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==Introduction==
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Cirrhosis represents an “end-stage liver” - the final, irreversible result of diffuse hepatic disease, involving architectural disruption of the entire liver. Underlying chronic injury leads to loss of hepatic tissue with replacement [[Liver Fibrosis|fibrosis]]. Nodular regeneration occurs within regions of hepatic tissue in between fibrous tissue bands, giving rise to the characteristic multinodular gross appearance of this condition.
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The three characteristic microscopic features of cirrhosis are:
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*Nodular regeneration
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*[[Liver Fibrosis|Fibrosis]]
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*Bile duct hyperplasia
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'''Bile duct hyperplasia''' around portal regions is a non-specific response to a variety of long-standing hepatic insults, but occurs especially in association with diseases that [[Biliary Tract - Obstruction|obstruct bile drainage]].
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'''Vascular abnormalities''' are also associated with cirrhosis. Anastomoses occur between the hepatic portal vein and systemic vasculature due to increased portal pressure. Additionally, [[Portosystemic Shunt|vascular shunts]] can result within regenerative nodules, either between central and portal veins, or between hepatic arteries and central veins.
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==Causes of Cirrhosis==
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Some of the many possible causes of cirrhosis in animals include:
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*Chronic [[Heart Failure, Right-Sided|right sided heart failure]]
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*[[Hepatitis, Chronic|Chronic hepatitis]]
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**[[Hepatitis, Lobular Dissecting|Lobular dissecting hepatitis in dogs]]
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**Hepatitis due to [[Infectious Canine Hepatitis|infectious canine hepatitis virus]]
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*Chronic [[cholangitis]] or [[Biliary Tract - Obstruction|bile duct obstruction]]
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*Chronic toxicity
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**[[Ragwort Toxicity|Pyrrolizidine alkaloid plants]] in herbivores
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**[[Primidone]] anticonvulsants in dogs
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*Inherited diseases of metal metabolism
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**[[Copper]] (Dalmatians, Bedlington terriers, West Highland white terriers)
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**[[Iron]] metabolism
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Cirrhosis is usually the end result of multiple pathological processes, in particular cell death and active inflammation with fibrosis. Regardless of the original underlying aetiology, however, the end-stage liver can no longer perform its functions, and is therefore associated with clinical manifestations of [[Liver Failure|hepatic failure]].
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==References ==
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Blood, D.C. and Studdert, V.P. (1999)''' Saunders Comprehensive Veterinary Dictionary''' (2nd Edition), ''Elsevier Science''.
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Ettinger, S.J. and Feldman, E.C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat''' Volume 2 (Fifth Edition), ''W.B. Saunders Company''.
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Maxie, M.G. (2007) '''Pathology of Domestic Animals Volume''' 2 (Fifth Edition), ''Elsevier Saunders''.
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McGavin, M.D. and Zachary, J.F. (2007) '''Pathologic Basis of Veterinary Disease''' (Fourth Edition),'' Elsevier Mosby.''
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Smyth, B (2008) '''Alimentary System Study Guide''''', Royal Veterinary College''.
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*a term often used for fibrotic lesions, especially widespread fibrosis
*a term often used for fibrotic lesions, especially widespread fibrosis
*it is an end stage liver with poor functional ability
*it is an end stage liver with poor functional ability
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*ascites
*ascites
**common finding
**common finding
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**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure[[Category:Liver_-_General_Pathology]]
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**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure
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[[Category:To_Do_-_Clinical]]
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[[Category:Liver_-_General_Pathology]]
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[[Category:Nicola Parry reviewing]]