Liver: amyloidosis

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Sections available in full article Introduction, Geographic incidence, Age predisposition, Breed predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Treatment, Initial symptomatic treatment, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr Nick Bexfield BVetMed DSAM DipECVIM-CA MRCVS European Specialist and RCVS Diplomate in Small Animal Internal Medicine
Dr Kyle Braund BVSc MVSc PhD FRCVS DipACVIM
Synonyms Hepatic amyloidosis

Introduction

  • Cause : usually 'reactive' secondary to chronic infection, chronic inflammation, neoplasia or an immune disorder.
  • Signs : relate to all systems affected by amyloidosis Amyloidosis :
    • Anorexia.
    • Fever.
    • Subcutaneous swellings.
    • Lethargy.
    • Icterus.
    • Lameness.
  • Diagnosis : liver biopsy or fine needle aspiration.
  • Treatment : general supportive treatment, colchicine Colchicine or dimethyl sulfoxide Dimethylsulfoxide.
  • Prognosis : guarded.

Diagnosis

Clinical signs

  • Icterus.
  • Hepatomegaly.
  • Subcutaneous swellings.
  • Ascites if hemoabdomen.
  • Lameness if presents during an acute bout of joint inflammation.
  • Signs of concurrent renal amyloidosis (proteinuria, chronic kidney disease).

Sequelae

Prognosis

  • Guarded. However, colchicine therapy appeared to deter progression of hepatic amyloidosis in 2 Shar Pei dogs for at least 2 years.

Expected response to treatment

  • Amelioration of signs.

Reasons for treatment failure

  • Incorrect diagnosis.
  • Owner non-compliance, especially if dimethyl sulfoxide is being used.

Sources

Publications

Refereed papers

  • Recent references from PubMed.
  • Loevan K O (1994) Hepatic amyloidosis in two Chinese Shar Pei dogs. JAVMA 204 (8), 1212-1216 PubMed.
  • Loevan K O (1994) Spontaneous hepatic rupture secondary to amyloidosis in a Chinese Shar Pei. JAAHA 30 (6), 577-579.
  • DiBartola S P, Tarr M J, Webb D M, Giger U (1990) Familial renal amyloidosis in Chinese Shar Pei dogs. JAVMA 197 , 483-487 PubMed.
  • Spyridakis L, Brown S, Barsanti K, Hardie E M & Carlton B (1986) Amyloidosis in a dog: treatment with dimethylsulfoxide. JAVMA 189 , 690-691.

Other sources of information

  • Scherk M A & Center S A (2005) Toxic, Metabolic, Infectious, and Neoplastic Liver Diseases. In: Textbook of Veterinary Internal Medicine. 6th edn. Eds: S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 1464-1477.

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