Vet’s 2025 Guide to Canine Hepatic Amyloidosis 🧡 Diagnosis, Supportive Care & Prognosis

By Dr. Duncan Houston BVSc

💡 Introduction

Hepatic amyloidosis involves deposition of amyloid proteins—abnormally folded fibrils—within the liver’s sinusoids and vessel walls. It compresses hepatocytes, causing liver enlargement ("lardaceous liver"), dysfunction, portal hypertension, and risk of spontaneous rupture.

1. Epidemiology & Risk Factors 🧬

• Familial amyloidosis occurs in Chinese Shar-Peis, Beagles, Collies, English Foxhounds, Walker Hounds—often younger in Shar-Peis.
• Secondary AA amyloidosis arises from chronic inflammation, infections, immune disease, and neoplasia; AL amyloid is less common.
• Almost any dog age ≥1 year; prevalence increases in dogs >5 years.

2. Pathophysiology

• Amyloid fibers deposit in hepatic sinusoids/vessel walls → hepatocyte compression & liver failure.
• Extensive deposition may lead to portal hypertension, coagulopathy, and liver rupture.

3. Clinical Signs & Complications ⚠️

• Lethargy, decreased appetite, weight loss, vomiting, diarrhea.
• Increased thirst/urination, ascites, abdominal discomfort/pain.
• Jaundice, bleeding tendencies, pale mucous membranes, tachycardia, collapse.
• Concurrent kidney disease—proteinuria, hypertension, and thrombosis risk (~40%).

4. Diagnostic Work-Up in 2025 🧪

• Bloodwork & urinalysis: elevated liver enzymes, bilirubin; proteinuria suggests renal involvement.
• Imaging: ultrasound shows hyperechoic or heterogeneous liver; CT/PET-CT in advanced cases.
• Biopsy: ultrasound-guided liver biopsy/fine-needle aspiration confirms amyloid via Congo red staining.
• Bone marrow/kidney evaluation: if proteinuria/renal compromise are present.

5. Treatment & Management ❤️

5.1 Remove Underlying Triggers

• Treat chronic infections, immune diseases, and neoplasia—slows secondary AA deposition.

5.2 Supportive Medical Care

• Hospitalization with IV fluids, nutritional support, plasma transfusion if bleeding occurs.
• Diuretics for ascites, vitamin K for coagulopathy, and proton pump inhibitors as needed.
• Low-fat, easily digestible diet; adjust for renal involvement if necessary.

5.3 Pharmacologic Interventions

• Colchicine: used in Shar-Peis and familial amyloidosis to reduce amyloid deposition—requires monitoring.
• Immunosuppressives: e.g., corticosteroids used in sterile pyogranulomatous hepatic amyloidosis.

5.4 Monitoring & Chronic Care

• Serial bloodwork, urinalysis, blood pressure, and imaging every 2–3 months.
• Manage renal support, thrombosis prevention, and ascites control.
• Consider palliative or hospice care when liver failure progresses.

6. Prognosis & Long-Term Outlook 📅

• Guarded to poor; median survival 2–10 months, depending on organ involvement.
• Shier prognoses in Shar‑Peis, but much shorter survival in Akitas, progressed or multi‑organ involvement.
• Better outcomes when underlying causes are effectively managed and colchicine is started early.

7. Ask A Vet Home Support 🏡

• Track appetite, thirst, urination, ascites, vomiting logs via app.
• Medication reminders for colchicine, diuretics, and hepatoprotectants.
• Upload images of the abdomen for ascites or swelling review.
• Alert triggers for bleeding, lethargy, collapse or labored breathing.
• Coordinate follow-up testing and imaging reminders.

🔍 Key Takeaways

• Hepatic amyloidosis is serious and often fatal—amyloid deposits disrupt liver function.
• Diagnosis relies on imaging and liver biopsy with Congo red staining.
• Treatment is supportive—fluids, nutrition, colchicine, and immunosuppressive therapy.
• Prognosis is guarded; survival generally measured in months.
• Ask A Vet enhances home monitoring, medication adherence, and early detection of complications.

🩺 Conclusion ❤️

Although hepatic amyloidosis remains a challenging and often terminal condition, early detection, targeted therapy, and rigorous supportive care can prolong quality of life for months. In 2025, management tools such as colchicine and robust monitoring via Ask A Vet offer veterinarians and owners a structured path to navigate this rare disease. 🐶✨

Dr Duncan Houston BVSc – supporting complex liver disease care with compassion, clarity and integrated home monitoring.

Visit AskAVet.com and download the Ask A Vet app to track symptoms, monitor labs, schedule follow-ups, and stay connected with expert guidance every step of the way. ❤️