Chronic Active Hepatitis

 

9/21/11 – I just started a Google Group for CAH in Dogs. Please join and share your story! http://groups.google.com/group/chronic-active-hepatitis-in-dogs

 

In an earlier post, I introduced you to my dog, Misty Blue, the Blue Doberman and touched on a skin issue that is common to dilute color Dobes. Today, I would like to touch on a much more serious issue that she has that is also very common to female blue Dobermans called Chronic Active hepatitis (CAH).

I pulled this description from the PetPlace.com website . Please click here to visit their site to see the full article.

Chronic Active Hepatits is a chronic and progressive inflammation of the liver of dogs that leads eventually to the replacement of normal liver tissue with scar tissue. The disease is also called chronic canine inflammatory hepatic disease. In most cases, the cause of this disorder is never discovered. Potential causes include canine hepatitis virus (adenovirus I), leptospirosis, copper storage disease, drug toxicity, and genetic factors. Reactions on the part of the immune system to the liver inflammation may contribute to the progressive worsening of the disease.

All breeds of dogs can be affected, although the incidence is greater in the Bedlington terrier, West Highland white terrier, Doberman pinscher, cocker spaniel and Skye terrier. CAH usually occurs in middle-aged animals, and females appear to be at higher risk.

CAH came into our lives very suddenly a little less than a year ago. Misty is normally a very, very (very) active girl. We knew something was wrong when she was laying around the house and not eating much at all for a few days. In the days following that, she started vomiting … a lot. She did not want to eat anything and the few things that we were able to coax her to eat came right back up. She was drinking a ton of water, like 6-8 bowls of water a day. We knew that there was something very wrong so of course, we got her in immediately to see our vet, Dr. Bracken at the Arcadia Animal Clinic.

After a few days of medication that was supposed to ease her stomach and reduce the vomiting, she was still not feeling much better. So, Dr. B had us come back in to have an ultrasound and biopsy of her liver done. A few days later, he called us with the results. She did indeed have Chronic Active Hepatitis and the levels in her liver were at a very dangerous level. We needed to start an immediate and very aggressive treatment program.

Misty was put on a strong antibiotic, steroids, a medicine to help reduce the levels of copper in her liver (forgot what it was called but it was a liquid that I had to squirt down her throat because she hated the taste), Zinc Acetate and a medicine that contains Sam E called Denosyl. I was also instructed to add a capsule of Vitamin E to her food at each feeding.

I started scouring the internet to read all about this condition and what I read scared me half to death. Most of the articles out there indicate that once a dog starts showing signs of the disease, their days are numbered. Some dogs only lived for days after diagnosis while some could survive for months or even years. I read that the first thing I needed to do was to reduce the amount of Copper in her diet because in very simple terms, this condition is the inability of the liver to process Copper, causing it to build up to toxic levels. I then learned that every commercial dog food on the market contains copper because it is a required nutrient that is essential for dogs. So, what do I do now?

I started her on a homemade diet using the following recipe:

Canine Casserole

• One 4 lb bag of frozen boneless chicken breasts (boiled and chopped)
• 4 medium sweet potatoes (boiled, peeled and chopped)
• 4 cups rice (cooked)
• 1 bag frozen green beans (thawed)
• 6 eggs (hard boiled, peeled and chopped)
• ¼ cup Flax Oil
• Powdered vitamin supplement (check with your vet for the best kind for your dog’s needs)

Cut the boiled chicken into small pieces and place in a large mixing bowl.  Remove the skins from the boiled and cooled sweet potatoes then cut into chunks and add to the bowl. Add the rice, green beans, eggs, flax oil and vitamin supplements. Wait for everything to cool. Wash your hands, remove you rings and bracelets and dig your hands in to mix all the ingredients together. Fill up several Tupperware containers with the mixture and keep one in the fridge and the others in the freezer until you need them. Defrost the frozen containers overnight in the fridge. Check with your vet for feeding quantities and frequency. 

It seems that all the medicine she was on brought her appetite back and she LOVED the taste of her new food. She started devouring it and it seemed that she could never get enough. I think the steroids also made her constantly hungry. I was spending more time cooking for her than I was for my husband. But it all paid off because she showed a remarkable improvement within a few days.

Dr. B rechecked her blood every few weeks until her liver levels were down to a normal level again. After a few months, she was off everything except the Denosyl and Zinc Acetate. She will probably remain on these two indefinitely. I have kept her on the homemade diet ever since but she has been steadily losing weight even though she eats like a pig. I have been growing concerned about her weight and thought that she might not be getting all of the nutrients that she needs from this diet. I heard many wonderful things about Innova brand dog food and that it contains a very low copper content. So, I started slowly introducing it into her diet. Right now, she is at ½ Innova and ½ homemade food. She seems to be doing fine. The only thing that I have noticed is that she is drinking more water than usual.. But it is the dead of summer in Phoenix and she should be drinking more water.

I will be bringing her in for blood work in a few days just to make sure that things are still under control. Unless these tests prove otherwise, I think that Misty is real lucky to have such a very caring and knowledgeable vet as Dr. Bracken. She’s also lucky to have a dog-mom and dog-dad that are willing to do whatever it takes to keep her healthy and happy. So, hopefully Misty has beaten the odds and will live out a normal life without any more complications. If any do come up, I will be sure to post them to keep those of y0u that are battling the same issue up to date.

Update on 7/28/09 – Misty’s blood results came back and her liver levels are still doing great. Wooo Hooo! She is still eating half homemade food and half Innova dry food. She is starting to gain weight back and she is acting live her normal self. She needs to stay on the Denosyl and Zinc Acetate for the long run to help her process the little bit of copper that she is consuming. This is great news!

Update on 9/1/09 – Well, Misty has definitely gained all of her lost weight back and her appetite is still very strong. She is sure to let me know when it is even a minute past her feeding time. it just amazes me how dogs can tell time! I tried cutting back the homemade food again but she immediately started getting VERY GASSY on just the Innova! Yikes!  I know that this is top of the line food, so I immediately figured that the little bit of copper that it contains was affecting her digestion. So, we are back to half and half again. I feel very fortunate that she has made such a remarkable recovery. Please feel free to post a comment below if you have a dog with this terrible disease. I am happy to answer any question that I can. I am no expert but I do know how devastating & scary this terrible disease can be. By all means, if you have any other treatments or diets that have worked for you, please share the info by posting a comment. I know that there are lots of you out there reading this because Google Analytics tells me so. Please speak up!!!!

Update on 1/8/10 – Misty had a little set back a few weeks ago. She had been doing really good on the half homemade food and half Innova for a long time, so I got lazy and decided to wean her off of the homemade food. A few days after she was on only dry food, she started getting sick again. She was drinking a lot of water and was having frequent diarrhea. I took her in for blood tests and her liver enzyme levels were elvated. So, I went back to making her homemade food again and now she is doing fine.

Moral of the story… If your dog has Chronic Active Hepatitis, you can’t feed them too much commercial dog food.

Update on 6/21/10 – I’ve received a few emails today and a new post asking for more info and an update on Misty. I am assuming that my blog has made it on to a discussion forum somewhere. That  is great news because I would love to help as many people/dogs as I can. So, feel free to send me your questions. Just please note that I am not an expert on this subject. I was just very, very lucky to have a great vet that knew what to look for and caught the disease early enough to treat it. Also, please note thaqt what I am discussing on this blog is specifically Copper Toxicity Chronic Active Hepatitis. I believe that there are other types of CAH, so please check with your vet before following any of my advice. It may be harmful if we are not talking about the same type of problem.

Misty is still doing very well. Knowing that she will always have this disease, I am always super cautious when she shows any signs that it may be active again. She had a bout of bad diarrhea for about a week and I was scared to death. Dr. Bracken took some blood tests and her liver levels were almost normal. She must have just caught a bug of some sort. Wheew. She is on thyroid medicine now because those levels were up. She is still on the diet of half homemade food and half Innova. However, I am about to try to switch her to a new dry food that is lower in copper than Innova and I am also going to try to replace my homemade food with a very high quality dehydrated homemade food that does not have any copper added to it. I will be posting updates as I go along. I will also be posting some very helpful information in the next few days that I received from a dog food retailer called Pawsitive Foods.  Stay tuned and best of luck to all of you that are searching for answers. There is hope!

Update on 8/14/11 – This week, my Misty Blue will celebrate her 9th birthday! Happy Birthday to my sweet girl. Considering that the average lifespan of a Doberman is 9-10 years, I think she has done remarkably well after being diagnosed with CAH about 3 years ago. She had blood tests and an ultrasound done a few months ago. Her liver looked great and get this… her blood work showed normal levels of copper! Wooo Hooo! Her Thyroid levels are really low and we are working on that but at least it is wonderful to know that she has beaten this terrible disease! She is still on Denosyl and Zinc Acetate every day and probably will be for life to keep it from coming back. I certainly hope that you find the same success. Please feel free to drop me a line if you want any advice.

Note: The preceding information is simply a compilation of information that I have gathered from my own research and should not be used to substitute advice from a licensed veterinarian.