Lecture 10 - Triglycerides, Cholesterol, and Glucose

What enzyme digests triglycerides? What does it convert it into?

-Lipase

-Monoglycerides and FFA

What are the causes of hypertriglyceridemia?

-Post-prandial

-Diabetes mellitus

-Acute necrotizing pancreatitis

-Cholestatic disease

-Familial

What is lipemia? What are the effects on laboratory tests?

-Increased concentration of triglyceride carrying lipoproteins (elevated triglycerides does not equal lipemia)

-Interferes with t. bili, Hgb, and t. protein

What are potential causes of hypercholesterolemia?

-Hypothyroidism

-Cholestatic diseases

-Hyperadrenocorticism

-Nephrotic syndrome

-Primary hypercholesterolemia

What are the sources of glucose?

-Diet

-Glycogenolysis

-Gluconeogenesis (production of glucose from amino acids and fats)

How is glucose utilized in the body?

-Glycogenesis

-Glucose uptake in tissues

-Maintenance of blood glucose

What are the diagnostic tests for glucose?

-Blood: chem panel or glucometer

-Urine: dipstick

-Serum insulin and insulin/glucose ratios

What is the most common glycated protein? Where is it found?

-Fructosamine

-Bound to albumin

What are the diseases associated with hyperglycemia?

-Diabetes mellitus

-Hyperadrenocorticism (Cushing’s)

-Transient hyperglycemia (fear, stress, pancreatitis, hyperthyroidism, etc)

What are the diseases associated with hypoglycemia?

-Neoplasia

-Hypothyroidism

-Hypoadrenocorticism (Addison’s)

-Decreased functional hepatocellular mass

-Sepsis

-Young animals with anorexia

-Inappropriate sample prep

What are the clinical signs of GI disease and what are the concurrent lab abnormalities?

-Anorexia = decreased K+

-Vomiting = hypochloridemic metabolic acidosis

-Diarrhea = hyponatremia, hypochloridemia, metabolic acidosis

What are the laboratory abnormalities seen with a gastric ulcer?

-Anemia

-Elevated urea relative to creatinine

What are the laboratory abnormalities seen with a displaced abomasum?

-Hypochloridemic metabolic alkalosis

-Paradoxical aciduria

What are the laboratory abnormalities seen with a proximal duodenal obstruction?

-Hypochloridemic metabolic alkalosis

-Hyperglycemia

What are the essential enzymes produced by the pancreas?

-Amylase

-Trypsin

-Lipase

What is pancreatitis? What are the forms?

-Destruction of the pancreas by activated digestive enzymes

-Mild/moderate/severe, necrotizing, abscess

What are some tests to diagnose pancreatitis?

-Amylase

-Lipase

-Pancreatic lipase immunoreactivity (PLI)

Is amylase effective for diagnosing pancreatitis? Why or why not?

No → neither sensitive nor specific and is present in many different tissues

What does an elevated lipase mean?

-Pancreatitis (>3-5 times)

-Renal disease

-Peritonitis

-Hepatic disease

-Steroid administration

-Liver and pancreatic carcinoma

What is exocrine pancreatic insufficiency (EPI)? What are the main clinical signs?

-pancreatic cells responsible for producing digestive enzymes are lost

-Steatorrhea, weight loss, flatulence

What are possible causes of an EPI?

-Pancreatic acinar atrophy (genetic)

-Chronic pancreatitis

-Blocked pancreatic duct

How is EPI diagnosed?

Serum trypsin-like immunoreactivity (highly sensitive)