canis - Articles
Hepatomegaly
Introduction
- Hepatomegaly in dogs is typically recognized during presentation for non-specific signs such as weakness, lethargy and inappetence. These patients are sometimes jaundiced.
- Causes: infectious and toxic causes are typically associated with younger animals while neoplastic and cardiac causes are seen more frequently in older dogs.
- Treatment: definitive diagnosis is required to establish an appropriate therapeutic plan and to correctly assess the quality of response so that modifications to treatment can be implemented.
- Prognosis: dependent on the underlying cause and ranges from excellent to hopeless.
Presenting signs
- Incidental finding.
- Abdominal distension.
- Signs associated with underlying disease.
Public health considerations
- Leptospirosis Leptospirosis can be a zoonosis.
Special risks
- Patients with hepatic disease often require hepatic biopsy Biopsy: hepatic for definitive diagnosis, but hepatic insufficiency can result in coagulation factor deficiency resulting in increased tendency to bleed or even DIC Disseminated intravascular coagulation. It is routine to perform coagulation testing in patients undergoing hepatic biopsy.
Pathogenesis
Etiology
- Congestion:
- Right sided cardiac failure, eg pericardial effusion Pericardial disease.
- Upper caudal vena cava obstruction.
- Neoplasia Liver: neoplasia :
- Hepatocellular carcinoma Liver: hepatocellular carcinoma.
- Bile duct carcinoma Biliary system: disease (cholestatic disease).
- Hepatoma.
- Lymphoma Lymphoma.
- Hemangiosarcoma (primary) Hemangiosarcoma.
- Neuroendocrine carcinoma (carcinoid).
- Metastatic neoplasia, eg hemangiosarcoma, intestinal adenocarcinoma, mast cell neoplasia Skin: mastocytoma.
- Malignant histiocytosis Malignant histiocytosis.
- Leukemia Leukemia.
- Inflammation:
- Toxic damage.
- Hepatic abscess.
- Cholangiohepatitis (immune-mediated) Liver: cholangiohepatitis.
- Infection Liver: acute disease :
- Leptospirosis Leptospirosis.
- Cholangiohepatitis (bacterial) Liver: cholangiohepatitis.
- Viral hepatitis Liver: chronic hepatitis.
- Distemper Canine distemper disease.
- Infiltrative/metabolic:
- Fat, glycogen. Typically associated with endocrinopathy, eg diabetes mellitus Diabetes mellitus or hyperadrenocorticism Hyperadrenocorticism.
- Neoplasia.
- Miscellaneous:
- Torsion.
- Extramedullary hematopoiesis.
- Benign nodular hyperplasia.
- Hematoma.
- Polycystic liver.
- Lysosomal storage disease Storage disease.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Clifford C A, Pretorius E S, Weisse C et al (2004) Magnetic resonance imaging of focal splenic and hepatic lesions in the dog. JVIM 18 (3), 330-338 PubMed.
- Stockhaus C, Van den Ingh T, Rothuizen J & Teske E (2004) A multistep approach in the cytologic evaluation of liver biopsy samples of dogs with hepatic diseases. Vet Pathol 41 (5), 461-470 PubMed.
- Cuccovillo A & Lamb C R (2002) Cellular features of sonographic target lesions of the liver and spleen in 21 dogs and a cat. Vet Radiol Ultrasound 43 (3), 275-278 PubMed.
- Wang K Y, Panciera D L, AL-Rukibat R K et al (2002) Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytological findings in dogs and cats: 97 cases (1990-2000). JAVMA 224 (1), 75-78 PubMed.