SAIM Resident Michigan State University East Lansing, MI, United States
Abstract:
Background: The clinical presentation of hepatic portal hypertension due to cirrhotic vs. non-cirrhotic causes is similar in dogs. Thus, dogs with portal hypertension due to non-cirrhotic causes can be misdiagnosed with cirrhosis. Limited information is available comparing clinical and diagnostic findings in dogs with cirrhotic vs. non-cirrhotic hepatic portal hypertension.
Objectives: To retrospectively evaluate for differences in signalment, physical exam, clinicopathologic, and imaging findings between dogs with cirrhotic and non-cirrhotic causes of hepatic portal hypertension.
Animals: 62 dogs with portal hypertension (n=31 due to cirrhosis; n=31 due to non-cirrhotic causes). Methods: Multi-institutional retrospective study. Dogs were included if they had clinical evidence of portal hypertension and liver dysfunction. Abdominal imaging and liver biopsy were required. Dogs were identified as having a cirrhotic or non-cirrhotic cause of portal hypertension based on liver biopsy (WSAVA criteria applied).
Results: Dogs with cirrhotic causes of portal hypertension were older (P< 0.001), and had higher serum bilirubin (P< 0.001) and ALP (P< 0.001) concentrations compared to dogs with non-cirrhotic causes of portal hypertension. Serum albumin concentrations (P=0.04) and platelet count (P=0.004) were lower in dogs with cirrhotic vs. non cirrhotic causes. Dogs with cirrhotic causes of portal hypertension also had nodular change (P< 0.001) and heterogeneity (P< 0.001) of the liver reported more frequently on abdominal ultrasound.
Conclusions and Clinical Importance: Liver biopsy remains the gold standard for diagnosis of the cause of hepatic portal hypertension in dogs. However, clinicopathologic and imaging findings can be used to prioritize between cirrhotic and non-cirrhotic causes.
