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==Description==

==Description==

'''Chronic hepatitis''' is an inflammatory-necrotising disease of at least 6 months duration.  It is characterised by hepatocellular [[Adaptive Immune System - WikiBlood #Adaptive Immunity to Viruses|apoptosis]] or [[Necrosis - Pathology|necrosis]], a variable mononuclear or mixed inflammatory cell infiltrate, [[Liver General Pathology - Pathology#Regeneration|regeneration]] and [[Liver General Pathology - Pathology#Fibrosis - Repair|fibrosis]] (1).  It predominantly consists of lymphocytic-plasmacytic inflammatory infiltration.   

'''Chronic hepatitis''' is an inflammatory-necrotising disease of at least 6 months duration.  It is characterised by hepatocellular [[Adaptive Immune System - WikiBlood #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.   

A number of aetiologies include:

A number of aetiologies include:

*[[Stomach and Abomasum Consequences of Gastric Disease - Pathology|vomiting]] and [[Diarrhoea|diarrhoea]]

*[[Stomach and Abomasum Consequences of Gastric Disease - Pathology|vomiting]] and [[Diarrhoea|diarrhoea]]

*polyuria and polydipsia

*polyuria and polydipsia

*ascites - most consistent in dogs with [[Liver General Pathology - Pathology#Cirrhosis|cirrhosis]]

*ascites - most consistent in dogs with [[Cirrhosis|cirrhosis]]

*and rarely [[Liver General Pathology - Pathology#Jaundice (Icterus)|icterus]], seizures, fever and bleeding diathesis

*and rarely [[Icterus|icterus]], seizures, fever and bleeding diathesis

====Biochemistry====

====Biochemistry====

*Increased alanine aminotransferase (ALT) and alkaline phosphatase (ALP).  However these may not be increased if end-stage [[Liver General Pathology - Pathology#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

*Hypoalbuminaemia

*Hypoalbuminaemia

====Ultrasonography====

====Ultrasonography====

Ultrasonographically, liver may be normal or non specific changes in echogenecity may be seen in early stages of the disease.  In cases of [[Liver General Pathology - Pathology#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===

===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 General Pathology - Pathology#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.

==Prognosis==

==Prognosis==

Response to treatment is variable.  Poor prognosis for dogs with [[Liver General Pathology - Pathology #Fibrosis - Repair|fibrosis]] and [[Liver General Pathology - Pathology #Cirrhosis |cirrhosis]].

Response to treatment is variable.  Poor prognosis for dogs with [[Liver Fibrosis|fibrosis]] and [[Cirrhosis |cirrhosis]].