Prednisolone therapy for chronic hepatitis in English springer spaniels: a prospective study of 12 cases

Abstract

Background: English springer spaniels (ESS) show an increased risk of chronic hepatitis (CH). In a previous study of 68 ESS with CH, in which only one dog received corticosteroids, a median survival time of 189 days was noted. Some ESS with CH appear to improve with prednisolone treatment; therefore, we aimed to investigate the response to prednisolone in this breed.

Participants: ESS with histologically confirmed idiopathic CH were treated with prednisolone 1-2 mg/kg/day. Nine female and three male ESS were enrolled (median age at diagnosis of five years). Patients were monitored clinically and had biochemistry samples taken to assess markers of hepatocellular damage and function.

Results: The mean starting dose of prednisolone was 1.1 mg/kg/day. All symptomatic patients showed an initial clinical improvement. Two cases were euthanased while receiving prednisolone. The median time since diagnosis is 1715 days (range: 672-2105 days) and the remaining patients are clinically well, with seven patients still receiving a mean dose of 0.4 mg/kg prednisolone every other day. Statistical analysis demonstrated significant (P<0.05) reductions in serum alkaline phosphatase, alanine aminotransferase and bilirubin following 2-4 weeks of prednisolone treatment.

Conclusion: This study demonstrates improved clinical and biochemical parameters when some ESS with CH are managed with prednisolone and standard supportive treatments.

Keywords: dogs; hepatic disease; histopathology.

Figure 1

Serum (ALKP) as a multiple of the upper limit of the reference range in 12 ESS with CH, at diagnosis (before prednisolone treatment), first recheck (2–4 weeks after starting 1–2 mg/kg/day prednisolone) and at tapering doses of prednisolone. A significant difference was identified between the values at diagnosis and first recheck; however, due to variability of dosing, the authors did not assess statistical differences between the remaining prednisolone doses. Each coloured shape represents an individual patient. ALKP, alkaline phosphatase; CH, chronic hepatitis; EOD, Every Other Day; ESS, English springer spaniels.

Figure 2

Serum (ALT) as a multiple of the upper limit of the reference range in 12 ESS with CH, at diagnosis (before prednisolone treatment), first recheck (2–4 weeks after starting 1–2 mg/kg/day prednisolone) and at tapering doses of prednisolone. A significant difference was identified between the values at diagnosis and first recheck; however, due to variability of dosing, the authors did not assess statistical differences between the remaining prednisolone doses. Each coloured shape represents an individual patient. ALT, alanine aminotransferase; CH, chronic hepatitis; EOD, Every Other Day; ESS, English springer spaniels.

Figure 3

Serum (bilirubin) as a multiple of the upper limit of the reference range in nine ESS with CH, at diagnosis (before prednisolone treatment), first recheck (2–4 weeks after starting 1–2 mg/kg/day prednisolone) and at tapering doses of prednisolone. A significant difference was identified between the values at diagnosis and first recheck; however, due to variability of dosing, the authors did not assess statistical differences between the remaining prednisolone doses. Each coloured shape represents an individual patient. CH, chronic hepatitis; EOD, Every Other Day; ESS, English springer spaniels.