Hepatic nodular hyperplasia forms benign air- and fluid-filled lesions within the dog's liver. A silent disorder that normally afflicts middle-aged dogs, it may go unnoticed by owners and veterinarians until one of the lesions ruptures. A ruptured liver lesion may require surgery and blood transfusions because the lesion will often continue to bleed, enlarging the abdomen. If not treated with surgery and antibiotics, the dog may bleed to death or suffer a severe infection.
Mainly a geriatric condition, the symptoms of hepatic nodular hyperplasia may be overlooked because they often evolve over time. The dog may exhibit lethargy and lack of appetite. If the condition inadvertently impairs the liver function as the lesions become large, your dog may exhibit yellowing gums, skin and eyes. A distended abdomen is often discovered upon palpitation, according to Pet MD.
Hepatic nodular hyperplasia tends to occur through the natural aging process of the dog. The mean age of onset and diagnosis is 11 years, according to the District of Columbia Academy Veterinary Medicine. Certain breeds, such as the Scottish terrier, appear to suffer from a higher incidence of the disorder. Dogs that have suffered prior injuries to the liver region often develop the lesions later in life. certain metabolic factors and imbalances due to aging also can be to blame for the lesions in the liver.
A veterinarian will evaluate your dog's history and perform a physical examination. If the liver lesion has ruptured, the dog may exhibit signs of anemia and abdominal pain. An ultrasound will determine the extent of the lesions and where the area of rupture has occurred. Often the lesions appear to be either primary liver cancer or metastatic liver cancer. To rule out cancer, a needle biopsy is often performed. A larger wedge biopsy must be obtained surgically. A blood count (CBC) will be taken. Most dogs suffering from hepatic nodular hyperplasia will have elevated serum alkaline phosphatase (ALP) within their blood. ALP is a general body protein found in in the liver. Despite the elevation of ALP, all other liver proteins and enzymes will remain in the normal range.
When a liver lesion ruptures, your dog will require emergency surgery to save its life. Prompt surgical excision of the area must be made and all internal bleeding stopped. The dog will normally require a blood transfusion before or during surgery. Once surgery has been performed the dog will usually recover with no adverse effects. If the lesions do not rupture, the dog can comfortably live its entire life with no medical intervention and the lesions are just considered a natural part of the aging process.
Any dog suffering from hepatic nodular hyperplasia must undergo regular blood work and ultrasounds to ensure the lesions are not growing too large. A lesion that is too large is in serious danger of rupturing and may require surgical intervention before the rupture occurs. An overly large nodule can often impair the function of the liver and also must be surgically removed.