A retrospective study of oral prednisolone treatment in canine chronic hepatitis

Abstract

Background: Only one study reports prednisone to prolong survival in dogs with chronic hepatitis irrespective of the causative agent. The aim of this retrospective study was to investigate the effects of prednisolone treatment on survival, clinicopathological variables, and histological grade and stage of idiopathic chronic hepatitis in 36 dogs. Animals and methods: Medical records were reviewed of 36 prednisolone-treated dogs (median age: 8.6 years; range: 2.0-14.6 years) with chronic hepatitis not associated with primary copper accumulation. Clinicopathological results were analyzed pair-wise for 20 dogs, before and after oral prednisolone administration (1 mg/kg BW/day). Dogs were treated for at least 6 weeks, and for an additional 6 weeks if hepatitis was still present at rebiopsy. Follow-up data pertaining to clinical outcome and survival time (Kaplan-Meier estimate procedure) were analyzed. Results: At the follow-up, 11 dogs were in complete remission, 8 dogs had recurrent clinical signs, and 17 dogs had residual disease. Despite treatment, 20 dogs died of hepatitis-related causes. Dogs without cirrhosis survived significantly longer than dogs with cirrhosis. Prednisolone treatment normalized coagulopathies associated with chronic idiopathic hepatitis within one week in all 10 dogs that had coagulopathies at initial diagnosis. Conclusions: Our findings suggest that prednisolone has, in part, beneficial effects on hepatic inflammation and that it may, at least in some cases, limit the progression of fibrosis, which emphasizes the importance of early diagnosis and treatment. We did not see any benefit of prednisolone treatment for dogs with cirrhosis. We could document a highly favorable effect of prednisolone treatment on the coagulopathy associated with canine chronic idiopathic hepatitis.

Sensitivity and Specificity of PlasmaALT,ALP, and Bile Acids for Hepatitis in Labrador Retrievers

“…If these dogs were included in the study and specificity was determined in all dogs, true specificity of biochemical indicators would likely be lower. In the present study, twelve dogs received 1 mg/kg prednisone treatment for 1 week to normalize coagulation parameters, and liver biopsy was therefore precluded. It is known that prednisone treatment can lead to glycogen accumulation in the hepatocytes .…”

“…It is known that prednisone treatment can lead to glycogen accumulation in the hepatocytes . In addition, prednisone has beneficial effects on inflammation and in some dogs might even reduce or limit the progression of fibrotic changes . In our study, no steroid induced hepatocellular changes (ballooning) were present on histopathology, but it cannot be excluded that short‐term prednisone treatment ameliorated necro‐inflammatory activity in these dogs.…”

“…Platelet count was determined in an EDTA blood sample. When coagulation parameters were not within reference range, the liver biopsy procedure was postponed and dogs were treated with 1 mg/kg prednisone daily during 1 week to normalize coagulation parameters …”

Hepatic progenitor cells in canine and feline medicine: potential for regenerative strategies

“…In dog and cat, liver transplantation is not performed. Since the etiology of liver disease is often not known, current therapy in veterinary medicine is restricted to symptomatic treatment and the use of corticoids [114-117]. To be able to improve patient survival and disease outcome, new curative therapies for advanced liver disease are required.…”

Hepatic Fibrosis in Dogs

“…The response of dogs with idiopathic CH to glucocorticoids seems to be quite variable. In a retrospective study of 20 dogs with idiopathic CH that were treated with prednisolone at a dosage of 1 mg/kg PO q24h for at least 6 weeks, fibrosis resolved in 5 dogs, improved in 4 dogs, and worsened in 5 dogs, but a statistically significant difference in histological fibrosis scores before and after treatment was not found . However, in an older retrospective study that did not separate dogs with copper‐associated CH from those with idiopathic CH, prednisolone treatment was associated with longer median survival times .…”