Chronic Hepatitis of Skye Terriers and Cocker Spaniels
Chronic hepatitis in Skye Terriers and Cocker Spaniels is associated with increased hepatic copper concentrations. However, increased copper levels are attributed to cholestasis and decreased biliary excretion of copper and not to a primary copper retention disorder.
Young male Cocker Spaniels (American and English) appear to be most affected. Ascites is the most common physical abnormality; other clinical signs include depression, icterus, dehydration, and melena. Hepatitis can affect Skye Terriers at any age. Dogs can be asymptomatic or in end-stage liver failure. Three separate stages of liver disease have been described and vary from mild inflammation with no evidence of cirrhosis or copper accumulation to advanced macronodular cirrhosis, cholestasis, and marked copper accumulation.
The most common laboratory abnormalities are mild anemia; mature neutrophilia; low BUN; hypoalbuminemia; bilirubinuria; bilirubinemia; and elevated AP, blood ammonia, and serum bile acids.
Supportive care and use of specific therapy as indicated (eg, antibiotics if bacterial cultures are positive), along with choleretics, antifibrotic agents, and low-protein diets may be effective. Ursodeoxycholic acid is used if significant cholestasis is noted without biliary obstruction. The use of colchicine as an antifibrotic agent may be limited by side effects that include nausea, vomiting, and hemorrhagic diarrhea. Use of immunosuppressive drugs is controversial but recommended if there is no evidence of infectious disease, if there is strong evidence of immune-mediated disease, or if active disease is evident on biopsy. Prednisolone can be given at 1-2 mg/kg, divided bid until clinical remission, after which the dosage is slowly reduced. Complete remission is difficult to evaluate clinically and may require a followup biopsy. Prognosis depends on the amount of damage sustained by the liver and the degree of fibrosis but can be favorable if damage is mild to moderate and if initial therapy is effective.
Prognosis is poor due to the extent of liver damage at the time of diagnosis.