Infectious Hepatitis (ICH) in Dogs


Infectious Hepatitis also known as Canine Adenovirus Infection (CAV-1) is caused by Canine Adenovirus type 1 (CAV-1) belonging to the Adenoviridae genus. Canine Adenovirus type 2 (CAV-2) is a cause of cough in canines (viral disease which causes upper respiratory tract infections).

Infectious Hepatitis is an acute viral infection which primarily affects the liver. Other body organs such as kidneys, eyes and endothelial cells get affected in the more severe form.

Infectious Hepatitis affects a variety of wild animals such as wolves, bears, coyotes and foxes.

The virus can survive in the environment for long periods of time given the right conditions.

Transmission can happen from feces, urine, blood, saliva of the infected animal. Once in the body, the virus colonizes the tonsils before spreading and affecting liver and other body organs. Clinical signs such as fever, weakness, vomiting, diarrhea are the first to be seen followed by some serious complications.

Pets with developing immunity (puppies and younger dogs), younger dogs with weakened immunity from existing infections and medical conditions. It is occasionally seen in adult dogs. Post recovery, the virus can remain dormant for upto 9 month in the kidneys.

Causes

ICH is caused by Canine Adenovirus type 1 (CAV-1). Transmission happens from direct contact with infected pet, from contamination (parks, dog walking areas, grounds, kennels, bedding, toys, objects) and from infected feces and urine.

Clinical Signs & Symptoms

ICH has three phases, Peracute, Acute and Subacute forms. The symptoms seen are:

In the Peracute (very severe) form, the symptoms are
› Pyrexia (Fever)
› Central nervous system (CNS) signs
› Collapse of blood vessels
› Coagulation disorder (DIC)
› Coma or death frequently occurs within hours (without displaying any symptoms)

In the Acute form (severe), complaints are
› Pyrexia (Fever) (up to 106°F (41.1°C)
› Anorexia (Loss of Appetite)
› Lethargy
› Vomiting
› Diarrhea (Loose stools)
› Polydipsia and Polyuria (excessive drinking and urinating)
› Gastroenteritis (Vomiting and Diarrhea)
› Coagulation disorder (DIC)
› lymphadenitis (swelling of lymph nodes)
› Ocular symptoms such as Conjunctivitis (Inflammation of the eye) and Corneal Clouding (Blue eye)
› Enlarged liver
› Abdominal pain
› Ascites (accumulation of fluid in the abdomen)
› Vasculitis (Inflammation of the blood vessels)
› Red dots
› Petechia (bruising of skin)
› Encephalitis (Inflammation of the brain)

In the Subacute form, the symptoms are
› Pyrexia (Fever) up-to 106°F (41.1°C)
› Anorexia (Loss of Appetite)
› Lethargy
› Vomiting
› Diarrhea (Loose stools)
› Polydipsia and Polyuria (excessive drinking and urinating)
› Gastroenteritis
› Coagulation disorder (DIC)
› lymphadenitis (swelling of lymph nodes)
› Ocular symptoms such as Conjunctivitis (Inflammation of the eye) and Corneal Clouding (Blue eye)

Diagnosis

Veterinarians will require a complete history of your dog which includes medical history, vaccination records, existing health concerns, current and previous medications, onset of symptoms, diet and exercise routine and any information which can help in establishing a correct diagnosis. Diagnosis is done with a combination of tests. These include routine lab examinations and special tests which can detect the presence of the virus. They are:

› Physical examination
› Urinalysis
› Complete Blood Count (CBC)
› Liver Biopsy
› Biochemical profile
› Coagulation Test – to check for the clotting function of the blood
› Viral culture test
› Serology Tests for antibodies to CAV-1
› Abdominal Radiograph (X-rays) – For any signs of the enlargement of liver(hepatomegaly), abdominal swelling and Fluid buildup in abdominal cavity.
› Abdominal Ultrasonography – Detailed view of the liver enlargement and Necrosis(cell death).
› Ultrasound – will provide information based on the frequency of the echo: tissue/cellular death will show a decreased echo(hypoechoeic), whereas abdominal fluid buildup will not show any echo(anechoic).

Treatment

ICH has no specific treatment but this depends on the severity of the infection. Treatment consists of
› Fluid therapy
› Use of IV fluids
› Antibiotic medications
› Drugs to treat secondary illnesses and diseases
› Serum therapy (Administration of a particular serum which is effective during the first 48 hours of the infection)

Prevention

ICH is a contagious infection with a global presence. Vaccination is the single most effective way to prevent this. A stronger immunity system can ward off the infection and will also help in a speedy recovery.

Home Care

Home care should aim at improving the condition. Treatments can take a weeks upto a month, depending on the severity. If you observe any behavioral changes, or if the condition does not improve, please contact your veterinarian.

› Isolate your pet immediately once the diagnosis confirms ICH.
› Vaccination is the single most effective way to prevent the infection.
› It is mandatory to provide a stress-free environment for your dog. Keep water and food bowls within reach. Avoid physical activity. Keep your dogs away from any noise and commotions.
› You have to administer and monitor all prescribed medicine as directed by your veterinarian.
› Do NOT travel with your dog.
› Do NOT allow your dog to roam freely. This works two ways, firstly if the pet is infected, it greatly reduces the chances of risk of exposure to other pets and humans and secondly in-case of a healthy pet, it reduces the chances of contracting the infection.
› Use of environmental disinfectants is recommended. Prompt disposal of any and all materials after use is suggested.
› Routine and regular checkups to access the progress, further tests may be advised this includes Liver and kidney function tests, blood tests. Monitor and administer all medications as directed by your veterinarian and complete the dosage.
› Humans, especially children, pregnant women and ones handling infected pets need to exercise caution. Wear gloves when dealing with a pet, cleaning the litter boxes, disposing any and all contaminated materials, garbage disposals etc. A thorough wash of hands is advised. Practice hygiene.
› There is high probability this infection can re-occur. Seek veterinarian advise post recovery on ways to prevent this from happening.

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