J. Rothuizen

Circulatory disorders of the liver in dogs and cats

This paper presents a review of the literature on hepatic circulation and circulatory disorders of the liver in the dog and cat, and also includes a number of our own not previously published data. Circulatory disorders of the liver are frequently observed in dogs and cats. These disorders can be divided into congenital portosystemic shunts, disorders associated with outflow disturbances, and disorders associated with portal hypertension. Outflow disturbances result in passive congestion of the liver and in both species are mainly due to cardiac failure. Portal hypertension with resultant portosystemic collateral circulation and ascites mainly results from chronic liver disease, particularly cirrhosis. The main vascular disorder resulting in portal hypertension and ascites in the dog is primary hypoplasia of the portal vein.

Chronic active hepatitis with cirrhosis in the Doberman pinscher.

Chronic active hepatitis with cirrhosis and increased liver copper levels in 8 female (3 spayed) Doberman Pinschers is described. The response to immunosuppressive therapy in two dogs was poor. Laboratory results were not specific for the disease in the Doberman Pinscher and may occur in other liver diseases. The increased copper levels are most probably secondary to hepatocellular cholestasis. Although the pathogenesis is unknown, the disease in the Doberman Pinscher may be regarded as a separate entity.

Progressive remission of portosystemic shunting in 23 dogs after partial closure of congenital portosystemic shunts.

The congenital portosystemic shunts in 23 dogs were closed partially in 18 and completely in five with a single silk ligature. The clinical results were studied and the degree of portosystemic shunting was measured by a scintigraphic method, the results being expressed as the shunt index (SI). In 17 of the dogs, the mean (sd) SI decreased from 0.92 (0.16) before surgery to 0.34 (0.25) during surgery after the attenuation of the shunt, and then to 0.10 (0.12) one month later. The dogs venous ammonia concentration decreased from 203 (122) μM before surgery to 36 (18) one month after surgery. At the same time the clinical scores improved significantly. There were positive correlations between the SI and the general evaluation of the dogs well-being by their owners (rs=0.60), the ammonia concentration (rs=0.86), and the diameter of the shunt (rs=0.86). In the other six dogs, the intraoperative and/or postoperative SI was high. In two of them the shunt was further attenuated during a second operation, which resulted in lower SI values; in two a second small shunt was responsible for the high SI; in one multiple portosystemic shunts were found postmortem; and one dog was lost to follow-up.

Copper-induced hepatitis in an Anatolian shepherd dog.

serovars Icterohaemorrhagiae and Canicola, canine adeno-2virus, canine parainfluenza virus, canine parvovirus and canine distemper virus (Nobivac DHPPi; Intervet Nederland). No data were available concerning its relatives. Physical examination by the referring veterinarian (A. F.) revealed no abnormalities apart from an enlarged spleen. Alanine aminotransferase (ALT) and alkaline phosphatase (ALP) concentrations were increased to 315 U/litre (reference range 10 to 100 U/litre) and 289 U/litre (reference range 23 to 210 U/litre) (VetTest 8008; Idexx), respectively. An explorative celiotomy revealed a small liver which was pale in colour and had a zonal pattern. The surface was nodular and it had rounded edges. Two 2 cm wedge biopsies were taken, fixed in 10 per cent buffered formalin, embedded in paraffin and stained with haemotoxylin and eosin, Von Gieson stain and the reticulin stain according to Sweet and Gordon (Bancroft and Stevens 1990). The staining and histological analysis were performed by one pathologist (T. v. d. I.), for both the initial and follow-up biopsies. The liver architecture in general was preserved, although there was an increase in reticulin fibres mainly around the hepatic veins with some centrocentral bridging, and focal destruction of the acinus with nodular transformation. The subcapsular, portal and perivenous lymph vessels were markedly dilated. There was striking inflammation in both the portal and perivenous areas and within the parenchyma, consisting of many pigment-laden macrophages, a moderately increased number of lymphocytes, plasma cells and

Extrahepatic cholestasis in the dog and the differentiation of extrahepatic and intrahepatic cholestasis.

The clinical and pathological features of extrahepatic cholestasis in 19 dogs are presented. The condition was most often caused by partial or complete occlusion of the choledochal duct due to neoplastic diseases (12 cases), inflammatory processes (3 cases), or eventration and incarceration of the liver (1 case). In only three cases was the condition due to intraluminal obstruction of the choledochal duct. The anamnestic, laboratory and pathological parameters of these 19 dogs were compared with the findings in 21 dogs with intrahepatic cholestasis. Statistical analysis of these parameters indicated that the presence of acholic faeces, the degree of icterus and the level of plasma gamma GT where the only parameters of value in the clinical differentiation of extrahepatic from intrahepatic cholestasis. Histological examination of liver biopsies is a simple aid to a confident in vivo diagnosis of extrahepatic cholestasis.

Segmental auxiliary liver transplantation in dogs: a search for an ideal graft--illusion or reality?

Segmental auxiliary liver transplantation (SALT) has been carried out in 13 mongrel dogs to assess the possibility of a certain size of liver segment to accept without sequelae the total splanchnic and arterial blood normally diverted to the liver of the host. Prednisone (1 mg/daily) and azathioprine (2 mg/kg daily) were used as immunosuppression. Five dogs died during the first hours after the operation. Three because of technical failure and two of acute portal hypertension secondary to total portal and arterial blood diversion in dogs with liver segments of 195 +/- 49 g as a result of overloading of the graft. The remaining 8 dogs were divided into: 4 dogs into which a liver segment (195 +/- 49 g) was transplanted (group A) and 4 dogs in which a liver segment (385 +/- 85 g) was used (group B). Partial portal and total arterial blood diversion in group A dogs was not associated with portal hypertension but resulted in poor function of the graft and in poor survival. In contrast, the graft in group B dogs was able to cope with both total or partial portal blood and with a normal arterial blood diversion. Infection and graft rejection prohibited long-term survival (8-28 days). Data from this study support the view that the present technique of SALT with a graft corresponding to 300-400 g in mongrel dogs of about 30 kg is a potential alternative as temporary liver support in the diseased animal.