Equine Med- Liver 2

kelseyfmeyer's version from 2016-10-03 18:51

Nother case and stuff

Question Answer
what are the core equine vxs?ewe, eee, west nile, rabies, tetanus
this cute mini horse comes to you with diarrhea and ADR... you take her HR and it is 70!!!! WHAT DO?if it was a 1000 lb horse shed be concerned-- with a mini, not quite as upset (like comparing a chihuahua and a great dane)
if you are a fancy equine hospital and this horse comes off the trailer with elevated CK what are you think?creatinine kinase-- can be elevated with mm damage ie riding in a trailer for like 3 hours
how to tell if elevate PCV if dehydration?look at proteins. if proteins low, NOT dehydration
SUPER SUPER high triglycerides=?hyperLIPEMIA not hyperlipidemia
so if the liver totally fills up with fat, is it most likely a primary or secondary liver dz?prolly 2* to sthing else..liver doesn't usually just fill up with fat for no reason.
explain the negative energy leading to hepatic lipidosisfat in adipose tissue, esp if chunky horse. Then horse goes into neg energy balance (not eating for a while) signal to adipose to release triglycerides as FFA to go to the liver, to go to krebs, so can make energy this way. The signal for this is hormone sensitive lipase. When that happens excessively, the liver is overtaken by ability to metabolize the FFAs, and they accumulate in form of fat cells in the liver. (in cattle they also make a ton of ketones and become ketonuric).
Soooo we know how neg energy balance can lead to fatty liver- but how come this mini is having HYPERLIPEMA? (as in not just high but like horrible high)minis and ponies and stuff, and some other horses are prone to having this problem where they make ABNORMAL VLDLs which can't be utilized by stuff when it is deliverd via blood from if in neg energy balance, they release massive amounts of dysfunctional VLDLs into the bloodstream which just hang out and cause hyperlipemia AND hepatic lipidosis
what 2 drugs can you give to tell the neg energy balance body to please stop dumping FFAs and VLDLs into the circulation? (ie Increase uptake of triglycerides by adipose tissue)If you give heparin and insulin, it can counteract some of the enzymes responsible for taking the FFAs out of storage (hormone sensitive lipase) and slow down or stop release of fat from adipose tissue. Also might dec amount of FFAs converted into VLDLs
what food can you suppliment to a mini who isnt eating to keep them out of neg energy balance?karo syrup
4 goals of therapy for hyperlipemic/hepatic lipidosis horse?(1) Stop mobilization of fat→ positive energy balance (Feed, dextrose CRI, insulin) (2) Treat liver disease (Supportive, NSAIDs, Colchicine, DMSO) (3) Increase uptake of triglycerides by adipose tissue (4) Treat underlying disease and reduce stress
what is Colchicine what do we use it for?anti fibrotic agent for liver-- treat general liver dz
what is DMSO used to treat?it is an antiinflammatory
prog of hyperlipemia in ponies?60-100% mortality reported
prog of hyperlipemia in minis? (number) if triglycerides are <1200mg/dL=good
is fatty liver hyper or hypoechoic on US?hypoechoic
high GGT means?biliary issue
sooo if your liver is sparkily like xmas lights.... what do you call it?diffuse hyperechoic foci (could be fibrosis or sthing)
so what toxic plant types can you consume and not have CSs until like 4-12 mo later?pyrrolizidine alkaloid tox (senecio, crotalaria, heliotropium)
what are the almost totally definitive signs for pyrrolizidine tox?fibrosis and megalocytosis
why would a toxin (which?) cause megalocytosis?active compound pyrrole, binds DNA and wont let them divide-- so gets big cells
what plant, if horses eat large amounts of, can cause photosensitization?clover and pyrrolizidines (senecio, crotalaria, heliotropium)
how can you differentiate photosensitization from clover versus pyrrolizidine (senecio, crotalaria, heliotropium)?clover wont have the megalocytosis like pyrrolizidine
how do you treat clover poisoning?support and hope
If you see skin changes from toxic plants, how long do you think this has been a prob?skin changes usually indicate chronicity