Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
- Ask authors questions and read what others have to say.
Diagnosis and treatment of canine chronic hepatitis
Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
- Ask authors questions and read what others have to say.
Read
Chronic hepatitis is a common disease in dogs but can often go undetected, especially in the early stages; Cynthia Webster presents an overview of the disease, with an emphasis on the diagnostic and treatment options.
Cynthia RL Webster
DVM, Dipl. ACVIM (SAIM), Cummings School of Veterinary Medicine, Tufts University, MA, USA.
Dr. Webster graduated from Cornell University in 1985 and after working in private practice returned for residency training at Cummings School of Veterinary Medicine. She was board-certified in small animal internal medicine in 1993 and then did a post-doctoral fellowship in hepatocyte transport biology. Currently Professor and Associate Chair in the Department of Clinical Sciences at Tufts Veterinary School, she has authored over 100 peer reviewed manuscripts as well as several book chapters. Most recently, she chaired the ACVIM Consensus Panel on the diagnosis and treatment of chronic hepatitis in the dog.
Key Points
- An accurate diagnosis of chronic hepatitis (CH) requires pathologic evaluation of multiple hepatic biopsies – preferably obtained by laparoscopy – from different liver lobes.
- All liver biopsy specimens should be evaluated for quantitative copper concentration, since excess hepatic copper is an important and treatable cause of CH.
- Significant hepatic inflammation can be present in dogs that have no clinical or diagnostic imaging signs of liver disease.
- In dogs with idiopathic CH where a meticulous search for other causes has been undertaken, a trial of immunosuppressive medication is indicated to determine if immune-mediated hepatitis is present.
Introduction
Chronic hepatitis (CH) can occur in any breed of dog, and the onset can be insidious. It progresses to end-stage cirrhosis when significant fibrosis and nodular regeneration develops and is defined histopathologically by certain key features, as outlined in (Box 1). It is critical to differentiate CH from a histologic diagnosis of non-specific reactive hepatitis, where mild-to-moderate inflammatory infiltrates in the portal, lobular and centrilobular regions are present without evidence of cell death or degeneration. These infiltrates are due to the escape of inflammatory cytokines and endotoxins from disease elsewhere in the splanchnic bed.
Etiology
In the majority of dogs with CH the etiology cannot be determined, so-called idiopathic CH ( 3 ) ( 4 ), but various causes or potential causes are worthy of note.
Several studies have failed to identify hepatotropic viruses in dogs with CH, but histopathological and/or serologic evidence of Leptospira bacteria have been identified in laboratory colonies of dogs, and more recently molecular means have identified leptospiral organisms in dogs with granulomatous hepatitis ( 5 ). Whether it is the organism or an immune reaction to the organism which causes the CH is unknown. Leishmaniasis is associated with granulomatous CH, whilst other bacterial (Bartonella), rickettsial (Ehrlichia, Anaplasma) and protozoal (Neospora, Toxoplasma, Sarcocystis) infections may cause canine CH. These infections, however, are more often acute to subacute, and part of a more systemic disease process.
Several drugs and supplements have the potential to cause CH in the dog, and clinicians should be vigilant in obtaining a complete medication history ( 6 ). Most drugs can potentially cause acute liver injury, but a few, including anticonvulsants (phenobarbital, primidone and phenytoin), oxibendazole, lomustine (CCNU), amiodarone, mitotane and NSAIDs can lead to chronic hepatic inflammation. [...]
Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
- Ask authors questions and read what others have to say.
About
How to reference this publication (Harvard system)?
Author(s)
Copyright Statement
© All text and images in this publication are copyright protected and cannot be reproduced or copied in any way.Related Content
Readers also viewed these publications
Subscribe
Access to the content of the Veterinary Focus website is reserved for animal health professionals. If you do not yet have a user account with Royal Canin you can create a free account by selecting the New User form. Subscription to the journal is free and issues in your preferred language can be obtained at the Veterinary Focus website.
Comments (0)
Ask the author
0 comments