July • 2000   LIVER DISEASE POTPOURRI CONT'D   Reactive Hepatopathy   The liver often exhibits a variety of non-specific changes in reaction to disease elsewhere in the body (reactive hepatopathy). Typically find mild to moderate (2–3 fold), increases in serum ALT (SGPT) and alkaline phosphatase. Bile acids are usually normal. Can be difficult to distinguish from primary liver disease, even with good quality hepatic biopsies. Cannot distinguish with fine needle aspiration cytology.   Nodular Hyperplasia   A common finding in dogs older than 6 years. Alkaline phosphatase elevation is usually of mild to moderate degree with minimal elevation in ALT (SGPT). Bile acids are generally normal, unless hyperplasia is severe (can be elevated to 50–80 µmol/L). Accurate diagnosis is dependent on quality and site of biopsy samples. The histology can resemble chronic progressive hepatitis depending on where biopsy was obtained. FNA cytology does not enable diagnosis of nodular hyperplasia.   Vacuolar Hepatopathy   Vacuolar hepatopathy is most often thought of as a consequence of Cushing’s syndrome, hepatic lipidosis, or corticosteroid exposure. However, vacuolar hepatic change can be seen as a component of a variety of liver diseases including reactive hepatopathy, nodular hyperplasia, toxin exposure and primary inflammatory liver disease. Vacuolar hepatopathy is often idiopathic. Idiopathic vacuolar hepatopathy is typically seen in asymptomatic dogs with significantly elevated alkaline phosphatase These dogs do not have Cushing's syndrome. Increases in adrenal sex hormones (androgens or cortisol precursor hormones) have been reported and may be responsible for the vacuolar hepatopathy.       Please send comments to the webmaster. ©1997-2008 Antech Diagnostics, Inc. Site design and maintenance by amesDesign.