PubMed Abstract PMID: 14738204
This abstract also posted in the files section of the K9Kitchen discussion group.

Monica's Comments
This author notes that, although several liver treatment drugs have reached the market, they have very few controlled studies to see how well these drugs will treat the various forms of liver disease.

Chronic hepatitis is actually several diseases grouped together by one result: a sick or dying liver. Several causes create this problem so, Dr. Honeckman says that, if you know the cause (by asking for a liver biopsy), you can select the right medicine to treat the real problem. In fact, he explicitly states that a biopsy is essential for a definite diagnosis and optimal therapy.

For example, he notes that copper-associated disease should be treated with zinc and copper chelators. On the other hand, idiopathic and chronic disease is considered immune related and treatment consists of three prongs:
· Controlling inflammation using prednisone or azathioprine
· Reversing fibrosis using colchicine
· Protect against oxidant damage using vitamin E, ursodeoxycholic acid and S-adenosylmethionine

He notes that if the liver disease is discovered early, the dog could still live for years after recovery. However, prognosis is poor for those dogs discovered with end-stage conditions.

The full study is published in the November 2003 issue of Clinical Techniques in Small Animal Practice.

The Abstract
Chronic hepatitis is a common disorder in dogs seen by general practitioners. Several new drugs have been marketed for treating this disease. Unfortunately, there are few controlled studies that examine the efficacy of these medications for the treatment of canine chronic hepatitis. A rational therapeutic approach can be implemented based on histopathologic findings of a liver biopsy. A liver biopsy is essential for establishing a definitive diagnosis and guiding the optimal therapy. The biopsy allows characterizing the inflammatory process, quantitating hepatic copper concentrations, and determining if fibrosis is present. Copper associated hepatopathy is treated with zinc and copper chelators. Idiopathic chronic hepatitis is thought to be immune mediated. The treatment of idiopathic chronic hepatitis consists of controlling inflammation (prednisone, azathioprine), reversing fibrosis (colchicine), and protecting against oxidant damage (vitamin E, ursodeoxycholic acid, S-adenosylmethionine). The prognosis for chronic hepatitis is quite variable. Dogs with end-stage disease have a poor prognosis, while dogs diagnosed earlier can have a mean survival of years. Early diagnosis and intervention are key to the successful treatment of dogs with chronic hepatitis.

Study Authors
Honeckman A.
Mobile Veterinary Diagnostics, Casselberry, FL 32707, USA

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