1) A 9-year-old neutered male Labrador retriever was referred for increased liver enzymes. Physical examination and diagnostic testing found no other abnormalities.
2) A liver biopsy showed chronic hepatitis with bridging fibrosis and elevated copper levels, indicating copper-associated chronic hepatitis.
3) Treatment included a hepatic support diet low in copper, zinc supplementation, ursodiol, SAMe, and penicillamine to reduce copper levels. Regular monitoring was needed to assess treatment response.
Enumerates the effect of different anesthetic agents on the CNS and compares their relative efficacy and safety in providing good outcome in neuroanesthesia
Simple & Surgical Extractions in Veterinary Dentistry for Dogs and CatsBrett Beckman
Online Courses 24/7 Access: http://veterinarydentistry.net/courseswebinars/veterinary-webinars-on-demand/
Simple and surgical extractions for dogs and cats. Veterinary dentistry and oral surgery.
Enumerates the effect of different anesthetic agents on the CNS and compares their relative efficacy and safety in providing good outcome in neuroanesthesia
Simple & Surgical Extractions in Veterinary Dentistry for Dogs and CatsBrett Beckman
Online Courses 24/7 Access: http://veterinarydentistry.net/courseswebinars/veterinary-webinars-on-demand/
Simple and surgical extractions for dogs and cats. Veterinary dentistry and oral surgery.
Veterinary Dentisry - Regional Anesthesia for Oral Surgery in Dogs and CatsBrett Beckman
Online Courses 24/7 Access: http://veterinarydentistry.net/courseswebinars/veterinary-webinars-on-demand/
This presentation details regional anesthesia utilizing nerve blocks in veterinary dentistry for dogs and cats.
Veterinary Dentisry - Regional Anesthesia for Oral Surgery in Dogs and CatsBrett Beckman
Online Courses 24/7 Access: http://veterinarydentistry.net/courseswebinars/veterinary-webinars-on-demand/
This presentation details regional anesthesia utilizing nerve blocks in veterinary dentistry for dogs and cats.
The Effects of Rauwolfia Vomitoria Extract on the Liver Enzymes of Carbon Tet...IOSR Journals
Rauwolfia vomitoria is a natural medicinal plant which has been used over the years for the treatment of various ailments. The effects of extract of rauwolfia vomitoria on liver enzymes of carbon tetrachloride induced hepatotoxicity were observed in adult wistar rats weighing between 120g and 190g. They were divided into four groups A,B, C and D of six rats each. Group A served as the control and received 0.41ml of distilled water. The experimental groups B, C and D received different doses of drugs as follows : group B received 0.50ml of rauwolfia vomitoria extract, group C received 0.5ml of carbon tetrachloride and group D received 0.41ml of carbon tetrachloride + 0.4ml of rauwolfia vomitoria extract. The drugs were administered once in a day using intubation method for a period of twenty one days. Twenty four hours after the last administration, the animals were anaesthetized under chloroform vapour and dissected . liver tissues were removed and weighed. Blood samples were collected by cardiac puncture and Serum samples were separated from clot by centrifugation using bench top centrifuge. Activities of serum aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase were determined using randox kit method. The relative liver weight for carbon tetrachloride treated group were significantly higher (p<0.001)><0.001) than the control. The extract exhibited a liver protective effect against carbon tetrachloride induced hepatotoxicity
The immunofluorescent antibody
and ELISA Lyme titer tests do not
differentiate between antibodies due
to natural exposure to the Borrelia
burgdorferi organisms versus antibodies
directed against antigens from Lyme
vaccines. In the past, in a vaccinated
animal with a positive Lyme titer, we
needed to follow up with the Western
blot test, whose banding pattern helped
differentiate between antibodies due
to natural exposure and/or Lyme
vaccination. Although the banding pattern
seen after OspA subunit vaccination is
simple (a lone band at p31), patterns seen
with natural infection are complex,
especially over time, and can be confused
with that seen after vaccination with
bacterin.
In collaboration with the New England Regional Genetics Network, the Weitzman Institute aims to improve access to genetics services for underserved populations by offering primary care provider educational support through a free five-part webinar series that aims to enhance provider knowledge, practice, and attitudes regarding genetic services.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
TESDA TM1 REVIEWER FOR NATIONAL ASSESSMENT WRITTEN AND ORAL QUESTIONS WITH A...
Increased liver enzyme activity in a dog
1. Jonathan A. Lidbury, BVMS, MRCVS, &
Jörg M. Steiner, DrMedVet, PhD,
Diplomate ACVIM & ECVIM
(Companion Animal)
Texas A&M University
W h a t ’s t h e Ta k e - H o m e ? H E PATO L O G Y
Peer Reviewed
Increased Liver Enzyme Activity
in a Dog
Based on the history, physical examination, and
laboratory and diagnostic imaging findings, which
of the following would be your next step?
A. No further diagnostics at this time, but repeat a
serum biochemical profile in 2 months
A 9-year-old neutered male Labrador retriever
B. Measure pre- and postprandial serum bile acid
concentrations
was referred for increased serum alanine
C. Test for leptospirosis, hyperadrenocorticism,
and hypothyroidism
aminotransferase (ALT) activity.
D. Perform a hepatic biopsy
E. Start treatment with hepatoprotectants and a
commercial “hepatic support” diet
History. The increased ALT activity (4 times the upper limit of the refer-
ence interval) was noticed incidentally by the dog’s primary care veterinarian
4 weeks earlier. A repeat serum biochemical profile obtained 2 weeks ago
showed a similar elevation in ALT activity. The owner reported that the dog
was not displaying any clinical signs of disease. Other than heartworm pre-
ventive, the dog was not receiving any medications and had no known expo-
sure to toxins.
ASK YOURSELF ...
ALT = alanine aminotransferase
22 ...........................................................................................................................................................NAVC Clinician’s Brief / August 2010 / What’s the Take-Home?
2. Glucose (mg/dL) 106 60–135
Cholesterol (mg/dL) 242 120–247
BUN (mg/dL) 13 5–29
Creatinine (mg/dL) 0.9 0.3–2
Magnesium (mg/dL) 1.8 1.7–2.1
Physical Examination. The patient was showed an ALT activity of 584 U/L
judged to be overweight (body condition (reference interval, 10–130 U/L). Urinal-
Total calcium (mg/dL) 9.9 9.3–11.8
score of 7/9). Moderate dental calculus ysis results were within normal limits.
Phosphate (mg/dL) 3.7 2.9–6.2
was noted on oral examination and bila-
Total protein (g/dL) 6.3 5.7–7.8
terial ceruminous discharge was noted Diagnostic Imaging. An abdominal
on otic examination. No other abnor- ultrasound examination showed gastric
Albumin (g/dL) 2.9 2.4–3.6
malities were found. distension but no other significant find-
Globulin (g/dL) 3.4 1.7–3.8
ings. No changes of the liver or biliary
ALT (U/L) 584 10–130
Laboratory Results. The results of a system were observed.
ALP (U/L) 145 24–147
complete blood count and blood smear
examination were unremarkable. A
GGT (U/L) 9 0–25
serum biochemical profile (Table 1) CONTINUES
Total bilirubin (mmol/L) 0.3 0–0.8
Sodium (mmol/L) 144 139–147
Potassium (mmol/L) 3.9 3.3–4.6
Chloride (mmol/L) 115 107–116
Table 1. Serum Biochemical Profile Results
Variable Result Reference Interval
ALP = serum alkaline phosphatase; ALT = serum alanine aminotransferase; BUN = blood urea
nitrogen; GGT = gamma glutamyltransferase
What’s the Take-Home? / NAVC Clinician’s Brief / August 2010..........................................................................................................................................................23
3. W h a t ’s t h e Ta k e - H o m e ? CONTINUED
• Inflammatory (acute hepatitis, chronic hepatitis, lobular
dissecting hepatitis, copper hepatopathy)
• Neoplasia (primary, metastatic)
CORRECT ANSWER: Diagnostics. Because the liver has a considerable
• Infectious (leptospirosis, infectious canine hepatitis,
D. PERFORM A HEPATIC BIOPSY reserve capacity, patients with liver disease can
toxoplasmosis, Heterobilharzia infection)
have normal liver function test results.2 The
• Trauma (contusions, herniation, torsion)
ALT activity is a marker for hepatocellular dam- results of the dog’s serum biochemical profile did
• Hyperplastic hepatic nodules
age (Table 2). While serum alkaline phosphatase not suggest hepatic insufficiency. Paired pre- and
activity may be increased due to a number of postprandial serum bile acid measurement is sen-
extrahepatic conditions, increased serum ALT sitive and specific for detecting hepatic insuffi-
• Endocrine disease (diabetes mellitus, hyperadrenocorticism,
activity is considered to be a more specific ciency in dogs. However, in this case, serum bile
adrenal hyperplasia)
marker for hepatobiliary disease.1 This patient acid measurement would not have aided in diag-
• Inflammatory (enteritis, pancreatitis, peritonitis, systemic
had ALT activity level greater than 4 times the nosis or therapy selection.
inflammatory response syndrome, sepsis)
upper limit of the reference interval, and this ele-
• Hypoxia (anemia, thromboembolic disease, congestive heart
vation persisted for more than 4 weeks. This Abdominal ultrasound is a useful imaging modal-
failure, circulatory shock)
finding suggested clinically important hepatobil- ity for evaluation of the hepatobiliary system.
• Anaphylaxis
iary disease and warranted further investigation. However, clinicians must recognize that patients
• Metabolic (storage diseases)
may have clinically important hepatic parenchy-
mal disease despite an apparently normal liver
and biliary tract on abdominal ultrasonography.3
• Drug toxicity (barbiturates, carprofen, antimicrobials,
azathioprine, glucocorticoids, griseofulvin, ketoconazole)
Table 2. Causes of Increased Serum ALT
• Toxic (heavy metals, copper, carbon tetrachloride,
Extrahepatic Disease. Because of the liver’s cen-
Activities in Dogs
petrochemicals, mycotoxins, blue-green algae, sago palm)
tral role in metabolism and its unique dual blood
supply, it is often affected by extrahepatic disease.
Primary Hepatopathies Hepatopathies can be the primary disease process
• Severe muscle injury (uncommon)
or can be secondary to extrahepatic disease,
drugs, or toxins.4 The diagnostic and therapeutic
approach for patients with primary and secondary
hepatopathies differs greatly. Based on the signal-
ment, history, physical examination, and clinico-
pathologic findings, there was no evidence that
this dog had extrahepatic disease or exposure to
xenobiotics. Consequently, extensive testing for
Secondary Hepatopathies extrahepatic disease was not indicated.
Hepatic Biopsy. Collection of a hepatic biopsy
was indicated due to the strong suspicion of a
chronic primary hepatopathy. No evidence of a
coagulopathy was found on a coagulation profile
(including prothrombin time and activated partial
thromboplastin time) or a buccal mucosal bleed-
ing time.
Xenobiotic-Related Causes
Seven hepatic wedge biopsies were collected
laparoscopically (Figure 1). Six of these were
submitted for histopathology, and one specimen
was immediately frozen. In addition, bile was
submitted for aerobic and anaerobic culture.
Extrahepatic Sources of ALT The frozen specimen was submitted for copper
ALT = alanine aminotransferase
24 ...........................................................................................................................................................NAVC Clinician’s Brief / August 2010 / What’s the Take-Home?
4. • Depending on magnitude and
duration, increases of serum
ALT activity are clinically
important and warrant further
investigation.*
• Hepatic function tests can be
TX AT A GLANCE
normal in patients with early
quantification by flame atomic absorption Treatment. The patient was switched to
chronic hepatitis.
spectrometry (Colorado State University a commercial hepatic support diet with a • Treatment should be
• Abdominal ultrasound exam-
Veterinary Diagnostic Laboratories; vegetable protein source, restricted cop- started as early as
ination can be unremarkable
possible in the course of
in patients with chronic
dlab.colostate.edu). per content, and increased zinc content.5
chronic hepatitis.
hepatic parenchymal disease.
Supportive treatment with ursodiol and
• Treatment should be
• Increases in serum hepatic
Diagnosis. Histopathologic evaluation of SAMe was initiated. The patient’s
guided by hepatic
enzyme activities can be from
the liver biopsy specimens showed chronic hepatic copper accumulation was treated
histopathology, hepatic
extrahepatic sources (eg,
periportal hepatitis with bridging fibrosis. with D-penicillamine.6
copper quantification, and
alkaline phosphatase can be
Copper-staining showed accumulation of bile/liver culture.
of hepatic or bone origin) or
copper in hepatocytes (Figure 2). The See Aids & Resources, back page, for • Chelating agents and
due to primary or secondary
hepatic copper concentration was 1651 references and suggested reading. reduced dietary copper
hepatopathies.
ppm dry weight (reference interval, intake are the main
• Biopsy is indicated in patients
120–400 ppm). The final diagnosis was treatments for copper-
that are suspected of having
associated chronic
chronic primary hepatopathy.
copper-associated chronic hepatitis.
hepatitis.
• Hepatoprotectants have a
place in the treatment of
copper-associated chronic
hepatitis.
TAKE-HOME MESSAGES • The use of corticosteroids
and other antiinflamma-
* In our opinion, further investigation is
tory drugs in the treatment
warranted when a single ALT activity
determination is greater than 5 times
of copper-associated
the upper limit of the reference inter-
chronic hepatitis is
val, or when multiple determinations
controversial.
1
demonstrate activity greater than 2
• Assessment of the
times the upper limit of the reference
interval for more than 4 weeks.
Laparoscopic view of the liver; patient’s response to
biopsy sites are visible on the
margin of the liver treatment is crucial.
2 Copper-associated chronic hepatitis; this histopathologic section shows
abundant copper granules in the cytoplasm of periportal hepatocytes and
in some hepatocytes Rhodamine stain; original magnification, 40x
SAMe = s-adenosylmethionine
What’s the Take-Home? / NAVC Clinician’s Brief / August 2010...........................................................................................................................................................25