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Hepatic Fibrosis, Chronic Fibrotic Liver Disease
Chronic fibrotic liver disease is a general name for the terminal stage of
chronic inflammatory conditions that can be developed in the liver. Chronic fibrotic liver disease is a group of severe diseases which often lead to death through progressive liver failure.
Hepatic fibrosis is overly active wound healing in which excessive connective tissue builds up in the liver and normal structural elements of tissues are replaced with excessive amounts of scar tissue. It can be caused by chronic injury, especially if there is an inflammation; viruses, increased hepatic copper concentration. Hepatic fibrosis can be present at birth (congenital). Fibrosis itself causes no symptoms but can lead to portal hypertension when the scarring distorts blood flow through the liver. Hepatic fibrosis can develop into cirrhosis (the failure to properly replace destroyed liver cells).
The disease has been described in young German shepherd dogs who often have ascites (swelling of the abdomen), loss of appetite, weight loss and hepatic encephalopathy.
Congenital hepatic fibrosis with autosomal recessive or dominant inheritance has been described in humans, cats, piglets, and dogs. Hepatic copper concentration is specifically measured in patients with congenital hepatic fibrosis.
Needle liver biopsy is the primary tool for the diagnosis and assessment of fibrosis . Treatment involves correcting the underlying condition when possible. Response to treatment with anti-fibrotic therapy with glucocorticosteroids or colchicine is variable. The prognosis depends on the underlying condition. Some dogs may die shortly after diagnosis; others may survive two-and-a-half years, and yet others may survive up to four years after the initial diagnosis.
Research into the reversal of hepatic fibrosis now concentrates on two areas: eradication of the primary cause, and secondly a direct attack on the pathways of which are used for producing liver scars. Evidence challenged the old theory of hepatic fibrosis being irreversible. Documented cases of spontaneous resolution of fibrosis in animals appeared simultaneously with new antiviral trials in man. Surprisingly, successful viral eradication appeared to prove that fibrosis can regress in human patients. However, to date no antifibrotic therapy is clinically available. In case of development of liver failure, liver transplantation remains the only option in man. However, such therapy significantly impairs patients' quality of life (QOL), and many cases show recurrence of fibrosis in the transplanted organ.
Recently, medication capable of arresing the formation and proliferation of scar tissue in the liver (fibrosis inhibitors) have been proposed as novel therapeutic agents for the fibrotic disease; however, none of these has proved to be effective. New agents that can improve patients' QOL, and effectively inhibit or retard the progress of hepatic fibrosis are needed. The noninvasive measurement of liver fibrosis using transient elastography and fibrosis marker scores can be a useful tool to identify patients at risk.
Adapted from:
1. Idiopathic hepatic fibrosis in 15 dogs. HC Rutgers, S Haywood, and DF Kelly. In: The Veterinary Record, Vol 133, Issue 5, 115-118
2. Liver fibrosis and regeneration in dogs and cats : An immunohistochemical approach.
Jooske IJzer. In: Veterinary Science Tomorrow
3. Hepatic Fibrosis Inhibitors. Publication #EP1941906. In: European Patent Office
4. Congenital hepatic fibrosis associated with Mallory bodies and copper retention.Evans J, Harris O, Van Deth AG. In: Aust N Z J Med. 1984 Aug;14(4):500-3
5. Friedrich-Rust M, Koch C, Rentzsch A, Sarrazin C, Schwarz P, Herrmann E, Lindinger A, Sarrazin U, Poynard T, Schäfers HJ, Zeuzem S, Abdul-Khaliq H
Noninvasive assessment of liver fibrosis in patients with Fontan circulation using transient elastography and biochemical fibrosis markers. In: J Thorac Cardiovasc Surg 2008 Mar; 135(3):560-7.
Go Pets America recommends seeking the advice of your local veterinarian for the most appropriate vaccination program and for the diagnosis and treatment of your pet's health problems. For vaccination requirements please contact your state and local licensing authorities.
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