Hepatitis, Chronic
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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
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