Hepatic Dysfunction

Abstract

This article reviews the common pathophysiology that constitutes hepatic dysfunction, regardless of the inciting cause. The systemic consequences of liver failure and the impact of this condition on other organ systems are highlighted. The diagnostic tests available for determining the cause and extent of liver dysfunction are outlined, treatment strategies aimed at supporting hepatic health and recovery are discussed, and prognosis is briefly covered. The article emphasizes the fact that because of the central role of the liver in maintaining normal systemic homeostasis, hepatic dysfunction cannot be effectively addressed as an isolated entity.

Outcomes of cellophane banding or percutaneous transvenous coil embolization of canine intrahepatic portosystemic shunts

“…The portal pressure increased from 8 to 13 mmHg. Three dogs in the PTCE group underwent concurrent surgical procedures including castration at the initial procedure (2) and castration at the time of a second coil embolization procedure (1). Three dogs in the PTCE group underwent placement of additional coils, 2 of which also underwent laparoscopic ovariectomy.…”

“…This vascular diversion affects hepatic development, leading to insufficiency and, ultimately, liver failure. Hepatic insufficiency can cause a myriad of clinical signs, such as seizures, ataxia, obtundation, anorexia, vomiting, diarrhea, pollakiuria, stranguria, and death . The severity of these signs justifies surgical correction aimed at improving the perfusion of the deprived liver .…”

Acute liver failure in dogs and cats

“…This may then be followed by hyperbilirubinemia, prolonged PT, and hypoglycemia. Hypoalbuminemia is typically a finding of end‐stage liver failure …”

“…Increase in both ALT and AST activities are sensitive indicators of acute liver damage, but the degree of increase in these values above the reference interval does not necessarily correlate with the degree of hepatocellular damage . Transaminases are stored in hepatocyte cytosol and are released into circulation immediately following damage to the hepatocyte membrane.…”

“…Ultrasound‐guided FNA is the least invasive and most economical way to obtain a diagnostic sample. However, this technique has several important limitations: the sample size obtained is small and may limit the accuracy of diagnosis, only a small portion of the liver is sampled, the sample may be distorted during fixation, and post‐sample visualization to monitor for hemorrhage is limited . FNA is most useful in a certain subset of hepatic diseases such as hepatic parasite infestations, diffuse neoplasia, and suppurative hepatitis .…”