English Springer Spaniels (ESS) in the UK show an increased prevalence of chronic hepatitis (CH). As a viral aetiology was initially suspected, historically these dogs were rarely treated with corticosteroids. In a previous study of 68 ESS with CH, in which only 3 dogs were treated with corticosteroids, a median survival time of 189 days was noted [range: 1–1211 days]. CH in the ESS shares similarities with human autoimmune hepatitis; it occurs more commonly in young females and has a similar histological appearance. Anecdotally some ESS with CH responded well to prednisolone. This study aimed to investigate the clinical and biochemical response following corticosteroid treatment.

ESS being treated in first-opinion and referral practice with a histological diagnosis of idiopathic chronic hepatitis were enrolled prospectively between 2009 and 2017. Attending veterinary surgeons were asked to give prednisolone 1–2 mg/kg/day and submit regular blood results and progress reports to the authors. Ten female and four male ESS were enrolled with a median age at diagnosis of 5 years 7 months [range: 11 months–10 years]. No cases had been treated with corticosteroids within 6 months of the study. The mean prednisolone starting dose was 1.1 mg/kg/day [range: 1–2 mg/kg/day]. All cases received additional therapies including combinations of S-adenosylmethionine, silybin, ursodeoxycholic acid, and hepatic diet. The prednisolone dose was tapered appropriately over several months according to the patient's clinical and biochemical response, focusing on alkaline phosphatase (ALKP), alanine aminotransferase (ALT) and bilirubin.

All cases showed an improvement clinically, including resolution of jaundice (4/4), vomiting (5/5) and polyuria/polydipsia (4/4). Two out of the 14 cases were euthanased due to CH while receiving prednisolone, with survival times of 122 and 741 days from diagnosis. The remaining 12 patients are alive and clinically well, with 9 patients still receiving a mean dose of 0.4 mg/kg prednisolone every other day (EOD) [range: 0.25 mg/kg/EOD - 1 mg/kg/day]. The median time since diagnosis is 630 days [range: 60–1,350 days]. Two-sided Wilcoxon test demonstrated significant (p<0.05) reductions in serum ALKP, ALT and bilirubin following prednisolone therapy. Median values before and immediately after starting immunosuppressive doses of prednisolone were 810 to 403 IU/L, 1000 to 299 IU/L and 24.0 to 4.0 µmol/L for ALKP, ALT and bilirubin, respectively.

The results of this study demonstrate a markedly improved survival over a historical cohort when ESS with CH are managed with immunosuppressive doses of prednisolone. Serial measurements of ALKP, ALT and bilirubin are useful for monitoring the patient's progress.

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