Jaundice, also referred to as icterus, describes the yellow color taken on by the tissues throughout the body due to elevated levels of bilirubin, a substance that comes from the breakdown of red blood cells.

Regardless of the cause, jaundice is considered abnormal in the dog. Jaundice is recognized by a yellow color to the animal's skin. It is often more apparent in the whites of the eyes, in the skin at the base of the ears, along the gums, and in the skin of the abdomen. There are three primary classifications of causes of jaundice.

Prehepatic Causes

Prehepatic causes are those occurring before the blood passes through the liver and are also referred to as hemolytic causes. These result from a breakdown of red blood cells.

Blood parasites – hemobartonellosis (rare), babesiosis

Drugs

Certain toxins – ingestion of onions, pennies composed of zinc

Immune-mediated hemolytic anemia

Blood transfusion reactions

Tumors of blood vessels, such as the hemangiosarcoma

Heartworm disease, especially vena cava syndrome

Hepatic Causes

Hepatic causes are those disorders associated with the liver and include:

Inflammatory diseases of the liver (hepatitis), bile duct system (cholangitis), or both (cholangiohepatitis)

Toxins, such as heavy metals, copper, certain chemicals

Certain drugs, such as corticosteroids, thiacetarsamide, halothane, phenobarbital, carprofen, chemotherapeutic drugs

Cancer

Infections – viral, bacterial, protozoal

Cirrhosis (severe, end-stage liver disease)

Posthepatic Causes

Posthepatic causes are disorders that occur after blood passes through the liver and include disorders that result in blockage of the bile flow from the liver.

Pancreatic diseases, such as pancreatitis and pancreatic cancer

Gall bladder diseases, such as gall stones, cancer, or inflammation of the gall bladder and bile duct

Intestinal diseases that block the bile ducts

What to Watch For

Yellow color to gums, whites of the eyes, skin

Lethargy

Loss of appetite, weight loss and loss of body condition

Difficulty breathing

Vomiting, diarrhea

Abdominal distension

Excessive drinking and urinating

Diagnosis

Baseline tests such as a complete blood count (CBC), biochemical profile, and urinalysis are recommended in jaundiced patients. The tests also evaluate electrolytes, blood sugar, protein level, and urine concentration. Additional tests may include:

Abdominal and chest X-rays to assess organ size and shape and to assess for the presence of any masses or foreign objects

Abdominal ultrasound to assess the size, shape, and structure of abdominal organs, especially the liver

Serologic tests for infectious diseases that may affect the liver or cause destruction of red blood cells, toxoplasmosis, neosporosis, babesiosis

Coagulation profiles to assess blood clotting, as abnormal clotting may occur with severe liver disease and pancreatitis

Liver biopsy where liver disease is a consideration

A Coombs test to evaluate for immune-mediated destruction of red blood cells

Exploratory laparotomy in those patients where all other tests have not provided a diagnosis

Treatment

There are several steps your veterinarian might recommend to treat the jaundiced patient symptomatically, especially during diagnostic testing and prior to obtaining an underlying cause and beginning specific therapy. These include:

Discontinue any therapy initiated before the onset of jaundice.

Allow the patient to rest and avoid stress.

Administer intravenous fluid and electrolyte therapy to those patients that are severely ill or dehydrated.

Administer blood products to those patients that are profoundly anemic.

Home Care

Administer all prescribed medication as directed by your veterinarian. Observe your pet very closely. If clinical signs are not improving and/or are getting worse, contact your veterinarian at once.

Remove any drugs or other substances in the environment that may have triggered the jaundice.