CHRONIC HEPATITIS

WHAT IS IT?

WHAT PART OF THE BODY DOES IT AFFECT

Chronic Hepatitis is a catch-all diagnosis for a number of diseases where there is inflammation and death of liver tissue. Affected dogs develop a progressive liver disease. There can be many possible causes including viruses, bacterial infection, and some drugs.

When looking at the liver (either in medical text or in surgery), it appears as nothing more than a largish reddish brown mass. With the exception of the attached gall bladder, it has few distinguishing external or internal features. It is divided into several lobes or sections, but even these are joined together in such a way that they are sometimes difficult to distinguish one from another.

However, the liver is an extremely important and unique organ in the body, as it is responsible for performing well over 1,000 different tasks, most of which are necessary to life and could not be done anywhere else in the body.

Uniquely, the liver has the ability to grow back (or regenerate). Even in cases where large portions of liver tissue have been severely damaged, the liver constantly amazes clinicians with its ability to recover. Sections that have lost their ability to function, when given supportive medications and a little time, will frequently recover completely.

The medium through which the liver carries out its functions is the blood. The liver is an organ through which thousands of miles of blood vessels course, carrying blood in such a way that it comes into contact with each and every liver cell.

It is so filled with blood and vessels that a freshly cut section appears just like a saturated sponge. Twenty percent of the blood pumped by each and every beat of the heart goes through the liver. Every blood vessel leaving the gastrointestinal tract goes directly into the liver.
The liver takes from, adds to, and changes in some way, all of the blood that passes through its mass. Its cells perform their 1,000-plus tasks 24 hours of every day responding to every need of the body through a complicated array of chemical communications. If a section of an animal’s body needs a compound that is manufactured by the liver, molecular messages tell it to produce and release more. If other products such as glucose get too low in the blood, the liver converts a storage compound (called glycogen) into glucose and then releases it into the veins leaving the liver. Other materials will be collected from the blood and stored for future needs. All at the same time, different molecules will be constantly manufactured by the cells, while other potentially harmful ones will be filtered out and destroyed.

To tell you about all of the functions of the liver would take an entire book, so here is a list of some of the important ones:

o Production of proteins – Building blocks of the dog’s body, the main components of muscle, skin, cell
  walls, tendons, connective tissue, blood vessels.

o Metabolism of carbohydrates and lipids – Energy stores that run the dog’s body.

o Vitamin production and storage – Vitamins A, D, E and K. are stored or in some way regulated by the
  liver.

o Storage of nutrients – Those other than vitamins, fats, glycogen etc. Pre-determined quantities of
  several metals like iron, copper and since are kept within the liver for future use in the body. Blood is also
  another important storage factor within the liver. It is estimated that up to 15% of all blood within the body
  is within the liver at any one time.

o Digestion – Many of the compounds produced or excreted from the liver form bile, which goes from the
  gall bladder through the bile duct into the small intestine to aid the breakdown of food.

o Detoxification - The breaking down and excretion of numerous compounds. If the liver fails to eliminate
  these, the dog dies.

The liver has a large reserve capacity, meaning there must be damage to a significant portion of it before any signs of illness are often noticed. The first signs are generally vague and non-specific, and can include loss of appetite, vomiting, weight loss, depression, lethargy and/or increased drinking and urination. As the disease becomes advanced, there will be signs more specific to liver failure such as jaundice (you may for example notice that the white of the dog’s eyes become yellow), coagulation (thickening/clotting of the blood) problems, fluid accumulation (ascites), extreme weight loss, and neuralgic abnormalities such as head pressing or behavioural changes, due to the build up of toxins normally metabolised by the liver.

If your Vet suspects that your dog’s liver might be the cause of the clinical signs being expressed in your dog, he will first elect to perform some routine diagnostic blood tests which will show elevations of liver enzymes (ALTs), if the dog is indeed compromised by problems with its liver. Once the problem has been pinpointed and confirmed from these results, your Vet might choose to perform a liver biopsy, which will be sent to a Pathologist for examination and reporting. This is necessary in order to differentiate chronic hepatitis from other causes of liver disease (such as liver cancer or infection) and of course to determine the severity or extent of the problem.

Unfortunately, liver damage is often advanced by the time the disease is recognised. Depending on the stage of your dog’s illness when it is diagnosed, treatment may involve intravenous fluids, antibiotics, corticosteroids, dietary management, and possibly medication to reduce copper levels in the liver (should they be present). As you can see, it is important therefore that if you notice any signs that your dog may have problems with its liver that you get to your Vet as quickly as possible.

A full-scale research project into the cause of Chronic Hepatitis in English Springer Spaniels is being carried out by Principal Researchers Penny Watson and Nick Bexfield at The Queen’s Veterinary School Hospital, University of Cambridge.

ESS Breed Clubs Health Co-ordinators:

Lesley Bloomfield Tel: 01923 823579 Email:
Louise Scott (Tel: 020 8427 3396 Email:

Liver and Gall Bladder Diagram

WHAT ARE THE SYMPTOMS OF CHRONIC HEPATITIS?

HOW IS IT DIAGNOSED?

WHAT IS THE TREATMENT?

RESEARCH PROJECT