Chronic Active Hepatitis

Chronic Active Hepatitus (CAH) is suspected in the presence of persistently elevated ALT values, definitively diagnosed by liver biopsy.

The incidence of occurence tends to be high in Doberman Pinschers, but it is also found in other breeds, most notably, Bedlington Terriers, and Golden Retrievers.

It is viewed as being a progressive inflammatory state that causes the liver to degenerate to the point of liver failure and death. We do not have a standard treatment, nor do we know the definitive cause. There are no studies that prove CAH is heritable. .Low fat, low protein diets can help, and some have used steroids with a degree of success. The steroids were originally given when researchers thought this was an autoimmue disease, because humans do have a form of autoimmune CAH, with similar histology results on biopsy. However, leading researchers in the field no longer view CAH as an autoimmune disease in the canine.

According to current research, there is usually a elevated level of copper found early on in the liver, but this seems to be a result of the disease, and not the cause.   Removal of the copper does not cure CAH, but in the early stages copper chelation therapy may slow the progress of CAH.

During CAH, as the liver cells die, and they release a protein that causes the elevated ALT values.   Scar tissue then replaces the dead liver cells.   This effects the blood vessels that exit the liver.   This is important because the liver is a major filtering organ for the body.

Symptoms usually show when at least half of the liver has been destroyed.   The dog is usually sick by that point in time, and demonstrating the following clinical signs of CAH: vomiting, diarrhea, jaundice (yellow tinge to skin and whites of eyes), weight loss, and fluid accumulation in the abdomen (ascites).Genetic

For more info on Chronic Active Hepatitis and liver disease in Dobermans, go to:
Portosystemic Shunts in Dogs

submitted by
Suzanne McDonald
DPCA Public Education Committee

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