Liver disease in dogs can be challenging to diagnose and manage due to its varied causes and complex presentations. From chronic hepatitis to copper-associated liver disease, veterinary professionals need a deep understanding of diagnostic tools, treatment approaches, and patient management strategies to provide the best possible care.

In this blog, we’ll explore the latest insights into canine hepatobiliary disease, focusing on chronic hepatitis, diagnostic advancements, and treatment innovations.

Understanding Chronic Hepatitis in Dogs

Chronic hepatitis (CH) is a progressive inflammatory condition of the liver that can lead to fibrosis and cirrhosis if left untreated. The disease has various known and suspected causes, including:

• Infectious agents – Leptospira spp. and other bacteria have been linked to some cases.

• Toxins & drugs – Phenobarbital, primidone, phenytoin, and lomustine can contribute to liver damage.

• Copper accumulation – Some breeds, like Bedlington Terriers, Dalmatians, and Labrador Retrievers, are genetically predisposed to copper-associated hepatitis.

• Immune-mediated causes – Though not fully understood, immune system dysregulation is suspected in some cases.

The early stages of CH are often asymptomatic, making it difficult to detect before significant liver damage occurs.

Diagnosing Liver Disease: The Role of Histopathology & Imaging

Since the liver has a high regenerative capacity, early diagnosis is key to preventing irreversible damage. The gold standard for diagnosing chronic hepatitis remains liver biopsy and histopathology, allowing for:

• Identification of inflammatory patterns – Determines whether an immune-mediated or infectious process is at play.

• Copper staining – Helps diagnose copper-associated liver disease.

• Fibrosis evaluation – Determines the severity of tissue damage.

While abdominal radiography and ultrasound are useful for detecting changes in liver size and texture, they often fail to provide a definitive diagnosis. Advanced techniques such as thromboelastography (TEG) and fluorescent in situ hybridization (FISH) are also emerging as valuable tools for assessing coagulation status and detecting bacterial infections in the liver.

Treatment Approaches: From Anti-Inflammatories to Nutraceuticals

Management of canine chronic hepatitis depends on the underlying cause and the extent of liver damage. Some of the key treatment strategies include:

1. Anti-Inflammatory & Immunosuppressive Therapies

• Corticosteroids – Used in cases with biopsy-confirmed inflammation but contraindicated in advanced fibrosis.

• Cyclosporine & Azathioprine – Immunosuppressive options for suspected immune-mediated hepatitis.

2. Copper-Associated Hepatitis Treatment

• Copper chelators – Such as D-penicillamine or zinc therapy to reduce copper absorption.

• Dietary modifications – Low-copper diets are essential in managing affected dogs.

3. Hepatoprotective Agents & Antioxidants

• Ursodeoxycholic acid (UDCA) – Supports bile flow and protects liver cells.

• S-adenosyl-L-methionine (SAMe) & Vitamin E – Act as antioxidants to reduce liver damage.

4. Supportive Care & Diet Adjustments

• High-quality, digestible protein – Helps maintain liver function without excessive strain.

• Diuretics like spironolactone – Used in cases with ascites.

Why This Matters for Veterinary Professionals

Liver disease in dogs is often progressive and requires a multidisciplinary approach for diagnosis and management. By staying updated on new diagnostic tools and treatment options, veterinarians can improve outcomes for their patients.

For those looking to deepen their understanding of hepatobiliary diseases, this topic is covered in The Webinar Vet’s latest course:

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Reference:

This blog is based on the course notes from Dr. Nick Bexfield, as part of the Advanced Small Animal Medicine: Case-Based Insights and Innovations course.