Felis ISSN 2398-2950

Liver: cirrhosis

Contributor(s): Kyle Braund, Philip K Nicholls, Penny Watson

Introduction

  • Hepatic degeneration, necrosis, regeneration, fibrosis.
  • Cause: end-stage of chronic hepatic disease.
  • Signs: jaundice, anorexia, depression, weight loss, ascites, vomiting, diarrhea, neurological signs.
  • Diagnosis: histopathology, blood biochemistry, hepatic function tests.
  • Treatment: symptomatic management.
  • Prognosis: poor.

Pathogenesis

Etiology

Pathophysiology

  • Loss of hepatic function   →  
    • Impaired fat digestion and metabolism and increased mobilization from peripheral stores   →   hyperlipidemia.
    • Impaired carbohydrate metabolism   →   hypoglycemia or hyperglycemia.
    • Impaired protein synthesis   →   catabolism of body protein   →   increased ammonia levels and cachexia.
    • Loss of detoxifying capacity and development of arteriovenous shunts   →   hepatic encephalopathy Hepatic encephalopathy.
    • Altered metabolism of hormones   →   disrupted circulating hormonal levels, eg insulin, glucagon, growth hormone, insulin-like growth factors, corticosteroids, catecholamines   →   polydipsia/polyuria (due to increased corticosteroids in liver failure), fluid retention.
    • Decreased synthesis of clotting proteins, along with vitamin K deficiency due to anorexia and fat maldigestion due to lack of bile acids   →   coagulation disorders.
  • Acute fulminating liver failure   →   release of tissue thromboplastins and other stimulators of coagulation   →   DIC.
  • Portal hypertension +/- concurrent hypoalbuminemia   →   ascites.
  • Jaundice   Jaundice  develops as result of failure of the hepatocytes to remove unconjugated bilirubin form circulation.
  • In the normal animal this unconjugated bilirubin is conjugated with glucoronic acid which is excreted in the bile.
  • Accumulation of bilirubin in the tissue results in yellow discoloration.

Timecourse

  • Weeks, months.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Center S A (1999) Chronic liver disease - current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.

Other sources of information

  • Johnson S E (2000) Chronic hepatic disorders. In:Textbook of Veterinary Internal Medicine.5th edn. Ettinger S J & Feldman E C (eds). W B Saunders, Philadelphia. pp 1298-1325.


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