Page 483 - Problem-Based Feline Medicine

22 – THE CAT WITH ABDOMINAL DISTENTION OR ABDOMINAL FLUID 475

PORTAL VEIN ATRESIA OR HYPOPLASIA HEPATIC AMYLOIDOSIS

Classical signs Classical signs
● Ascites. ● Lethargy, anorexia, weight loss, anemia,
● Hepatic encephalopathy. hepatomegaly.

Clinical signs Clinical signs

An underdeveloped portal venous system causes Amyloidosis is a systemic disease with deposition of
ascites from pre-sinusoidal portal hypertension in a amyloid protein AA in numerous tissues including the
young animal. Other signs could include hepatic liver.
encephalopathy, poor weight gain, reduced appetite ● In most cases, including familial amyloidosis in
and dyspnea secondary to ascites. Abyssinian cats, renal failure from renal amyloi-
dosis dominates the clinical presentation.
Nephrotic syndrome causing ascites is rare because
Diagnosis amyloid affects primarily the renal medulla.
Rare. ● In some cases, including as a familial disease in
some lines of Siamese cats and Oriental short-
Elevated serum bile acids. hair cats, amyloid deposition in the liver is clini-

Abdominal ultrasound examination will confirm peri- cally most important.
toneal fluid and a small liver. – Signs are mostly due to chronic liver disease
(lethargy, anorexia, weight loss), or acute hemor-
Abdominocentesis reveals a transudate. rhage (anemia, hemoperitoneum) resulting from

Angiography or exploratory laparatomy may be used to spontaneous hepatic rupture. Signs of liver failure
confirm the diagnosis. (icterus, hepatic encephalopathy) are not common.
– Abdominal distention may occur due to
hepatomegaly, splenomegaly, intestinal dila-
LIGATION OF PORTOSYSTEMIC SHUNT tion and hemoperitoneum.

Classical signs Diagnosis

● Ascites. Liver enzymes are normal to variably elevated.
Liver biopsy will demonstrate amyloid. If amyloidosis is
Clinical signs suspected, biopsy of the intestinal tract may be consid-
ered to demonstrate amyloid deposition because there is
Ligation of a portosystemic shunt may cause ascites an increased risk of hemorrhage from liver biopsy.
from pre-sinusoidal portal hypertension.
HEPATIC NECROSIS
Diagnosis

Common for 2 days following surgical ligation of a Classical signs
portosystemic shunt. Ascites is less likely to occur with
● Acute depression and anorexia.
an ameroid constrictor or cellophane banding.
Abdominal ultrasound examination will confirm peri-
toneal fluid. Clinical signs
Abdominocentesis reveals a transudate to modified Hepatic necrosis may result from a wide variety of
transudate. mechanisms (e.g. tissue hypoxia, free radical forma-