Hot Literature: Does ascites affect survival time in dogs with chronic hepatitis?
Ascites is a known negative prognostic factor in people with liver disease, so the authors of a recent study published in the Journal of Veterinary Internal Medicine set out to determine whether this is true in dogs as well, especially since no definitive prognostic indicators have been established for chronic hepatitis in dogs. The study's authors retrospectively identified 34 dogs diagnosed with chronic hepatitis at their institution, after excluding those dogs that were found to have an underlying cause of the liver disease such as toxicosis, infection, and copper storage abnormalities. Dogs with significant nonhepatic concurrent disease were also excluded. Of the 34 dogs, 14 had ascites. Those with ascites had significantly shorter survival times after initial diagnosis (0.4 months) than those without ascites had (24.3 months). In addition, the survival time after signs of chronic hepatitis were initially noted was shorter for the dogs with ascites (two months) than for those without (33 months).
The dogs' sex appeared to have no effect on the outcome of the study. The only significant differences between the groups related to treatment were that dogs with ascites more often received spironolactone and dogs without ascites more often had dietary therapy. Among the reasons that ascites may have such a negative association with these dogs' survival are that the neuroendocrine abnormalities related to ascites may increase morbidity and that the ascites may only develop when severe liver pathology already exists. This study's findings can help practitioners and owners make recommendations and decisions respectively when faced with chronic hepatitis and concurrent ascites in a dog. However, the researchers conclude that ascites is not necessarily a death sentence; some dogs with ascites survive for prolonged periods.
Raffan E, McCallum A, Scase TJ, et al. Ascites is a negative prognostic indicator in chronic hepatitis in dogs. J Vet Intern Med 2009;23:63-66.