https://www.barkandwhiskers.com/2015-08-30-nl-chronic-active-hepatitis/
https://www.barkandwhiskers.com/p/bf0e4b1b-9271-4aee-bb61-a45d5a89bb03/
By Dr. Becker
Chronic active hepatitis, or CAH, is a disease in which a pet suffers from persistent and progressive inflammation of the liver. The word active in this context means that the liver cells are continually inflamed and dying. Over time, this inflammatory process replaces normal liver tissue with scar tissue, leading to a condition called cirrhosis (scarring) of the liver.
CAH is more common in dogs than cats and is sometimes called chronic canine inflammatory liver disease. CAH is seen in all dog breeds, both sexes and at all ages, although it is most common in middle-aged to older female animals.
Certain breeds are predisposed to the disease, including Bedlington Terriers, Doberman Pinschers, Skye Terriers, Standard Poodles, Cocker Spaniels and West Highland White Terriers.
What are the causes of chronic active hepatitis?
Most cases of chronic active hepatitis have no known cause. However, certain diseases can lead to CAH, including leptospirosiscopper storage disease, autoimmune diseases, and drug and chemical toxicities.
Another disease that can trigger CAH is infectious canine hepatitis, or ICH, caused by canine adenovirus type 1 (CAV-1). The infection can damage cells throughout the dog’s body, including the liver.
At one time, there was a vaccine to protect dogs against adenovirus type 1, but it was abandoned because it caused a condition called blue eye. Today we vaccinate against canine adenovirus type 2 (CAV-2), which is a kennel cough virus, and the same core vaccine also provides cross-protection against canine adenovirus type 1. Fortunately, outbreaks of infectious canine hepatitis are rare in the United States.
Aflatoxins found in moldy grains are another cause of CAH, which is one of the reasons why I do not recommend feeding animals dry foods containing grains such as corn, wheat, soy, or rice.
Additionally, the way an animal’s immune system responds to liver inflammation can contribute to the progressive worsening of the disease.
Symptoms of CAH
Symptoms of chronic active hepatitis include:
Slowness Excessive urination Lack of appetite Jaundice (yellowish discoloration of the gums and skin) Vomiting Accumulation of fluid in the abdomen (ascites) Weightloss Poor physical condition Excessive thirst Neurological symptoms such as dullness or seizures caused by a buildup of ammonia in the body
Diagnosing CAH
Diagnostics your veterinarian will need to perform: a variety of blood tests, including a blood clotting profile; urine analysis; serum bile acids; ammonia levels; abdominal x-rays and/or ultrasound; Liver biopsy; and culture and sensitivity tests to check for liver infection.
The definitive diagnosis of CAH is usually based on blood chemistry test results indicating increased liver enzyme levels, as well as a liver biopsy.
Treatment options
Treatment for CAH focuses on treating the underlying causes, decreasing inflammation in the liver, supporting its recovery, and trying to stop the progression of the disease.
Very sick animals should be hospitalized and treated aggressively. They will need to receive intravenous (IV) fluid therapy to treat dehydration caused by severe vomiting, diarrhea, and/or anorexia (refusal to eat).
Any medication that needs to be eliminated through the liver should be stopped immediately.
Medications may be given to decrease fluid buildup in the abdomen, improve bile flow, treat any infections present, treat gastrointestinal ulceration if present, relieve swelling in the brain to control seizures, decrease production and absorption of ammonia in the body, remove copper from the liver and decrease liver scarring.
Holistic veterinarians, including myself, may also treat CAH patients with supplemental zinc, vitamin K, S-adenosylmethionine (SAMe), milk thistle, n-acetylcysteine (NAC), glutathione and a variety of Chinese herbs.
Nutritional support and dietary management will also be necessary. I highly recommend stopping all processed foods and switching to an organic, fresh diet containing high-quality proteins, fresh fruits and vegetables loaded with detoxifying antioxidants and balanced for patients with liver dysfunction, which means generally lower levels of copper than those found in traditional foods. pet food.
Chronic active hepatitis can be a difficult disease to treat and, unfortunately, is rarely cured. If left undiagnosed or poorly treated and monitored, CAH can progress to liver cirrhosis and ultimately life-threatening liver disease.
But with constant care and monitoring, the progression of the disease can often be slowed and the animal can enjoy a very good quality of life.
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