Difference between revisions of "Hepatitis, Chronic"
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==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 | + | *Mixed and purebred dogs are affected but there is a familial predisposition in |
| − | + | **Doberman pinscher | |
| − | + | **Bedlington Terrier | |
| − | + | **Cocker Spaniel | |
| − | + | **Dalmation | |
| − | + | **Skye Terrier | |
| − | + | **Poodle | |
| − | + | **Labrador Retriever | |
| − | + | **German Shepherd Dog | |
| − | + | **Scottish Terrier | |
| − | + | **Beagle | |
| − | + | ||
| − | + | ==Description== | |
| − | == | + | Chronic hepatitis is an inflammatory-necrotising disease of at least 6 months duration. It is characterised by hepatocellular apoptosis or necrosis, a variable mononuclear or mixed inflammatory cell infiltrate, regeneration and fibrosis (1). It predominantly consists of lymphocytic-plasmacytic inflammatory infiltration. |
| + | |||
A number of aetiologies include: | A number of aetiologies include: | ||
*Familial predisposition | *Familial predisposition | ||
*Copper accumulation (copper storage disease) | *Copper accumulation (copper storage disease) | ||
| − | |||
*Chronic drug therapy | *Chronic drug therapy | ||
| − | *Infectious | + | *Infectious for examplae infectious canine hepatitis- |
*Autoimmune or steroid responsive disorder | *Autoimmune or steroid responsive disorder | ||
| + | ==Diagnosis== | ||
===Clinical Signs=== | ===Clinical Signs=== | ||
| − | These include | + | These include |
| − | *anorexia | + | *lethargy, weakness, anorexia and weight loss |
| − | + | *vomiting and diarrhoea | |
| − | * | ||
*polyuria and polydipsia | *polyuria and polydipsia | ||
| − | *ascites | + | *ascites |
| − | *and rarely | + | *and rarely icterus, seizures, fever and bleeding disthesis |
===Laboratory tests=== | ===Laboratory tests=== | ||
| − | + | ====Biochemistry==== | |
| − | + | *Increased alanine aminotransferase (ALT) and alkaline phosphatase (ALP). However these may not be incrased if end-stage cirrhosis is reached. | |
| − | |||
| − | Biochemistry | ||
| − | *Increased alanine aminotransferase (ALT) and alkaline phosphatase (ALP). However these may not be | ||
| − | |||
*Hypoalbuminaemia | *Hypoalbuminaemia | ||
| − | + | *Decreased urea | |
| − | *Decreased | ||
| − | |||
| − | |||
| − | |||
*Increased bile acids | *Increased bile acids | ||
| − | |||
| − | |||
| − | ==Imaging== | + | ===Imaging=== |
| − | |||
| − | + | ===Histopathology=== | |
| + | This is required for definitive diagnosis. Histology reveals lymphoplasmacellular inflammation and necrosis of the hepatocytes adjacent to the portal tracts. | ||
| − | |||
| − | |||
==Treatment== | ==Treatment== | ||
| − | * | + | *Glucocorticoids at 1-2 mg/kg/day PO. Taper down with improved clinical signs and normal liver enzymes values |
| − | |||
| − | |||
| − | |||
*Ursodeoxycholic acid at 15mg/kg PO SID | *Ursodeoxycholic acid at 15mg/kg PO SID | ||
| − | * | + | *Antioxidants |
| − | + | *Copper chelation with Penicillamine or Zinc if copper exceeds 2000ppm | |
| − | |||
| − | *Copper chelation if copper exceeds 2000ppm | ||
| − | |||
| − | |||
==Prognosis== | ==Prognosis== | ||
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==References== | ==References== | ||
*(1) Van den Ingh, TSGAM et. al. (2006). Morphological classification of parenchymal disorders of the canine and feline liver. In Rothuizen J et. al., editors: WSAVA standards for clinical and histological diagnosis of canine and feline liver disease, Oxford, England, Saunders. | *(1) Van den Ingh, TSGAM et. al. (2006). Morphological classification of parenchymal disorders of the canine and feline liver. In Rothuizen J et. al., editors: WSAVA standards for clinical and histological diagnosis of canine and feline liver disease, Oxford, England, Saunders. | ||
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Revision as of 11:43, 7 August 2009
 |
This article is still under construction. |
Signalment
- Common in dogs, especially young to middle-aged dogs.
- Mixed and purebred dogs are affected but there is a familial predisposition in
- Doberman pinscher
- Bedlington Terrier
- Cocker Spaniel
- Dalmation
- Skye Terrier
- Poodle
- Labrador Retriever
- German Shepherd Dog
- Scottish Terrier
- Beagle
Description
Chronic hepatitis is an inflammatory-necrotising disease of at least 6 months duration. It is characterised by hepatocellular apoptosis or necrosis, a variable mononuclear or mixed inflammatory cell infiltrate, regeneration and fibrosis (1). It predominantly consists of lymphocytic-plasmacytic inflammatory infiltration.
A number of aetiologies include:
- Familial predisposition
- Copper accumulation (copper storage disease)
- Chronic drug therapy
- Infectious for examplae infectious canine hepatitis-
- Autoimmune or steroid responsive disorder
Diagnosis
Clinical Signs
These include
- lethargy, weakness, anorexia and weight loss
- vomiting and diarrhoea
- polyuria and polydipsia
- ascites
- and rarely icterus, seizures, fever and bleeding disthesis
Laboratory tests
Biochemistry
- Increased alanine aminotransferase (ALT) and alkaline phosphatase (ALP). However these may not be incrased if end-stage cirrhosis is reached.
- Hypoalbuminaemia
- Decreased urea
- Increased bile acids
Imaging
Histopathology
This is required for definitive diagnosis. Histology reveals lymphoplasmacellular inflammation and necrosis of the hepatocytes adjacent to the portal tracts.
Treatment
- Glucocorticoids at 1-2 mg/kg/day PO. Taper down with improved clinical signs and normal liver enzymes values
- Ursodeoxycholic acid at 15mg/kg PO SID
- Antioxidants
- Copper chelation with Penicillamine or Zinc if copper exceeds 2000ppm
Prognosis
References
- (1) Van den Ingh, TSGAM et. al. (2006). Morphological classification of parenchymal disorders of the canine and feline liver. In Rothuizen J et. al., editors: WSAVA standards for clinical and histological diagnosis of canine and feline liver disease, Oxford, England, Saunders.