ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs
Webster, C.R.L. et al. (2019) ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs. Journal of Veterinary Internal Medicine, 33 (3), pp. 1173-1200
This consensus statement on the diagnosis and treatment of chronic hepatitis (CH) in dogs is based on the expert opinion of seven specialists, a review of the veterinary literature and selective use of literature on CH in humans.
The statement presents the information under nine main headings:
- Definition of CH
- Drugs and toxins
- Metabolic conditions
- immune-mediated CH
For each the relative strength of the evidence is discussed.
- Signalment and clinical signs including discussion on breed, sex and age predispositions and clinical signs taken from the literature
- Clinical pathology including discussion on serum enzymology, function tests, haematology and coagulation testing and urinalysis
- Biopsy acquisition including discussion on pre-biopsy considerations, sampling methods and biopsy specimen interpretation
- Treatment including discussion on the treatment options for the specific causative agents as well as for non-specific idiopathic CH
- Complications – including portal hypertension, ascites, hepatic encephalopathy, gastroduodenal ulceration, coagulation and infection
The statement concludes with suggestions of critical areas for future research on CH in dogs.
Limitations include the fact that there is no explicit statement of the aim or methodology used in the main body of the paper and the limited search of the veterinary literature.
These consensus guidelines provide practitioners with a useful overview of the current evidence on the diagnosis and treatment of chronic hepatitis in dogs. They provide a good basis on which to produce local practice guidelines.
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