Doberman hepatitis

From Dog
Chronic hepatitis in a dog

Doberman chronic hepatitis is a genetic disease characterized by progressive inflammatory liver disease.

Doberman hepatitis shows a complex pattern of inheritance, and also involves an MHC class II immune-mediated association, suggesting a role of the immune system in the development of the disease[1].

In affected dogs, copper levels are elevated secondary to decreased biliary excretion[2]. However, hepatitis and increased hepatic copper levels without cholestasis have been reported in some cases[3], suggesting that copper accumulation may be an inciting factor[4].

This disease primarily affects middle-aged females, and clinical signs include anorexia, weight loss, vomiting, diarrhea, ascites, jaundice, polyuria and polydipsia. Advanced signs include melena, hematochezia and hepatic encephalopathy.

The hemostatic abnormalities may be due to reduced synthesis rather than increased consumption of coagulation factors[5].

Diagnosis is based on breed predisposition, and blood tests which usually show elevated ALT, alkaline phosphatase, bilirubin, ammonia, bile acids and reduced albumin. Coagulation disorders may be secondary to hepatic failure or concurrent von Willebrand’s disease[6].

Radiography and ultrasonography may show microhepatica, ascites and splenomegaly. Ultrasonography may identify nodular lesions in the liver. Necroinflammatory alterations associated with copper-laden parenchymal cells are the notable histopathologic finding.

Treatment consists of symptomatic and supportive care and immunosuppressive doses of prednisolone and azathioprine. Use of ursodeoxycholic acid may be beneficial.

Prognosis is usually poor because the disease is often advanced before it is detected.

References

  1. Dyggve H et al (2011) Association of Doberman hepatitis to canine major histocompatibility complex II. Tissue Antigens 77(1):30-35
  2. Webb CB et al (2002) Copper-associated liver disease in Dalmatians: a review of 10 dogs (1998-2001). J Vet Intern Med 16(6):665-668
  3. Cooper VL et al (1997) Hepatitis and increased copper levels in a dalmatian. J Vet Diagn Invest 9(2):201-203
  4. Merck Veterinary Manual
  5. Prins M et al (2010) Coagulation disorders in dogs with hepatic disease. Vet J 185(2):163-168
  6. Bexfield NH et al (2012) Breed, age and gender distribution of dogs with chronic hepatitis in the United Kingdom. Vet J 193(1):124-128