LIVER DISEASE AND PANCREATITIS

LIVER DISEASE

Some definitions:

Hepatitis = Inflammation of the liver

Jaundice = Yellow staining of the skin and membranes due to excessive BILIRUBIN in circulation

Cirrhosis = Fibrous bands of scar tissue replace normal liver tissue.

Ascites = Fluid accumulation in the abdominal cavity, usually a TRANSUDATE - mostly water (proteins are held in the bloodstream) passing out of circulation across the walls of blood vessels.

Signs of Liver disease:

Vomiting and nausea, Diarrhoea, weight loss, polyuria and polydipsia,jaundice, ascites, pain, sometimes pale faeces if the bile duct is obstructed

Jaundice-

In the normal liver the breakdown products of haemoglobin from old red blood cells are metabolised into bilirubin. This is then further changed into stercobilinogen and urobilinogen which are excreted in faeces and urine respectively.

Jaundice arises due to excessive bilirubin in circulation (in dogs a small amount of bilirubin in urine may be normal, not so in cats)

a)Pre hepatic jaundice is due to excessive red cell breakdown - as in haemolytic anaemia

b) Hepatic jaundice is due to liver damage - such as in hepatitis or poisonings

c) Post hepatic jaundice is due to blockage of the bile ducts, as in gallstones or pancreas problems.

Ascites-

A damaged liver causes increased pressure in the liver circulation, forcing fluid out, also there is reduced production of protein (albumen) necessary to keep fluid in the bloodstream. The liver also fails to break down the hormone aldosterone, responsible for salt and water retention.

Tests

Blood samples for liver damage (the enzymes AST ALT GGT SAP) and liver function (Bile Acids).
Ultrasound investigation.
Biopsy.

Management

1) it may be possible to treat the primary cause (leptospirosis, haemolytic anaemia)

2) Dietary management is crucial in preserving liver function.

-High calorie intake using CARBOHYDRATES

- Low fat intake

-Regulated protein using high biological value sources (e.g. white meats)

-Low salt

- Vitamin and mineral supplements - B vitamins, Vits K, C. Zinc

3) Drugs are used to control the disease - diuretics, corticosteroids, anabolic steroids.

PANCREATITIS

Usually a disease of middle aged overweight dogs, sometimes seen in older male Siamese cats.

Often onset after a fatty meal. The pancreas starts secreting its digestive enzymes into the tissues rather than down the pancreatic duct. This effectively means the pancreas starts digesting itself.

Signs

Depression, fever, severe anterior abdominal pain, leading to the praying posture. Vomiting and the eventual development of shock.

Diagnosed

Using the signs plus checking for excessive levels of enzymes in the bloodstream - Lipase and Amylase.

Treatment

Fluids to treat shock

Pain relief, but not morphine

Atropine to dry up pancreatic secretion

Long term - low fat diets and obesity management

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