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Comprehensive study of haemato-biochemical, ascitic fluid analysis and ultrasonography in the diagnosis of ascites due to hepatobiliary disorders in dog

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Two percent of the dogs with ascites of hepatic insufficiency were recorded. Decline in the values of Hb, PCV, RBCs and increased TLC and prothrombin time were recorded. Hypoproteinemia, hypoalbuminemia with elevated bilirubin and liver enzymes were observed. Abdominal ultrasound revealed anechoic structure with focal and diffused hyper echoic, cirrhosis of liver and gall bladder disorders were recorded. Ascitic fluid was clear/transudate with a few mesothelial cells, lymphocytes, monocytes and neutrophils in most of the ascitic dogs. Decreased serum total protein, albumin and elevated serum ALT, AST, ALP, total bilirubin, prolonged prothrombin time and SAAG was good indicator for diagnosis of ascites due to HBD. Ascitic fluid analysis and serum ascites albumin gradient (SAAG) may be a key indicator for diagnose etiopathogenesis of ascites in dog.
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Ascites is a pathological accumulation of free fluid
within the peritoneal cavity (Hall and German 2005) and it
is mostly accompanied with sever chronic liver disease due
to portal hypertension, hypoalbuminenia and increased renal
sodium and water retention (Rutgers and Biourge 2007).
The diagnosis of liver disorders is a challenge to clinicians
because clinical signs are often very vague and non-specific,
especially in the early stage of hepatobiliary diseases.
Because of varied functions of liver, no single test can
accurately identify the hepatic disease or its underlying
cause hence, a battery of test is required to assess ascites
due to hepatobiliary disorder. So, comprehensive study of
ascitic fluid, serum biochemical and serum marker is the
need of the present scenario for proper diagnosis of ascites
due to hepatic damage. Therefore the present study was
taken up to detect the haemato-biochemical, ascitic fluid
analysis and ultrasonography changes of ascites due to
hepatobiliary disorders in dog.
MATERIALS AND METHODS
Dogs having signs of distended abdomen presented at
Referral Veterinary Polyclinic (RVP), Indian Veterinary
Research Institute, Izatnagar, was taken under study. History
of each dog was noted in relation to breed, age, sex, body
weight etc. for epidemiological study. The samples of ascitic
fluid and venous blood samples were obtained on the same
day. Collected serum samples were stored in deep freezer
at –20°C for biochemical estimation.
Haematology: Haemoglobin, PCV, total erythrocyte and
leukocyte counts and red blood cell indices (MCV, MCH,
MCHC).
Serum biochemistry: BUN, creatinine, ALT, AST, ALP,
total bilirubin, total protein (TP), albumin, sodium and
potassium and prothrombin time (PT).
Ultrasonography: Ultrasonographic examination was
carried out with 2.5–5.0 MHz transducers.
Abdominal paracentesis: Abdominal paracentesis was
performed on standing and or left lateral recumbency and
the surrounding area was clipped and full surgical
preparation was done. Site was chosen 2 to 3 cm caudal to
the umbilicus and 2 to 3 cm left of the midline. Urinary
bladder was emptied before centesis. A 22 or 20 G needle
or catheter was inserted at an angle of 45o to the body wall.
Fluid was collected directly into the sterile vials with or
without EDTA for further analysis (Alleman 2003, Rudolff
2005).
Ascitic fluid analysis: (a) Physical examination: Colour/
turbidity and specific gravity. (b) Microscopic examination:
1. Cell count was done by haemocytometer counting
chamber. 2. Cytological examination: Ascitic fluid cytology
smear was stained by Giemsa. (c) Biochemical test: Total
protein, albumin and serum ascitic albumin gradient
(Alleman 2003).
Ph.D. work of first author, approved by Deemed University,
Indian Veterinary Research Institute, India.
Present address: 1,6Assistant Professor (sara82vet
@yahoo.com, sasivetext@gmail.com), Teaching Veterinary
Clinical Complex, VCRI Orathanadu, Thanjavur. 2Principal
Scientist (dbmondal@gmail.com). 3Assistant Professor (SS;
kalyan_srm@rediffmail.com); 4Scientist (mahivet2002
@yahoo.co.in). 5Assistant Professor (vijayvet1985@gmail.com),
MVC, Chennai.
Indian Journal of Animal Sciences 84 (5): 503–506, May 2014/Article
Comprehensive study of haemato-biochemical, ascitic fluid analysis and
ultrasonography in the diagnosis of ascites due to hepatobiliary disorders in dog
M SARAVANAN1, D B MONDAL2, K SARMA3, K MAHENDRAN4, H VIJAYAKUMAR5 and V SASIKALA6
Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh 243 122 India
Received: 1 December 2012; Accepted: 18 January 2014
ABSTRACT
Two percent of the dogs with ascites of hepatic insufficiency were recorded. Decline in the values of Hb, PCV,
RBCs and increased TLC and prothrombin time were recorded. Hypoproteinemia, hypoalbuminemia with elevated
bilirubin and liver enzymes were observed. Abdominal ultrasound revealed anechoic structure with focal and diffused
hyper echoic, cirrhosis of liver and gall bladder disorders were recorded. Ascitic fluid was clear/transudate with a
few mesothelial cells, lymphocytes, monocytes and neutrophils in most of the ascitic dogs. Decreased serum total
protein, albumin and elevated serum ALT, AST, ALP, total bilirubin, prolonged prothrombin time and SAAG was
good indicator for diagnosis of ascites due to HBD. Ascitic fluid analysis and serum ascites albumin gradient
(SAAG) may be a key indicator for diagnose etiopathogenesis of ascites in dog.
Key words: Abdominal paracentesis, Ascites, Liver, Portal hypertension
504 SARAVANAN ET AL. [Indian Journal of Animal Sciences 84 (5)
32
Serum ascitic albumin gradient (SAAG): It was
calculated by subtracting the albumin concentration of the
ascitic fluid from the albumin concentration of a serum
obtained on the same day (Beg et al. 2001).
Statistical analysis: All data were expressed as
means±SE. The analyses were performed with SPSS 16.0.
The Student’s t-test was used to analyze the study
parameters.
RESULTS AND DISCUSSION
Incidence: Total number of dogs brought to RVP, IVRI,
Izatnagar irrespective of the nature of the diseases were
3,600 during the course of the study (March 2011– 2012).
Out of these, 72 dogs (2.0 %) were observed with ascites
due to hepatic insufficiency. Spitz dogs (54.2%) had higher
incidence followed by Mongrel (16.4%), Labrador Retriever
(12.5%), German Shepherd (6.9%), Doberman pinscher
(6.9%), Great Dane (1.4%) and Golden Retriever (1.4%).
Higher incidence was recorded in male mongrel dogs
(75.0%) whereas in female Doberman pinscher (80.0%)
showed higher incidence. Most of the ascities were noticed
more than 5 years old (33.3%) followed by 4–5 years
(15.3%), 1–2 years (13.9%), 2–3 years (12.5%), 3–4 years
(12.5%) and less than one year (12.5%) of age. 2–3 years
old male (88.9%) had higher incidence whereas in female
more than 5 years (66.7%) old dogs. In the present study
the overall sex-wise distribution revealed that male dogs
(54.2%) had higher incidences of ascites. Most of the ascites
dogs were fed with homemade vegetarian diet. Cases of
ascites were recorded from time to time by various
researchers in different breeds of dog namely Labrador
Retriever (James et al. 2008), German Shepherd (Nottidge
et al. 2003), Doberman pinscher (Fuentealba et al. 1997)
and Great Dane (Raffan et al. 2009). Various authors have
reported ascites in different age groups, viz. from 16 weeks
to 9 years (mean 3.12 years) and from 1 to 13 (mean 5)
years (James et al. 2008). Ascites is being considered to be
a common complication of chronic hepatitis in dogs (Raffan
et al. 2009) and it could be aggravated by the activation of
hepatic stellate cells with subsequent presinusoidal collagen
accumulation and fibrosis, that results in sinusoidal
occlusion followed by portal hypertension and promote the
formation of fluid accumulation (Hall and German 2005).
Clinical signs: All the dogs showed abdominal distension
followed by inappetance (69.4%), lethargy (63.9%), pale
mucous membrane (45.8%), respiratory dyspnoea (15.3%),
pedal oedema (12.5%), diarrhoea (8.3%), vomiting (6.9%),
melena (6.9%) and polyuria/polydipsia (4.2%). The clinical
signs of hepatobiliary dysfunctions (HBD) are relatively
vague and highly variable in nature. The findings of present
study were similar to the observations of various authors
(Watson and Bunch 2009, Saravanan et al. 2012).
Haematology: Highly significant (P<0.001) decrease in
Hb, PCV and RBCs count were noticed in ascitic dogs.
Significant (P<0.05) increase in TLC, neutrophil and
basophil count and decreased lymphocyte count were
observed as compared to healthy dogs (Table 1). Liver being
the prime organ, involved in the production of erythropoietin
and other factors required for erythropoiesis and so the
dysfunction of liver may lead to anaemia (Sharma et al.
2001). Washabau (2010) observed severe leukocytosis and
neutrophilia in dogs with granulomatous hepatitis, hepatic
cirrhosis, hepatic abscess and hepatic neoplasia and
emphasized the probable causes for significant increase in
total leukocytes, neutrophil and basophil counts in the study.
Serum biochemical profile: Significant increase (P<0.05)
in ALT, AST, ALP, total bilirubin and prolonged
prothrombin time activities were observed in ascitic dogs.
Serum AST and ALT measurements were highly useful in
detecting hepatocellular injury and monitoring clinical
progress (Tennant and Center 2008). Solter et al. (1994)
stated that the high serum ALP as a sensitive marker for
cholestasis in most of the mammalian species including
dogs. Highly significant (P<0.001) decrease in total protein
and albumin level were noticed in ascitic dogs (Table 2),
which could be due to the primary role of liver in the
synthesis of major plasma protein as well as site of
degradation and synthesis of many other proteins that is
influenced by liver diseases in many ways (Webster 2005).
Ascites leads to increased albumin distribution and lowers
the blood albumin concentration, which decreases the
plasma oncotic pressure and aggravates the ascites (Richter
Table 1. Mean±SE of haematological profile in ascitic dogs
Parameters Control (n=6) Ascites dog (n=72)
Hb (g/dl) 12.28±0.23 8.90±0.25**
PCV % 43.0±0.83 27.37±0.68**
RBC (×106/ /μl) 4.31±0.07 2.73±0.10**
MCV (fl) 100.29±2.95 104.83±2.44NS
MCH (pg) 30.03±0.74 33.73±0.68NS
MCHC (%) 29.97±0.18 32.46±0.36NS
WBC (×103/ /μl) 10.39±0.42 18.57±0.87*
Lymphocyte (%) 27.67±1.05 18.50±1.01*
Monocyte (%) 1.67±0.33 1.93±0.13NS
Neutrophil (%) 69.50±0.92 78.19±1.07*
Basophil (%) 0.17±0.17 0.87±0.09*
Eosinophil (%) 1.0±0.26 0.61±0.11NS
Table 2. Mean±SE of serum biochemical profile in ascitic dogs
Parameters Control (n=6) Ascites dog (n=72)
BUN (mg/dl) 26.26±1.89 31.29±3.26NS
Creatinine (mg/dl) 0.62±0.15 1.17±0.15NS
Prothrombin time (sec) 5.0±0.25 8.50±0.31*
ALT (IU/L) 41.55±3.37 173.47±12.29*
AST (IU/L) 29.72±2.0 161.18±11.15*
ALP (IU/L) 48.51±2.28 120.74±7.89*
Total protein (g/dl) 6.63±0.09 5.15±0.10**
Albumin (g/dl) 3.31±0.09 2.02±0.03**
Globulin (g/dl) 3.32±0.04 3.13±0.10NS
A: G ratio 1.0±0.03 0.83±0.14NS
Total bilirubin (mg/dl) 0.36±0.03 0.99±0.07*
Na+ (mEq/L) 136.3±0.8 139.2±1.7NS
K+ (mEq/L) 4.9±0.1 4.3±0.1NS
May 2014] DIAGNOSIS OF ASCITES DUE TO HEPATOBILIARY DISORDERS IN DOG 505
33
2003, Tennant and Center 2008). Estimation of serum
albumin levels and prothrombin time are often considered
tests of liver function. These findings are agreeing with the
present study.
Ultrasonography: All the 72 dogs were observed with
anechoic structure (ascitic fluid) in abdominal cavity
followed by 18 dogs (25%) with focal hyper echoic and 33
dogs (45.8%) showed diffused hyper echoic liver
parenchyma (Fig. 1) with normal size of liver. Liver
cirrhosis (Fig. 2) were found in 19 dogs (26.38%) as
evidenced by hyper echoic bright small size liver with
irregular margin. Gall bladder disorders (cholecystitis/
cholelithiasis/ distension) (Fig. 3) were noticed in 10 dogs
(13.90%). Also multiple hepatic cysts in 1 case (1.4%) and
multiple hepatic nodules in 1 case (1.4%) were recorded.
In the present study, liver, kidney (right and left), spleen,
intestine and urinary bladder were suspended in ascitic fluid
during USG examination.The presence of ascitic fluid in
the abdominal cavity greatly enhanced the image of various
abdominal organs, viz. liver, spleen, intestine, urinary
bladder and right and left kidney. Mc Grothy and Doust
(2004) stated that the abdominal ultrasound is being
considered as more sensitive than survey radiography to
detect peritoneal fluid. Cholecystitis as generalized gall
bladder wall thickening is associated with acute
pyelonephritis, portal hypertension, chronic renal diseases,
and hepatitis (Mattoon and Nyland 2002).
Ascitic fluid analysis: Ascitic fluid was aspirated in
severely distended/ tensed abdomen to relive respiratory
dysponea. Colour/turbidity of ascitic fluid was clear/
transudate in 68 dogs followed by clear/straw colour in 2
dogs and clear reddish yellow in 2 dogs. Cytologically,
ascitic fluid revealed a few mesothelial cells, lymphocytes,
monocytes and neutrophils (Fig. 4) in most of the ascitic
dogs, whereas two dogs showed tumor cells in the ascitic
fluid. Specific gravity (1.014±0.001), total nucleated cell
count (388.93±66.32/cmm), total protein (1.96±0.08 g/dl),
albumin (0.83±0.05 g/dl) and serum ascites albumin
gradient (1.20±0.05 g/dl) of ascitic fluid were showed
transudative ascites. Paracentesis could assist in timely
identifying the pathological causes which are responsible
for the fluid accumulation or it can help further investigation
to diagnose the diseases condition (Papasouliotis and
Dewhurst 2005). The mean specific gravity, total nucleated
cell count, total protein, albumin and serum ascites albumin
gradient found to be a transudative type of ascites of the
present study. These findings are in line with the findings
of Burgees (2004).
The SAAG reflects the oncotic pressure gradient between
the vascular bed and elevated gradient (greater than or equal
to 1.1 g/dl) usually being associated with increased portal
pressure, whereas a low gradient (<1.1 g/dl) is associated
with conditions where the ascites is not related to portal
hypertension (Tarn and Lapworth 2010). Burgees (2004)
and Saravanan et al. (2012) opined that the serum-ascites
albumin gradient (SAAG) provides better discrimination
between ascites of chronic liver diseases from other origin.
Hence, SAAG > 1.1 g/dl is suggestive of the presence of
portal hypertension due to chronic liver disease.
Refractory form of ascites were noticed in 16 dogs
(22.22%), of which 3 dogs showed recurrence within a
month and the remaining 13 dogs after 1 month from the
day of clinical presentation and standard therapeutic
intervention. Among these 13 recurrent ascitic dogs, one
dog exhibited recurrence of ascites after 6th, 8th, 11th, 13th
and 15th month during standard therapeutic intervention.
However, 3 dogs exhibited ascites recurrence at 4th, 6th, 8th
and 10th month of standard therapeutic intervention.
Reoccurrence of ascites in dogs is mostly because of the
pet owners discontinuing therapy once after their pets
getting clinical aid, response within few day of therapy.
Hence, this also could be one of the reasons for recurrence
and diuretic resistance ascites which were observed in the
present study. Cirrhotic patients with ascites were
characterized by marked alterations in their splanchnic and
systemic haemodynamics leading to spanchnic congestion,
central hypovolaemia and arterial hypertension with
activation of rennin-angiotensin and vasoconstrictor
systems with renal increase of sodium reabsorption. One
of the most adverse consequences of such hemodynamic
dysfunctions were the development of refractory ascites in
which standard medical treatment with low sodium diet and
Figs. 1–3. 3. USG: Diffused hyper echoic liver parenchyma with massive ascitic fluid (sagittal view). 2. USG: Cirrhotic liver
parenchyma with massive ascitic fluid (sagittal view). 3. USG: Cirrhotic liver parenchyma, gall stone (cholelithiosis) with ascitic fluid
(sagittal view).
506 SARAVANAN ET AL. [Indian Journal of Animal Sciences 84 (5)
34
diuretics are unable to resolve the ascites. Further massive
ascites and hepatorenal syndrome (HRS) are frequent
complication of liver cirrhosis (Gerbes and Gulberg 2006).
Refractory ascites generally affects with advanced cirrhosis
that may also develop HRS. Both the refractory ascites and
HRS are the independent predictors of short survival
(Salerno et al. 2010). Decreased serum total protein,
albumin level and increased ALT, AST, ALP, total bilirubin,
prothrombin time and serum ascites albumin gradient
(SAAG) were good indicator for diagnosis of ascites due
to HBD.
ACKNOWLEDGMENTS
Authors are extremely grateful to the Director, Indian
Veterinary Research Institute, Izatnagar, for providing all
facilities for the study.
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... Increased AST in hepatic dysfunction is mainly associated with degeneration and necrosis of hepatocytes (Dial, 1995). Finding of increased AST in dogs with hepatic dysfunction was also reported by Saravanan et al. (2014). The mean value of ALP increased significantly in dogs afflicted with hepatic disorder. ...
... However, the highest ALP activity was seen in animals affected by cholangitis, biliary cirrhosis, or extrahepatic bile duct obstruction (Tennant and Center, 2008). Finding of increased ALP was also reported by Saravanan et al. (2014). The mean value of GGT in dogs with liver disorder escalated significantly as compared to healthy dogs. ...
... Liver has large reserves of albumin so hypoalbunemia generally occurs in chronic liver dysfunction as is associated with condition like cirrhosis, congenital portosystemic shunt (Rothuizen, 2009). The findings of reduced total protein and albumin in dogs with hepatic dysfunction was also reported by Saravanan et al. (2014). Consequently, there was a significant reduction in mean A:G in dogs affected with hepatic dysfunction. ...
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The study involved screening of 521 dogs, presented at Veterinary Clinical Complex, PGIVER and State Veterinary Polyclinic, Jaipur for the treatment of various gastro-intestinal disturbances. The overall prevalence of ascites was recorded as 2.87%. The sex wise prevalence was high in male (3.32% n=9,) as compared to female (2.40% n=6). Highest prevalence was recorded in dogs of 3 to 6 years age group followed by 2 months to 3 years and above 6 years age groups. The Labrador breed showed highest prevalence followed by German shepherd, Beagle, non descript and Pug, respectively.
... All the positive cases of ascites were confirmed according to their clinical signs, ascitic fluid analysis result, haemato-biochemical changes and imaging techniques results and out of 21 cases, 28.6% (6/21) cases were confirmed as hepato-renal dysfunction. The present findings were in agreement with other workers [14][15][16] who reported that the prevalence of ascites in canines was from 0.59% to 2.5% in Uttarakhand, Nigeria, and Bareilly. Major clinical signs observed in ascites cases were abdominal distensions (95.23%), fluid wave test (95.23%), ...
... inappetance (90.47%), dyspnoea (80.95%), exercise intolerance (52.38%), pale mucous membrane (42.85%), icterus (28.57%), melena (23.80%) vomition (19.04%), peripheral edema (14.28%) and tachycardia (9.52%) and these findings were in accordance with the work of Saravanan et al. [16] Varied signs observed in ascites cases might be due to reduced or failure function of different vital organs viz. liver, heart, kidney etc. Anaemic animals have decreased the ability of blood supply to tissues with adequate oxygen for proper metabolic functions. ...
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Ascites is a common problem in dogs but due to the involvement of different etiological factors, the clinicians are facing lots of difficulty in therapeutic management. There is no detailed investigation carried out in Mizoram till today. Given this background and facts, the present study has been undertaken to know the role of the hepato-renal problem on ascites and its pathological changes in dogs. Study revealed that the incidence of ascites in Mizoram is 1.9% and 6 cases were confirmed as ascites due to the hepato-renal problem. The haemato-biochemical analysis revealed anemia, neutrophil leukocytosis, Hypoproteinaemia, Hypoalbuminemia, hyponatremia, hypochloraemia, hyperbilirubinemia, increased alanine aminotransferase (ALT), alkaline phosphatase (ALP), blood urea nitrogen (BUN) and creatinine level in all the ascitic dogs. Ultrasonography (USG) examination revealed anechoic areas mild to extensive suggestive of fluid accumulation along with floating of intestines and internal viscera, is echoic kidney cortex and medulla; enlarged renal pyramids with anechoic echo texture, focal hyperechoic and loss of echogenicity of hepatic parenchyma with increased size and distended gall bladder. Radiographic examination showed ground glass appearance with increased in vertical heart size (VHS). Electrocardiogram (ECG) showed sinus tachycardia, atrial standstill and prolonged QRS duration. Echocardiography examination revealed increased left ventricular internal diameter at diastole (LVDd), Left ventricular internal diameter at systole (LVDs), left atrial to aortic ratio (LA: AO) and e-point to septal separation (EPSS) values and …
... The increased level of ALT could be owing to the majority of ALT is found in the cytoplasm of hepatocytes, and it is released into the serum in cases of hepatic dysfunction or increased hepatocyte membrane permeability [20]. Similar findings were observed by [21], and [2]. ...
... The mean values of ALP and GGT showed significant (P < 0.05) increase in dogs with hepatobiliary dysfunction when compared with healthy control. Similar findings were obserevd by Mircean et al. (2008) and Saravanan et al. (2014) but findings were in contrary with Assawarachan et al. (2019). Elevated ALP activity was regarded as a sign of either intrahepatic or extrahepatic biliary blockage because it was associated with cholestasis. ...
Article
Objectives: The aim of study was to asses hepatobiliary ultrasound score between apparently healthy dogs and dogs with hepatobiliary dysfunctions diagnosed via clinical examination and hemato-biochemical analysis supported by ultrasonography. Materials and Methods: A total of 22 dogs presented at Veterinary Clinical Complex, College of Veterinary Science & Animal Husbandry, Kamdhenu University, Junagadh, showing clinical signs of hepatobiliary dysfunction were subjected to clinico-hemato biochemical and ultrasonographic (USG) examinations by standard methods. For assessment of ultrasound score Different ultrasonographic features were categorized on the basis of (1) liver surface, (2) parenchymal score (echogenicity of parenchyma and nodularity of parenchyma), and (3) biliary score (gallbladder wall thickness, amount of gall sludge, and visibility of bile duct). Six apparently healthy dogs served the control group. Results: The dogs affected with hepatobiliary dysfunction showed clinical signs like lethargy, anorexia/hyporexia, diarrhoea, pale conjuctival mucous membrane, polyuria/polydipsia, ascites, fever, vomiting, jaundice, pain on abdominal palpation, emaciation, melena, constipation, limb/scrotal oedema and petechial haemorrhages. Significant decline in Hb, TEC, PCV and platelet counts and significant elevation in TLC and Neutrophils (%) was noted as compared to control values. Significant increase in ALT, ALP, GGT, total bilirubin, direct bilirubin and total bile acids; significant decline in total protein and albumin were also noted as compared to control values. Hepatosonography revealed different focal and diffuse lesions. Majority of the dogs affected with hepatobiliary dysfunctions showed moderate severity (14/22, 63.64 %). Conclusions: When treating diseased animals, one must take into account the clinical and hemato-biochemical changes brought on by hepatobiliary dysfunction. Here, explained ultrasound score system can be used for screening of different hepatobiliary affections thus better diagnosis of the liver diseases in dogs can be given via visulizing liver damage. Introduction The biggest parenchymal organ in the body, the liver performs at least 1500 metabolic processes vital to the life of the host. [12] Drug metabolism, removal of exogenous and endogenous toxins, synthesis of vital substances such as albumin and blood clotting factors, protein, fat, and carbohydrate metabolism, vitamin storage and activation, glycogen, triglyceride, and mineral storage, activation, conversion, secretion, deactivation, and excretion of various hormones, bile salt synthesis, and bilirubin conjugation and excretion. Hepatobiliary dysfunction in dogs can be caused by drug-induced toxicity, viral infections, congenital or neoplastic diseases, metabolic abnormalities, degenerative processes, vascular injury, autoimmune diseases, and even severe trauma. Disorders of Biliary tract disorders include extrahepatic bile duct obstruction (EBDO) in dogs as well as diseases of the biliary tract itself, such as bacterial cholecystitis, cholangitis, cholangiohepatitis, and necrotizing cholecystitis. Cholangiohepatitis and cholecystitis are most frequently linked to Ascending infection. Labrador Retrievers, Doberman Pinschers, English Cocker Spaniels, Bedlington Terriers, West Highland White Terriers, and many other breeds are the most susceptible breeds for occurrence of hepatitis [10]. The majority of dogs affected by hepatobiliary dysfunction over their lifetime are between the ages of 4 and 8 years old [8]. Females were more likely than males to suffer from liver disorders [16]. Jaundice, bleeding tendency, and ascites are typical clinical indicators of liver disease, while depression, lethargy, anorexia, vomiting, diarrhoea, and weight loss are non-specific symptoms [14] .
... The presence of anechoic fluid, fibrin, and floated liver lobe in the abdominal cavity were unfailing findings during ultrasonographical investigation. Similar results were also observed by Mani et al. (2014) and Chaturvedi et al. (2013). Radiographic evaluation of dogs can also be helpful for the differentiation of many conditions. ...
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The present work was conducted to evaluate the trend of ascites in canines of the North Gujarat region, India during 2017−2020. A total of 5094 dogs were presented for diverse clinical history at Veterinary Clinical Complex Deesa and Dantiwada. Amongst the dogs evaluated with clinical approach supported by ultrasonographic investigation in ascites suspected cases, total 91 were found affected. A thorough evaluation was conducted on all the dogs for various clinical signs. In most cases, the prominent clinical signs were abdominal distension, abnormal heart sound, and lethargy. History of no deworming was noticeable feedback from dog owners. Year wise prevalence of ascites was noted as 1.12% (2017), 1.12% (2018), 1.38% (2019) and 3.25% (2020) irrespective of etiologies. An increasing trend of ascites cases was observed over the years under evaluation. Female dogs were found more prone to ascites condition. Higher prevalence was observed in dogs one to the 5-year age group. Maximum numbers were reported from non-descript breed (n=19), labrador (n=13) and German shepherd (n=10). Anechoic fluid and fibrin in the abdominal cavity were consistent findings in most cases during ultrasonographic evaluation. Ascites can be prevented by regular deworming and by diet management.
... Umumnya asites ditandai dengan adanya distensi abdomen yang disebabkan karena adanya akumulasi cairan. Tanda klinis ini dilaporkan berkaitan dengan penyakit hati kronis, gagal jantung kongestif, sindrom nefritik, malnutrisi, ancilostomiasis, dan rendahnya kadar protein darah khususnya albumin (Regmi dan Shah, 2017), berbagai tipe dari neoplasma (Dabas et al., 2011;Srinivas et al., 2020) serta peningkatan retensi ion natrium-sodium ginjal (Saravanan et al., 2014). Singh et al. (2019) menyatakan bahwa asites dapat terjadi pada hipertensi portal, hipoalbuminemia, dan retensi ginjal terhadap natrium dan air. ...
Article
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Feline infectious peritonitis merupakan infeksi virus pada kucing dengan tanda klinis terjadi asites pada bentuk efusif. Asites merupakan bentuk umum keadaan sistemik yang ditandai dengan adanya distensi abdomen yang disebabkan karena adanya akumulasi cairan. Seekor kucing lokal berumur 1 (satu) tahun dengan bobot badan 4 kg bernama Minmin datang ke Rumah Sakit Hewan Pendidikan Universitas Udayana dengan keluhan terjadi penurunan nafsu makan, lemas, susah defekasi dan rongga abdomen membesar. Pada pemeriksaan fisik diketahui adanya distensi abdomen. Untuk peneguhan diagnosis dilakukan pemeriksaan ultrasonografi, rontgen, dan abdominocentesis dan diperoleh hasil bahwa terjadi akumulasi cairan pada rongga abdomen, hepatomegali, dan nefritis. Dilakukan pemeriksaan hematologi rutin dan biokimia darah yang menunjukkan adanya peradangan kronis dan abnormalitas fungsi ginjal. Hasil uji rivalta menunjukkan hasil positif akumulasi eksudat yang ditandai dengan bentukan jellyfish like. Terapi yang diberikan berupa pemberian diuretik furosemide 10 mg/ml injeksi intravena dengan jumlah pemberian 0,45 ml (2 x sehari), hepatoprotektor ornipural injeksi subkutan dengan jumlah pemberian 2 ml (setiap 2 hari sekali), nefroprotektor ketosteril per oral dengan jumlah pemberian ½ tablet (setiap 2 hari sekali), antibiotik cefotaxim sodium 1g/ml injeksi intravena dengan jumlah pemberian 1,3 ml (2 x sehari), antiradang dexamethasone 5mg/ml injeksi subkutan dengan jumlah 0,4ml (2 x sehari), dan transfer factor 1 x 1 tablet selama 7 hari. Pengobatan yang diberikan memberikan hasil yang baik terhadap penurunan derajat distensi abdomen.
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A ten month old Alsatian bitch presented with complaint of recurring ascites over a period of three months and had ‘been refractory to diuretic therapy. The condition was diagnosed as liver cirrhosis by serum chemistry, exploratory laparotorny and histopathology of the liver. Result of the serum chemistry showed a progressively decreasing serum albumin and liver, enzymes. Similarly the Albumin /Globulin (A:G) ratio was progressively decreasing. Haematological findings were that of anaemia of chornic disorder (mild normocytic, normochromic, non responsive). The PCV, HB and RBC also decreased progressively.Exploratory laparotomy findings were that of a slightly enlarged liver with diffuse miliary nodules on .both the parietal and visceral surfaces. Few larger nodules ‘were also present. ‘The liver was firmer inconsistency and two separate masses of fibrinous tissue measuring about 5 cm in length and 2cm in thickness were seen floating in the abdominal transudate. The transudate which measured about 15 litreswas colourless and slightly cloudy. The bitch was euthanised following laparotomy and on the owners request due to the non-responsiveness of the animal to diuretic and other supportive therapies.
Book
The 6th edition of a well-known and much used standard text in the field. This book covers all aspects of the biochemical abnormalities caused by various diseases and how they relate to the biochemical changes in the blood, urine, cerebrospinal fluid, joint fluids, other body fluids and in cells. The purpose is to provide the fundamental bases for understanding the biochemical changes which occur in disease processes and in turn to provide the rationale for applying this understandig to the diagnosis of the disease process. A substantial appendix is provided so that the user can quickly identify the reference ranges for a large number of animal species. Every veterinary school or college in the USA and throughout the world has a department or section which teaches and provides a clinical laboratory service to their in-house and out-patients. Private veterinary laboratories also provide this service to clients and patients. Every major pharmaceutical house has a group which studies animals in the course of their drug safety studies. New and developing studies include the deleterious effects of environmental toxicants to include wildlife and fishes. * An appendix is provided in the book so that the user can quickly identify the reference ranges for a large number of animal species.
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This chapter describes the biochemical mechanisms responsible for the cardinal clinical manifestations of hepatic insufficiency. The chapter also describes biochemical tests used in the clinical diagnosis of liver disease and to assess hepatic function. The liver plays an essential role in: nutrient metabolism, including the control and maintenance of the blood glucose level; detoxification and excretion of hydrophobic metabolites and xenobiotics; synthesis of most plasma proteins; and in digestion through synthesis, biliary secretion, and conservation of bile acids that are essential both for digestion and intestinal absorption of fats and other lipids including fat-soluble vitamins. The clinical manifestations of hepatic disease are directly attributable to alterations in the metabolic, excretory, synthetic, and digestive functions of the liver. Conventional tests for hepatic disease provide information about the integrity of the hepatocytes and the status of the biliary system. Hepatic function can be assessed by estimating the excretory capacity and synthetic functions of the liver. This chapter explains in detail the functional anatomy of liver. The chapter also elaborates clinical manifestations of hepatic insufficiency and laboratory assessment of hepatic function.
Article
Aim The classification of ascites into 'transudative' and 'exudative' has recently been challenged. The present study was aimed to differentiate ascites on the basis of serum/ascites albumin gradient, a proposed biochemical criteria for differential diagnosis of ascites and also to compare its diagnostic accuracy with the traditional marker : ascitic fluid total proteins, classifying ascitic fluid into transudate and exudate. Material & method Paired ascitic fluid and serum samples from 100 patients were examined with an established method for the diagnosis of cause of ascites. The present study included 76 patients having ascites related to portal hypertension (cirrhosis -54, cardiac -10, secondary bacterial peritonitis -6, liver metastasis -6), and 24 patients of tubercular ascites not related to portal hypertension. Results The diagnostic accuracy of SAAG and AFTP were 96% and 68% respectively. Conclusion Differential diagnosis of ascites should be based on the serum/ascites albumin gradient which is a better distinguishing marker for separating ascites related to portal hypertension from all other causes of ascitic fluid collection, irrespective of infection.
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PERITONITIS is localised or diffuse inflammation of the peritoneal cavity and is most commonly associated with bacterial contamination from the gastrointestinal tract. Mortality associated with this condition is high, and rapid diagnosis and early surgical and/or medical intervention is essential to optimise the outcome. This article describes the diagnostic tests, and various medical and surgical options available for the treatment of peritonitis in small animals, with emphasis on the management of bacterial (septic) peritonitis and uroperitoneum (urine peritonitis). In addition, it discusses the factors that influence the prognosis and outcome of affected cases.