Chronic Active Hepatitis (CAH) in Dogs

Overview of Canine Chronic Active Hepatitis (CAH)

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

Diagnosis of Chronic Active Hepatitis in Dogs

Treatment for Dogs with Chronic Active Hepatitis

Home Care and Prevention for Chronic Active Hepatitis

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.

Information In-depth on Chronic Active Hepatitis in Dogs

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 canine chronic inflammatory hepatic disease. Affected individuals may be ill for weeks to months with signs of intermittent anorexia, weight loss, lethargy, excessive urinating and drinking, and jaundice. In the end stages of this disease when scarring of the liver is severe and the liver can no longer function properly, affected dogs may develop fluid accumulation in the abdomen and signs of hepatic encephalopathy. Hepatic encephalopathy is malfunction of the brain due to the accumulation of toxins that are ordinarily cleared from the blood stream by the liver.

There are several diseases/disorders that can appear similar to CAH. These include:

Diagnosis In-depth of Chronic Active Hepatitis in Dogs

The clinical signs associated with CAH are rather vague and nonspecific, so your veterinarian may not be able to make a presumptive diagnosis without performing certain diagnostic tests. A complete history and thorough physical examination are important initial steps to take. The following tests are then considered to rule out other disorders and to confirm a diagnosis of CAH:

Your veterinarian may recommend additional tests to exclude or diagnose concurrent conditions and to confirm the diagnosis of CAH. These tests are not necessary in every dog, so are selected on a case-by-case basis:

Treatment In-depth for Dogs with Chronic Active Hepatitis

Goals in the treatment of CAH include eliminating any underlying cause; decreasing inflammation within the liver and providing an environment in which the liver can recover; controlling any complications; and attempting to stop progression of the disease. Patients with CAH may need to be hospitalized and treated aggressively. Depending on the stage of disease and clinical signs involved, outpatient therapy may or may not be sufficient. It is extremely important to have a diagnosis confirming CAH prior to treatment, as treating the symptoms is often ineffective.

Follow-up for Dogs with Chronic Active Hepatitis

Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your pet does not improve rapidly. Administer all prescribed medications and diets as directed. Alert your veterinarian if you are experiencing problems treating your pet.

Initially blood tests are taken every few weeks to monitor response to therapy and the status of the liver. As the animal stabilizes, the testing frequency may be decreased to every 4 to 6 months.. In patients with ascites, monitor body weight on a daily basis. As fluid is lost from the body, the dog’s body weight will drop.

A second liver biopsy is often needed at some point to assess what is happening on a cellular level within the liver. This disease is very difficult to treat and is rarely cured. With consistent care and monitoring, the progression of the disease can sometimes be slowed, and the dog can be provided with a good quality of life. If the disease is ignored or if treatment and monitoring are inconsistent, then CAH often progresses to cirrhosis of the liver and end stage liver failure.