Evaluation of hepatobiliary ultrasound scores in healthy dogs and dogs with liver diseases

Abstract

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.