Coral Springs Animal Hospital's Pawfessional Spring 2014 | Page 4

By: Elizabeth Rawson, DVM,
MS, DACVS, CCRT- Coral

By: Jessica Larson, DVM,
DACVIM- Coral Springs
Animal Hospital Internist

Springs Animal Hospital Surgeon
1. Persistent liver enzyme elevations, even in an
asymptomatic pet, are not normal!
a.

If liver enzymes remain elevated without
intervention for 4-8 weeks then further work
up is indicated:

Laparoscopic liver biopsy is appropriate in acute or
chronic hepatic enzyme elevations, particularly ALT
b. ALT: hepatocellular, reflects damage but NOT
function; number can indicate no. of hepatocytes involved but NOT severity of injury:
i.

ii.

Hepatocyte damage, drugs, endocrine disease (HAC, T4, DM), hypoxia (PSVA, MVD),
inflammation (acute hepatitis, chronic hepatitis, Cu associated), infection, metabolic
(dyslipidemia), neoplastic, toxic (chemical,
heavy metal, Cu storage disorder), mycotoxin, trauma, torsion and regeneration.
Chronic hepatitis, with or without copper
accumulation, is often identified

c. ALP: hepatic membrane, reflects cholestasis/
parenchyma disease
i.

ii.

Cholestasis (intrahepatic, extrahepatic),
pancreatitis, drugs, bone isoenzyme (dogs),
hyperparathyroidism, renal disease, endocrin e ,
e n t eri t i s
(I B D ) ,
met ab olic
(dyslipidemia),
regeneration,
chronic
“stress” of illness, nodular hyperplasia;
Scottish terriers – not so benign

1. New evidence that may reflect progressive degenerative vacuolar hepatopathy
2. Biopsy indicated
iii. Mucocele formation – related to hyperadrenocorticism
iv. “Vacuolar hepatopathy” – not so benign
1. Warrants work up; find underlying cause
2. Ultrasound examination often reveals non specific changes to hepatic parenchyma, necessitating further steps.
3. Ultrasound guided liver cytology may not be
conclusive, or even accurate, in some cases.
4. Histopathology will often reveal the underlying
cause and provide particular architectural tissue
changes that will provide insight into diagnosis,
treatment and