Hepatitis, Chronic

Signalment

Familial predisposition including Dobermann, Bedlington Terrier, Cocker Spaniel, Dalmation, Sky Terrier, Poodle, Labrador Retriever, German Shepherd Dog, Scottish Terrier, Beagle.

Description

Chronic, at least 6 months, of hepatocellular necrosis, mostly lymphocytic-plasmacytic infiltration. A number of causes include:

• Copper accumulation
• Drugs
• Infections

Diagnosis

Clinical Signs

These include

• Lethargy, weakness, anorexia and weight loss
• Vomiting and diarrhoea
• Polyuria and polydipsia
• Ascites
• Rarely with icterus, seizures, fever and bleeding tendency

Haematology & Biochemistry

• Increased ALT and ALP. However these may not be incrased if end-stage cirrhosis is reached.
• Hypoalbuminaemia
• Decreased urea
• Increased bile acids

Biopsy

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