Liver 1

No

Will clinical signs change upon focal liver injury?

Diffuse

In what type of hepatobiliary injury (focal/diffuse/severe) will there be increased leakage enzymes, induction enzymes, and bile acids?

Hepatocellular

Which group of liver pathologies includes the DAMNIT types?

Biliary

Which group of liver pathologies includes inflammation, neoplasias, toxins, and other types?

Insufficiency

Which group of liver pathologies includes decreased functional hepatocytes or liver mass? This can include hepatocyte destruction and portosystemic shunts.

Cholestasis

What is the term for the stoppage or suppression of bile flow? Stoppage can be due to obstruction and suppression can be due to functional causes.

Phenobarbitone

What drug is a therapeutic cause of hepatocellular disease and can induce microsomal enzymes, such as ALP? Chemotherapies, trimethoprim-sulfa, griseofulvine, anesthetic agents, and methimazole can also cause this.

Yes

Can liver regeneration following acute injury cause elevated liver enzymes?

ALP

Natural growth of bone can cause an increase in what enzyme associated with the liver? Bone tumors, metabolic bone disease, and osteomylitis can also affect this.

ALP, GGT

Generally, in liver enzyme alterations due to sample handling, what two enzymes will decrease with hemolysis, while others will increase?

70-80

Liver failure will occur after what range of percentage damage to liver tissue? Decreased synthesis of albumin, cholesterol, glucose, and urea will point to this. Serum enzyme levels can still be normal if there are too few hepatocytes present to produce them.

Small

In which animals (large/small) are the hepatic parameters: ALT, AST, ALP, GGT, and bilirubin?

Large

In what animals (large/small) are the hepatic parameters: GDH, AST, SDH, GGT, and Bilirubin?

Mild

What type of liver parameter change is <3x the upper RI?

Moderate

What type of liver parameter change is 3-9x the upper RI?

Marked

What type of liver parameter change is >10x the upper RI?

Leakage

ALT, AST, GDH, SDH, and LDH are what type of enzyme when observing liver damage?

Induced

ALP and GGT are what type of enzyme when observing liver damage? These help indicate cholestasis when elevated as they are found in hepatocellular membranes along the bile canaliculi and in bile duct epithelial cells.

ALT

What enzyme is fairly liver specific only in cats, dogs, rabbits, rats, and primates? It can also increase in muscle damage.

Marked

What type of increase in ALT is seen in toxic, hypoxic, and traumatic conditions, such as acute severe liver injury, necrosis, or cell death?

Mild

What to moderate ALT increases are seen in diabetes mellitus, feline hyperthyroidism, aged animals, secondary to heart conditions and GI disease, and with certain drugs (anticonvulsants, phenobarbitol, NSAIDs, steroids in dogs)?

No

Is ALT a useful parameter in large animals?

AST

What enzyme is found in liver and myocardial/skeletal muscle, is concurrent to estimation of CK, is required to exclude muscle damage, has a longer half-life in serum than CK, and if there is no muscle damage it will increase similar to ALT? It is induced by anticonvulsants, not induced with corticosteroids, and increases with exercise.

Anticonvulsants

What type of drugs can cause induction of AST?

GDH

What enzyme is primarily useful in large animals to indicate acute hepatocellular necrosis, taking the place of ALT?

SDH

What enzyme, also called ID, is very liver specific in large animals and is usually unstable and impractical in lab settings?

ALP

What enzyme has isoforms found in high concentrations in the liver, bone, and corticosteroid-induction in dogs?

Liver

Which isoform of ALP is an indicator of cholestasis, has high diagnostic sensitivity in dogs (increases before icterus), low sensitivity in horses and cats, and moderate sensitivity in cattle, but is not used very often in large animals?

Yes

Is any increase of ALP in a cat significant? Icterus usually appears before it will increase, as it is less sensitive in cats. GGT can be used as an alternative parameter in small animals. Increases usually signify primary liver disease or hyperthyroidism.

Increase

ALP will increase or decrease 12-24 hours after volatile anesthetic or anticonvulsant agents? Scottish terriers have elevated levels.

Dog

Corticosteroid induced alkaline phosphatase ALP is used only in what animal? Endo/exogenous corticosteroids cause synthesis of this enzyme, and it is not induced by cholestasis. Marked elevations will indicate steroid/vacuolar hepatopathy with hepatocyte swelling and impaired bile flow.

Vacuolar

What type of hepatopathy can be due to a glycogen or hydropic change, such as due to steroids? Glycogen deposition, hydropic changes, and lipid accumulation can be involved.

Bone

Which type of ALP is produced by osteoblasts, increases with young growing animals, bone disease, hyperthyroidism in cats, and is high in siberian huskies at 6 weeks old?

No

Is ALP used in ruminants?

Increase

Do pancreatitis and foreign bodies increase or decrease ALP?

GGT

What enzyme is increased by similar causes as ALP, is a marker of cholestasis/biliary hyperplasia, and has species differences? In dogs sensitivity is similar to ALP, in cats it is also similar, and in horses and cattle sensitivity is better than ALP. It is induced by corticosteroids, anticonvulsants in dogs, and is not increased in pancreatic or GIT disease. If it is elevated over ALP then there is biliary tree disease.

GGT

What enzyme is used in ruminants to detect sporidesmin toxicity (facial exema) and toxins from Pithomyces fungus? This is a secondary photosensitivity due to impaired excretion of chlorophyll metabolites. Chronic fascioliasis also increases this enzyme.

Bovine, Canine

GGT is excreted in the colostrum of what two species, but not in horses? It can be used as an indicator of colostrum intake in calves.

Chronic

What type of hepatitis is seen with persistent unexplained increases in ALT with or without other lab changes? It is the best screening test currently available for early detection of this.