Liver: cirrhosis

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Sections available in full article Introduction, Presenting signs, Geographic incidence, Age predisposition, Sex predisposition, Breed predisposition, Cost considerations, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Standard treatment, Monitoring, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Mr Nick Bexfield BVetMed DSAM DipECVIM-CA MRCVS European Specialist and RCVS Diplomate in Small Animal Internal Medicine
Dr Kyle Braund BVSc MVSc PhD FRCVS DipACVIM

Introduction

  • See also Liver: chronic disease - overview.
  • Hepatic degeneration, necrosis, regeneration, fibrosis.
  • Cause : usually obscure - end-stage of chronic hepatic diseases Liver: chronic disease - overview.
  • Signs : of liver failure.
  • Diagnosis : on liver biopsy, hepatic function tests severely impaired, hepatic enzymes often only slightly elevated.
  • Treatment : symptomatic management.
  • Prognosis : poor, irreversible.

Diagnosis

Clinical signs

  • Those of chronic liver disease including:
    • Ascites.
    • Icterus.
    • Signs of hepatic encephalopathy (confusion, head pressing, circling, disorientation, seizures and other neurological deficits).
    • Small liver on abdominal palpation.
    • Bleeding disorder.
    • Poor body condition.

Diagnosis

Differential diagnosis

  • Chronic hepatitis.
  • Chronic hepatopathies:
    • Hepatic neoplasia.
    • Vascular hepatopathy.
  • Idiopathic hepatic fibrosis.

Sequelae

Prognosis

  • Poor: changes progressive and irreversible.

Expected response to treatment

  • Supportive and symptomatic treatment may improve appetite and general demeanor; relapse probable.

Reasons for treatment failure

  • Progressive and irreversible disease.

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 , 228-241.
  • Hill P B, Auxilia S T, Munro E, Genovese L, Silkstone M A & Kirby B (2000) Resolution of skin lesions and long-term survival in a dog with superficial necrolytic dermatitis and liver cirrhosis. JSAP 41 (11), 519-523 PubMed.
  • Center S A (1999) Chronic liver disease - current concepts of disease mechanisms. JSAP 40 (3), 106-114.
  • Sevelius E (1995) Diagnosis and prognosis of chronic hepatitis and cirrhosis in dogs. JSAP 36 , 521-528.

Other sources of information

  • Willard M D (2005) Inflammatory canine hepatic disorders. In: Textbook of Veterinary Internal Medicine.6th edn. Eds S J Ettinger & E C Feldman. Philadelphia: W B Saunders. pp 1441-1447.
  • 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.

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