Background and Aim: Ultrasonography is the first-line method for examining the canine liver. Hepatic ultrasound scoring systems are widely described in human medicine, yet there is no information on the use of semi-quantitative ultrasound scoring systems in canine liver diseases. This study aimed to evaluate the hepatobiliary ultrasound scores between physically healthy dogs and dogs with primary liver diseases confirmed by clinical, biochemical, and histological parameters. We also evaluated the putative correlations between ultrasound scores and ALT or ALP levels. Moreover, the severity of ultrasound scoring and fold changes in liver enzymes was also evaluated. Materials and Methods: A cross-sectional study design was conducted to compare the results of the six different parameters (liver surface, echogenicity of parenchyma, nodularity of parenchyma, gallbladder wall thickness, amount of gall sludge, and visibility of bile duct) of ultrasound scores between dogs with and without liver disease. Results: Our results showed that 17.4%, 88.2%, and 100% of dogs with liver diseases were identified according to the ultrasound severity classified as mild (total score 0-2), moderate (total score 3-5), and severe (total score 6-12). Approximately 30% of patients with chronic hepatitis, the most common canine liver disease, presented with normal or mild ultrasound score category, whereas most of the patients with vacuolar hepatopathy and steroid-induced hepatopathy due to secondary reactive changes had moderate-to-severe ultrasound score category. There were 75% of patients with tumor and 80% of patients with hepatic fibrosis that were identified with severe ultrasound score category. Dogs with moderate-to-severe ultrasound scores had significant liver enzyme elevation (both alanine aminotransferase [ALT] and alkaline phosphatase [ALP]) compared to those of dogs with mild ultrasound scores. Ultrasound score was moderately associated with ALT and highly associated with ALP levels (p=0.553 and p=0.730, respectively). Conclusion: Our semi-quantitative, simplified ultrasonographic scoring system may have potential to be used as a screening tool to detect some groups of liver diseases. Keywords: diagnosis, dogs, hepatic disease, ultrasound score.

Hyperlipidemia is a risk factor for nonalcoholic fatty liver disease (NAFLD) in humans. However, the association between serum lipids and canine chronic hepatitis remains unknown. In this study, serum lipids, hepatic profiles, and hepatic ultrasound scores of healthy dogs and dogs with chronic hepatitis were evaluated. Serum triglyceride and cholesterol concentrations were significantly higher (p < 0.01) in dogs with chronic hepatitis. There were 62.2% of dogs with chronic hepatitis accompanied by hypertriglyceridemia, hypercholesterolemia, or both. Positive correlations were observed between serum ALT and cholesterol (r = 0.8287, p < 0.01), serum ALP and cholesterol (r = 0.8436, p < 0.01), serum GGT and cholesterol (r = 0.5640, p < 0.01), serum bile acid and cholesterol (r = 0.3310, p < 0.01) and serum ALP and triglycerides (r = 0.2582, p < 0.05). No significant differences were found between ultrasound scores of diseased dogs with and without hypertriglyceridemia and diseased dogs with and without hypercholesterolemia. Canine chronic hepatitis is associated with hyperlipidemia. A significant positive association was identified between hyperlipidemia, especially hypercholesterolemia, liver enzymes, and bile acid concentration in dogs suffering from chronic hepatitis. The underlying mechanisms connecting hyperlipidemia and canine chronic hepatitis remain elusive.

A 5-year-old female neutered domestic short-haired cat presented with abdominal enlargement. An abdominal ultrasound revealed that large multiple hepatic cysts with irregular walls, hypoechoic fluid, and internal septations occupied most of the liver parenchyma. Serum liver enzymes, bilirubin, and bile acids concentrations were within normal limits. A fecal examination using simple floatation and formalin-ether sedimentation techniques was negative for liver fluke (Platynosomum fastosum), intestinal protozoa, and other helminth eggs. Praziquantel was prescribed for two distinct courses one month apart without obvious improvement of the hepatic cysts. An abdominal laparotomy and histopathological examination finally enabled diagnosis of cyst-like lymphocytic cholangiohepatitis of the liver tissue. Twelve weeks of oral prednisolone resulted in marked ultrasonographic improvement of the hepatic cysts. The liver parenchyma was heterogeneous and filled with multiple small anechoic cavities. Twenty-three months after ceasing the prednisolone, there was no recurrence of hepatic cysts.