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, 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

Prognosis