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Adenovirus 1 in Dogs Written by:

PetMD Editorial
PUBLISHED: MARCH 26, 2010

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Infectious Canine Hepatitis in Dogs PETMD EDITORIAL

Infectious canine hepatitis is a viral disease of that is caused by the canine adenovirus
CAV-1, a type of DNA virus that causes upper respiratory tract infections. This virus
Distemper in Dogs Lifestyle
targets the parenchymal (functional) parts of the organs, notably the liver, kidneys, eyes
and endothelial cells (the cells that line the interior surface of the blood vessels).
TIFFANY TUPLER, DVM Vaccines:
What Are
The virus begins by localizing in the tonsils around 4 to 8 days after nose and mouth They and
exposure. It then spreads into the bloodstream -- a condition know as viremia (in the Which
blood stream) -- and localizes in the Kupffer cells (specialized white blood cells located Does
in the liver) and endothelium of the liver. Ideally, these white cells, called macrophages, Your Pet Need? What Is
defend the body against infectious invaders, but some viruses  have the ability to HANIE ELFENBEIN, DVM the DHPP
macropahages as vehicles for replication and spread. CAV-1 is one such virus, taking
Vaccine
advantage of the Kupffer cells to replicate and spread, in the process damaging the
adjacent hepatocytes (liver cells that are involved in protein synthesis and storage, and (5-in-1
transformation of carbohydrates). During this stage of the infection, the virus is shed Vaccine)
into the feces and saliva, making both infectious to other dogs. for Dogs?
NATALIE STILWELL, DVM, MS, PHD
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In a healthy dog with an adequate antibody response, the viral cells will clear the organs
in 10 to 14 days, but will remain localized in the kidneys, where the virus will continue to
be shed in the urine for 6 to 9 months.
In dogs with only partial neutralizing antibody response, chronic hepatitis takes place.
This severe condition often results in cytotoxic ocular injury due to inflammation and
death of the cells in the eye with inflammation of the front of the eye (anterior uveitis).
This condition leads to one of the more outwardly visible and  classic signs of infectious
hepatitis: “hepatitis blue eye.”

There are no breed, genetic, or gender associations for acquiring the CAV-1 virus, but 
but it is primarily seen in dogs that are less than one year of age.

Symptoms
Symptoms will depend on the immunologic status of the host and degree of initial
injury to the cells (cytotoxic):

Peracute (very severe) stage will have symptoms of fever, central nervous system
signs, collapse of blood vessels, coagulation disorder (DIC); death frequently occurs
within hours
Acute (severe) stage will show symptoms of fever, anorexia, lethargy, vomiting,
diarrhea, enlarged liver, abdominal pain, abdominal fluid, inflammation of the
vessels (vasculitis), pinpoint red dots, bruising of skin (petechia), DIC, swollen,
enlarged lymph nodes (lymphadenopathy), and rarely, inflammation of the brain
(nonsuppurative encephalitis)
Uncomplicated infection will have symptoms of lethargy, anorexia, transient fever,
tonsillitis, vomiting, diarrhea, lymphadenopathy, enlarged liver, abdominal pain
Late stage infection will result in 20 percent of cases developing eye inflammation
and corneal swelling four to six days postinfection; recovery often within 21 days,
but may progress to glaucoma and corneal ulceration

Causes
Contact with infectious CAV-1 adenovirus
Unvaccinated dogs are at highest risk

Diagnosis
You will need to give a thorough history of your dog's health, onset of symptoms,
previous illnesses, and possible incidents that might have led to this condition. Contact
with other dogs, such as in kennels, or frequency of contact with feces, such as in open
spaces where dogs are permitted to defecate, may play a role in acquiring this virus.

Your veterinarian will perform a thorough physical exam on your dog, with standard
laboratory work. A complete blood profile will be conducted, including a chemical
blood profile, a complete blood count, a urinalysis and an electrolyte panel. Other
laboratory work that will need to be done to confirm a diagnosis of infectious hepatitis
include coagulation tests to check for the clotting function of the blood, serology for
antibodies to CAV-1, viral isolation of the virus cells, and viral culture. Your doctor will be
checking for other common diseases as well, including parvovirus and distemper.

Imaging techniques will include an abdominal radiography to look for enlargement of

the liver (hepatomegaly) and fluid buildup in the abdominal cavity, and abdominal
ultrasonography, which can give a more detailed view of the liver and whether it is
enlarged of is suffering from necrosis (cell death). The latter technique is especially
necessary if there is abdominal swelling, as the radiography will show a reduced image
detail if there is fluid blocking the view to the liver, where ultrasound imaging will
return information based on the depth of frequency of the echo, based on the structure
of the tissues. That is, cellular/tissue death in the liver will show decreased echo
(hypoechoeic), and severe fluid build up in the abdomen will not return any echoes
(anechoic).

A liver biopsy may also need to be performed to make a conclusive diagnosis.

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Treatment
If the infection is in the very early stage and is uncomplicated, treatment may be given
on an outpatient basis. However, treatment is usually given inpatient. Fluid therapy will
be given for electrolyte imbalances that result from vomiting and diarrhea. Potassium
and magnesium are often very low and need to be supplement immediately. Blood
component therapy will be given for coagulopathy (disorders in the blood's ability to
clot). With overt DIC, fresh blood products and low molecular weight heparin will need
to be sued to stabilize your dog's condition.

Nutritional support will include giving frequent small meals as tolerated, optimizing
nitrogen intake, and feeding the dog according to protein needs. The amount of
protein will depend entirely on your dog's individual condition, as some dogs will have
high protein in the body and some will have low. Inappropriate protein restriction may
impair tissue repair and regeneration. Nitrogen will be restricted if your dog is showing
obvious signs of hepatic encephalopathy (a neuropsychiatric abnormality that causes
inflammation of the brain and is related to liver failure).

Partial intravenous nutrition will be given for a maximum of five days, or preferably, total
intravenous nutrition if oral feeding is not tolerated by the dog. Your doctor will
prescribe antibiotics and/or fluid reducers as necessary.

Living and Management

The veterinarian will schedule follow up visits to monitor fluid, electrolyte, acid-base,
and coagulation status, and to adjust supportive measures. Sudden kidney failure will
also need to be monitored for. A highly digestible diet will need to be fed to your dog
during recovery, and a safe place set aside to rest and recover from the illness. Restrict
your dog's activity during the recovery period, as well as access to other pets. be
especially mindful about cleaning up after your dog, as the virus can continue to be
shed long after the recovery period.

Prevention of this infection requires a a modified live virus vaccination for this disease at
six to eight weeks of age. The initial vaccination is followed by two booster shots given
at three to four weeks apart until the dog reaches 16 weeks of age, with an additional
booster given at one year. This is a highly effective vaccine. 

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