Vacuolar Hepatopathy in Dogs–3 Things You Must Do to Help Your Doggo!
Louie was an adorable curly black Cocker Spaniel mix with bad breath.
After enduring one too many nasty-smelling kisses, Louie’s caregivers brought him to the vet clinic to get his teeth cleaned. We were all surprised when his pre-anesthetic blood tests revealed alarmingly high ALP liver enzyme levels. We postponed his dental procedure and scheduled more testing to find the source of the problem.
After a series of tests, we landed on a diagnosis of vacuolar hepatopathy–a disease of the liver.
In this guide, we’ll examine this strange but common condition of vacuolar hepatopathy in dogs. We’ll also discuss the three most important ways to help your dog lead a comfortable life.
Understanding Vacuolar Hepatopathy in Dogs
Vacuolar hepatopathy (VH) is a condition that occurs in a dog’s liver cells.
Vacuoles are small bubbles within liver cells that often contain glycogen, a carbohydrate storage molecule. These bubbles filled with glycogen cause liver cells to swell and become fragile. Sometimes these changes cause no symptoms and other times they lead to severe symptoms and liver failure.
Why Did Louie Develop VH?
Why did Louie develop vacuolar hepatopathy? The condition develops in liver cells as a response to injury that falls into three main categories:
- Reaction to Steroids: Steroids are the most common trigger of vacuole formation in liver cells. Steroids can come from medications like prednisone or excessive naturally produced steroids as we see in Cushing’s disease.
- Reaction to Disease: VH can develop as a reaction to other illnesses like hypothyroidism, diabetes, cancer, hepatitis, heart or kidney diseases. (1)
- Unidentifiable Causes: Sometimes there is no apparent cause for vacuolar hepatopathy. Genetics may play a role– the Scottish Terrier breed has a higher risk of developing VH.
Cushing’s disease occurs when a dog’s adrenal glands produce too many steroid hormones and it’s a common cause of VH.
So the next test we did was a low-dose dexamethasone suppression test. It came back negative so we ruled out Cushing’s disease as a cause for Louie’s VH. Our blood tests also checked Louie for hypothyroidism, cancer and kidney disease. Fortunately, we found no evidence of any of these problems.
Symptoms Seen in Dogs with VH
Louie, like many dogs with vacuolar hepatopathy, showed no visible symptoms.
When VH is caused by excessive steroids in a dog’s body, you may see side effects from the steroids including
- Being extra thirsty
- Urinating more
- Having a bigger appetite
- Panting more than usual
- Developing a “hanging” belly
- Experiencing hair thinning
On the flip side, VH that’s progressed further due to other health issues might lead to more concerning signs. These can include fluid accumulation in the abdomen, diarrhea, tiredness, and a lack of appetite.
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What Was Louie’s Treatment?
Louie’s parents were surprised to hear that there is no specific treatment for VH.
Instead, veterinarians focus on finding and treating underlying diseases such as Cushing’s disease and cancer. Dogs with VH who are taking steroid medication may be switched to alternative treatments. In some cases, ursodeoxycholic acid (Actigall®) is used to treat dogs that also have elevated bile acid levels.
We decided to start Louie on an oral supplement called Denamarin®. It contains SAMe (S-Adenosylmethionine) and silybin which may help by protecting liver cells.
What to Expect Long-Term
If VH is the result of short-term steroid usage, a dog’s liver might recover when the medication is stopped. (2)
Many dogs with chronic VH live normal life spans and never seem bothered by the condition. Other dogs experience a progression of the disease which may eventually result in liver failure. Scottish Terriers have a higher risk of becoming ill with VH and may also develop liver cancer. (3)
Louie wasn’t taking steroid medication and we found no obvious cause for his liver condition. His owners went into a “monitor and support” mode that revolved around three important points…
3 Key Strategies for Managing Vacuolar Hepatopathy in Dogs
1. Monitor for Cushing’s Disease
Watch closely for symptoms of Cushing’s disease which often include increased thirst, appetite and urination. Report any changes to your veterinarian as early detection is vital for effective management.
2. Regular Blood and Liver Testing
Schedule regular appointments for comprehensive blood tests and ultrasound imaging of the liver. If the disease progresses, your veterinarian may recommend a different treatment strategy.
3. Protect the Liver
Protect your dog’s liver by avoiding things that threaten liver health. These may include medication, anesthesia and infections. Treat any other diseases your dog has since the liver can be affected by so many different health issues.
FAQs
What is the prognosis for dogs with vacuolar hepatopathy?
The prognosis varies, but in many cases, vacuolar hepatopathy doesn’t shorten a dog’s lifespan or affect quality of life. However, underlying diseases causing VH can impact both.
Will a special diet help with vacuolar hepatopathy?
A special diet may help a dog with VH but it must be individualized depending on the situation. Dogs with hyperlipidemia can benefit from a fat-restricted diet. Consult your vet for a tailored dietary plan.
Are there medications to reduce liver vacuoles?
While no medication directly treats liver vacuoles, underlying diseases are treated as needed. Supplements like SAM-e, vitamin E, and silybin may offer liver support, though the evidence is limited.
Helpful Resources
If you’d like to learn more about vacuolar hepatopathy in dogs, check out the following resources:
- Canine Liver Disease Support Group
- K9Cushings.com website about canine Cushing’s disease with forum discussions