ISSN 2398-2969      

Liver: chronic disease - overview

icanis
Contributor(s):

Nick Bexfield


Introduction

  • Includes: chronic active hepatitis, copper associated hepatitis, drug induced hepatitis, lobular dissecting hepatitis, idiopathic hepatitis.
  • Cause: malformation, toxicity, neoplasia, endocrinopathy, infection.
  • Signs: may present as acute hepatitis, or may be non-specific: lethargy, anorexia, vomiting. Signs of hepatic encephalopathy.
  • Diagnosis: biochemistry, hepatic function tests, ultrasonography, ultimately hepatic biopsy.
  • Treatment: elimination of cause if known, supportive and symptomatic measures.
  • Prognosis: depends on underlying cause.

Pathogenesis

Etiology

Pathophysiology

  • Cumulative hepatic insult → functional reserve capacity exceeded (>70% damage) → failure to perform diverse metabolic functions → clinical signs.
  • Increased resistance to blood flow through liver due to hepatocytes swelling → development of portal hypertension →ascites. Ascites may also develop due to hypoalbuminemia Hypoproteinemia.
  • Acquired shunting vessels may develop due to sustained portal hypertension.
  • Failure to detoxify ammonia from intestine due to reduced hepatic mass and presence of acquired shunting vessels → hepatic encephalopathy Hepatic encephalopathy.
  • Portal hypertension → gastrointestinal wall congestion and edema → gastrointestinal ulceration → hematemesis and melena.
  • Inadequate bile delivery to intestine → impairment of fat digestion → diarrhea.
  • Decreased production of clotting factors →bleeding tendency.
  • Inflammation of biliary system → partial obstruction to biliary flow →icterus.
  • Decreased production of urea in the urea cycle → reduced blood urea.
  • Decreased production of albumin →hypoalbuminemia.
  • Chronic liver disease may result in fibrosis. If the injury is severe and/or ongoing, the liver will respond by laying down fibrous tissue. This represents a final common pathway to a variety of insults to the liver.
  • When bridging fibrosis causes permanent distortion of the liver associated with regenerative nodules, it is termed cirrhosis Liver: cirrhosis.

Timecourse

  • >12 weeks of active illness.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Au A Y, Hasenwinkel J M, Frondoza C G (2013) Hepatoprotective effects of S-adenosylmethionine and silybin on canine hepatocytes in vitro. J Anim Physiol Anim Nutr (Berl) 97 (2), 331-41 PubMed.
  • Mandigers P J, van den Ingh T S, Spee B, Penning L C, Bode P, Rothuizen J (2004) Chronic hepatitis in Doberman pinschers. A review. Vet Q 26 (3), 98-106 PubMed.
  • Watson P J (2004) Chronic hepatitis in dogs: a review of current understanding of the aetiology, progression and treatment. Vet J 167 (3), 228-241 PubMed.
  • Center S A (1999) Chronic liver disease: current concepts of disease mechanisms. JSAP 40 (3), 106-114 PubMed.
  • Sevelius E (1995) Diagnosis and prognosis of chronic hepatitis and cirrhosis in dogs. JSAP 36 (12), 521-528 PubMed.
  • Andersson M, Sevelius E (1991) Breed, sex and age distribution in dogs with chronic liver disease: a demographic study. JSAP 32 (1), 1-5 VetMedResource.

Other sources of information

  • Watson P J (2005) Diseases of the liver. In: BSAVA Manual of Canine and Feline Gastroenterology. 2nd edn. Eds: E J Hall, J W Simpson & D A Williams. BSAVA Publications. pp 240-268.
  • Willard M D (2005) Inflammatory canine hepatic disorders. In:T extbook of Veterinary Internal Medicine. 6th edn. Eds: S J Ettinger & E C Feldman. W B Saunders, Philadelphia. pp 1442-1447.

Related Images

RELATED ARTICLES

Adder bite poisoning

American Cocker Spaniel

Ampicillin

Amyloidosis

Anemia: immune mediated hemolytic

Anemia: non-regenerative

Anesthesia: in liver insufficiency

Anticoagulant rodenticide poisoning

Bedlington Terrier

Bile acid deficiency

Biliary system: disease (cholestatic disease)

Biopsy: hepatic

Biopsy: ultrasound-guided

Blood biochemistry: albumin

Blood biochemistry: alkaline phosphatase (ALP)

Blood biochemistry: ammonia

Blood biochemistry: aspartate aminotransferase (AST)

Blood biochemistry: bile acids

Blood biochemistry: cholesterol

Blood biochemistry: direct bilirubin

Blood biochemistry: gamma glutamyltransferase

Blood biochemistry: glucose

Blood biochemistry: overview

Blood biochemistry: urea

Canine adenovirus type 1 disease

Carprofen

Cocker Spaniel

Colchicine

Congenital portosystemic shunt (CPSS)

Dalmatian

Diabetes insipidus: nephrogenic

Diabetes mellitus

Diarrhea: chronic

Dietetic diet: for convalescence

Dobermann

Endocardiosis: tricuspid valve

English Springer Spaniel

Enteritis: lymphocytic plasmacytic

Fine-needle aspirate

Furosemide

Gastric ulceration

Gastroduodenal reflux

German Shepherd Dog

Heart: congestive heart failure

Hemostatic disorder: acquired

Hepatic encephalopathy

Hepatocutaneous syndrome

Hepatorenal syndrome

Hyperadrenocorticism

Hyperlipidemia

Hypoproteinemia

Lactulose

Laparotomy: midline

Leptospirosis

Life stage: geriatric

Liver function assessment

Liver: acute disease

Liver: chronic hepatitis

Liver: chronic hepatitis (Doberman)

Liver: cirrhosis

Liver: congenital diseases

Liver: copper accumulation - West Highland White and Skye Terriers

Liver: idiopathic fibrosis

Liver: lobular dissecting hepatitis (Standard Poodle)

Liver: neoplasia

Liver: steroid hepatopathy

Liver: toxic hepatitis

Lymphoma

Muscle relaxant: overview

Obesity

Pancreas: neoplasia: gastrinoma

Pancreatitis: acute

Paracetamol

Penicillamine

Peritoneal-pericardial diaphragmatic hernia (PPDH)

Peritonitis

Polyuria/polydispia (PU/PD)

Poodle: Standard

Pyometra

Radiography: abdomen

Radiology: liver

Ranitidine

Retriever: Labrador

S-adenosylmethionine

Silybin

Skye Terrier

Spironolactone

Sucralfate

Therapeutics: anesthesia/analgesia

Ultrasonography: liver

Ursodeoxycholic acid

Vitamin B Complex

Vitamin D

Vitamin E

Vomiting

West Highland White Terrier

WSAVA Liver Diseases Guidelines

Zinc salts

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!

 
 
 
 

To show you are not a Bot please can you enter the number showing adjacent to this field

 Security code