Canine Vacuolar Hepatopathy in Dogs

This condition itself often does not have any visible symptoms unless the liver starts to fail, however, a significant number of the dogs that develop hyperadrenocorticism, or Cushing’s Syndrome, also develop vacuolar hepatopathy due to the increase in glucocorticoids. Symptoms of hyperadrenocorticism can include:

• Abdominal enlargement
• Excessive thirst
• Excessive urination
• Hair loss
• Increased appetite
• Increased panting
• Thin skin
• Urinary tract infections

Types

There are several breeds of dog who are somewhat prone to canine vacuolar hepatopathy due to either a predisposition for hyperadrenocorticism, also known as Cushing’s disease or predisposition to developing high levels of cholesterols or triglycerides, known as hyperlipidemia. 

Breeds prone to hyperadrenocorticism:

• Beagles
• Boston Terriers
• Boxers
• Dachshunds
• Jack Russell Terriers
• Poodles
• Scottish Terriers
• Staffordshire Terriers
• Yorkshire Terriers

Breeds prone to hyperlipidemia, due to increased levels of triglycerides:

• Brittany Spaniels 
• Miniature Schnauzers

Due to increased cholesterol levels:

• Briards
• Dobermans
• Great Pyrenees
• Rottweilers
• Rough-coated Collies
• Shetland Sheepdogs

As dogs that have canine vacuolar hepatopathy are generally asymptomatic except for the symptoms of the underlying disorder, the disorder is usually caught due to testing for other disorders. Standard blood tests for dogs include a complete blood count and a biochemistry profile, and these tests will show an increase in alkaline phosphatase (ALP), a liver enzyme. Your veterinarian will perform a complete physical analysis including urinalysis at this time, checking for an enlarged liver and urinary tract infections, as well as determining if any other disorders are occurring concurrently.

It is important to inform your dog’s doctor about any medications or supplements your dog is taking as these can contribute to the formation of vacuoles and may need to be reassessed. Imaging of the liver by radiograph or ultrasound will show a “swiss cheese” appearance to the liver due to the vacuoles, but the definitive diagnosis has to be made based on a liver biopsy as other necroinflammatory disorders of the liver may show the same clinical signs as vacuolar hepatopathy.

Determining and treating any underlying conditions such as Cushing’s disease, a reaction to steroids, or hyperlipidemia, is the primary focus of therapy for vacuolar hepatopathy. It is essential with this disorder to thoroughly re-examine all of the medications and supplements that are being given to your pet. Steroids may either cause or exacerbate the formation of vacuoles, and holistic and herbal treatments should be checked for anything that may have a stimulating effect on the adrenal glands or pituitary gland.

Medications that may contribute to the further formation of vacuoles should be discontinued and replaced with an alternate treatment. Your veterinarian is also likely to recommend a change in the diet for your dog, which will depend on the underlying cause of the disorder. Protein should not be restricted, but in the case of lipid-filled vacuoles, a fat restricted diet may be recommended. Vitamins and antioxidants will be added to your dog’s daily regimen, and in some cases, hepatoprotective medications may be prescribed.