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Protein Deposits in Liver (Amyloidosis) in Dogs

Hepatic Amyloidosis in Dogs

Hepatic amyloidosis in dogs refers to the abnormal deposition of a fibrous protein called amyloid in the liver, which is a characteristic feature of a group of disorders known as amyloidosis. This condition often arises as a secondary reaction to underlying inflammatory or lympho-proliferative disorders, where excessive production of lymphocytes, a type of white blood cell, triggers the amyloid deposition. Reactive or secondary amyloidosis is most common in affected dogs, usually associated with primary inflammatory disorders, although familial amyloidosis has been observed in certain breeds such as beagles, shar peis, and foxhounds.

The deposition of amyloid can affect multiple organs, with clinical signs frequently linked to renal involvement. Hepatic amyloidosis may manifest through elevated liver enzymes, significant liver enlargement, coagulation abnormalities, liver rupture leading to hemoabdomen (blood in the abdomen), and/or liver failure. The accumulation of amyloid in the liver typically progresses slowly and insidiously.

Specific breeds like Chinese shar-peis with cyclic fevers (shar-pei fever syndrome), Akitas experiencing cyclic fever and multiple joint inflammations, and collies exhibiting “gray collie syndrome” are predisposed to developing amyloidosis. In these cases, renal symptoms usually precede liver-related manifestations, although some dogs may present symptoms of liver failure initially.

Symptoms and Types

  • Shar-peis may experience episodic fever and swollen hocks.
  • Akitas may exhibit episodic joint inflammation, pain, and signs of meningitis.
  • Common symptoms across breeds include sudden lack of energy, anorexia (loss of appetite), polyuria and polydipsia (excessive thirst and urination), vomiting, pallor, abdominal fluid (blood or fluid accumulation), yellowish skin and/or whites of eyes, enlarged abdomen, swelling, joint pain, and diffuse pain such as head pain and abdominal discomfort.

Causes

  • Familial immune disorders/genetics
  • Chronic infection
  • Cyclic neutropenia (gray collie syndrome)
  • Bacterial endocarditis (inflammation of the inner layer of the heart)
  • Chronic inflammation
  • Tumor

Diagnosis

To diagnose hepatic amyloidosis in your dog, it’s crucial to provide a detailed history of your dog’s health and the onset of symptoms to your veterinarian. The history can provide important clues about which organs are primarily affected. Your veterinarian will conduct a comprehensive physical examination and may request the following tests:

  • Blood chemical profile, complete blood count, electrolyte panel, and urinalysis: These fundamental tests help rule out other potential causes of disease. They can reveal abnormalities in kidney and liver function, as well as indicate the presence of anemia or infection.
  • Clotting profile: This test assesses the liver’s functionality.
  • X-ray and ultrasound imaging: These imaging techniques can detect abnormalities in organs where amyloid may be accumulating.
  • Biopsy: In some cases, a minor surgical procedure may be necessary to obtain a sample of liver or other affected organs for biopsy analysis.
  • Joint taps: If joint swelling is present, samples of joint fluid may be collected for cytology, a microscopic examination of cells, to confirm or rule out the presence of malignancies.
  • Analysis of abdominal fluid: The composition of any fluid buildup in the abdomen can be analyzed in the laboratory.

These diagnostic measures help veterinarians confirm the presence of hepatic amyloidosis and determine the extent of organ involvement in affected dogs.

Treatment

While there is no cure for amyloidosis, supportive care plays a crucial role in managing the condition. Depending on the severity of symptoms and organ involvement, the following treatments may be recommended:

  • Blood transfusions: If your dog has experienced significant blood loss, blood transfusions may be necessary to restore blood volume and oxygen-carrying capacity.
  • Fluid therapy: Administering fluids helps maintain hydration and supports organ function. Adjustments to the dog’s diet may also be necessary to accommodate changes in organ function.
  • Tailored diet: Each patient should have a customized diet to address the specific organ dysfunction that is most affected.
  • Surgery: Surgical intervention may be required in cases of liver lobe fracture or other complications associated with hepatic amyloidosis.

By providing supportive care and addressing specific symptoms, veterinarians aim to improve the quality of life for dogs affected by hepatic amyloidosis.

Recovery and Management

Managing hepatic amyloidosis in dogs poses challenges and typically carries a guarded to poor prognosis. Many animals will experience episodes of fever and cholestasis, where bile flow from the liver to the small intestine is impaired. While some dogs may respond to medication, resulting in resolved clinical signs and reduced hepatic amyloid, outcomes vary.

Shar-peis may survive for more than two years with appropriate management. However, Akitas with cyclic clinical signs tend to have a grave prognosis. Your veterinarian will schedule follow-up appointments as necessary to monitor your dog’s organ function and overall condition. Regular monitoring is essential for assessing response to treatment and making any necessary adjustments to the management plan.

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