Term
Hepatocellular leakage enzyme. Tissue source: liver. Stable at room temp 5 hours; requires rapid analysis. Is used in large animals (if test available); could be used in small animals |
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Definition
| SDH sorbitol dehydrogenase |
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Term
Hepatocellular leakage enzyme that is found in: Liver, Muscle, RBCs |
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Definition
| AST aspartate aminotransferase The "STupid enzyme" since it's in more than one organ & even in RBCs |
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Term
| Hepatocellular leakage enzyme that is found in: Liver, Muscle. Clinically, most elevations are due to liver damage, rather than muscle damage |
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Definition
| ALT alanine aminotransferase. For years, ALT was taught as LIVER specific (lucky liver enzyme). Now recognized to elevate w/ severe m. damage of uncommon magnitude |
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Term
| Hepatocellular leakage enzyme that is found in: Liver. Used in birds and large animals |
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Definition
| GLDH glutamate dehydrogenase This enzyme is liver specific and more stabile that SDH, but it is not YET widely available. |
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Term
| Which of the following is NOT a hepatocellular leakage enzyme? ALT AST ALP SDH GLDH |
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Definition
| ALP alkaline phosphatase abbreviated ALP, ALKP, SAP, AlkPhos ALP is an induction enzyme |
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Term
Which of these 6 tissue sources of ALP (alkaline phosphatase) can cause clinically significant serum elevations? Liver, Bone, Drug-induced, Placenta, Renal, Intestinal? |
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Definition
Liver, Bone, Drug-induced (eg, glucocorticoids, phenobarbital) |
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Term
| The half-life of ____ is very short in cats (~6.5 hours) |
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Definition
| ALP alkaline phosphatase The half-life of ALP is relatively short in cats; even small increases raise concern for cholestasis in many instances |
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Term
| List the serum biochemical markers of cholestasis. |
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Definition
ALP (alkaline phosphatase), GGT (gamma glutamyl transferase), Tbili (total bilirubin), Chol (cholesterol)
When there is cholestasis, all 4 of these enzymes are expected to increase |
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Term
| In equines and bovines, fasting/anorexia/bovine rumen stasis causes increased ________? |
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Definition
Tbili (not cholestasis, other cholestatic markers normal) HORSES: incr. within 12 hr of fasting; plateaus 2-3 days; mild to mod incr BOVINES: fasting or rumen stasis; mild incr. |
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Term
| What endocrine diseases cause increased cholesterol? |
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Definition
| Hyperadrenocorticism (Cushing's), Diabetes mellitus, Hypothyroidism |
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Term
| Top dDx for feline patient with elevated: ALT, AST, ALP (10X elevation), GGT (~2X elevation), Tbili, Urine Tbili |
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Definition
| Feline hepatic lipidosis. There is evidence of hepatocellular damage and cholestasis. The marked increase in ALP compared to severity of GGT increase raise strong concern for feline hepatic lipidosis. |
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Term
Does a feline patient with increases in the following have cholestasis or hyperthyroidism? ALT, AST, ALP, GGT, TBili, Chol, Urine TBili
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Definition
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Term
| What type of poikilocytosis may be seen with hepatic disease? |
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Definition
| Acanthocytes. With hepatic disease, abnormal cholesterol metabolism can cause erythrocyte membrane abnormalities. |
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Term
| What are the categories for increased Tbili dDx? |
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Definition
| Pre-hepatic, Hepatic, Post-hepatic. Prehepatic refers to hemolytic disease; concurrent heme abnormalities are expected. Hepatic and post-hepatic refer to various causes of cholestasis, i.e., functional or anatomic that occur with within the liver or along the biliary tree after it exits the liver. |
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Term
| Does a feline patient with elevations of the following have cholestasis or hyperthyroidism? ALT, AST, ALP |
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Definition
| Hyperthyroidism. Thyroid hormone is directly hepatotoxic, which causes increased hepatocellular leakage enzymes, ALT & AST. Thyroid hormone also increases bone turnover, which causes increased production of the bone isoenzyme of ALP. Routine serum biochemistry does not distinguish between the different isoenzymes of ALP. |
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Term
| What are the erythrocyte indices in anemic animals with liver disease? |
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Definition
| Usually mild to moderate, normocytic, normochromic anemia. May be microcytic OR microcytic and hypochromic uncommonly with portosystemic shunts and other causes of hepatic failure. Hyperammonemia interferes with incorporation of iron into hemoglobin. |
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Term
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Definition
| Ammonium biurate crystalluria = pathologic crystalluria almost always. Seen with hepatic failure. Hyperammonemia is implicit when this crystal is observed. |
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Term
Interpret this ACTH stim from a dog.
Pre-ACTH, cortisol µg/dL 6 (ref. int. 0.5 – 3.0)
Post-ACTH, cortisol µg/dL 32 (ref. int. 6.0 – 18.0)
*****did not cover this in depth in 2013 |
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Definition
| Spontaneous hyperadrenocorticism |
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Term
Interpret this ACTH stim from a dog.
Pre-ACTH, cortisol µg/dL 0.2 (ref. int. 0.5 – 3.0)
Post-ACTH, cortisol µg/dL 1.0 (ref. int. 6.0 – 18.0)
*******did not cover this in depth in 2013 |
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Definition
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