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Liver: toxic hepatitis
Introduction
- Same as Liver: acute disease.
- Cause: ingestion of plant toxins, chemicals Lead toxicity, therapeutic agents, insect envenomation.
- Signs: anorexia, depression, vomiting, diarrhea.
- Diagnosis: blood biochemistry, histopathology, history of toxin ingestion, medication, etc.
- Treatment: supportive and elimination of toxin if identified.
- Prognosis: depends on severity of hepatic insult, usually favorable.
Cost considerations
- Moderate costs in establishing a diagnosis and treatment.
Special risks
- Anesthesia, as many commonly used drugs are metabolized in liver.
Warn owner of increased anesthetic risk.
Pathogenesis
Etiology
Drugs
- Acetaminophen Paracetamol.
- Anticonvulsants Therapeutics: anti-epileptics.
- Azathioprine Azathioprine.
- Halothane Halothane.
- Ibuprofen Ibuprofen poisoning.
- Ivermectin.
- Ketoconazole Ketoconazole.
- Methoxyflurane Methoxyflurane.
- Methotrexate Methotrexate.
- Paracetamol Acetaminophen (paracetamol) poisoning.
- Phenazopyridine.
- Sulfonamides Therapeutics: antimicrobial drug.
- Tetracycline Tetracycline.
- Tolbutamide.
Chemicals
- Alphachloralose Alphachloralose poisoning.
- Arsenic.
- Bromethalin Bromethalin poisoning.
- Carbamate insecticide Carbamate poisoning.
- Metaldehyde Metaldehyde poisoning.
- Carbon tetrachloride.
- Chlorinated hydrocarbons.
- Ethylene glycol Ethylene glycol poisoning.
- Heavy metals.
- Organophosphorus Organophosphorus poisoning.
- Paraquat Paraquat poisoning.
- Phosphorus.
- Selenium.
Plant toxins
- Aflatoxin.
- Blue-green algae toxin.
- Amanita mushroom toxin.
- Pyrrolizidine alkaloids.
Bacterial endotoxins
Pathophysiology
- Cumulative hepatic insult → functional reserve capacity exceeded → failure to perform diverse metabolic functions → clinical signs.
- Inadequate bile delivery to intestine → impaired fat digestion → diarrhea.
- Hepatic cellular damage → cellular release of bilirubin → jaundice.
- Inflammation of biliary system → partial obstruction to biliary flow → jaundice.
- Decreased production of clotting factors → bleeding tendency.
- Failure to detoxify ammonia and mercaptans from intestine → hepatic encephalopathy.
Timecourse
- Within hours of ingestion of toxin.
- Less than or equal to 2 weeks duration with no previous evidence of hepatobiliary disease.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Hughes D & King L G (1995) The diagnosis and management of acute liver failure in dogs and cats. Vet Clin North Am Small Anim Pract 25 (2), 437-460 PubMed.
- Bunch S E (1993) Hepatotoxicity associated with pharmacologic agents in dogs and cats. Vet Clin North Am Small Anim Pract 23 (3), 659-670 PubMed.
Other sources of information
- Bunch S E (2000) Acute hepatic disorders and systemic disorders that involve the liver. In:Textbook of Veterinary Internal Medicine. 5th edn. Ettinger S J & Feldman E C (eds). W B Saunders, Philadelphia. pp 1326-1340.
- Laflamme D P (2000) Nutritional management of liver disease. In:Kirk's Current Veterinary Therapy XIII. Bonagura J D (ed). W B Saunders, Philadelphia. pp 693-697.