Introduction
- Cause : overwhelming toxic insult, infectious or metabolic disease.
- Signs : non-specific; anorexia, vomiting, depression +/- polydipsia/polyuria, jaundice, ascites, bleeding, encephalopathy.
- Diagnosis : biochemistry, hepatic function tests, ultrasonography, hepatic biopsy.
- Treatment : underlying cause if recognized; otherwise supportive and symptomatic.
- Prognosis : depends on severity and treatment of inciting factor.
- See also Liver: chronic disease
.
Diagnosis
Clinical signs
- Icterus.
- Abdominal pain.
- Ascites.
- Depression.
- Pyrexia.
- Neurological dysfunction related to cerebrum.
- Petechial hemorrhages.
- Bleeding.
- Abdominal pain.
Diagnosis
Differential diagnosis
- Acute toxic insult .
- Other causes of diarrhea .
- Other causes of icterus, eg hemolysis (most commonly immune-mediated hemolytic anemia ).
- Acute pancreatitis .
- Acute gastritis .
- Other causes of vomiting .
- Pyloric obstruction .
- Small intestinal obstruction.
- End-stage liver disease.
- Systemic infection - bacterial, mycotic, parasitic, protozoal.
Sequelae
Prognosis
- Depends on severity and elimination of underlying insult.
- Poor if coagulopathy and/or hepatic encephalopathy present.
- Less severe forms may result in complete regeneration.
- Persistent inflammation may result in chronic hepatitis .
- May result in cirrhosis.
Expected response to treatment
- Resolution of vomiting, depression, anorexia, etc within days of treatment initiation.
- Serum biochemistry gradually returns to normal.
Reasons for treatment failure
- Failure to identify and treat underlying disease/inciting factor.
- Failure to reverse may lead to fibrosis of liver and permanent damage → cirrhosis .
Sources
Publications
Refereed papers
- Recent references from PubMed.
- Watson P J (2004) Chronic hepatitis in dogs: a review of current understanding of the aetiology, progression and treatment. Vet J 167 , 228-2421 PubMed.
- Toshach K, Jackson M V V & Dubielzig R R (1997) Hepatocellular necrosis associated with SC injection of an intranasal bordetella bronchiseptica - canine parainfluenza vaccine. JAAHA 33 , 126-128 PubMed.
- Maddison J E (1992) Hepatic encephalopathy. Vet Intern Med 6 , 341-353PubMed.
- Meyer D J & Williams D A (1992) Diagnosis of hepatic and exocrine pancreatic disorders. Semin Vet Med and Surg 7 , 275-284.
- Dayrell-Hart B, Steinberg S A, VanWinkle T J & Farnbach G C (1991) Hepatotoxicity of phenobarbital in dogs: 18 cases. JAVMA 199 , 1060-1066 PubMed.
Other sources of information
- Scherk M A & Center S A (2005) Toxic, Metabolic, Infectious and Neoplastic Liver Diseases. In: Textbook of Veterinary Internal Medicine. 5th edn. Eds: S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 1464-1477.
- Watson P J (2005) Diseases of the liver. In: BSAVA Manual of Canine and Feline Gastroenterology. 2nd edn. Eds E J Hall, J W Simpson & D A Williams. BSAVA publications. pp 240-268.
- Center S A (1996) Acute hepatic injury: hepatic necrosis and fulminant hepatic failure. In: Strombeck's Small Animal Gastroentererology. Eds W G Guilford. W B Saunders, Philadelphia. pp 654-705.
- Watson T (1996) Nutritional management of canine liver disease. Waltham Symposium, Birmingham. pp 42-46.
