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==Introduction==
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.
The three characteristic microscopic features of cirrhosis are:
*Nodular regeneration
*[[Liver Fibrosis|Fibrosis]]
*Bile duct hyperplasia
'''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]].
'''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.
==Causes of Cirrhosis==
Some of the many possible causes of cirrhosis in animals include:
*Chronic [[Heart Failure, Right-Sided|right sided heart failure]]
*[[Hepatitis, Chronic|Chronic hepatitis]]
**[[Hepatitis, Lobular Dissecting|Lobular dissecting hepatitis in dogs]]
**Hepatitis due to [[Infectious Canine Hepatitis|infectious canine hepatitis virus]]
*Chronic [[cholangitis]] or [[Biliary Tract - Obstruction|bile duct obstruction]]
*Chronic toxicity
**[[Ragwort Toxicity|Pyrrolizidine alkaloid plants]] in herbivores
**[[Primidone]] anticonvulsants in dogs
*Inherited diseases of metal metabolism
**[[Copper]] (Dalmatians, Bedlington terriers, West Highland white terriers)
**[[Iron]] metabolism
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]].
==References ==
Blood, D.C. and Studdert, V.P. (1999)''' Saunders Comprehensive Veterinary Dictionary''' (2nd Edition), ''Elsevier Science''.
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''.
Maxie, M.G. (2007) '''Pathology of Domestic Animals Volume''' 2 (Fifth Edition), ''Elsevier Saunders''.
McGavin, M.D. and Zachary, J.F. (2007) '''Pathologic Basis of Veterinary Disease''' (Fourth Edition),'' Elsevier Mosby.''
Smyth, B (2008) '''Alimentary System Study Guide''''', Royal Veterinary College''.
*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
*ascites
*ascites
**common finding
**common finding
**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure[[Category:Liver_-_General_Pathology]]
**other factors are involved: lowered plasma albumin, causing lowered colloid osmotic pressure
[[Category:To_Do_-_Clinical]]
[[Category:Liver_-_General_Pathology]]
[[Category:Nicola Parry reviewing]]