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Cirrhosis

Cirrhosis of the liver can occur as the end result of several liver diseases, which may be why it is hard to find information on this condition as a separate entity. Cirrhosis can occur in copper storage diseases of the liver, as the end result of idiopathic chronic hepatitis (also called chronic active hepatitis, chronic canine inflammatory hepatic disease and probably other names), as a breed related disorder (several terrier breeds, Dobermans, Labs, cockers and standard poodles), due to anti-seizure medications and possibly due to long term treatment with non-steroidal anti-inflammatory drugs such as carprofen or meloxicam. It is sometimes the end result of infectious illnesses, especially leptospirosis and infectious canine hepatitis (pretty rare now).

Of these conditions, the one that usually shows up without much warning is the idiopathic vacuolar hepatopathy. This condition can sometimes go on for long periods of time with no really obvious clinical signs and affected patients may have markedly decreased liver size and function when the condition finally causes clinical signs. Even at this point it is often possible to help make patients feel better and stave off end stage cirrhosis for some time.

The usual recommendations are to use a low to moderate protein diet to try to decrease the liver’s work load, use metronidazole or neomycin orally if there are signs of central nervous system disturbance, to give lactulose for the same reason, and to to consider the use of cholchicine, ursodiol (Actigal Rx), SAMe (Denosyl SD-4 Rx), and miulk thistle.  Copper chelating agents may be added if necessary and to provide general supportive care, such as gastrointestinal protects if GI ulceration occurs, fluid therapy if there is dehydration, Vitamin K if blood clotting problems occur, and possibly Vitamin E as an anti-oxidant. In liver disease, at least if copper toxicosis is possible, it is best to avoid Vitamin C supplementation as it can make the copper toxicity worse

As the diseases mentioned above progress, they slowly destroy liver cells, resulting in scarring and an increase in fibrosis in the liver, or cirrhosis. . . .

It can be pretty hard to go back at the time that cirrhosis has set in to figure out why it occurred, so when the liver disease is discovered at this stage, it may not be possible to offer information on the underlying disease and thus the diagnosis of cirrhosis, rather than a more specific diagnosis.

 

Roger L. Welton, DVM
Founder and Chief Editor, Web-DVM.net
CEO, Attending Veterinarian, Premier Veterinary Care

Host, Space Coast Pet Podcast

 

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