Hepatocutaneous syndrome in Shih Tzus: 31 cases (1996–2014)

Deborah L. Hall-Fonte Oradell Animal Hospital, 580 Winters Ave, Paramus, NJ 07652.

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Sharon A. Center Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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Sean P. McDonough Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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Jeanine Peters-Kennedy Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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Thomas S. Trotter Red Bank Veterinary Hospital, 197 Hance Ave, Tinton Falls, NJ 07724.

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John M. Lucy Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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Elyse Berger Oradell Animal Hospital, 580 Winters Ave, Paramus, NJ 07652.

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Christopher Byers MidWest Veterinary Specialty Hospital, 9706 Mockingbird Dr, Omaha, NE 68127.

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Clifford G. Cummings Cummings Veterinary Hospital, 5111 Church Rd, Easton, PA 18045.

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Elizabeth Burke Thoreau Veterinary Hospital, 3300 Fox Hill Rd, Easton, PA 18045.

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Julie Stegemen Southern California Veterinary Specialists, 1371 Reynolds Ave, Irvine, CA 92614.

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Jason Pintar Garden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753.

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Larry Kantrowitz Animal Emergency and Referral Associates, 1237 Bloomfield Ave, Fairfield, NJ 07004.

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Kristopher Sharpe Blue Pearl Specialty and Emergency Medicine for Pets, 1425 Michigan St NE Ste F, Grand Rapids, MI 49503.

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Tristan Weinkle South Carolina Veterinary Specialists and Emergency Care, 3924 Fernandina Rd, Columbia, SC 29210.

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Abstract

OBJECTIVE To characterize findings in Shih Tzus with progressive superficial necrolytic dermatitis and degenerative vacuolar hepatopathy consistent with hepatocutaneous syndrome.

DESIGN Retrospective case series.

ANIMALS 31 Shih Tzus.

PROCEDURES Medical records were reviewed to obtain information on signalment, history, treatment, outcome, and results of clinicopathologic testing, abdominal ultrasonography, and histologic examination of skin and liver specimens. A pedigree analysis was performed.

RESULTS There were 16 males and 15 females. Median age at the time of diagnosis was 8 years (range, 5 to 14 years). Common clinical signs included lethargy, inappetence, weight loss, and lameness. Twenty-five dogs had cutaneous lesions consistent with hepatocutaneous syndrome; the remaining 6 initially only had hepatic abnormalities, but 3 of the 6 subsequently developed cutaneous lesions. Common clinicopathologic abnormalities included microcytosis (15/24 [63%] dogs) and high serum alkaline phosphatase activity (24/24 [100%] dogs). Hepatic ultrasonographic findings included a hyperechoic or heteroechoic appearance to the parenchyma with innumerable hypoechoic nodules. Histologic hepatic lesions consisted of degenerative vacuolar (glycogen and lipid) hepatopathy associated with minimally fibrotic to nonfibrotic, noninflammatory, proliferative nodules. Pedigree analysis confirmed a common ancestry in 12 of 18 dogs. Median survival time was 3 months (range, 1 to 36 months).

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that HCS may have a heritable component in Shih Tzus, although the condition may also be identified in Shih Tzus without affected relatives. Clinical, clinicopathologic, ultrasonographic, and histologic abnormalities in affected Shih Tzus were similar to those previously reported for dogs of other breeds with HCS. (J Am Vet Med Assoc 2016;248:802–813)

Abstract

OBJECTIVE To characterize findings in Shih Tzus with progressive superficial necrolytic dermatitis and degenerative vacuolar hepatopathy consistent with hepatocutaneous syndrome.

DESIGN Retrospective case series.

ANIMALS 31 Shih Tzus.

PROCEDURES Medical records were reviewed to obtain information on signalment, history, treatment, outcome, and results of clinicopathologic testing, abdominal ultrasonography, and histologic examination of skin and liver specimens. A pedigree analysis was performed.

RESULTS There were 16 males and 15 females. Median age at the time of diagnosis was 8 years (range, 5 to 14 years). Common clinical signs included lethargy, inappetence, weight loss, and lameness. Twenty-five dogs had cutaneous lesions consistent with hepatocutaneous syndrome; the remaining 6 initially only had hepatic abnormalities, but 3 of the 6 subsequently developed cutaneous lesions. Common clinicopathologic abnormalities included microcytosis (15/24 [63%] dogs) and high serum alkaline phosphatase activity (24/24 [100%] dogs). Hepatic ultrasonographic findings included a hyperechoic or heteroechoic appearance to the parenchyma with innumerable hypoechoic nodules. Histologic hepatic lesions consisted of degenerative vacuolar (glycogen and lipid) hepatopathy associated with minimally fibrotic to nonfibrotic, noninflammatory, proliferative nodules. Pedigree analysis confirmed a common ancestry in 12 of 18 dogs. Median survival time was 3 months (range, 1 to 36 months).

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that HCS may have a heritable component in Shih Tzus, although the condition may also be identified in Shih Tzus without affected relatives. Clinical, clinicopathologic, ultrasonographic, and histologic abnormalities in affected Shih Tzus were similar to those previously reported for dogs of other breeds with HCS. (J Am Vet Med Assoc 2016;248:802–813)

Contributor Notes

Address correspondence to Dr. Center (sac6@cornell.edu).
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