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Hematology in Hepatic Disease in Small Animals


Sharon A. Center

, BS, DVM, DACVIM, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University

Last full review/revision May 2015 | Content last modified Jun 2016

Depending on the severity and underlying cause of liver disease, a nonregenerative or regenerative anemia may develop. Severe or acute anemia can impact the liver as a result of hypoxia, causing alterations in hepatocyte membranes, leading to release of transaminases and induction of ALP. Altered RBC morphology (poikilocytes, irregularly irregular RBCs) is common in cats with cholangiohepatitis and hepatic lipidosis (HL). Cats with HL, severe cholangiohepatitis, and EHBDO also may develop Heinz bodies, reflecting oxidative injury that may lead to hemolysis. Severe hypophosphatemia in HL may develop secondary to a re-feeding syndrome and cause hemolysis severe enough to require a blood transfusion; this can be avoided by providing fluid therapy supplemented with potassium phosphate when nutritional support is implemented. In dogs with diffuse necroinflammatory liver disease (altered sinusoidal perfusion), RBCs with microvascular shearing (eg, schistocytes, acanthocytes) may be seen. RBC microcytosis is common in congenital or acquired portosystemic shunting, although the pathologic mechanism remains unclear.

Change in WBC count or distribution are variable. Leukocytosis may reflect inflammatory, infectious, necrolytic, or diffuse infiltrative hepatic disorders, or release of endogenous glucocorticoids or administration of glucocorticoids. Leukopenia can reflect sepsis or toxicosis. In severe diffuse necroinflammatory liver injury, damaged sinusoidal microvasculature can provoke platelet aggregation, contributing to thrombocytopenia and disseminated intravascular coagulation.

Hepatic Disease in Small Animals
Overview of Hepatic Disease in Small Animals
Hematology in Hepatic Disease in Small Animals
Coagulation Tests in Hepatic Disease in Small Animals
Enzyme Activity in Hepatic Disease in Small Animals
Other Serum Biochemical Measures in Hepatic Disease in Small Animals
Hepatic Function Tests in Small Animals
Imaging in Hepatic Disease in Small Animals
Cholecystocentesis in Hepatic Disease in Small Animals
Liver Cytology in Small Animals
Liver Biopsy in Small Animals
Pathologic Changes in Bile in Small Animals
Nutrition in Hepatic Disease in Small Animals
Fulminant Hepatic Failure in Small Animals
Hepatic Encephalopathy in Small Animals
Portal Hypertension and Ascites in Small Animals
Portosystemic Vascular Malformations in Small Animals
Acquired Portosystemic Shunts in Small Animals
Other Hepatic Vascular Disorders in Small Animals
Hepatotoxins in Small Animals
Infectious Diseases of the Liver in Small Animals
Feline Hepatic Lipidosis
Biliary Cirrhosis in Small Animals
Canine Cholangiohepatitis
Canine Chronic Hepatitis
Lobular Dissecting Hepatitis in Small Animals
Canine Vacuolar Hepatopathy
Metabolic Diseases Affecting the Liver in Small Animals
Hepatocutaneous Syndrome in Small Animals
Nodular Hyperplasia in Small Animals
Hepatic Neoplasia in Small Animals
Miscellaneous Liver Diseases in Small Animals
Diseases of the Gallbladder and Extrahepatic Biliary System in Small Animals
Cholecystitis in Small Animals
Canine Gallbladder Mucocele
Other Disorders of the Gallbladder in Small Animals
Other Disorders of the Bile Ducts in Small Animals
Extrahepatic Bile Duct Obstruction in Small Animals
Cholelithiasis in Small Animals
Biliary Tree Rupture and Bile Peritonitis in Small Animals
Feline Cholangitis/Cholangiohepatitis Syndrome
Hepatobiliary Fluke Infection in Small Animals
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