Early Hepatocutaneous Syndrome in Dogs

The West Highland terrier is one breed with an increased risk of hepatocutaneous syndrome.
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Sometimes, skin sores or lesions on dogs may simply be a result of infection or injury. Other times, like in the case of hepatocutaneous syndrome, skin sores or lesions are a sign of underlying conditions, often involving the liver. Also known as necrolytic migratory erythema, superficial necrolytic dermatitis or metabolic epidermal necrosis, hepatocutaneous syndrome typically affects older dogs and, because it is a result of underlying medical conditions, often has a poor prognosis.

Skin Deficiencies Cause Lesions

The sores or lesions associated with hepatocutaneous syndrome are the result of skin cell degeneration, often due to nutritional imbalances. Healthy skin requires fatty acids and proteins the liver provides. It is believed that a disruption in liver function affects the transfer of these fatty acids and proteins, resulting in the skin lesions. Hepatocutaneous syndrome is found in older dogs diagnosed with liver disease, pancreatic disease, diabetes mellitus and Cushing’s disease.

Symptoms to Look For

Skin lesions are the main symptoms associated with hepatocutaneous syndrome. They typically occur around the muzzle, lower legs and footpads. Lesions often cause severe crusting of the footpads, making it difficult for your dog to walk. Other symptoms include lethargy, loss of appetite and weight loss.

Dogs With Greater Risk

Because hepatocutaneous syndrome is connected to liver dysfunction, it is typically found in older dogs. Any breed may suffer from the condition, though it is more commonly seen in miniature poodles, Lhasa apsos, cocker spaniels, West Highland terriers and Shetland sheepdogs.

Identifying Hepatocutaneous Syndrome

In order to determine if skin lesions are hepatocutaneous syndrome, your veterinarian will run specific diagnostic tests. Blood work highlights elevated liver enzymes or blood glucose. Skin biopsies show abnormalities and deficiencies in the cells. Ultrasounds may identify liver or pancreatic tumors, as well as a common honeycomblike appearance to the liver that is commonly associated with hepatocutaneous syndrome.

Treatment and Prognosis

Because hepatocutaneous syndrome is related to a serious underlying condition, the prognosis is not good for most dogs. In cases whereby the lesions are the result of tumors, surgical removal of the tumors may eliminate the lesions. Unfortunately, tumors of the liver metastasize, or spread throughout the body, leaving the chances of a complete cure very slim. Treatment for hepatocutaneous syndrome typically addresses discomfort and supportive care. Many patients pass away or are euthanized within a year.