ISSN 2398-2969      

Liver: lipidosis

icanis

Synonym(s): Hepatic lipidosis


Introduction

  • Signs: usually mild, often asymptomatic. May result in hepatic failure if widespread.
  • Cause: primary (idiopathic) or secondary to underlying diseases such as diabetes mellitus, hypothyroidism, pancreatitis, starvation, idiopathic hyperlipidemia in Schnauzer dogs.
  • Diagnosis: biopsy.
  • Prognosis: usually not clinically significant - reversible if underlying disease controlled.

Pathogenesis

Etiology

Predisposing factors

General
  • Underlying diseases as above.
  • Starvation.

Specific

  • Dietary deficiency in nutrients important in lipoprotein synthesis:
    • Arginine, choline, methionine and carnitine: critical to mitochondrial function in processing fatty acids.

Pathophysiology

  • Use of fat regulated by complex interactions between blood glucose concentration and hormonal nutritional and neural factors.
  • Prolonged starvation: heightened mobilization of fatty acids from fat stores and reduced synthesis of lipid-transporting proteins → increased hepatic deposition of triglycerides.
  • Protracted anorexia in toy breed puppies → inadequate gluconeogenesis, hypoglycemia, ketogenesis associated with hypoinsulinemia and hyperglucagonemia, and diffuse microvesicular hepatic lipidosis.
  • Poorly balanced diet, especially if markedly deficient in protein, can → similar effects due to altered lipoprotein synthesis and consequent disturbed dispersal of VDLs from liver.
  • Mobilization of fat stores → infiltration of hepatocytes → fat vacuoles in hepatocytes.

Timecourse

  • Usually insidious but may be acute (<2 weeks) or chronic (weeks to months) depending on underlying cause.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Ibrahim W H (2003) Effects of carnitine and taurine on fatty acid metabolism and lipid accumulation in the liver of cats during weight gain and weight loss. Am J Vet Res 64 (10), 1265-1277 PubMed.
  • Center S A (1999) Chronic liver disease - current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.
  • Marks S L et al (1994) Nutritional support in hepatic disease - Part II. Dietary management of common liver disorders in dogs and cats. Comp Cont Ed Pract Vet 16 (10), 1287-1295 VetMedResource.

Other sources of information

  • Watson P J (2005)diseases of the liver.In:BSAVA Manual of Canine and Feline Gastroenterology. 2nd edn. Eds: E J Hall, J W Simpson & D A Williams. BSAVA publications. pp 240-268.
  • Cornelius L M (2000)CVT update: Therapy for Hepatic Lipidosis.In:Kirk's Current Veterinary Therapy. XIII edn. ED: J D Bonagura. W B Saunders, Philadelphia, USA. pp 686-690.

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