi type D
blackleg is caused 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?treatment is the same as prevention; attempts should be made to avoid negative energy balance and to minimize fatty acid mobilization from adipose tissue (Reducing severity and 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 and release of insulin which dec fat use.
(didn't get to in class) what are the risks of giving propylene glycol?(I had trouble with this......maybe hyperglycemia? an article says PG has some side effects including ataxia, salivation, hyperventilation, and depression.)
(didn't get to in class) how does insulin help fatty liver syndrome?insulin dec 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 inc 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 and gut edema?? see straining

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