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
Increased bleeding tendencies
Diagnosis
Liver biopsy and culture/sensitivity
Treatment
Hospitalization and support (fluid and electrolyte therapy) as needed for dehydration from severe vomiting, diarrhea and anorexia
Treatment of any underlying disorders.
Nutritional support and dietary management
Antibiotic therapy
Corticosteroids to decrease inflammation
Drugs that stimulate the liver (choleretic) to enhance bile flow
SAMe to improve liver metabolism
Copper chelating drugs to bind and eliminate copper from the liver
Diuretics to help decrease water retention in the body
Vitamin K supplementation
Antifibrotic agents to decrease scarring in the liver
Home Care and Prevention
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.
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