Hepatitis, Chronic
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Signalment
Familial predisposition including 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 predominantly consists of lymphocytic-plasmacytic inflammatory 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
- 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
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