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Chronic hepatitis is the inflammation or necrosis of the liver that has occurred over an extended period of time. It often ends up being idiopathic, meaning that the origin of the disorder may never be known. There is a genetic component, particularly in chronic hepatitis that is accompanied by high levels of copper in the liver tissues, and several breeds are predisposed to developing chronic hepatitis. The symptoms are often obscured until damage has already begun. If your pet is showing signs of chronic hepatitis, contact your veterinarian without delay.
Breed specific chronic hepatitis is the inflammation and possible necrosis of the liver due at least in part to a breed predisposition for developing this disorder.
The symptoms of chronic hepatitis are the same regardless of its cause, and generally are only seen after damage to the liver has already taken place:
There are several breeds of dog that are predisposed to chronic hepatitis, believed to be due to a genetic defect in the way that they metabolize copper. Studies done with Bedlington Terriers indicate that this disorder may be autosomal recessive, but these findings are not yet conclusive for other breeds. Female Doberman Pinschers are more likely to develop this disease than males whereas the reverse is true for Cocker Spaniels. Breeds that are more liable to develop this disorder include:
Chronic hepatitis can occur in dogs of any size, gender, or age, but there are several breeds who are predisposed to developing chronic issues with their liver. Bedlington Terriers have been determined to have a specific autosomal recessive trait that causes a defect in the metabolism of copper, causing it to build up in the liver rather than being excreted into the bile. Most of the other breeds that are prone to chronic hepatitis also have a build up of copper in the liver, but it is not yet known if the build up is the cause of the hepatitis or if the hepatitis itself is the cause of the copper build up. The Cocker Spaniel, the Poodle, and the Scottish Terrier breeds often have less copper retention than other breeds.
Many symptoms of chronic hepatitis are somewhat vague and could signal several different conditions, particularly the earlier symptoms of the disorder. Your veterinarian will perform a physical evaluation of your dog, and if the liver is swollen, she may be able to feel this when she palpates the abdomen. In severely advanced cases of damage, the liver may shrink instead, making it difficult to palpitate at all. Standard blood tests such as a biochemistry profile and complete blood count may show elevated liver enzymes, regenerative anemia, or coagulation disorders even before any symptoms become apparent.
Ultrasound imaging can help determine the size and shape of the liver and may reveal abnormalities such as nodules on the liver or swelling in the abdominal cavity. The final diagnosis can only be defined by using a liver biopsy. The biopsy may be taken by ultrasound guided needle biopsy, laparoscopic biopsy, or a wedge biopsy, but samples taken by fine needle aspiration are not sufficient for proper testing.
By the time that symptoms are showing significant liver damage may have already occurred, and treatment will be aimed at stopping further progression of the disease and providing additional support to the liver. If fluids have built up in the abdominal cavity, these will first need to to be drained by a process known as abdominocentesis, in which a needle is inserted directly into the cavity, and excess fluid is drawn out. Dogs who develop this type of fluid build up may have diuretics prescribed to them to prevent any further build up.
Acute symptoms will generally result in a stay at the clinic, and IV fluids will be administered in order to prevent dehydration and to address any imbalances in blood chemistry. In cases where the clotting is compromised blood or plasma transfusions may also become necessary, and gastroprotective medications may also be recommended. Chelating agents and zinc may be used to bind the copper so that it is removed naturally through the urine, although this treatment seems to be less effective in the Doberman Pinscher breed.
Prognosis for this condition is usually guarded to poor and is dependent on several factors, including the amount of damage that has already occurred by the time the disease is diagnosed, the breed of the dog, and how well the condition is managed at home after the initial treatment. Certain breeds, such as the Cocker Spaniel are more likely to succumb to this disorder, and if symptoms such as blood sugar imbalances, clotting deficiencies, or fluid buildup are present, this may also impact the prognosis. Management at home usually includes a change of diet to a high-quality, low copper diet to prevent any future buildup of copper and some dogs may need to have supplemental zinc or additional chelation treatments to maintain liver health for as long as possible.
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