the rule is that a hepatobiliary dysfunction leads to a hepatobiliary clinical sign.

Combined all in WaBBBeNN

1- Water (Wa):

Polyuria PU/ Polydipsia which are multi-factorial:

psychogenic

hypercortisolism

renal concentrating defects.

2- Bilirubin (1st B): A cholestatic disease causes bilirubinuria and icterus that may appear also by a hemolytic disease. Then by severe cholestasis leads to acholic grey feces.

3- Blood (2nd B): Coagulopathy occurs due to the inability to synthesize clotting factors following severe hepatic failure or common obstruction. Subclinical clotting disorders may convert into clinical apparent ones just after hepatic biopsy, surgery or gastroduodenal ulcer.

4- Belly (Be): Ascites

Severe chronic hepatic disease causes hypoalbuminemia, portal hypertension, sodium and water retention.

Also rupture of bile duct leads to bile peritonitis as well as fluid accumulation.

5- Nervous (N): Hepatic encephalopathy occurs as a result of bacterial action on some substrate in colon that forms some potential encephalopatic toxins like ammonia, GABA and mercaptans ..etc, then by low detoxification of diseased liver or portosystemic shunt, metabolic encephalopathy rises leading to wax and wane nervous signs that may ended by coma.

6- Non-specific signs (the last N):

Vomiting and small bowel diarrhea which is less frequent than vomiting.

Hematmesis as a result of ulceration.

Vet clinics generally sell our own drugs. Human pharmacists have minimal, if any, training with veterinary medicines and are not qualified to give advice about such.

A veterinarian is permitted to purchase prescription medications wholesale for sale through their clinic, following proper prescribing laws. Most clinics have a lockable pharmacy room or cupboard for this purpose, plus a lockable fridge.

While we can write prescriptions for non-veterinary medicines, which is vital because many drugs are not made in a formula specifically registered for animals, especially less commonly used ones, we can also purchase human pharmaceuticals for use in our clinic or by our patients. The majority of the time we don’t actually need a human pharmacist’s involvement at all.

A human pharmacy may be involved if we’ve been unable to source our medications through our usual channels, or for acquiring something obscure in a hurry, or some owners prefer to have a script to fill at a pharmacy rather than to purchase from a vet clinic because of cost, or so that the medication can be acquired in a hurry if the vet clinic is closed (eg insulin if a bottle breaks).

But the majority of medications we purchase ourselves. We prescribe them ourselves. We dispense them ourselves.