Acute Liver Disease in a Dog

FRASIER, A 5-YEAR-OLD NEUTERED CHIHUAHUA, presented for acute-onset epistaxis and hemorrhagic diarrhea. The patient was dull and dehydrated, and generalized abdominal pain was noted on physical examination. CBC and serum chemistry panel results revealed moderate anemia, mild thrombocytopenia, marked ALT elevation, panhypoproteinemia, hyperphosphatemia, and moderate azotemia. Urine specific gravity was 1.013, and PT/PTT were prolonged. Hepatic dysfunction was confirmed on in-house ammonia tolerance testing. The dogs clinical coagulopathy was suspected to result from acute liver failure, which has been linked to spontaneous bleeding.^1,2 Abdominal ultrasonography revealed bilateral hyperechoic renal cortices and a large hypoechoic liver, and FNA was performed with a 22-gauge needle^3,4; cytology suggested hepatocellular necrosis. Leptospirosis, fungal disease, toxin ingestion, cholangiohepatitis, and neoplasia were among the primary differentials for presumptive acute liver failure in this dog.⁴