Chavezlloyd Alexandria Baldago
Chronic hepatitis is a condition in dogs that may occur due to various disease processes. It indicates a previous occurrence of inflammation and possibly cell death in the liver. The inflammation is caused by the infiltration of different types of white blood cells that are involved in the immune system. Necrosis, which refers to the death of a large number of liver cells, may also occur.
The invasion of white blood cells and cell death in a dog’s liver can be due to previous damage caused by infectious agents like viruses or bacteria or as a result of toxic damage. Toxic damage may occur due to poisons ingested by the dog or abnormal accumulation of substances required by the body, such as copper. Though some breeds like Bedlington Terriers, Labrador Retrievers, Doberman Pinschers, Dalmatians, West Highland White Terriers, Welsh Corgis, Keeshonds, and others are notably affected, this toxicity can affect any breed of dog. Copper accumulation in hepatocytes can cause oxidative damage, and its presence can escalate hepatocyte damage caused by other factors. Until dietary recommendations are modified and implemented, this problem will continue to affect canines. Inflammation and cell death can also occur due to a primary attack by the immune system against liver cells, known as an “autoimmune” disease.
Cancer in the liver is not called chronic hepatitis, even if it causes similar damage.
Chronic vs Acute
The term “chronic” refers to a condition that has been causing damage for a prolonged period, typically lasting several weeks or more. On the other hand, “acute” hepatitis is usually characterized by a shorter duration of just a few days. While some cases of acute hepatitis can be treated successfully, many types of chronic hepatitis are not curable. However, with appropriate treatment and close monitoring, a significant number of patients with chronic hepatitis can maintain a good quality of life with minimal clinical symptoms for an extended period.
Chronic hepatitis can affect any breed of dog regardless of gender or age, although it is more common in middle-aged or older dogs. Certain breeds may be more prone to specific types of hepatitis. For instance, some breeds may develop chronic hepatitis due to the accumulation of copper in the liver cells. The excessive concentration of copper harms the liver cells and, if left untreated, typically leads to severe chronic hepatitis.
The liver has multiple functions, therefore the clinical signs associated with liver disease can vary significantly.
Symptoms of hepatitis in dogs can include:
- Lack of appetite
- Increased urination
- Excessive thirst and urination
- Swollen belly filled with fluid (ascites)
- Yellowish gums (jaundiced) and moist tissues
- Seizures, mental dullness
Apart from obtaining a detailed history of the affected dog’s health prior to the appearance of symptoms, the next step would be to conduct a comprehensive physical examination of the dog, which includes carrying out a blood chemical profile, a complete blood count, an electrolyte panel, and a urinalysis. The results of the bloodwork will enable your veterinarian to identify any signs of impaired kidney function.
To further evaluate the disease, complete abdominal ultrasonography is essential. This diagnostic tool screens for concurrent diseases and helps acquire bile. It’s important to note that the liver can appear normal upon examination, and changes seen in chronic hepatitis can include uniform increases in liver echogenicity, decreased distinction of portal vein margins, and normal to small liver size. Abnormalities in the liver parenchyma, biliary tree, portal vein, and peritoneum should be assessed, along with acquired shunting and the presence of free peritoneal fluid.
In order to accurately diagnose chronic hepatitis, a liver biopsy is necessary. There are 3 ways to perform a liver biopsy, surgically, via laparoscopy, or through the skin using a special needle under ultrasound guidance. However, surgical or laparoscopic biopsies are more informative compared to ultrasound-guided biopsies. The information obtained from the biopsy is required to determine the type and severity of liver disease, as well as to assess your dog’s prognosis.
The treatment for chronic hepatitis in dogs is a complex process that depends on the severity and type of liver disease, as well as the clinical signs exhibited by the dog. In severe cases, hospitalization, intravenous fluid therapy, and supportive care may be required.
The most common medications prescribed for treating the disease are immunosuppressive or anti-inflammatory. In some cases, dietary changes may be necessary. Certain medications may also be used in specific situations, such as dogs whose illness is linked to copper accumulation, abdominal fluid build-up, or neurological symptoms.
Although this condition cannot be cured with the available treatments, the good news is that the dog can still live a good quality of life for months and even years with continued therapy. Regular blood work is necessary to ensure the dog is responding well to the treatment. This helps to adjust the medication and keep the dog relatively free of clinical signs.