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Francevet Treating Liver Disease Without Videos
- 1. Treating Liver Disease (in 30 minutes!) Craig B Webb, PhD, DVM, DACVIM Professor & Head Small Animal Medicine Section Colorado State University Veterinary Teaching Hospital
- 2. Disclosure #2: I think Nutramax Labs is a Great Company!
- 3. Medical Management of Congenital Portosystemic Shunts “Sophie” 1 yo FS Chihuahua “Jack” 8 mo MC Domestic short hair
- 4. Emergent Treatment of Seizures IV Fluids with Dextrose Warm Water Enema with Lactulose Diazepam (Phenobarbitol or KBromide if necessary) Levetiracetam to reduce post-op seizures (20 mg/kg TID at least 24 hrs pre-op)
- 5. PSS Medical Treatment •Lactulose •Acidify the colon, cathartic •Drives Ammonia to Ammonium (not absorbed) •0.25-0.5 ml/kg, 3-4x/day, to effect Lactic Acid
- 6. PSS Medical Treatment •Lactulose •Acidify the colon, cathartic •Reduces Ammonia production & absorption •0.25-0.5 ml/kg, 3-4x/day, to effect Lactic Acid
- 7. PSS Medical Treatment •Diet •Protein Restriction IF Hepatic Encephalopathy • 11% Dry Matter basis •Hepatic Diets for Non-HE Liver dogs 17.8% DM [Cu] 4.6 ppm 14% DM [Cu] 7 ppm 19% DM [Cu] 4.9 ppm
- 8. PSS Medical Treatment •Diet •Protein for a Growing Puppy (20-25% DM) •Add cottage cheese or vegetable-based protein 17.8% DM [Cu] 4.6 ppm 14% DM [Cu] 7 ppm 19% DM [Cu] 4.9 ppm
- 9. PSS Medical Treatment •Diet •Vitamin Supplementation •Water soluble: B1 (thiamine – cats!) •Fat soluble: K (clotting) & vitamin E (oxidative stress) •Fiber •SCFA = acidification = NH3 to NH4+ •Antioxidants •More to come
- 10. PSS Medical Treatment •Microbiota •Lactic acid producing bacteria •Metabolism of fiber to SCFA •Decrease pH, Decrease [Ammonia]
- 11. Treating Feline Cholangitis Neutrophilic Acute or Chronic “Grumpy” 8 yo MC Domestic short hair Anorexia, vomiting, ptyalism Febrile, jaundice
- 12. Treating Feline Cholangitis Neutrophilic Acute (or Chronic) Non-Specific & Supportive Fluids, Electrolytes, Nutrition, Pain Vit K1 {0.5-1.5 mg SQ, q 12 h (2-3 doses)}
- 14. Empirically Cover the Enterics Ampicillin or Clavimox Metronidzole or Pradofloxacin 2 months +/-
- 15. Empirically IF Chronic or IF antibiotic failure add Prednisolone 1 mg/kg BID for 2 weeks; 1 mg/kg SID for 2 weeks; 0.5 mg/kg SID for 2 weeks; 0.5 mg/kg q48hr
- 16. Treating K9 Hepatopathies [Cu] - associated Hepatitis “Bella” 8 yo FS Labrador Ret Anorexia, lethargy, vomiting Weight-loss, jaundice
- 17. Avoid Copper in Diet, Treats, Supplements Do not restrict protein unless HE BalanceIT.com
- 21. Chelate the Copper •[Cu] > 600 µg/g - 1000 µg/g dry weight •Penicillamine on an empty stomach •2-6 months •Problem: Penicillamine on an empty stomach •Hyporexia, nausea, vomiting
- 22. How to Help Stop the Vomiting Decrease Nausea Increase Appetite
- 23. Treating K9 Hepatopathies K9 (Immune) Chronic Hepatitis 1-2 mg/kg day Taper Steroid hepatopathy Hard to monitor 5 mg/kg BID Without steroids Vomiting Monitor Enzymes
- 24. Treating Any Liver Disease Support the Liver “Drain the Swamp” Ursodiol Choleretic Hepatoprotective Biliary cirrhosis Denamarin Antioxidant SAMe + Silybin
- 26. Dr. Twedt – Before Vit E
- 27. Dr. Twedt – After Vit E
- 28. Treating Feline Hepatic Lipidosis Center S. Vet Clin NA Sm Anim Pract 2005 Vit K (for Procedures) Vit E B-soluble vitamins Thiamine Vit B12 L-Carnitine SAMe
- 29. RedRubber&CurvedCarmalts Empower the Owner with Easy Access VIDEO #1 will be here
- 30. www.milainternational.com Video #2 will be here
- 32. THANK YOU! Serge Martinod Directeur Scientifique, Dr. Vétérinaire, Arcanatura SAS