ДІАГНОСТИКА ЗАХВОРЮВАНЬ ПЕЧІНКИ У ТВАРИН: СУЧАСНІ МЕТОДИ ТА ПЕРСПЕКТИВИ
DOI:
https://doi.org/10.37000/abbsl.2025.117.04Ключові слова:
печінка, захворювання печінки, діагностика, печінкові ферменти, ультразвукове дослідження, комп’ютерна томографія, магнітно-резонансна томографія, калістатин, вітамін D, тварини.Анотація
Діагностика захворювань печінки у тварин є складним та багатофакторним процесом через різноманіття клінічних проявів та потенційних причин ураження цього органу. Симптоми захворювань печінки часто є неспецифічними, можуть перекриватися із проявами інших патологій і, у деяких випадках, бути відсутніми, тоді як ураження печінки вже прогресує. Етіологія захворювань печінки включає інфекційні, генетичні, аутоімунні та метаболічні причини, що значно ускладнює діагностику та потребує комплексного підходу.
Основу діагностики складають первинне обстеження та фізикальний огляд тварини, під час яких оцінюють наявність клінічних ознак: слабкості, втоми, набряку живота, болю, нудоти та інших порушень. Для підтвердження діагнозу використовують лабораторні методи (аналізи крові, дослідження печінкових ферментів, оцінку білкового, ліпідного та вуглеводного обміну, аналіз сечі на білірубін) та інструментальні методи: рентгенографію черевної порожнини, ультразвукове дослідження, комп’ютерну томографію, магнітно-резонансну томографію та ядерну сцинтиграфію. Особлива увага приділяється оцінці рівня калістатину та вітаміну D, що дозволяє більш точно визначити функціональний стан печінки.
У даному огляді систематизовано сучасні підходи до діагностики печінкових захворювань у тварин, розглянуто переваги та обмеження рутинних та спеціалізованих методів дослідження, а також наведено перспективні напрямки підвищення точності діагностики.
Посилання
Guyton, A. C., & Hall, J. E. (2016). Textbook of Medical Physiology. 13th ed. Philadelphia: Elsevier.
Gärtner, L. P., & Hiatt, J. L. (2018). Color Textbook of Histology. 4th ed. Elsevier.
McGavin, M. D., & Zachary, J. F. (2017). Pathologic Basis of Veterinary Disease. 6th ed. Elsevier.
Bondarenko, A. T. (2020). Biochemical mechanisms of liver damage in animal toxicoses. Veterinary Medicine Bulletin, 106(2), 45–51.
Dubrovin, V. I. (2019). Pathophysiology of the liver in dogs with hepatitis. Scientific Bulletin of S. Z. Gzhytskyi National University of Veterinary Medicine and Biotechnologies, 21(95), 98–103.
Cullen, J. M. (2017). Histopathology of the Liver of Domestic Animals. Wiley-Blackwell.
Meyer, D. J., & Harvey, J. W. (2021). Veterinary Laboratory Medicine: Interpretation and Diagnosis. 6th ed. Elsevier.
Center, S. A. (2018). Interpretation of Liver Enzymes. The Veterinary Clinics of North America: Small Animal Practice, 48(1), 15–33.
Kovalenko, V. P., & Savchuk, O. I. (2021). Clinical and biochemical assessment of liver function in dogs. Veterinary Biochemistry, 7(1), 24–30.
Gorelova, T. M. (2022). Biochemical indicators in chronic hepatitis in cats. Scientific and Technical Bulletin of the Institute of Animal Biology of NAAS, 3, 57–61.
Washabau, R. J., & Day, M. J. (2012). Canine and Feline Gastroenterology. Elsevier Saunders.
Twedt, D. C. (2020). Liver and Biliary Tract. In: Ettinger S. J., Feldman E. C. (Eds.) Textbook of Veterinary Internal Medicine.
Kumar A, Kumar N, Anamika, Satya. Significance of hepatic enzymes: A review. Int J Adv Biochem Res 2023;7(1 B):95-100. DOI:10.33545/26174693.2023.v7.i1b.170.
Biochemical and Hematological Indexes of Liver Dysfunction in Horses. J Eq Vet Sci. 2023;126:104294.
Hepatic Enzyme Profile in Horses. Animals (Basel) 2022;12(7):861. MDPI
Laboratory evaluation of the hepatobiliary system. Vet Clin Pathol. Review. 2017.
Kashliak N.O., Vlizlo V.V. Symptoms, biochemical indicators and general blood analysis for hepatopathy in dogs. Sci Messenger LNU Vet Med Biotechnol, Series: Vet Sciences. 2023
Oikonomidis IL, Milne E. Clinical enzymology of the dog and cat. Aust Vet J. 2023;101(9):e13291. DOI:10.1111/avj.13291.
Loan NVTH, Van Chao N, Thi Nhung T. Clinical features and hematological and biochemical blood parameters of dogs with hepatobiliary disorders. Vet World. 2025;18(4):23. DOI:10.14202/vetworld.2025.23
KD Assawarachan N, Ongvisespaibool T, Hakhen B, Chuchalermporn P, Thengchaisri N. Predictive Factors for Two-Year Survival in Dogs with Hepatobiliary Diseases. Animals (Basel). 2023;13(16):2677. DOI:10.3390/ani13162677.
Enzyme Activity in Hepatic Disease in Small Animals. MSD Vet Manual. 2023. [Online] Available.
Assawarachan SN, et al. A descriptive study of the histopathologic and biochemical abnormalities in dogs with liver disease. PLoS One. 2020;15(8):e0237500. DOI:10.1371/journal.pone.0237500.
Oikonomidis I.L., Milne E. Clinical enzymology of the dog and cat. Aust Vet J. 2023; 101(9): e13291. DOI: 10.1111/avj.13291
Loan N.V.T.H., Van Chao N., Thi Nhung T. Clinical features and biochemical blood parameters of dogs with hepatobiliary disorders. Vet World. 2025; 18(4): 23–29.
Assawarachan N., Ongvisespaibool T., Hakhen B., et al. Predictive factors for two-year survival in dogs with hepatobiliary diseases. Animals (Basel). 2023; 13(16): 2677. DOI: 10.3390/ani13162677
MSD Veterinary Manual. Enzyme Activity in Hepatic Disease in Small Animals. https://www.msdvetmanual.com.
Assawarachan S.N., et al. Histopathologic and biochemical abnormalities in dogs with liver disease. PLoS One. 2020; 15(8): DOI: 10.1371/journal.pone.0237500.
Bexfield, N., & Watson, P. (2021). Canine hepatopathies: Update on diagnosis and clinical interpretation of liver enzymes. Journal of Small Animal Practice, 62(7), 483–495.
Center, S. A. (2020). Interpretation of liver enzyme elevations in dogs and cats. Veterinary Clinics of North America: Small Animal Practice, 50(2), 317–333.
Honcharuk, O. V., & Kirichenko, V. V. (2022). Enzymatic indicators of liver functional status in dogs and cats with hepatobiliary system disorders. Veterinary Medicine Bulletin, 108(2), 44–51.
Tivers, M. S., & Brown, P. J. (2021). Diagnostic value of serum ALP and GGT in canine and feline cholestasis. Veterinary Record Open, 8(1), e12.
Stepanenko, I. M., & Dyachenko, S. P. (2023). Features of transaminase activity in dogs with chronic hepatitis. Scientific Bulletin of Veterinary Medicine, 26(3), 65–72.
Giannini, E. G., Testa, R., & Savarino, V. (2020). Liver enzyme alteration: a guide for clinicians. World Journal of Gastroenterology, 26(16), 1843–1860.
Watson, P. J. (2024). Advances in the diagnosis of hepatobiliary disease in small animals. Frontiers in Veterinary Science, 11, 1402339.
Derkach, N. O., & Tarasenko, R. M. (2021). Comparative characteristics of enzymatic markers of cholestasis in dogs and cats. Scientific Journal “Veterinary Biotechnology”, 38(1), 23–29.
Watson P.J. (2021). Liver function tests in small animal medicine: interpretation and clinical relevance. Veterinary Clinics of North America: Small Animal Practice, 51(1), 15–32.
Center S.A. (2022). Diagnostic approach to hepatobiliary disease in dogs and cats. Journal of Veterinary Internal Medicine, 36(5), 1625–1643.
Sevelius E., Karlstam E. (2023). Serum albumin concentration and hepatic function in canine hepatopathies. Veterinary Record, 192(2), e1295.
Gow A.G. et al. (2021). Hypoalbuminemia in dogs: differential diagnosis and prognostic significance. Journal of Small Animal Practice, 62(8), 661–671.
Allen D.G., Thamm D.H. (2024). Oncotic pressure and fluid balance in dogs with hypoalbuminemia. Veterinary Clinical Pathology, 53(3), 451–459.
Webster C.R.L. (2020). Hepatic failure and protein metabolism in dogs and cats. Veterinary Clinics of North America: Small Animal Practice, 50(2), 317–332.
Dirksen K., Fieten H. (2021). Coagulation disorders in hepatic disease of dogs and cats. Animals, 11(12), 3518.
Lee K.C., Choi J. (2022). Evaluation of coagulation parameters in dogs with congenital portosystemic shunts. Veterinary Science, 9(5), 207.
Lawrence Y.A. et al. (2023). Vitamin K deficiency and coagulopathy in cholestatic liver disease in cats. Journal of Feline Medicine and Surgery, 25(2), 115–124.
Villiers E.J., Tvedten H. (2024). PIVKA as a diagnostic marker of vitamin K deficiency in small animals. Veterinary Clinical Pathology, 53(1), 98–107.
Watson P.J. (2021). Liver function tests in small animal medicine: interpretation and clinical relevance. Veterinary Clinics of North America: Small Animal Practice, 51(1), 15–32.
Center S.A. (2022). Diagnostic approach to hepatobiliary disease in dogs and cats. Journal of Veterinary Internal Medicine, 36(5), 1625–1643.
Eckersall P.D., Bell R. (2019). Acute phase proteins: biomarkers of infection and inflammation in veterinary medicine. Veterinary Journal, 244, 86–92.
Webster C.R.L. (2020). Hepatic failure and protein metabolism in dogs and cats. Veterinary Clinics of North America: Small Animal Practice, 50(2), 317–332.
Dirksen K., Fieten H. (2021). Coagulation disorders in hepatic disease of dogs and cats. Animals, 11(12), 3518.
Tivers M.S., Watson P.J. (2022). Diagnostic utility of plasma ammonia in dogs with congenital portosystemic shunts. Journal of Small Animal Practice, 63(4), 223–230.
Center S.A., Harvey J.W. (2023). Hepatic encephalopathy: pathophysiology, diagnosis, and management. Veterinary Clinics of North America: Small Animal Practice, 53(1), 101–123.
Center S.A. (2022). Hepatic glucose metabolism in small animals: clinical relevance. Journal of Veterinary Internal Medicine, 36(2), 721–734.
Sevelius E., Karlstam E. (2023). Bile acid physiology and disorders in dogs and cats. Veterinary Record, 192(2), e1295.
Villiers E.J., Tvedten H. (2024). Enterohepatic circulation and bile acid metabolism in small animals. Veterinary Clinical Pathology, 53(1), 98–107.
Center S.A. (2022). Diagnostic evaluation of bile acids in dogs and cats. Journal of Veterinary Internal Medicine, 36(3), 1425–1438.
Lawrence Y.A. et al. (2023). Urinary bile acids as biomarkers of hepatobiliary disease. Journal of Feline Medicine and Surgery, 25(2), 115–124.
Gow A.G. et al. (2021). Hyperlipidemia and hepatic disease in dogs. Journal of Small Animal Practice, 62(8), 661–671.
Allen D.G., Thamm D.H. (2024). Hepatic enzyme alterations and lipid metabolism in small breed dogs. Veterinary Clinical Pathology, 53(3), 451–459.
Smith J., Brown P. Hepatic function in small animals: new perspectives. Vet Clin North Am Small Anim Pract. 2021;51(2):251–270.
61.
Jones D., et al. Bilirubin metabolism and disorders in dogs and cats. J Vet Intern Med. 2022;36(3):1045–1056.
Ivanov, V., & Petrenko, A. (2023). Liver failure in dogs and cats. Ukrainian Journal of Veterinary Medicine, 27(1), 15–28.
Center S.A., et al. Bile acids as indicators of hepatic disease in dogs and cats. Vet Clin Pathol. 2020;49(4):603–615.
Lecoindre P., et al. δ-Bilirubin in small animals: clinical relevance. Vet J. 2021;273:105679.
Smithson C., et al. Functional cholestasis and bilirubin kinetics in companion animals. Anim Health Res Rev. 2022;23(1):45–56.
Petrov V., et al. Clinical chemistry and biomarkers in hepatic disorders of dogs and cats. Vet Res Commun. 2020;44:241–258.
Center, S.A. Textbook of Veterinary Internal Medicine. 9th ed. St. Louis: Elsevier, 2021. 3200 p.
Tvedten, H. Small Animal Clinical Diagnosis by Laboratory Methods. 6th ed. Hoboken: Wiley-Blackwell, 2020. 560 p.
Washabau, R.J., Day, M.J., Schultze, A.E. Canine and Feline Gastroenterology. 4th ed. St. Louis: Elsevier, 2021. 1300 p.
Center, S.A., Biller, D.S. Hepatobiliary Disease in Dogs and Cats: Pathophysiology, Diagnosis, and Management. Vet Clin North Am Small Anim Pract. 2022;52(2):259–297. https://doi.org/10.1016/j.cvsm.2021.11.005
Webster, C.R.L. Liver Function Tests in Dogs and Cats. Vet Clin Small Anim. 2020;50(3):501–520. https://doi.org/10.1016/j.cvsm.2020.02.006
Center, S.A. Portal-Systemic Shunts in Dogs and Cats. Vet Clin North Am Small Anim Pract. 2021;51(5):1041–1068.
Center, S.A. Hematologic and Coagulation Changes in Hepatic Disease. Vet Clin North Am Small Anim Pract. 2020;50(2):247–266.
Turek, J.J., et al. Evaluation of Serum Bile Acids and Bilirubin in Canine and Feline Liver Disease. J Vet Intern Med. 2021;35(4):1721–1731. https://doi.org/10.1111/jvim.16195
Dossin, O., et al. Diagnostic Imaging of the Liver in Dogs and Cats. Vet Radiol Ultrasound. 2020;61(S1):S41–S60. https://doi.org/10.1111/vru.12869
Steiner, J.M., Williams, D.A. Hematology and Biochemical Changes Associated with Hepatobiliary Disease in Dogs and Cats. Clin Lab Med. 2022;42(2):225–246.
McCarthy, R., et al. Pathophysiology and Clinical Significance of Hyperbilirubinemia in Small Animals. Vet Clin Small Anim. 2020;50(5):1123–1140.
Center, S.A., et al. Disseminated Intravascular Coagulation Associated with Hepatic Disease in Dogs and Cats. J Vet Emerg Crit Care. 2021;31(5):512–525.
Tobias, K.M., Johnston, S.A. Veterinary Surgery: Small Animal. 2nd ed. St. Louis: Elsevier, 2020. 3200 p.
Watson, P., et al. Urate Nephrolithiasis and Portal-Systemic Shunts in Dogs. Vet Clin Small Anim. 2022;52(4):789–805.
Penninck, D.G., et al. Ultrasonographic Evaluation of the Liver and Biliary Tract in Dogs and Cats. Vet Radiol Ultrasound. 2020;61(3):297–315. https://doi.org/10.1111/vru.12840
Hall, J.A., et al. Laboratory and Clinical Markers of Hepatic Dysfunction in Small Animals. Vet Clin Small Anim. 2021;51(6):1301–1320.
Center, S.A. Textbook of Veterinary Internal Medicine. 9th ed. St. Louis: Elsevier, 2021. 3200 p.
Tvedten, H. Small Animal Clinical Diagnosis by Laboratory Methods. 6th ed. Hoboken: Wiley-Blackwell, 2020. 560 p.
Washabau, R.J., Day, M.J., Schultze, A.E. Canine and Feline Gastroenterology. 4th ed. St. Louis: Elsevier, 2021. 1300 p.
Dossin, O., et al. Diagnostic Accuracy of Ultrasonography in Diffuse Liver Disease in Dogs and Cats. Vet Radiol Ultrasound. 2020;61(S1):S41–S60. https://doi.org/10.1111/vru.12869
Center, S.A., Biller, D.S. Hepatobiliary Disease in Dogs and Cats: Pathophysiology, Diagnosis, and Management. Vet Clin North Am Small Anim Pract. 2022;52(2):259–297. https://doi.org/10.1016/j.cvsm.2021.11.005
Turek, J.J., et al. Evaluation of Bile Acids and Bilirubin in Canine and Feline Liver Disease. J Vet Intern Med. 2021;35(4):1721–1731. https://doi.org/10.1111/jvim.16195
Penninck, D.G., et al. Ultrasonographic Evaluation of the Liver and Biliary Tract in Dogs and Cats. Vet Radiol Ultrasound. 2020;61(3):297–315. https://doi.org/10.1111/vru.12840
Webster, C.R.L. Liver Function Tests in Dogs and Cats. Vet Clin Small Anim. 2020;50(3):501–520. https://doi.org/10.1016/j.cvsm.2020.02.006
Steiner, J.M., Williams, D.A. Hematology and Biochemical Changes Associated with Hepatobiliary Disease in Dogs and Cats. Clin Lab Med. 2022;42(2):225–246.
Hall, J.A., et al. Cytology and Histopathology in Small Animal Hepatic Disease. Vet Clin Small Anim. 2021;51(6):1301–1320.
McCarthy, R., et al. Hepatobiliary Scintigraphy for Diagnosis of Extrahepatic Biliary Obstruction in Dogs and Cats. Vet Radiol Ultrasound. 2020;61(5):539–548.
Tobias, K.M., Johnston, S.A. Veterinary Surgery: Small Animal. 2nd ed. St. Louis: Elsevier, 2020. 3200 p.
Center, S.A., et al. Portal-Systemic Shunts in Dogs and Cats: Diagnosis and Imaging. Vet Clin North Am Small Anim Pract. 2021;51(5):1041–1068.
Liu, L., et al. Serum Calpastatin as a Biomarker for Early Liver Cirrhosis. Front Vet Sci. 2022;9:830145. https://doi.org/10.3389/fvets.2022.830145
Khanna, C., et al. CT and MRI in Veterinary Hepatic Oncology: Current Applications. Vet Comp Oncol. 2021;19(4):605–617.
Watson, P., et al. Urate Nephrolithiasis and Portal-Systemic Shunts in Dogs. Vet Clin Small Anim. 2022;52(4):789–805.
Center, S.A. Textbook of Veterinary Internal Medicine. 9th ed. St. Louis: Elsevier, 2021. 3200 p.
Tvedten, H. Small Animal Clinical Diagnosis by Laboratory Methods. 6th ed. Hoboken: Wiley-Blackwell, 2020. 560 p.
Washabau, R.J., Day, M.J., Schultze, A.E. Canine and Feline Gastroenterology. 4th ed. St. Louis: Elsevier, 2021. 1300 p.
Khanna, C., et al. Vitamin D in Chronic Liver Disease: Mechanisms and Clinical Implications. Front Vet Sci. 2022;9:830145. https://doi.org/10.3389/fvets.2022.830145
Li, S., et al. Serum 25-Hydroxyvitamin D and Liver Fibrosis: A Meta-analysis. Hepatology Int. 2021;15(5):1031–1042.
Zhang, Y., et al. Vitamin D Receptor Expression and Liver Disease Progression. J Hepatol. 2020;73(3):665–677.
Center, S.A., et al. Hepatobiliary Disease in Dogs and Cats: Diagnosis and Management. Vet Clin North Am Small Anim Pract. 2022;52(2):259–297.
Holick, M.F. Vitamin D: Physiology, Molecular Biology, and Clinical Applications. 3rd ed. Cham: Springer, 2020. 480 p.
Turek, J.J., et al. Evaluation of Bile Acids, Bilirubin, and Vitamin D in Canine Liver Disease. J Vet Intern Med. 2021;35(4):1721–1731.
Centers for Disease Control and Prevention (CDC). Vitamin D and Liver Health. Atlanta, GA: CDC, 2020.
##submission.downloads##
Опубліковано
Як цитувати
Номер
Розділ
Ліцензія
Ця робота ліцензується відповідно до Creative Commons Attribution-NonCommercial 4.0 International License.
