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Results: 2018 General Health Survey


Liver and Pancreas

Conditions listed in the Liver/Pancreas category were reported in 4.4% (51) of 1,171 surveys completed across all breeds/varieties surveyed.
 
Considering the entire population surveyed:
  • With the exception of English Toy Terriers, pancreatitis was a notable finding in all three other breeds/varieties surveyed. With almost 5% of Standard Manchester Terrier owners reporting this disease and with Pancreatitis the #5 leading cause of death in Manchester Terriers (UK/FCI), additional investigation and/or monitoring may be warranted.
  • Elevated liver enzymes was not listed as a condition in the survey.  Nevertheless, seven North American owners indicated this finding spontaneously, including 5 Toy Manchester owners. In future surveys and/or investigations of liver-related issues it would be advisable to provide a space where owners can report whether elevated liver enzymes were detected by their veterinarian and what the resolution was.
  • Liver disease may be associated with other issues. Across the entire population surveyed, 12 dogs were reported with concurrent digestive and kidney issues; three with concurrent digestive issues and elevated liver enzymes; and three with concurrent digestive and kidney issues plus elevated liver enzymes.
 
Follow-up
  • Additional surveying is recommended to investigate possible associations among diseases within the liver/pancreas category and the kidney and gastrointestinal categories.

Conditions

The following conditions are referenced below in the analysis for this section. The explanation for each disease/condition provided in the survey is included for reference:

  • Amyloidosis - hepatic (protein deposits in liver tissue)
  • Cholangiohepatitis (inflammation of liver, bile duct, gall bladder)
  • Cholecystitis (gall bladder infection)
  • Cholelithiasis (gall stones)
  • Cirrhosis/Fibrosis of Liver
  • Exocrine Pancreatic Insufficiency (decreased pancreatic enzyme production)
  • Hepatic Encephalopathy (nervous system abnormality due to liver-related ammonia buildup in blood)
  • Hepatitis (chronic liver inflammation/infection)
  • Pancreatitis (inflammation of pancreas)
  • Portosystemic Shunt (liver disease caused by abnormal blood flow)

Toy Manchester Terriers
The most common condition affecting Toy Manchester Terriers in the Liver/Pancreas category was Pancreatitis, which was reported in 2.6% (8) of Toy Manchesters. Additional conditions reported included two cases each of Cholangiohepatitis and Exocrine Pancreatic Insufficiency (0.7%), and one case of Cirrhosis/Fibrosis of Liver (0.3%).
In the ‘other’ section, owners also identified:
  • Five dogs with elevated liver enzymes (one also showing increased bile acid concentrations);
  • Three dogs with liver cancer; and,
  • Two dogs with liver decline or failure (no cause indicated).
While the reports of five Toy Manchesters (1.6%) with elevated liver enzymes was interesting, it is not possible to determine significance based on this survey. Elevated liver enzymes was not provided as a disease/condition choice on the survey, so collection of information on this phenomenon relied wholly on owners voluntarily including it in the ‘other’ box. As a result, it is possible that more dogs may have had elevated liver enzymes than were reported. None of the owners reporting high liver enzymes indicated any other liver issues on their surveys, however per the above it is impossible to determine if the dogs reporting liver issues did or did not have high liver enzymes at any point.

Associated Deaths
Three Toy Manchesters were reported to have died from conditions in the Liver/Pancreas category. Three dogs died of liver issues (one non-specific at age 16; one associated with Cirrhosis/Fibrosis of Liver at age 6; and one associated with Cholangiohepatitis at age 13). Liver and Pancreatic issues were also implicated in the death of and 8-year-old male attributed primarily to kidney failure.

Relation to Other Conditions
As was noted in the digestive section, some interplay between liver/pancreatic disease and gastrointestinal and/or kidney issues may be present and might warrant additional investigation or observation. Three owners of Toy Manchesters reported concurrent digestive issues and elevated liver enzymes; one reported concurrent digestive and kidney issues with elevated liver enzymes; and four reported dogs with concurrent kidney and digestive issues.
 
The possibility of a link between these conditions is further strengthened when results in other varieties are considered. A total of 12 dogs with concurrent digestive and kidney issues; three with concurrent digestive issues and elevated liver enzymes; and, three with concurrent digestive and kidney issues as well as elevated liver enzymes were identified across all breed/varieties examined in the survey.

Follow-up
  • Additional surveying is recommended to investigate possible associations among diseases within the liver/pancreas category and the kidney and gastrointestinal categories.

Standard Manchester Terriers
The most common condition affecting Standard Manchester Terriers in the Liver/Pancreas category was Pancreatitis, which was reported in 4.8% (9) of Standard Manchesters. Additional conditions reported included two cases each of Cholangiohepatitis and Hepatitis (1.1%), and one case each of Cirrhosis/Fibrosis of the Liver, Exocrine Pancreatic Insufficiency and Portosystemic Shunt (0.5%).

In the ‘other’ section owners also identified two dogs with elevated liver enzymes.
Standard Manchesters reported the highest proportional rate of Pancreatitis among the breeds/varieties reported on in this survey (4.8% compared to 3.1% in MTs, 2.6% in TMTs and 0.9% in ETTs). It is impossible based on current data to determine age at which dogs were affected.

Associated Deaths
Three Standard Manchesters were reported to have died from conditions in the Liver/Pancreas category. One dog died at 11 of Pancreatitis and Diabetes; one at age 14 with liver damage described/attributed to Cirrhosis/Fibrosis; and, one died at age 13 of “liver disease & hepatic encephalopathy”. The last dog was reported in the survey to have had Hepatic Encephalopathy, Hepatitis, Pancreatitis and Portosystemic Shunt.
 
Relation to Other Conditions
As was noted in the digestion section, some interplay between gastrointestinal and concurrent kidney and/or liver issues may have been present and might warrant additional investigation or observation. Six owners of Standard Manchesters reported dogs with concurrent kidney and digestive issues, and two more reported concurrent digestive and kidney issues with elevated liver enzymes.
 
Follow-up
  • Additional surveying is recommended to investigate possible associations among diseases within the liver/pancreas category and the kidney and gastrointestinal categories.

Manchester Terriers (UK/FCI)
The most common condition affecting Manchester Terriers (UK/FCI) in the Liver/Pancreas category was Pancreatitis, which was reported in 3.1% (14) of Manchesters. Additional conditions reported included one case each of Cholecystitis, Cholelithiasis  and Hepatitis.  
 
In the ‘other’ section, owners also identified one dog with liver cancer.

Associated Deaths
Seven Manchester Terriers (UK/FCI) were reported to have died from conditions in the Liver/Pancreas category.  Five dogs died of Pancreatitis, with three attributed to pancreatitis alone and two to pancreatitis and kidney failure together. Two of the dogs were 6 years old and three were 12-14 years old. Two dogs were also reported to have died from “liver problems” at 10 and 12 years of age. One dogs owner explained the liver issues were attributed to medication taken to treat an injured leg.

English Toy Terriers
Two ETT owners reported cases of pancreatitis (0.9%).

In the ‘other’ section, owners identified one dog with liver cancer.

Associated Deaths

Two English Toy Terriers died from conditions in this category, with one 9-year-old female dying of liver cancer and one 14-year-old female dying from “inflammation of the pancreas.”

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