CLINICAL APPROACH TO LIVER DISEASE GASTROENTEROLOGY

摘要

The clinician is frequently presented with patients that have abnormal liver enzymes identified on the routine biochemical profile. The question often asked when these findings occur is “does this animal have primary liver disease” ? The answer to this question is in most cases is usually no. Most animals with abnormal liver enzymes have secondary hepatic involvement that is the result of an extrahepatic event. The clinician must therefore first evaluate the entire patient when encountering the animal with abnormal enzymes to exclude the possibility of a secondary reactive or degenerative hepatopathy. In another words the liver is frequently an innocent by-stander being insulted by a primary non-hepatic disease. Additionally a second important principle is that the liver has a great reserve capacity and clinical signs of liver disease often do not appear until the disease is quite advanced.