Pathologic assessment of equine hepatic disease

Hollyer, Jennifer (2022) Pathologic assessment of equine hepatic disease. MVM(R) thesis, University of Glasgow.

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Hepatic disease is considered a common finding within equine practice. Despite frequency of diagnosis, aetiology of specific cases often remains unknown. As a result, clinicians may struggle to offer their clients a prognosis for affected horses. In 2003 a scoring system was devised for equine liver biopsies that intended not only to provide assessment of damage, but also prognosticate on the basis of that damage. Since that time, this system has not been reviewed. This study consisted of a review of the hepatic scoring system that is currently in place for equine hepatic tissue, assessed an extended fibrosis scoring system, and investigated the utility of image analysis in equine hepatic cases. Agreement between image analysis results and those results provided by a trained anatomic pathologist were determined. As both postmortem and biopsy tissue was used in this study, the impact of tissue sample type was also considered for all aspects of scoring.

A total of fifty-three cases were submitted for analysis from centres in England, Scotland and Ireland. Of these, twenty-six cases were known to be being investigated for hepatic disease. Twenty-two cases had ante-mortem diagnoses of extra-hepatic disease and five cases had no known ante-mortem diagnoses. Samples were collected over a period of eight years (2010-2017) with follow-up data for 19 horses after original sample submission (averaging 14.5 months) with the remaining thirty-four cases lost to follow-up.

None of the aspects of the traditional scoring system were found to be significant with regards to an ante-mortem diagnosis of hepatic disease nor did they provide information with regards to prognosis. Of the aspects of the proposed extended grading system, mild centrilobular fibrosis was found to be protective with regards to a diagnosis of hepatic disease and no aspect was found to be significant with regards to clinical outcome. Image analysis was found to be in agreement with pathologist driven assessment of hepatic tissue, but similarly, did not aid in diagnosis or prognostication with regards to hepatic disease. While tissue sample type did not impact anatomic pathologist driven tissue assessment, a difference was seen between image analysis results of biopsy versus post-mortem material using Sirius Red, collagen III and smooth muscle actin staining.

While the results from this study were not concordant with previous study, the utility of biopsy results in a clinical practice is not under question. Instead, biopsy results should be considered a useful tool in a hepatic work-up and utilised in conjunction with other clinical data to inform clinical decision making.

Item Type: Thesis (MVM(R))
Qualification Level: Masters
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
Supervisor's Name: Haining, Dr. Hayley and Hotchkiss, Dr. Joel
Date of Award: 2022
Depositing User: Theses Team
Unique ID: glathesis:2022-82694
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 11 Feb 2022 11:49
Last Modified: 08 Apr 2022 16:51
Thesis DOI: 10.5525/gla.thesis.82694

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