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Medical management of immune-mediated hepatitis

Author
DePauw, Shari
Abstract
An 8 year old spayed female Jack Russell Terrier presented for evaluation of previously
diagnosed chronic hepatitis. Physical exam revealed jaundice, hepatomegaly, petechiae, and
ecchymoses. Bloodwork showed severely increased liver enzymes, prolonged clotting times, and
decreased coagulation inhibitory proteins. ELISA and Western blot were strongly positive for
Borrelia infection. A liver Tru-cut biopsy revealed lobular dissecting hepatitis, but stains were
negative for the Borrelia organism. Differentials included primary immune-mediated hepatitis,
or immune-mediated hepatitis secondary to Borrelia, which has never been documented in the
dog. Medical management included doxycycline, dexamethasone, azathioprine, ursodiol, SAMe,
vitamin E, plasma, vitamin K, aspirin, and famotidine. The dog responded well to medical
therapy with normalization of her liver enzymes and improvement in general attitude over the
following months. This paper will discuss each of these medical therapies in more detail.
Journal/Series
Senior seminar paper Seminar SF610.1 2003 D47
Description
Senior seminar (D.V.M.) -- Cornell University, 2003.
Includes bibliographical references (leaves 12-14).
Sponsorship
Advisor: Tristan Weinkle
Date Issued
2003-02-05Subject
Dogs -- Diseases -- Case studies
Type
term paper