Weโre back! Thanks for sticking around while I took a week off 
Todayโs path rounds are on ๐๐ข๐ซ๐ซ๐ก๐จ๐ฌ๐ข๐ฌ!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐ข๐ซ๐ซ๐ก๐จ๐ฌ๐ข๐ฌ is the specific term for excessive fibrosis (scar tissue) in the liver, with production of lots of nodules of regenerated liver tissue.
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Technically any species can get this, however this specific healing response is most often seen in dogs.
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
There isnโt one specific cause of cirrhosis, as it is often the end result of severe liver disease. Basically, the liver disease causes some degree of inflammation in the liver, which it tries to heal by producing scar tissue. The remaining liver tissue tries to regenerate itself to maintain liver function, producing little islands of liver tissue in between the large bands of scar tissue. This produces the characteristic nodules that we see grossly!
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
When a liver becomes cirrhotic it already has some underlying disease, so that is a problem in itself. However, the liverโs attempts to heal itself through cirrhosis add additional problems: namely that all of the scar tissue prevents proper blood flow through the liver. This means that the regenerated nodules may not get appropriate nutrients, causing the cells to die and produce more fibrosis. This produces a vicious cycle that ultimately leads to an extremely lumpy liver, and liver failure.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
These animals typically present with the classic signs of liver failure, such as ๐๐ฌ๐๐ข๐ญ๐๐ฌ (excessive fluid in the abdomen). This fluid can be identified on ultrasound or X-ray, and will encourage the veterinarian to do bloodwork to look at liver enzymes. From there, the diagnosis of liver failure can be made. Often, the nodular appearance of the liver can be seen on ultrasound as well, confirming that cirrhosis is occurring.
๐๐จ๐ฐ ๐ข๐ฌ ๐ญ๐ซ๐๐๐ญ๐๐?
Unfortunately there arenโt many treatments available once an animal has reached this severe stage of liver failure. Supportive treatments can be implemented to make the animals more comfortable, but ultimately these animals are often euthanized.
๐๐ก๐จ๐ญ๐จ๐ฌ
1-5) Various examples of lumpy cirrhotic livers at necropsy.
6) A close up of some nodules!
7) The appearance of the nodules on ๐ก๐ข๐ฌ๐ญ๐จ๐ฉ๐๐ญ๐ก๐จ๐ฅ๐จ๐ ๐ฒ (looking at tissue under a microscope). The more pink nodules are the regenerative tissue, with large bands of pale scar tissue between them. Neat!
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Photos 1-3 courtesy of University of Calgary Faculty of Veterinary Medicine Diagnostic Services Unit.
Photos 4-7 courtesy of Noahโs Arkive.
