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Cholestasis - Coggle Diagram

- - - - obstructive
        
        def: compression of canaliculi w/in "meat" of liver leads to impaired bile flow
        
        something w/in tis, parenchyma that causes compression of tiny tubes in hepatocytes that impair bile flow
        
        how can bile canaliculi become compressed?
        
        neoplasia
        
        hepatic/biliary in origin or infiltrative
        
        hepatocellu carcinoma
        
        lymphoma
        
        space occupying mass or hepatocyte swelling
        
        metab
        
        excess glycogen
        
        inc w endocrinopathies or gen liver disorders
        
        lipid depos - hepatic lipidosis in cats
        
        causes hepatocytes to swell and pinch canaliculi
        
        alt lipid metab in gen
        
        inflamm/infec
        
        mech
        
        sm stones
      - func
        
        def: alt/impaired excre of bile acids into bile = reduce bile flow
        
        or no obstruction???
        
        how can reduc of bile acids occur (to reduc bile flow)
        
        infec
        
        sepsis
        
        lepto
        
        endotoxemia
    - - pathology is liver centric = more likely to damage hepatocytes
  - - - bile flow cannot get out of the liver due to obstruction in bile ducts distal to liver or gb
        
        Ex
        
        mech
        
        gall stones
        
        sludging
        
        mucocele
        
        biliary - dried bile that builds up in gb = ball of mucus and nothing can leave
        
        predispose to rupture
        
        bile not always sterile and can leak into abd
        
        gb looks like a kiwi on US
        
        neoplastic space occupying mass/tumor round bile duct, intes, or pancreas
        
        inflamm - not super common
        
        horse w GIT inflamm can impair flow of bile
        
        horse does not have gb!
        
        pancreatic pathology
        
        portal circ drains inflamm mediators (endotoxins) from intes and pancreas w delivery to liver for filtration
        
        mediators cause inflamm changes
        
        see mild inc in liver enz via damage or cholestasis (but not involving liver directly)
        
        intes pathology
        
        swelling/torsion
        
        obstruct common bile duct due to their proximity
        
        bowel dz
        
        obstruct common bile duct due to their proximity
- - - - why?
        
        bile is hanging around
    - - endocrinopathies
      - other reason for inc
      - endog stress
      - steroids
    - - not elim them approp
  - - - not always inc
    - - dogs dev elev in urin bili before blood