234 DISEASES OF THE LIVER 



liver becomes smaller, and may be smaller than normal. It 

 is firm and dense, but still retains the characteristic nutmeg 

 appearance. Connective tissue develops around the central 

 veins; the adjacent hepatic tissue is atrophic and pigmented, 

 and invading it are fine fibrous connective tissue trabecular. 

 The capsule is often thickened and opaque. 



Symptoms. —The symptoms vary greatly, depending largely 

 upon the causes. When due to primary cardiac or pulmonary 

 disease, the symptoms are complicated with these condi- 

 tions, those of the primary condition usually predominating. 

 The local symptoms are principally loss of appetite, dis- 

 turbance in digestion, nausea, vomiting, and more or less 

 obstinate constipation. Jaundice is a common symptom. 

 It may be moderate. The cyanosis which is present in the 

 conjunctiva with the jaundice produces a peculiar bluish- 

 green color of the mucous membranes. In cases where infec- 

 tion develops rapidly, the jaundice increases, often producing 

 nervous symptoms such as excitement, convulsions, etc. 



Ascites is a common symptom in the later stages resulting 

 from the extensive interference with the circulation. A large 

 amount of fluid is often found in the abdominal cavity, 

 especially in dogs. In the early stages the liver is enlarged, 

 while in the more advanced cases it may be atrophied. 

 Examination of the liver, therefore, by palpation may not 

 reveal any characteristic condition. An accompanying 

 gastro-intestinal catarrh develops which interferes with 

 digestion; the chronic course leads to general weakness and 

 emaciation. 



Diagnosis.— The diagnosis depends upon finding the 

 primary disease of the heart or lungs, the condition of the 

 liver, and the local symptoms of icterus, gastro-intestinal 

 catarrh, etc. An accurate diagnosis is somewhat difficult. 

 A careful examination of the patient and the prolonged 

 chronic course of the disease will assist in arriving at an 

 accurate conclusion. 



Prognosis.— As a rule unfavorable, especially in the dog. 

 It depends upon the primary condition, the stage of the 

 disease and the condition of the animal. 



