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==Introduction==
'''Chronic hepatitis''' is an inflammatory-necrotising disease of at least 6 months duration. It is characterised by hepatocellular [[Adaptive Immunity to Viruses|apoptosis]] or [[Necrosis - Pathology|necrosis]], a variable mononuclear or mixed inflammatory cell infiltrate, [[Liver Regeneration|regeneration]] and [[Liver Fibrosis|fibrosis]] (1). It predominantly consists of lymphocytic-plasmacytic inflammatory infiltration, and the disease process typically involves a slowly progressive inflammation which leads to fibrosis and posibly cirrhosis.
==Signalment==
==Signalment==
*Common in dogs, especially young to middle-aged dogs.
*Common in dogs, especially young to middle-aged dogs.
*Mixed and purebred dogs are affected but there is a familial predisposition in the following breeds:
*Mixed and purebred dogs are affected but there is a familial predisposition in the following breeds:
<gallery>
<gallery>
Image:Dobermann.jpg|'''Dobermann'''<p>John Adams (2007) WikiMedia Commons
Image:Dobermann.jpg|'''Dobermann'''<p>John Adams (2007) WikiMedia Commons
Image:Beagle.jpg|'''Beagle'''<p> sannse (2003) WikiMedia Commons
Image:Beagle.jpg|'''Beagle'''<p> sannse (2003) WikiMedia Commons
</gallery>
</gallery>
==Aetiology==
==Description==
A number of aetiologies include:
A number of aetiologies include:
*Familial predisposition
*Familial predisposition
*Autoimmune or steroid responsive disorder
*Autoimmune or steroid responsive disorder
===Clinical Signs===
===Clinical Signs===
These include:
These include:
*ascites - most consistent in dogs with [[Cirrhosis|cirrhosis]]
*ascites - most consistent in dogs with [[Cirrhosis|cirrhosis]]
*and rarely [[Icterus|icterus]], seizures, fever and bleeding diathesis
*and rarely [[Icterus|icterus]], seizures, fever and bleeding diathesis
===Laboratory tests===
===Laboratory tests===
Haematology:
*Mild non-regenerative anaemia and microcytosis
*Mild non-regenerative anaemia and microcytosis
Biochemistry:
*Increased alanine aminotransferase (ALT) and alkaline phosphatase (ALP). However these may not be increased if end-stage [[Cirrhosis|cirrhosis]] is reached.
*Increased alanine aminotransferase (ALT) and alkaline phosphatase (ALP). However these may not be increased if end-stage [[Cirrhosis|cirrhosis]] is reached.
*Hyperbilirubinaemia
*Hyperbilirubinaemia
*Increased prolonged activated partial thromboplastin time (APTT) and prothrombin time (PT) indicates severe liver dysfunction or [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation (DIC)]]
*Increased prolonged activated partial thromboplastin time (APTT) and prothrombin time (PT) indicates severe liver dysfunction or [[Disseminated Intravascular Coagulation|disseminated intravascular coagulation (DIC)]]
==Imaging==
Abdominal radiographs will only reveal microhepatica or ascites when advanced stages of disease are reached.
Abdominal radiographs will only reveal microhepatica or ascites when advanced stages of disease are reached.
Ultrasonographically, liver may be normal or non specific changes in echogenecity may be seen in early stages of the disease. In cases of [[Cirrhosis|cirrhosis]], microhepatica, irregularity in hepatic margin, focal lesions corresponding to regenerative nodules, hyperechogenicity of liver parenchyma associated with increased fibrous tissue and ascites may be seen.
Ultrasonographically, liver may be normal or non specific changes in echogenecity may be seen in early stages of the disease. In cases of [[Cirrhosis|cirrhosis]], microhepatica, irregularity in hepatic margin, focal lesions corresponding to regenerative nodules, hyperechogenicity of liver parenchyma associated with increased fibrous tissue and ascites may be seen.
==Histopathology==
This is required for definitive diagnosis and to differentiate chronic hepatitis from other hepatopathies. Chronic hepatitis is characterised by moderate to severe lymphoplasmacellular [[Inflammation - Pathology|inflammation]] and [[Liver Necrosis|necrosis]] of the hepatocytes adjacent to the portal tracts.
This is required for definitive diagnosis and to differentiate chronic hepatitis from other hepatopathies. Chronic hepatitis is characterised by moderate to severe lymphoplasmacellular [[Inflammation - Pathology|inflammation]] and [[Liver Necrosis|necrosis]] of the hepatocytes adjacent to the portal tracts.
==Treatment==
==Treatment==
**Penicillamine
**Penicillamine
**Zinc
**Zinc
==Prognosis==
==Prognosis==
Response to treatment is variable. Poor prognosis for dogs with [[Liver Fibrosis|fibrosis]] and [[Cirrhosis |cirrhosis]].
Response to treatment is variable. Poor prognosis for dogs with [[Liver Fibrosis|fibrosis]] and [[Cirrhosis |cirrhosis]].
==References==
==References==
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
*Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine (Fourth Edition)''' ''Mosby Elsevier''.
[[Category:Liver_-_Inflammatory_Pathology]]
[[Category:Liver_-_Inflammatory_Pathology]]