Something for Sophie

April 5, 2009

As it is a rare disease, information about canine hepatocutaneous syndrome is scarce. My dog contracted it about a year ago (2008), so I want to provide a little information to add to what little is out there. Hopefully it will help someone.

“Hepato” means the disease has to do with the liver. “Cutaneous” means “skin.” The disease is typically is seen in older dogs, although I don’t know what age that is. Our dog was six when she was diagnosed. The first sign you may notice in your dog is lethargy followed by cracks and swelling in the skin of the footpads, irritation in the skin of the vulva or other sensitive areas. You may also see what looks like irritations on the muzzle. By the time you see these things, the disease has already attacked the liver, leaving it looking like a honeycomb.

Foot baths and pain medications are recommended to treat the footpads as it is painful to put weight on them when they are so cracked. The cracks leave the dog susceptible to diseases picked up by the ground or other surfaces as well. I recommend getting paw protectors such as those available at Petco. These can be used in all weather and can be turned inside out to be put through the wash. They should only be used when the dog needs to walk around as the feet will sweat in them and that will cause further issues.

Your vet may want to do an ultrasound or liver biospy to confirm the disease. Amino acid transfusions are a recommended treatment as the liver is not longer adequately processing the proteins provided by the diet. The transfusions are given over 8 hours once a week. This will help clear up the outward signs of the disease. My dog was also prescribed Ursodiol, a liver medication, which she remained on for the rest of her life.

Our dog was very lethargic because of the pain medications. Because we had no previous experience with pain medications, we thought the lethargy was due to the disease and were considering euthanizing her at that point. We took her off the pain medications to see if that would help her recover her energy and were pleased to see that it did.

My dog was able to recover her energy and heal the cracks in her paw pads and other areas for many months. Although the liver is a remarkable organ in that it is able to regenerate, the prognosis is poor for dogs with this disease and most die within a year of diagnosis.

The blood tests done in February 09 showed that one of the two ‘numbers’ relevant to this disease had returned to normal and the other was half what is was in the previous year, although it was not in the normal range. We were encouraged by that, however within several weeks of those tests, she became finicky about her food. We tried several different foods and were prescribed supplements, hoping to get her back on track. We then tried cooked chicken, rice, hamburg, apples, carrots. At the end of March, she was showing signs of bleeding (black stools), which we had hoped was a treatable bleeding ulcer (something that can happen with this disease) but she was also showing slight signs of neurological deficits by having problems with balance.

By April, she was not eating, was drinking lots of water, could not go 8 hours without having to pee, and was throwing up the little she consumed. The jaundice that had come and gone had now returned and was very prominent. By April 2nd, she was much more unsteady and had more pronounced bleeding (blood instead of formed stools). She saw the vet in the morning of April 3rd. By now her hind legs were not very reflexively responsive to the vet’s touch and it was clear she was in the end stages of the disease. We arranged for her to be euthanized later that afternoon, by which time she was unable to lift her upper body or head as she had no muscle tone.

We had our day to say goodbye, although we had been doing that for months knowing the day would come. She went peacefully. We will surely miss her.


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