Changes

** Thrombocytosis - potential causes include production of thrombopoietin as a parneoplastic syndrome, iron deficiency, inflammatory cytokines and anaemia

** Thrombocytosis - potential causes include production of thrombopoietin as a parneoplastic syndrome, iron deficiency, inflammatory cytokines and anaemia

* Elevated hepatic enzymes - likely due to hepatocellular damage or biliary stasis though the level of enzyme increase is not proportional to severity of liver damage

* Elevated hepatic enzymes - likely due to hepatocellular damage or biliary stasis though the level of enzyme increase is not proportional to severity of liver damage

* Hypoalbuminaemia

* Hypoalbuminaemia

* Hyperglobulinaemia

* Hyperglobulinaemia

* Hypoglycaemia

* Hypoglycaemia - can occur as a paraneoplastic syndrome where there is increased utilisation of glucose or increased produciton of hormones with insulin-like activity.

* Elevated pre- and postprandial bile acids

* Elevated pre- and postprandial bile acids

===Plain Abdominal Radiography===

===Plain Abdominal Radiography===

A cranial abdominal mass is often observed with displacement of the stomach caudally and laterally with massive hepatic neoplasms. Occasionally mineralisation of the biliary tree is observed in dogs with cholangiocellular carcinoma. Three thoracic views should also be taken to assess lung metastasis although this is uncommon at the time of diagnosis.

Hepatomegaly, rounding of the margins of the liver and a cranial abdominal mass may be observed with displacement of the stomach caudally and laterally with massive hepatic neoplasms. Occasionally mineralisation of the biliary tree is observed in dogs with cholangiocellular carcinoma. Three thoracic views should also be taken to assess lung metastasis although this is uncommon at the time of diagnosis.

===Ultrasonography===

===Ultrasonography===

Always recommended to evaluate the condition of surrounding structures. It also allows classification of the mass as massive, nodular or diffuse. Doppler techniques can also be utilised to assess the vascular structure of tumours. Guided fine-needle aspirates or core biopsies can also be taken at this time (a coagulation profile is hightly advised prior to liver biopsy due to risk of haemorrhage). If the lesion is solitary and massive surgical resection without preoperative biopsy is usually undertaken as diagnosis and treatemnt are accomplished in the singel procedure.

Always recommended to evaluate the condition of surrounding structures. It also allows classification of the mass as massive, nodular or diffuse. Doppler techniques can also be utilised to assess the vascular structure of tumours. Guided fine-needle aspirates or core biopsies can also be taken at this time (a coagulation profile is hightly advised prior to liver biopsy due to risk of haemorrhage). If the lesion is solitary and massive surgical resection without preoperative biopsy is usually undertaken as diagnosis and treatemnt are accomplished in the single procedure.

===Advanced Imaging===

===Advanced Imaging===

CT and MRI are more sensitive in detecting small lesions and confirming the relationship of the mass with surrounding tissues and vasculature.  

CT and MRI are more sensitive in detecting small lesions and confirming the relationship of the mass with surrounding tissues and vasculature.  

==Hepatocellular Tumours (Hepatocellular carcinomas (HCC) and Hepatomas)==

 

===Signalment and Description===

===Hepatocellular Tumours (Hepatocellular carcinomas (HCC) and Hepatomas)===

* HCC occurs more frequently in dogs and hepatomas more commonly in cats. Male dogs over 10 years old are the most frequently affected. Miniature schnauzers may have a breed predisposition.

* HCC occurs more frequently in dogs and hepatomas more commonly in cats. Male dogs over 10 years old are the most frequently affected. Miniature schnauzers may have a breed predisposition.

* Regional lymph nodes, peritoneum and lungs are the most frequent sites of metastasis in dogs with nodular and diffuse HCC.

* Regional lymph nodes (hepatic and diaphragmatic nodes), peritoneum and lungs are the most frequent sites of metastasis in dogs with nodular and diffuse HCC.

* Metastatic rate for dogs with massive HCC: 0-37%

* Metastatic rate for dogs with massive HCC: 0-37%

* Metastatic rate for dogs with nodular and diffuse HCC: 93-100%

* Metastatic rate for dogs with nodular and diffuse HCC: 93-100%

* Hepatomas are usually incidental findings and non-significant

* Hepatomas are usually incidental findings and non-significant

 

===Cholangiocellular Tumours (Bile duct  carcinomas and adenomas)===

==Cholangiocellular Tumours (Bile duct  carcinomas and adenomas)==

===Signalment and Description===

* Bile duct carcinomas are the most common malignant hepatobillary tumours in cats and the second most frequent in dogs, particularly females

* Bile duct carcinomas are the most common malignant hepatobillary tumours in cats and the second most frequent in dogs, particularly females

* Intrahepatic carcinomas are more frequent in dogs. In cats there have been reports of both equal levels of occurrence of intra-and extrahepatic tumours and of a a extrahepatic dominance.

* Intrahepatic carcinomas are more frequent in dogs. In cats there have been reports of both equal levels of occurrence of intra-and extrahepatic tumours and of a a extrahepatic dominance.

* Bile duct adenomas are non-significant unless they of sufficient size to compress surrounding soft tissue structures

* Bile duct adenomas are non-significant unless they of sufficient size to compress surrounding soft tissue structures

==Carcinoids (Neuroendocrine Tumours)==

===Carcinoids (Neuroendocrine Tumours)===

===Signalment and Description===

* Usually occur in younger animals compared with other primary hepatobiliary tumours.

* Usually occur in younger animals compared with other primary hepatobiliary tumours.

* Primary tumours are aggressive and often affect more than one liver lobe and metastasise to most frequently the regional lymph nodes, the lungs and peritoneum.  

* Primary tumours are aggressive and often affect more than one liver lobe and metastasise to most frequently the regional lymph nodes, the lungs and peritoneum.  

==Sarcomas (Haemangiosarcoma (HSA), Leiomyosarcoma, Fibrosarcoma)==

===Sarcomas (Haemangiosarcoma (HSA), Leiomyosarcoma, Fibrosarcoma)===

===Signalment and Description===

* HSA is the most common hepatic sarcoma in cats

* HSA is the most common hepatic sarcoma in cats

* Leiomyosarcoma is the most common hepatic sarcoma in dogs

* Leiomyosarcoma is the most common hepatic sarcoma in dogs

Carcinogens and toxins for example nitrosamines can induce hepatic tumours in an experimental environment.  

Not reported. Surrounding abdomina organs may show poor tolerance.

==Treatment and Prognosis==

 

==Prognosis==

==References==

==References==