Term
| What is the second most common liver dz in cats? |
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Definition
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Term
| What is cholangitis histologically? |
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Definition
-inflammation of the biliary tree
+/- parenchmal inflammation
+/-bile duct proliferation
+/- fibrosis |
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Term
| What is neutrophilic cholangitis? |
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Definition
-bile duct lumen & wall
-neutrophils in tissue, think bacterial issue |
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Term
| Describe the pathophysiology behind neutrophilic cholangitis. |
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Definition
| -ascending bacterial infection from intestine up the common bile duct |
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Term
| How does acute & chronic neutrophilic cholangitis differ? |
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Definition
-acute: inflammation extends to the hepatic parenchyma
-chronic: mixed cell infiltrate (lymphs & plasma cells), fibrosis & bile duct proliferation |
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Term
| What is the typical signalment of neutrophilic cholangitis? |
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Definition
-commonly > 10y
-no breed or sex predilection |
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Term
| In general, describe the dz seen w/ acute neutrophilic cholangitis. |
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Definition
-acutely ill
-anorexic, lethargic, febrile |
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Term
| In general, describe the dz seen w/ chronic neutrophilic cholangitis. |
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Definition
-milder less specific CS
-maybe waxing/waning |
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Term
| What CS do we see w/ feline cholangitis? |
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Definition
-jaundice: acte > chronic
-abdominal pain: acute > chronic
-ptyalism
-dehydration |
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Term
| What do we see on lab work w/ feline cholangitis? |
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Definition
-inc ALT
-hyperbilirubinemia
-neutrophilic leukocytosis w/ left shit
-bilirubinuria
-prolonged coag times |
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Term
| What do we see on rads w/ feline cholangitis? |
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Definition
-hepatomegaly
+/- mineralized choleliths |
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Term
| What do we see on U/S w/ feline cholangitis? |
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Definition
| -patchy echogenicity of parenchyma |
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Term
| What is the issue w/ using FNA for feline cholangitis? |
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Definition
-may show inflammation
-may have issue w/ too much blood in it |
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Term
| What kind of biopsies do you perform on feline cholangitis patient? |
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Definition
-laparoscopy & laparotomy
-tru-cut: they might bleed out
-SAMPLE MULTIPLE LOBES |
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Term
| How do we treat feline neutrophilic cholangitis? |
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Definition
-abx based on culture & sensitivity
-8-12w untiil liver enzymes normalize |
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Term
| In addition to abx, what are some other tx for neutrophilic cholangitis? |
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Definition
-ursodeoxycholic acid
-vitamin E
-vitamin K
-B vitamins
-NAC or SAMe
-IV fluids: avoid lactate |
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Term
| What is the prognosis of neutrophilic cholangitis? |
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Definition
-good w/ early tx >75% survival
-less favorable: delayed dx/tx, sepsis, comorbidity
-at risk for lymphocytic cholangitis |
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Term
| What is lymphocytic cholangitis? |
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Definition
-lymphocytic inflamamtion in the portal areas
-fibrosis & bile duct proliferation are common |
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Term
| Describe the immune-mediated mechanism of lymphocytic cholangitis. |
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Definition
-CD3+T cells >>> B cells
-MHC II expression |
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Term
| What is the typical signalment of lymphocytic portal hepatitis? When is it found? |
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Definition
-cats > 15y
-incidental finding |
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Term
| What clinical signs do we see w/ lymphocytic cholangitis? |
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Definition
-Persians predisposed
-wt loss w/ normal to inc appetitie
-ascites
-hepatomegaly
-jaundice
-peripheral lymphadenopathy |
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Term
| What do we see on blood work w/ lymphocytic cholangitis? |
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Definition
-inc ALT, ALP, GGT
-hyperbilirubinemia
-hyperglobulinemia
-lymphopenia
-mature neutrophilia
-mild anemia
-ascitic fluid: inc P, low cellularity |
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Term
| What do we see on rads w/ lymphocytic cholangitis? |
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Definition
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Term
| What do we see on U/S w/ lymphocytic cholangitis? |
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Definition
-patchy parenchyma: hyperechoic w/ cirrhosis
-often called a "cluster of grapes"
-irregular liver margins |
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Term
| How do we definitively diagnose lymphocytic cholangitis in cats? |
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Definition
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Term
| How do we treat lymphocytic cholangitis in cats? |
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Definition
-immunomodulation: pred
-co-administration of metronidazole |
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Term
| If a cat has white feces, what is probably the cause? |
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Definition
| -extrahepatic bile duct obstruction |
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Term
| What is the signalment of congenital PSS? |
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Definition
-single, extrahepatic
-male cats <3y w/ copper colored irises |
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Term
| What are the CS of congenital PSS? |
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Definition
-poor growth
-hepatic encephalopathy: ptyalism, seizures, ataxia
-poor anesthetic recovery |
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Term
| What are the infectious dz that commonly affect the feline liver? |
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Definition
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