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Chronic Active Hepatitis (CAH) in Dogs

By: Dr. Bari Spielman

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Chronic active hepatitis (CAH) is a chronic and progressive inflammation of the liver of dogs that leads eventually to the replacement of normal liver tissue with scar tissue. The disease is also called chronic canine inflammatory hepatic disease. In most cases, the cause of this disorder is never discovered. Potential causes include canine hepatitis virus (adenovirus I), leptospirosis, copper storage disease, drug toxicity, and genetic factors. Reactions on the part of the immune system to the liver inflammation may contribute to the progressive worsening of the disease.

All breeds of dogs can be affected, although the incidence is greater in the Bedlington terrier, West Highland white terrier, Doberman pinscher, cocker spaniel and Skye terrier. CAH usually occurs in middle-aged animals, and females appear to be at higher risk.

What to Watch For

  • Loss of appetite (anorexia)
  • Lethargy
  • Weight loss
  • Vomiting
  • Diarrhea
  • Excessive urinating and drinking (polyuria/polydipsia)
  • Fluid in the abdominal cavity (ascites)
  • Jaundice (yellow color to the skin)
  • Increased bleeding tendencies

    Diagnosis

  • Complete blood count (CBC)
  • Biochemical profile
  • Urinalysis
  • Serum bile acids
  • Ammonia levels
  • Blood clotting profile
  • Abdominal X-rays
  • Abdominal ultrasound
  • Liver biopsy and culture/sensitivity

    Treatment

  • Hospitalization and support (fluid and electrolyte therapy) as needed for dehydration from severe vomiting, diarrhea and anorexia

  • Treatment of any underlying disorders.

  • Nutritional support and dietary management

  • Antibiotic therapy

  • Corticosteroids to decrease inflammation

  • Drugs that stimulate the liver (choleretic) to enhance bile flow

  • SAMe to improve liver metabolism

  • Copper chelating drugs to bind and eliminate copper from the liver

  • Diuretics to help decrease water retention in the body

  • Vitamin K supplementation

  • Antifibrotic agents to decrease scarring in the liver

    Home Care and Prevention

    Administer all medications and recommended diets as directed by your veterinarian. Return for follow up examinations and biochemical evaluations.

    There are no preventative measures for this disease, although performing biochemical profiles on dogs of susceptible breeds and initiating therapy in the asymptomatic stages will help slow the progression and development of serious clinical signs.

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