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Icterus Immunodeficiency Syndromes: Acquired 1243

Icterus
VetBooks.ir Icterus Prehepatic Hepatic Posthepatic

Mechanism Hemolysis Hepatocellular dysfunction Biliary obstruction (intra- or Biliary rupture
extrahepatic)
Examples IMHA—Primary or secondary Inflammatory liver disease (e.g., chronic Mucocele Trauma
(e.g., RBC parasites, neonatal hepatitis) Cholelith Complication of biliary
isoerythrolysis, neoplasia) Infection (e.g., leptospirosis, Cholangitis obstruction (e.g.,
Hemolytic toxins (e.g., Zn, histoplasmosis, ICH, FIP) Hepatic lipidosis* mucocele)
acetaminophen) Toxins/drugs (e.g., sago palm, Pancreatitis
Fragmentation (e.g., caudal caval blue-green algae, phenobarbital) Biliary neoplasia
syndrome, splenic torsion) Neoplasia Duodenal infiltrative disease
Hereditary disorders (e.g., PK Hereditary and breed-related disorders
or PFK deficiency, osmotic (e.g., copper hepatopathy)
fragility) Cirrhosis
Sepsis*
Key laboratory findings Marked anemia; ± ALT↑> ALP↑; ± cholesterol ↓; ± ALP↑>ALT↑; cholesterol Abdominal effusion
hemoglobinemia, albumin, BUN, glucose ↓; leukon ↑; GGT↑ (exception: supportive of bile
hemoglobinuria; RBC variable; ± ammonia ↑ hepatic lipidosis); leukon peritonitis; ALP↑>ALT↑;
morphology aberrations variable GGT↑; inflammatory
common leukogram
Bile acids Normal Not useful Not useful Not useful
Key imaging findings Spleen may be enlarged Liver size may be small, normal, US evidence of GB disease Abdominal fluid (US may
or enlarged/mass; ± altered or bile duct obstruction be required to identify
echogenicity on US small volume effusion);
gallbladder rupture may Differentials, Lists, and Mnemonics
or may not be identified
on US
*Multiple mechanisms for icterus may be involved.
ALP, Alkaline phosphatase; ALT, alanine aminotransferase; BUN, blood urea nitrogen; FIP, feline infectious peritonitis; ICH, infectious canine hepatitis; IMHA, immune-mediated hemolytic anemia; PK, pyruvate
kinase; PFK, phosphofructokinase; RBC, red blood cell; US, ultrasound; Zn, zinc.

Ileus Immunodeficiency Syndromes: Acquired

Functional Drugs
Abdominal surgery Antineoplastics
Ischemia Glucocorticoids
Irritable bowel syndrome (diarrhea is more likely) Other immunosuppressive agents (e.g., azathioprine, cyclosporine)
Pancreatitis Malnutrition
Inflammatory Intestinal parasitism
Fulminant bacterial enteritis Inflammatory bowel disease
Parvovirus Protein-calorie deficiency
Peritonitis Vitamin D deficiency
Obesity
Metabolic Infections
Diabetes mellitus Viral infection (FeLV, FIV, FIP, CDV, parvovirus)
Endotoxemia Rickettsial infections
Hypokalemia Leishmaniasis
Uremia Endocrine Disease
Neuromuscular Hyperadrenocorticism
Anticholinergic drugs Diabetes mellitus
Opioid drugs Neoplasia
Dysautonomia Miscellaneous
Spinal cord injury Neonatal colostrum deprivation
Visceral myopathy
Visceral neuropathy CDV, Canine distemper virus; FeLV, feline leukemia virus; FIP, feline infectious peritonitis; FIV, feline
immunodeficiency virus.
Physical Modified from Bonagura J: Kirk’s Current veterinary therapy XIII, St. Louis, 2000, Saunders.
Intestinal obstruction
Foreign body
Intussusception
Masses—neoplasia, granuloma
Mechanical—torsion, volvulus, incarceration in hernia, adhesions
Overdistention by aerophagia
From Ettinger S, Feldman E: Textbook of veterinary internal medicine, ed 7, St. Louis, 2010, Saunders.

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