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Hepatic Lipidosis in a 5 Year Old
Shetland Pony
Tom Sparks
Presenting Signs
• 5 year old Shetland mare
• Lost condition, unwell, jaundiced
• Temperature of 101 degrees Fahrenheit.
(Normal 99-101)
• Hep, EDTA, serogel samples received on
08/03/2010
Biochemistry Results
Test Result Unit Reference Range
GLDH 240 Mmol/l 0-12
Sodium 124.7 Mmol/l 130-151
Potassium 4.3 Mmol/l 2.6-5.2
Na:K ratio 29.0 Mmol/l
Chloride 88.6 Mmol/l 94-113
Calcium 2.83 Mmol/l 2.78-3.30
Phosphate 1.06 Mmol/l 0.9-2.1
Biochemistry Results
Test Result Unit Reference
Range
Urea 5.5 Mmol/l -6.84
Creatinine 115 Mmol/l 62-140
Triglyceride 44.39 Mmol/l -0.8
Total bilirubin 110 Mmol/l -25
ALKP 1503 U/l -280
AST 7889 U/l -240
GGT 55 U/l -40
Biochemistry Results
Test Result Unit Reference
Range
TP 63 g/l 60-83
Albumin 27 g/l 26-35
Globulin 36 g/l 30-55
CK 15150 U/l -150
Summary of Biochemistry Results
• Marked increase in GLDH, Triglyceride, Total
Bilirubin, ALKP, AST, GGT, and CK.
• Moderate decreases in Na, Cl and Urea.
Hepatic Lipidosis
• Poor feed quality or decrease in feed intake
particularly during a period of high energy
intake
• Negative energy balance triggering excessive
movement of fatty acids from adipose tissue
leading to an increase in hepatic triglyceride
synthesis and secretion of very low density
lipoproteins, hypertriglyceridemia and fatty
infiltration of the liver.
Treatment
1. Treatment of hepatic failure
2. Improvement of energy intake and balance
3. Elimination of stress or treatment of
concurrent disease
4. Increased triglyceride uptake by peripheral
tissues
Prevention
• Keeping mares in good BCS especially
throughout the winter
months/pregnancy/lactation
• Keep dietary changes to a minimum
• Ensure haylage is fed during times when
frost/snow may be a problem
• Stress must be kept to a minimum
• Ensure good routine health care ie dental etc
Prognosis
• Prognosis of hyperlipidaemia is poor
• It has been reported for mortality to occur in
up to 80% of cases that are presented for
treatment.
• Education of owners could improve the
situation.
• Try and treat the primary disease!
References
• Michelle Henry Barton, Debra Deem Morris,
Diseases of the liver, Equine Internal Medicine,
Stephen M Reed, Warwick M. Bayly, WB
Saunders and Company 1998, 731-733.
Questions?

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Pathology final pres

  • 1. Hepatic Lipidosis in a 5 Year Old Shetland Pony Tom Sparks
  • 2. Presenting Signs • 5 year old Shetland mare • Lost condition, unwell, jaundiced • Temperature of 101 degrees Fahrenheit. (Normal 99-101) • Hep, EDTA, serogel samples received on 08/03/2010
  • 3. Biochemistry Results Test Result Unit Reference Range GLDH 240 Mmol/l 0-12 Sodium 124.7 Mmol/l 130-151 Potassium 4.3 Mmol/l 2.6-5.2 Na:K ratio 29.0 Mmol/l Chloride 88.6 Mmol/l 94-113 Calcium 2.83 Mmol/l 2.78-3.30 Phosphate 1.06 Mmol/l 0.9-2.1
  • 4. Biochemistry Results Test Result Unit Reference Range Urea 5.5 Mmol/l -6.84 Creatinine 115 Mmol/l 62-140 Triglyceride 44.39 Mmol/l -0.8 Total bilirubin 110 Mmol/l -25 ALKP 1503 U/l -280 AST 7889 U/l -240 GGT 55 U/l -40
  • 5. Biochemistry Results Test Result Unit Reference Range TP 63 g/l 60-83 Albumin 27 g/l 26-35 Globulin 36 g/l 30-55 CK 15150 U/l -150
  • 6. Summary of Biochemistry Results • Marked increase in GLDH, Triglyceride, Total Bilirubin, ALKP, AST, GGT, and CK. • Moderate decreases in Na, Cl and Urea.
  • 7. Hepatic Lipidosis • Poor feed quality or decrease in feed intake particularly during a period of high energy intake • Negative energy balance triggering excessive movement of fatty acids from adipose tissue leading to an increase in hepatic triglyceride synthesis and secretion of very low density lipoproteins, hypertriglyceridemia and fatty infiltration of the liver.
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  • 10. Treatment 1. Treatment of hepatic failure 2. Improvement of energy intake and balance 3. Elimination of stress or treatment of concurrent disease 4. Increased triglyceride uptake by peripheral tissues
  • 11. Prevention • Keeping mares in good BCS especially throughout the winter months/pregnancy/lactation • Keep dietary changes to a minimum • Ensure haylage is fed during times when frost/snow may be a problem • Stress must be kept to a minimum • Ensure good routine health care ie dental etc
  • 12. Prognosis • Prognosis of hyperlipidaemia is poor • It has been reported for mortality to occur in up to 80% of cases that are presented for treatment. • Education of owners could improve the situation. • Try and treat the primary disease!
  • 13. References • Michelle Henry Barton, Debra Deem Morris, Diseases of the liver, Equine Internal Medicine, Stephen M Reed, Warwick M. Bayly, WB Saunders and Company 1998, 731-733.