829
edits
Changes
Jump to navigation
Jump to search
no edit summary
==Diagnosis==
==Diagnosis==
===Clinical Signs===
===Clinical Signs===
[[File:Jaundiced cat.jpg|thumb|Image of a jaundiced cat that was suffering from hepatic lipidosis. Note the icteric pinnae.<br><small>Copyright Sabar 2007 Wikimedia Commons]]</small>
Clinical signs may appear to be non-specific at first and they include:
Clinical signs may appear to be non-specific at first and they include:
*Severe persistent '''anorexia''' with lethargy. Cats may lose weight and have an unkempt appearance.
*Severe persistent '''anorexia''' with lethargy. Cats may lose weight and have an unkempt appearance.
*[[Icterus|Jaundice]] may or may not occur. It is a form of intra-hepatic icterus as the swollen hepatocytes partially obstruct the flow of bile in the canaliculi.
*[[Icterus|'''Jaundice''']] may or may not occur. It is a form of intra-hepatic icterus as the swollen hepatocytes partially obstruct the flow of bile in the canaliculi.
*[[Hepatic Encephalopathy|Hepatic encephalopathy]] may manifest mainly as depression and hypersalivation.
*[[Hepatic Encephalopathy|'''Hepatic encephalopathy''']] may manifest mainly as depression and hypersalivation.
*[[Diarrhoea|Diarrhoea]] and [[Vomiting|vomiting]] do not occur with all cases of hepatic lipidosis.
*[[Diarrhoea|'''Diarrhoea''']] and [[Vomiting|'''vomiting''']] do not occur with all cases of hepatic lipidosis.
*'''Palpable hepatomegaly''' may be appreciable as the liver enlarges with the storage of lipid in hepatocytes.
*'''Palpable hepatomegaly''' may be appreciable as the liver enlarges with the storage of lipid in hepatocytes.
*'''Coagulopathies''' sometimes occur in affected animals and may manifest as spontaneous subcutaneous, intra-articular or intra-cavitatory haemorrhage.
*'''Coagulopathies''' sometimes occur in affected animals and may manifest as spontaneous subcutaneous, intra-articular or intra-cavitatory haemorrhage.
===Laboratory Tests===
===Laboratory Tests===
====Haematology====
====Haematology====
Affected animals may have red blood cells of varying morphology ('''poikilocytosis''') and this may be related to alterations in erythrocyte membrane lipid content. Cats with hepatic lipidosis are also prone to the development of Heinz body anaemia and haemolysis due to hypophosphataemia.
Affected animals may have red blood cells of varying morphology ('''poikilocytosis''') and this may be related to alterations in erythrocyte membrane lipid content. Cats with hepatic lipidosis are also prone to the development of Heinz body '''anaemia''' and haemolysis due to hypophosphataemia.
====Biochemistry====
====Biochemistry====
[[Bilirubin|'''Hyperbilirubinaemia''']] often occurs and this may be clinically evident as [[Icterus|icterus]].
[[Bilirubin|'''Hyperbilirubinaemia''']] often occurs and this may be clinically evident as [[Icterus|icterus]].
Animals that have been inappetant for some time are likely to be '''hypokalaemic''' and it is important that this deficiency is treated for the patient to regain voluntary intake of food.
Animals that have been inappetant for some time or which have vomited recently are likely to be '''hypokalaemic''' and it is important that this deficiency is treated for the patient to regain voluntary intake of food. Animals with hepatic lipidosis often become '''hypophosphataemic''' but this may only occur with refeeding as the blood concentrations of glucose and insulin rise, driving phosphate intracellularly. A similar phenomenon occur when animals with [[Diabetes Mellitus|diabetic ketoacidosis]] are first treated with insulin.
====Other Tests====
Where this is available, proteins produced in the absence of vitamin K (PIVKAs) and '''clotting times''' may be measured to determine whether the animal has a coagulopathy.
Urinalysis may reveal '''bilirubinuria''' as the serum bilirubin concentration is increased as in any cholestatic disease.
===Diagnostic Imaging===
===Diagnostic Imaging===
====Ultrasonography====
====Ultrasonography====
[[File:Sono Hepatische Lipidose Katze 0.jpg|thumb|Ultrasonographic image of a feline liver affected by hepatic lipidosis. The liver has a similar echogenicity to the surrounding fat.<br><small>Copyright Kalumet 2009 Wikimedia Commons]]</small>
[[File:Sono Hepatische Lipidose Katze 0.jpg|thumb|Ultrasonographic image of a feline liver affected by hepatic lipidosis. The liver has a similar echogenicity to the surrounding fat.<br><small>Copyright Kalumet 2009 Wikimedia Commons]]</small>
An abdominal ultrasound scan will reveal an enlarged and '''diffusely hyperechoeic''' liver.
An abdominal ultrasound scan will reveal an enlarged and '''diffusely hyperechoeic''' liver. The underlying cause of the liver disease may also be apparent.
===Pathology===
===Pathology===
===Nutritional Support===
===Nutritional Support===
[[File:FelineHepaticLipidosisEsophagealFeedingTube.jpg|thumb|Image of a cat receving nutritional support via an oesophagostomy tube<br><small>Released into the Public Domain]]</small>
*For a period of 4 - 6 weeks.
*For a period of 4 - 6 weeks.
*This is the most important treatment in hepatic lipidosis. It is vital to ensure that the diet is of adequate calorific content with an increase in protein content. Specific nutrients such as arginine, taurine, or carnitine may also be added.
*This is the most important treatment in hepatic lipidosis. It is vital to ensure that the diet is of adequate calorific content with an increase in protein content. Specific nutrients such as arginine, taurine, or carnitine may also be added.