Chronic Active Hepatitis

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 consisting of the following:

  • Boiled chicken breasts
  • Sweet potatoes
  • Rice
  • Green Beans
  • Hard boiled eggs
  • Flax Oil
  • Powdered vitamin supplement

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!

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.

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Debby R - Hi, Just read your post today. How is Misty Blue since January? My Newfoundland D’Arcy was diagonsed on Memorial day weekend. Her disease is pretty advanced. I am not sure how much time she has. We are struggling with diet, as she is eating well now, but wants what she is not supposed to have. I am trying to keep her protein to 1 gm/lb of body weight. She does not want to eat the presciption diets. Thanks for mentioning the copper in commercial dog food. I was unaware of that. One thing going on with D’Arcy is that she is leakig ascites fluid from her surgical incision site. Not such a good sign. We take everyday as a blessing.

Kim - I cannot tell you how much better your post made me feel. My cherished 2 y/o dobe was just diagnosed with CAH. I took him for blood tests because I couldn’t get him to put on weight and he looked too skinny, no other signs of a problem. His liver enzymes came back thru the roof. I was beyond despair when I came across your success story and now I am determined to tackle this thru diet as much as possible. I wish you the best of luck and want you to know the comfort you have brought me and I am sure many others, including Misty.

adogslifephoto - One more thing I forgot to mention… I was very hesitant to put her on the Prednisone and antibiotics when she was first diagnosed but the vet explained to me that it was necessary to get her liver back into a stong and healthy state and flush out the copper. I don’t think she would have pulled through the initial onset of the disease without this. I would encourage you to try a series of these meds. Just make sure your vet knows you don’t want him on them for very long. bast of luck to you.

adogslifephoto - I am so very sorry to hear about your Dobie. You are doing the right thing by feeding him a home cooked diet. I am not a big believer in phamaceuticals but in this case, you may have no other option. My Dobie has been on Denamarin (previously Denosyl), Zinc Acetate, vitamin E and a homemade diet for over a year now and she is doing fantastic. She does get a bit of trembling once in a while. I never associated that with the liver condition. Very interesting. Thank you for sharing that with me. What are you cooking for him? Are you putting carbs into the food to beef up the calories? I use a lot of sweet potatoes and I add flax oil for some healthy fat. I give her a lot… like 2 1/2 cups twice a day and she gobbles it up. She is always hungry. Her weight is good though. I mix a little Innova dried food in because that is supposed to have the lowest copper content. I have gotten lazy a few times and didn’t make food and just gave her Innova for a few days and she starting showing symptoms immediately. So, I know that the diet is key to success. Maybe ask your vet to put him on Zinc Acetate. It will help him process the copper that he is getting in his diet. Oh, and only give him filtered or distilled water, especially if you have copper water pipes. I wish I could be of more help. Please keep me posted. My vet is wonderful if you want to try a phone consultation. His name is Dr. Bracken at the Arcadia Animal Clinic in Phoenix, AZ.

Doogan Q - I have a 6 yr old Dobie (male) diagnosed 4/09 with Chronic Active Hep. Very limited info from several different vets, one of whom wanted to start him on all sorts of drugs (prednisone, colchicine, etc). I’m not a big believer in overmedicating and the whole vaccine thing so I’m looking for a more holistic approach. He was on anti-biotics for a time to see if it would help to no avail. Liver enzymes thru the roof still, jaundice present but he has no other identifiable clinical signs of liver disease w/the exception of some periodic trembling and shaking which went away for a short time after I stopped feeding him Science diet L/D and started him on a homecooked diet. Only problem is he keeps losing weight and the tremors have re-appeared. He is on vitamins, digestive enzymes, and Denamarin. I’m at a loss as to what to do. I realize it’s not curable but was hoping that there was some way to slow down the progression of the disease.

Jeffrey C. - Thank you for your article. We have a 17 month old, neutered male standard poodle, Theo. He had all of the symptoms and was biopsied last friday 8/28/09. Results came back that he has CAH and we are still waiting for the copper results. The doctor immediately prescribed the Prednisone. Also, the doctor put him on Amoxiclllin following the biopsy. He seemed to snap right back after two days on the Amoxicillin and has now been on the Prednisone for three days. The challenge a couple of weeks ago was to stop his weight loss and keep him interested in food. Now we are feeding a Hill’s Science diet L/D dry food, per the doctor, with Merrick’s small servings, 2-3 oz. just to add some flavor–three 1 cup meals per day. So far he seems to be holding food down and has been mostly normal with no further weight loss. How long did it take to see normal liver enzyme levels and how long did it take to see weight gain and a return to her previous weight.
Thank you and good luck with all of your future test results.

adrian hitt - what a beautiful girl she is! thanks so much for the link. best to you!

woof!
adrian

The Best Foods For Dogs With Chronic Active Hepatitis » A Dogs Life Photo - [...] searching the web for answers on this very frightening disease in your dog, you may also want to click here to read a previous post that describes what Chronic Active Hepatitis is and how my dog has dealt [...]

Pawsitive Pet Foods » A Dogs Life Photo - [...] were searching for answers about CAH, you will probably want to check that out. In the meantime, click here for more info on Chronic Active Hepatitis and how Misty has managed to live with it for so [...]

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