Introduction
- Includes: chronic active hepatitis, copper associated hepatitis, drug induced hepatitis, lobular dissecting hepatitis, idiopathic hepatitis.
- Cause : malformation, toxicity, neoplasia, endocrinopathy, infection.
- Signs : may present as acute hepatitis, or may be non-specific: lethargy, anorexia, vomiting. Signs of hepatic encephalopathy.
- Diagnosis : biochemistry, hepatic function tests, ultrasonography, ultimately hepatic biopsy.
- Treatment : elimination of cause if known, supportive and symptomatic measures.
- Prognosis : depends on underlying cause.
Diagnosis
Clinical signs
- Lethargy.
- Decreased appetite.
- Vomiting.
- Diarrhea.
- Polydipsia/polyuria.
- Unkempt hair/coat.
- Jaundice.
- Small liver on palpation.
- Poor bodily condition.
- Ascites.
Signs of hepatic encephalopathy
- Behavioral changes - dementia, dullness, aggression, disorientation.
- Neurological abnormalities - circling, ataxia, head pressing, aimless pacing, seizures.
- Ptyalism (excessive salivation).
- Coma.
Diagnosis
Differential diagnosis
Primary liver diseases
- Chronic hepatitis
. - Neoplasia .
- Portosystemic shunts .
- Toxic hepatopathy (see Liver: acute disease ).
- Neoplasia - metastatic.
- Acute pancreatitis .
- Metabolic disease (hyperadrenocorticism , diabetes mellitus ).
- Causes of hemolytic anemia .
- Hepatocellular disease (see primary and systemic causes of liver disease).
- Obstructive: intrahepatic, eg neoplasia, inflammation; extrahepatic, eg pancreatic neoplasia
or inflammation, bile stones.
- Advanced hepatic disease.
- Hypoalbuminemia.
- Abdominal neoplasia.
- Right-sided congestive heart failure .
- Chylous ascites.
- Bacterial peritonitis .
- Other fluids (hemorrhage, bladder or biliary rupture).
Sequelae
Prognosis
- Depends on underlying cause and degree of hepatic damage.
- Generally poor diagnosis.
- Prognosis much poorer if ascites present.
Expected response to treatment
- Clinical improvement.
- Resolution of hepatic pathology.
Reasons for treatment failure
- Development of hepatic cirrhosis.
Sources
Publications
Refereed papers
- Recent references from PubMed.
- Center S A (2005) Chronic liver disease: current concepts of disease mechanisms. JSAP 40 (3), 106-114.
- Mandigers P J, van den Ingh T S, Spee B, Penning L C, Bode P, Rothuizen J (2004) Chronic hepatitis in Doberman pinschers. A review. Vet Q 26, 98-106 PubMed.
- Watson P J (2004) Chronic hepatitis in dogs: a review of current understanding of the aetiolgy, progression and treatment. Vet J 167 , 228-241 PubMed.
- Center S A (1999) Chronic liver disease: current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.
- Sevelius E (1995) Diagnosis and prognosis of chronic hepatitis and cirrhosis in dogs. JSAP 36 , 521-528.
- Andersson M, Sevelius E (1991) Breed, sex and age distribution in dogs with chronic liver disease: a demographic study. JSAP 32 , 1-5.
Other sources of information
- 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.
- Willard M D (2005) Inflammatory canine hepatic disorders. In: Textbook of Veterinary Internal Medicine. 6th edn. Eds: S J Ettinger & E C Feldman. W B Saunders, Philadelphia. pp 1442-1447.
