Hepatic tsis ua hauj lwm hauv miv tshwm sim los ntawm cov kab mob siab uas cuam tshuam rau lub siab ua haujlwm xws li hepatic lipidosis, cholangitis, amyloidosis lossis qog, tab sis nws kuj tuaj yeem yog vim muaj kab mob extrahepatic lossis tshuaj lom. Cov tsos mob ntawm tag nrho cov kab mob no tsis yog tshwj xeeb thiab suav nrog, nrog rau lwm tus: lethargy, poob phaus, tsis qab los noj mov, nce dej kom tsawg thiab ntuav. Nyob rau theem siab ntawm daim siab kev puas tsuaj, jaundice (daj mucous daim nyias nyias), kab mob siab encephalopathy thiab txawm ascites (sau cov kua dej ntawm lub plab) tshwm sim.
Koj puas xav paub ntau ntxiv txog daim siab tsis ua haujlwm hauv miv, nws cov tsos mob thiab kev kho mob? Ua raws li tsab xov xwm no hauv peb lub xaib thiab koj yuav kawm paub ntxiv txog cov kab mob uas tuaj yeem ua rau daim siab tsis ua haujlwm ntawm koj tus menyuam me.
daim siab tsis ua hauj lwm hauv miv yog dab tsi?
Nrog lub sij hawm feline daim siab tsis ua hauj lwm peb xa mus rau tag nrho cov kab mob thiab cov xwm txheej uas hloov qhov tseeb functionality ntawm lub siab ntawm miv. Muaj ntau yam kab mob ua kom lub siab ua haujlwm, qee qhov yog thawj thiab lwm tus yog thib ob vim yog co toxins lossis kab mob extrahepatic.
Lub siab feline ua haujlwm ntau, vim nws koom nrog hauv kev zom zaub mov, hauv kev sib txuas ntawm bilirubin, glycogen, lipoproteins, albumin thiab lim cov tshuaj lom. Tsis tas li ntawd, nws tau yoog rau cov tsiaj txhu ntawm miv vim tias los ntawm cov nqaij lawv tau txais, ntawm lwm cov as-ham, taurine thiab arginine, uas yog ob qho tseem ceeb amino acids rau miv. Lub siab feline tsim cov kua tsib ntsev los ntawm kev sib txuas ntawm cov kua tsib acids nrog taurine thiab arginine, nws cuam tshuam rau kev sib txuas ntawm ammonia los ntawm urea thiab tshem tawm, yog li qhov tsis txaus arginine yuav ua rau muaj tshuaj lom ammonia hauv peb cov miv, ua rau muaj kab mob siab encephalopathy uas feem ntau muaj. qhov tshwm sim tuag.
Ua rau feline siab tsis ua hauj lwm
daim siab tsis ua hauj lwm hauv miv tuaj yeem tshwm sim los ntawm ntau yam ua rau, suav nrog cov kab mob siab huv, kab mob sib kis, kab mob hauv lwm lub cev lossis los ntawm co toxins:
kab mob siab
Muaj kab mob siab sib txawv uas tuaj yeem ua rau lub siab cuam tshuam rau hauv miv thiab yog li tsim muaj qhov tsis txaus siab ntau dua lossis tsawg dua:
- Hepatic lipidosis: tseem hu ua fatty siab, muaj infiltration ntawm cov roj nyob rau hauv lub hlwb ntawm lub siab feline ua rau nws dysfunction, uas yuav ua tau. tuag rau peb cov miv. Nws feem ntau tshwm sim hauv cov miv rog rog uas tsis noj ob lossis peb hnub rau qee qhov laj thawj, tso cov rog ntawm lawv lub cev tso rau hauv cov ntshav thiab ncav cuag lub siab. Nws qhov laj thawj kuj yuav yog tias, thaum lawv tsum noj mov, lawv tsis ua ke ntawm cov roj ntsha uas tau siv los ntawm cov roj carnidation, uas tau txais los ntawm ob qho tseem ceeb amino acids uas cov miv yuav tsum tau nrog nws cov khoom noj. Cov laj thawj thib ob uas tuaj yeem tsim tau yog cholangitis, pancreatitis, kab mob plab lossis kab mob endocrine (hyperthyroidism, ntshav qab zib mellitus).
- Neutrophilic cholangitis: o ntawm cov kua tsib ntawm daim siab vim yog kis kab mob plab (Escherichia coli, streptococcus los yog clostridia). Feem ntau, nws muaj feem cuam tshuam nrog cov kab mob plab hnyuv thiab / lossis kab mob pancreatitis, qhov no tshwm sim hauv miv thiab hu ua feline triaditis, vim tias cov kab mob siab thiab cov kab mob pancreatic khoob rau hauv cov hnyuv ua ke, yog li cov kab mob hauv cov hnyuv lossis cov txiav tuaj yeem cuam tshuam rau daim siab.
- Lymphocytic cholangitis: Qhov no yog ib yam kab mob sib kis kab mob sib kis nrog cov lymphocyte infiltration.
- Liver cirrhosis: tshwm tom kawg ntawm cov kab mob siab ntev thiab muaj cov tsos mob ntawm fibrosis, txawv txav nodules thiab vascular anastomoses. portal leeg.
- Amyloidosis: muaj cov deposit ntawm amyloid protein nyob rau hauv daim siab, uas yuav lov nws ua rau cov ntshav ntws mus rau hauv lub plab (hemoabdomen). Nws kuj feem ntau tshwm sim hauv lwm yam kabmob xws li lub raum thiab feem ntau yog cov lus teb rau kev mob ntev. Nws tau piav ntau zaus hauv Abyssinian, Siamese thiab Oriental miv.
- : lawv tsis tshua muaj nyob rau hauv miv, feem ntau yog carcinoma ntawm cov kua tsib. Peb kuj tuaj yeem pom lymphomas hauv daim siab, tab sis feem ntau peb kuj yuav pom lawv nyob rau lwm qhov chaw.
kab mob sib kis
Raws cov kab mob sib kis uas tuaj yeem ua rau feline siab tsis ua haujlwm peb tseem ceeb:
- PIF: vim yog tsim ntawm pyogranulomas hauv daim siab nyob rau hauv daim ntawv qhuav ntawm tus kab mob.
- Toxoplasmosis: vim hepatocyte necrosis (kev tuag ntawm daim siab hlwb) thiab o.
Cats qhia a tsis txaus ntawm cov metabolizing enzymeglucuronyl transferase, uas yog lub luag haujlwm rau kev sib txuas ntawm qee cov tshuaj lossis lawv cov metabolites nrog glucuronic acid txhawm rau txhawm rau txhim kho lawv cov metabolism thiab tshem tawm. Qee cov tshuaj uas siv txoj kev no thiab yuav tsum tsis txhob muab rau peb cov miv vim tias lawv muaj tshuaj lom heev, thiab tuaj yeem ua rau lub siab necrosis, yog: paracetamol, ibuprofen thiab aspirin. Lwm cov tshuaj uas muaj lub siab toxicity hauv miv muaj xws li methimazole, tetracyclines, diazepam, L-asparaginase, thiab doxorubicin.
Portosystemic shunt
Consists of a congenital alteration in the circulation of the liver due to the existence of an additional blood vessel that connects the portal vein and lub caudal vena cava (lub cev ncig), yog li ntawd qee yam tshuaj lom ntawm txoj hnyuv mus txog rau daim siab tab sis tsis lim los ntawm kev sib txuas lus vascular, ces lawv nkag mus ncaj qha rau hauv kev ncig, ua rau muaj kev puas tsuaj rau lub hlwb. Tsis tas li ntawd, vim qhov no, ib qho atrophy ntawm daim siab raug tsim, txo nws qhov loj thiab ua rau daim siab tsis ua haujlwm.
Ntawm tag nrho cov ntawm lawv, cov kab mob uas feem ntau ua rau lub siab tsis ua hauj lwm hauv hom feline yog kab mob siab lipidosis thiab cholangitis.
Symptoms of Liver Failure in Cats
Cov tsos mob ntawm feline daim siab tsis ua hauj lwm yog nonspecific, nyob ntawm tus txheej txheem uas originates nws thiab nws hnyav peb yuav nrhiav tau:
- Vim
- Dab mob plab
- Anorexy
- Polydipsia
- Dysuria
- Apathy
- Ascites
Jaundice
Nyob rau hauv cov kab mob siab hepatic encephalopathy vim qhov nce hauv co toxins tsis lim los ntawm lub siab, qaug dab peg, dig muag, hypersalivation, kev coj cwj pwm hloov, aggressiveness, stupor thiab txawm coma yuav pom.
Feline Liver Failure Diagnosis
Kev kuaj mob ntawm cov kab mob uas tuaj yeem ua rau lub siab tsis ua haujlwm hauv peb cov miv tau ua tiav los ntawm keeb kwm zoo, kev kuaj mob, kuaj ntshav thiab biochemistry, ultrasound thiab biopsy.
Kev tshawb nrhiav lub cev
Thaum lub sij hawm anamnesis thiab kuaj cov feline peb yuav tsum tau soj ntsuam thiab nug tus kws kho mob cov cim qhia tias nws tshwm sim, saib nws lub xeev ntawm hydration, lub tsho tiv no, lub xeev ntawm lub mucous daim nyias nyias los soj ntsuam jaundice thiab lub cev mob, nrog rau palpation ntawm tus tsiaj thiab nrhiav kom muaj cov kua dej nyob rau hauv lub plab kab noj hniav qhia tau hais tias ascites. Jaundice thiab ascites yog cov cim qhia ntawm kab mob siab hauv miv, tshwj xeeb tshaj yog daim siab tsis ua haujlwm.
Qhia cov ntshav thiab ntshav chemistry ntawm tus miv tau ua. Kev ua haujlwm thiab kab mob siab yuav tsum tau nrhiav hauv nws:
- Cov kab mob siab: kev nce hauv ALT thiab AST enzymes qhia txog kev puas hlwb hauv daim siab, txawm hais tias lawv muaj ib nrab neej. ntawm ob peb teev hauv miv, yog tias peb tsis pom lawv nce, tsis muaj laj thawj vim li cas nws tsis muaj kab mob siab. Kev nce hauv cov enzymes ALP thiab GGT cov ntsiab lus ntau ntxiv rau kev puas tsuaj rau cov ducts thiab canaliculi, thaum tsuas yog GGT nce, nws taw qhia ntau rau daim siab puas.
- Hepatic function markers: lawv hloov pauv thaum lub siab tsis ua haujlwm siab, ua hyperbilirubinemia (nce bilirubin), hypoglycemia (tsawg qabzib), hypoalbuminemia. (tsawg albumin), hyper lossis hypocholesterolemia (tsawg los yog cov roj cholesterol siab) thiab nce lub sij hawm txhaws (vim tsis muaj vitamin K). Kev nce hauv bilirubin thaum tsis muaj hemolytic anemia lossis kab mob pancreatic yog qhov qhia tau zoo ntawm daim siab tsis ua haujlwm. Tsis tas li ntawd, ua ntej tshwm sim nce ntxiv hauv kev tshuaj ntsuam, miv feem ntau muaj bilirubinuria (bilirubin hauv zis), uas yog ib txwm muaj kab mob hauv cov tsiaj no. Yog tias cov bilirubin zoo li qub, qhov tseem ceeb tshaj plaws thiab cov cim tshwj xeeb rau kev kuaj lub siab tsis ua haujlwm hauv miv yog qhov nce hauv cov kua tsib acids sai thiab tom qab ob teev ntawm kev noj zaub mov.
Diagnostic imaging
Tshwj xeeb, cov txheej txheem tseem ceeb hauv cov xwm txheej no yog abdominal ultrasound, txawm hais tias feem ntau tsis pom kev hloov pauv txawm tias tus miv yeej muaj. kab mob siab. Qee zaum, pom cov kab mob focal, nce qhov loj ntawm daim siab nrog hyperechoic parenchyma (dawb nyob rau hauv daim duab) uas xav tias muaj lipidosis, dilation ntawm cov kua tsib ducts uas qhia cholangitis lossis peb tuaj yeem saib vascularization rau kev kuaj mob. ntawm portosystemic shunts.
daim siab Biopsy
Kev kuaj pom tseeb ntawm ntau yam kab mob uas ua rau lub siab tsis ua haujlwm hauv miv tau ua tiav los ntawm anatomopathological study los ntawm kev noj tshuaj biopsies. Txawm li cas los xij, nyob rau hauv cov xwm txheej ntawm lipidosis, nws tuaj yeem kuaj tau los ntawm cov kauj ruam dhau los thiab lub siab zoo-koob cytology (FNA), qhov twg ntau lub hlwb uas muaj roj yuav pom, txawm hais tias nws yuav tsum tau coj mus rau hauv tus account tias nws tuaj yeem koom nrog lwm yam kab mob, yog li nws yuav tsis yog qhov tseeb, yuav tsum tau kuaj ntshav biopsy. Hauv kev xav tias muaj tus mob cholangitis, cov kua tsib tuaj yeem tau los ntawm cov ducts rau cytology thiab kab lis kev cai, yam tsis tas yuav tsum tau kuaj ntshav hauv cov neeg mob neutrophil cholangitis.
Feline daim siab tsis ua haujlwm
NATION Kev kho mob hauv miv yog qhov nyuaj thiabyuav yog muaj mob rau tus tsiaj uas yog li cas tshwj xeeb kho txhua tus kab mob ib zaug kuaj pom nyias thiab cov tsos mob.
Hepatic lipidosis kho mob
Puas yog kab mob siab lipidosis kho tau hauv miv? Lipidosis yog ib yam kab mob loj heev uas yuav tsum tau kuaj xyuas thiab kho ntxov kom cawm tau peb cov miv, tsuas yog tom qab ntawd nws tuaj yeem kho tau. Nws txoj kev kho yog raws li nram no:
- Enteral food nrog esophagostomy los yog nasogastric tube (nce 25% txhua hnub kom txog rau hnub kcal tus miv xav tau hnub plaub).
- Fluidotherapy nrog isotonic crystalloids supplemented nrog poov tshuaj yog xav tau.
- Nutritional supplements and vitamins: taurine (kom tiv thaiv lossis kho qhov tsis txaus), L-carnitine (ua kom fatty acid oxidation) thiabvitamins E (antioxidant), B thiab K (kho coagulopathy vim nws qhov tsis txaus).
- Yog koj muaj kab mob siab hepatic encephalopathy, lactulose yuav tsum tau muab tshuaj rau qhov ncauj nrog tshuaj tua kab mob xws li amoxicillin lossis metronidazole.
- Txhawm rau rov ua kom cov khw muag khoom poob glutathione uas tiv thaiv oxidizing cov neeg ua haujlwm, N-acetyl-cysteine yuav tsum tau txhaj tshuaj maj mam txhaj tshuaj. Cov tshuaj tiv thaiv kab mob plab, tshuaj tiv thaiv kab mob plab, kev noj qab haus huv, thiab buprenorphine yuav tsum tau muab los tswj qhov mob yog tias muaj kab mob pancreatitis.
Thiab ntawm neutrophil cholangitis
Antibiotics yuav tsum tau muab tshuaj rau 4-6 lub lis piam nrog kab lis kev cai ua ntej thiab tshuaj tua kab mob (cephalosporins, amoxicillin-clavulanate, fluoroquinolones, metronidazole). Yog tias cov lus teb tsis zoo, ntxiv corticosteroids Nyob ntawm qhov mob hnyav, kev pab kho mob yuav tsum tau nrog:
- Fluidotherapy.
- Nyob zoo.
- Antiemetics.
- Ursodeoxycholic acid los txhawb cov kua tsib, tab sis tsuav yog tsis muaj kev cuam tshuam, nws kuj yog anti-inflammatory, immunomodulatory thiab antifibrotic.
- Antioxidants xws li S-Adenosyl methionine (SAMe) thiab vitamin E kom txo tau cov oxidative kev nyuaj siab uas ua rau tus kab mob.
- Nutritional supplements and vitamins.
Tshuaj tua kab mob thiab prednisolone tau muab tshuaj ntau heev (2-3 mg/kg/24 teev) nrog rau kev txo cov koob tshuaj raws li los teb thiab txhawb kev kho mob zoo ib yam li neutrophic. Yog tias cov lus teb rau prednisolone tsis txaus, cov tshuaj tiv thaiv kab mob xws li chlorambucil tuaj yeem ntxiv.
Tshuaj kab mob sib kis
Thaum muaj kab mob sib kis, kho tus kab mob thiab tiv thaiv daim siab nrog cov tshuaj tua kab mob antioxidant (SAMe, vitamin E), muab ursodeoxycholic acid thiab kho cov tsos mob nrog tshuaj tua kab mob, kho kua dej, kev noj qab haus huv stimulants los yog enteral pub, tswj qhov mob. thiab khoom noj khoom haus thiab vitamin ntxiv.
Tshuaj mob daim siab
Neoplasms, chemotherapy protocols yuav ua tiav yoog rau cov qog thiab, hauv cov qog resectable, phais.
Portosystemic shunt kho mob
Cov kev kho mob qhia yuav yog phais, tab sis nws tsis tas mus zoo thiab yuav tsum xub muab tshuaj tua kab mob, lactulose thiab qis. -protein noj.
