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Questions and Answers
What is the outcome of acute hepatitis in dogs?
What is a common clinical sign of CAV-1?
What is the most common isolate from biliary cultures in dogs and cats with liver disease?
What is the primary cause of cyanobacterial microcystin toxicosis?
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What is a potential cause of chronic hepatitis in dogs?
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What is a potential complication of leptospirosis?
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What is the typical treatment for aflatoxicosis?
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What is a potential cause of idiopathic chronic hepatitis in dogs?
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What are the most common organisms cultured from bile in dogs and cats with hepatic inflammation?
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What is the main cause of granulomatous hepatitis in dogs and cats?
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What is the primary treatment for chronic hepatitis in dogs and cats?
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What is the role of copper in hepatic disease?
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What is the characteristic pattern of copper accumulation in hepatocytes in cases where copper is the primary cause of hepatopathy?
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What is the ideal method for quantifying copper levels in the liver?
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What is a common sequela of portal hypertension in dogs?
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What is the goal of dietary intervention in dogs with hepatic encephalopathy?
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Study Notes
Canine Inflammatory/Infectious Hepatic Disease
Acute Hepatitis
- Can be rapidly fatal, completely reversible, or lead to chronic hepatitis
- Nonspecific clinical signs and elevations in ALT and ALP are expected
- Causes include:
- CAV-1: presents with fever, lethargy, abdominal pain, and elevated LE and kidney values
- Leptospirosis: causes vomiting, lethargy, icterus, diarrhea, polyuria/polydipsia, and anorexia
- Clostridium: commonly isolated from biliary cultures in dogs and cats with liver disease
- Aflatoxicosis: seen in dogs who ingested contaminated dog food
- Cyanobacterial microcystin toxicosis: often fatal, but some cases have been treated successfully with supportive care
- Amanita mushroom: usually fatal, causing hepatic inflammation, necrosis, and failure
- Carprofen: reports of hepatocellular necrosis in dogs, with elevations in liver enzymes and bilirubin
- TMS: induced hepatic necrosis and failure is likely an idiosyncratic drug reaction
Chronic Hepatitis
- Etiologies:
- Majority of cases are idiopathic
- Excess copper accumulation is a common definitive etiology
- Immune-mediated etiologies also exist
- Can occur secondary to phenobarbital
- Infectious causes may contribute, including E. coli, Enterococcus spp., Bacteroides spp., Streptococcus spp., and Clostridium spp.
- Acute hepatitis caused by drug or infection can progress to chronic hepatitis with time
- Treatment is mainly anti-inflammatory and immunosuppressive therapy
Copper-Related Hepatopathy
- Cupric oxidation state (Cu2+) is responsible for most of copper's hepatotoxicity
- Bedlington terriers have a primary defect in hepatic copper metabolism, resulting in marked lysosomal copper accumulation
- Copper accumulation can be primary or secondary to other diseases
- Breeds affected by copper-related hepatopathy include Labradors, Doberman, Skye Terrier, and WHWT
- Diagnosis is made using copper-specific stains and quantitative measurement of copper (atomic absorption spectroscopy)
Sequelae of Portal Hypertension
- Portal hypertension often occurs in dogs with hypoalbuminemia, leading to ascites, edema, ulceration of the GI tract, and signs of hepatic encephalopathy
- Treatment of GI signs is nonspecific and supportive, including the use of sucralfate, H2 blockers, and proton pump inhibitors
- Spironolactone in combination with furosemide can be used to treat ascites
- Therapeutic abdominocentesis is used in cases where the ascites is causing cardiorespiratory compromise
- Dietary intervention with a high-quality, low-protein diet, and lactulose treatment are used to manage hepatic encephalopathy
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Description
This quiz covers acute and chronic hepatitis in canines, including symptoms, diagnosis, and treatment options. Topics include leptospirosis, CAV-1, and clinical signs such as fever, lethargy, and elevated liver enzymes.
