Prevalence of canine hepatopathy among a clinic population fed commercial dry food: Age and Dietary factors influence the disease prevalence

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The objective of this study was to explore the prevalence of hepatopathy in dogs based on the liver enzyme profile and the association between liver enzyme alterations with diet. Results: This was a hospital-based, cross-sectional study. We analyzed the history and medical records of all dogs fed commercial dry food presented at a veterinary hospital. A complete physical examination, laboratory survey, and abdominal ultrasonography were performed on each subject. 720 dogs were included in this study. The patients consisted of 385 male dogs (53.5%) and 335 female dogs (46.5%) and the mean age ± SE was 5.92 ± 0.18 years (range, 1 to 17). The overall prevalence of hepatopathy in all dogs fed commercial dry food was 23.8%, 8.3%, and 3.7% based on the mild, moderate, and marked liver enzyme activity elevation (ALT and/or GGT), respectively and statistical analysis exhibited that the factors significantly related to hepatopathy were increasing age and diet type. A significant relationship was observed between age and ALT (Odd ratio: 1.121, CI: 1.064-1.181) and GGT (Odd ratio: 1.056, CI: 1.008-1.105). There was a significant relationship between commercial food brands and some biochemical factors including ALT, AST, GGT, ALP, Chol, and total bilirubin. Conclusion: In summary, our findings suggest that hepatopathy in dogs appears to be more common than previously thought, and aging and type of diet are risk factors for liver disease in dogs. Therefore, using good-quality diets will likely play an essential role in preventing liver disorders in dogs. Hepathopathy Dry food Prevelence Dog Figures Figure 1 Figure 2 Background The liver as the second largest organ in the body, performs over 500 vital functions. These include breaking down poisonous substances and removing waste products, protein, and bile production, regulating blood sugar and lipid levels, producing clotting coagulants, vitamins, and minerals storage, and as part of the reticuloendothelial system, it plays an important role in host immunity [ 1 , 2 ]. Primary and secondary agents can involve the liver. Due to the important role of the liver in removing a variety of drugs, toxins, and waste materials and also the proximity of the liver to organs such as the intestine and pancreas and receiving blood from the portal vein, there is a possibility of secondary liver damage in a variety of other diseases, including intestinal and pancreatic diseases. Also, a variety of diets can have a direct effect on liver function [ 3 , 4 ]. It seems that the prevalence of liver diseases in dogs is higher than previously reported. A recent study showed the prevalence of liver diseases in dogs was about three times higher than in cats [ 5 ]. Primary, mostly chronic hepatitis comprised 0.5% of all the patients presented to the hospital [ 6 ] and the risk of chronic hepatitis in several dog breeds has been increased [ 7 ]. Therefore, it is necessary to carry out more studies to evaluate the prevalence of liver diseases and related risk factors in dogs. One of the important known risk factors in the occurrence of liver diseases in humans is diet [ 8 ]. Several studies have reported that different dietary patterns are associated with the progression of obesity, type 2 diabetes mellitus, and components of the metabolic syndrome, particularly insulin resistance, and finally nonalcoholic fatty liver disease as the most common causes of chronic liver disease worldwide in humans [ 9 , 10 ]. Similarly, the quality of pet food and feed management can have a pivotal role in the healthy status and the prevention of diseases in animals. Therefore, in recent years, pet owners pay more attention to the quality of food for their pet's health. Unfortunately, for assessing liver function in critically ill patients, no ideal tool is currently available, [ 11 ]. In patients, a series of tests such as liver enzyme and function tests, microbial tests, histopathology, indocyanine green plasma disappearance rate and lidocaine metabolism, and imaging are used to evaluate liver injury and function [ 11 , 12 ]. However, it is not possible to evaluate all these tests in a large population of patients. Liver enzyme tests are widely available, easily performed, and are the most commonly used paraclinical methods for determining liver health [ 7 ]. Although liver function can not be reliably assessed based on enzyme activities, elevation of liver enzymes may be a sign of damage to the liver [ 13 , 14 ]. Alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT), are the enzyme used in small animal veterinary practice. The most important problem in liver assessment by liver enzyme profile is that these enzymes are not specific to the liver and are also found in other tissues and organs. However, some liver enzymes such as ALT and GGT have higher specificity for liver diseases and marked elevations of these enzymes are observed most often in persons with diseases that affect primarily liver and bile ducts [ 15 ]. Enzyme activities are often the first abnormal finding that leads a clinician to suspect a liver disease in the patient and are useful in the diagnostic process [ 16 ]. Furthermore, a strong correlation has been observed between the increase of liver enzymes and the presence of histopathological injuries in the liver of dogs, so most dogs with cholangitis and cholangiohepatitis have shown an increase in liver enzymes [ 17 ]. The aims of this study include 1: To evaluate the prevalence of hepatopathy in dogs fed commercial dry food based on biochemical results and enzyme changes and compare it with ultrasound findings.2. The other aim of this study was to ascertain whether there was any association between changes in liver enzymes and type of diet in dogs. Methods Sample size Prevalence of all liver diseases according to the previous studies is 1.24% in dogs [ 5 ]. This prevalence was utilized to calculate an appropriate sample size using the formula: \(\text{Sample size}=\frac{{Z}^{2}P(P-1)}{{d}^{2}}\) ,Where Z = confidence interval, P = estimated prevalence, d = precision. Where the estimated prevalence is less than 5%, a precision of less than 5% is advised [ 18 ]. In the present study sample size was calculated to be approximately 670 dogs, for a prevalence of 1.24% and 95% confidence interval (CI), with a predicted precision of 2%. Data collection The present study was a cross - sectional study carried out on 720 dogs presented at a veterinary hospital between 2017 and 2022. The patients who met the inclusion criteria were selected for more evaluation. Inclusion criteria included dogs that were older than 1 year and consistently were fed with a commercial diet at least for 6 months. Dogs that did not feed with a fixed diet, or used several types of diets and commercial foods were excluded from the study. A complete physical examination, laboratory survey, and abdominal ultrasonography were performed on each subject. For hematology and biochemistry analysis, three milliliters of blood samples were collected during the cephalic vein and immediately aliquoted into K2EDTA (Xinel, China) and clot activator tube (Vacutest®, Arzergrande, Italy). A complete blood count was conducted on an Automated hematology analyzer (Nihon Kohden, Cell tac-α, Japan) immediately after the blood collection The serum level of glucose, cholesterol, triglyceride, total and direct bilirubin, urea, creatinine, total protein, albumin, calcium, inorganic phosphate, and the activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatine kinase(CK) and gamma-glutamyl transferase(GGT) were measured by commercial kits [Pars Azmoon, Tehran, Iran] using an autoanalyzer (Global 240, BPC Co., Italy). Control serum (Trulab N sera, DiaSys Diagnostic System GmbH, Germany) was used for controlling measurement accuracy. Diet classification To evaluate the relationship between the type of nutrition and liver health, 12 types of common commercial food were selected, and the dogs were placed in one of the above groups according to what type of nutrition they had during the last six months. Liver injury grading scale A modified 3-point scale for grading the severity of liver and bile duct injuries based on the liver enzyme elevation was developed [ 1 ] (Table 1 ). Statistical analysis Statistical analysis was performed using PASW Statistics for Windows release 21 (SPSS Inc., Chicago, IL, USA). The One-way ANOVA followed by Tukey post hoc tests, T-test, and chi-square test were used. p < 0.05 was considered significant. All data are presented as mean ± Standard Error. Results Diet information The studied dogs were divided into 12 groups based on the commercial food consumed during at least the last six months. Dogs that did not have a fixed diet were excluded from the study. In each group, there were at least 50 dogs with equal gender distribution, and the average age range in the groups was 5.8 to 6.1 years. The analysis of commercial foods based on the information given by the respective manufacturer is given in Table 2 . Relationship between age and sex with increased liver-biliary enzymes Results of the 720 dogs (age: 1–17 years and median age 5.92 ± 0.18 years) showed, there was no obvious sex predisposition in dogs with hepatopathy. However, a significant relationship was observed between age and ALT (Odd ratio: 1.121, CI: 1.064–1.181) and GGT (Odd ratio: 1.056, CL: 1.008–1.105). According to the results, aging is probably a risk factor for increasing liver enzymes and liver diseases. The average age in the affected dogs was 6.9 ± 2.69. Subclassification of dogs based on the liver enzyme alteration Based on the increase of liver parenchyma enzymes (Table 1 C), dogs were divided into six groups from 0 (normal) to 6 (severe increase of liver enzymes). Based on the obtained results, 77.1% (score: 0), of dogs were within the normal range for liver enzymes, and 14.5% (score: 1, 2), 5.7% (score: 3, 4), and 8.8% (score:5, 6), of dogs, showed a mild, moderate and severe increase of liver enzymes, respectively. Subclassification of dogs based on the bile duct enzyme alteration Based on the increase of bile duct enzymes (Table 1 D), dogs were divided into six groups from 0 (normal) to 6 (severe increase of bile duct enzymes). Based on the obtained results, 43.5% (score: (score: 0), of dogs were within the normal range, and 32.7%(score: 1–2), 18.4% (score: 3–4), and 3.3% (score: 1–2) of dogs, showed a mild, moderate and severe increase of bile duct enzymes, respectively. Subclassification of dogs based on the liver and bile duct enzyme alteration Based on the increase of liver parenchyma and bile duct enzymes (Table 1 E), patients were divided into thirteen groups from 0 (normal) to 12 (severe increase of liver and/or bile duct enzymes). Based on the obtained results, 38.7% of dogs were in the normal range (score: 0), 48.8% (score: 1–4)of patients had a mild increase in liver-biliary enzymes, and 8.8% (score: 5–8)of patients had a moderate increase in liver-biliary enzymes, and 3.7% (score: 9–12) of patients showed a strong increase in liver-biliary enzymes. Subclassification of dogs based on abnormal ALT and/or GGT. Considering that ALT and GGT enzymes are more specific for liver and bile duct diseases rather than AST and ALP, in this classification, only dogs with ALT above 100 IU/L and/or GGT IU/L above 10 were considered liver patients. 259 of the studied cases (36%) had ALT above 100 IU/L and/or GGT above 10 IU/L. The average age in this group was 6.9 ± 2.69 years. This population was again divided into 12 groups from 1 to 12 according to the severity of the increase in bile ducts and liver parenchyma enzymes, and based on this, 66.4% (172/259), 23.2% (60/259) and 10.4% (27/259)of patients had a mild, moderate and severe increase in liver-biliary enzymes. Based on the total population 23.8% (172/720), 8.3% (60/720), and 3.7% (27/720) of dogs showed mild, moderate, and marked increase in liver-biliary enzymes. Figure 1, showed the prevalence of hepatopathy based on the ALT and/or GGT elevation in dogs fed with various commercial foods. Relationship between the increases of hepatobiliary enzymes with diet There was a significant relationship between commercial food brands and biochemical factors including ALT, AST, GGT, ALP, Chol, T.B. (p < 0.05), (Fig. 2). However, in post hoc comparisons, there was no significant difference in multiple pairwise comparisons. Relationship between increased liver-biliary enzymes and ultrasound findings Out of all referred patients, 101 dogs were examined by ultrasound. The liver hyperechoic sign was recorded in 52.94% of cases. In dogs showing liver hyperechoic signs on ultrasonography, significant increases in triglyceride, ALT, ALP, GGT, and total bilirubin were observed compared to dogs with normal hepatic echogenicity. Liver enlargement was seen in 46.53% of patients. These patients had significant elevation in terms of white blood cells, monocytes, cholesterol, AST, ALT, ALP, GGT, and total bilirubin. Gallbladder enlargement was seen in 29.70% of patients. These patients had significant elevation in terms of monocytes, cholesterol, triglycerides, AST, ALT, ALP, GGT, and total bilirubin with the group that did not show signs of gallbladder dilatation in ultrasound. Discussion This study identified a prevalence of 3.7% of remarkable biliary-hepatopathy in 720 dogs fed commercial foods based on the marked elevation of hepatobiliary enzymes in which at least one of the ALT and/or GGT was abnormal. Based on these criteria, 23.8% and 8.3% of patients had a mild and moderate increase in liver-biliary enzymes, respectively. This study also gives a unique insight into the correlation between hepatopathy with sex, age, diet, and ultrasound findings. Although other evaluations such as histopathological studies are needed to diagnose the type of liver damage, liver enzyme profile can be reliable in diagnosing the presence of many hepatopathies such as necrotic, inflammatory, and cholestatic diseases. Especially, the initial diagnosis of hepatopathy based on enzymes that are more specific for the liver will increase the accuracy of the results. The use of histopathology is not only not possible and practical in a large population of patients, but it will be more useful for diffuse diseases when it is sampled blindly from one lobe of the liver [ 19 ]. Acute and chronic hepatitis are considered the most common liver disease in dogs and liver enzyme elevations are common findings in these patients [ 20 , 21 ]. The other common and important hepatic disorder in dogs is copper-associated hepatopathy. The prevalence of this disease has increased over time and is related to the changes in copper content in commercial dog foods [ 22 ] [ 23 ]. In dogs with copper-associated hepatopathy, asymptomatic elevations in liver enzyme activity are often present that later progress to liver failure [ 24 ]. It seems that the prevalence of liver and biliary diseases in dogs has increased in recent years [ 25 , 26 ]. Poldevaart et al., (2009) recorded 0.5% of the incidence of hepatic disorders among the clinical cases [ 24 ]. A retrospective study showed the prevalence of all hepatic diseases from 2007 to 2010 was 1.24% [ 5 ]. Furthermore based on some other research studies the prevalence of hepatic disorders has been reported as 1–2%. [ 27 , 28 ]. However, some other studies showed the prevalence of liver diseases in dogs was higher. Vijayakumar et al., (2003) reported that the prevalence of hepatic disorders in dogs was 3.01% [ 29 ]. A previous study on 200 unselected canine post-mortem examinations showed the prevalence of chronic hepatitis was 12% [ 19 ]. In the present study, the dogs affected by hepatopathy were predominantly middle-aged to older animals, and the average age in the dogs was 6.9 ± 2.69. The findings are in partial agreement with Morozenko et al., and Poldervaart et al., (2009) who reported the median age of dogs with hepatitis as 6 and 7.7 years, respectively [ 21 , 24 ]. Bexfield et al., (2012) reported the average age of chronic hepatitis in dogs as 8 years [ 30 ]. Pet food quality has received increasing attention among pet owners in recent years. There are concerns that commercial pet foods might contain unbalanced nutrition and unlisted food sources which may influence the progression of various pathologies in pets [ 31 ]. In the present study, the results showed the negative effects of some commercial foods on liver health. Diet has a pivotal role in the induction, prevention, and treatment of various liver diseases. On the other hand, some degrees of maldigestion and malabsorption are respectable in patients with liver diseases. These changes are multifactorial and can be caused by decreased bile salt solubilization, and secondary pancreatic or intestinal damage [ 32 ]. Based on the analysis reported by the manufacturing analysis, no remarkable differences were observed in the comparison of the composition of commercial pet foods. The comparison showed that different foods contained 19 to 30 percent protein, 8 to 21 percent fat, 1.2 to 8 percent fiber, 5.2 to 10 percent ash, and 8 to 8.5 percent moisture, and were enriched with various mineral, vitamin, and antioxidant supplements. On the other hand, In all cases the primary food sources were similar. The most important point that likely has a significant impact on food quality is the quality of raw materials. Meat meal was used in many cases in the production of food. However, the quality of meat meals varies depending on the processing, raw materials, and storage conditions, and if processing and storage are not properly managed, it can become contaminated with various bacterial agents and fungal toxins. Interestingly in the present study, foods C, F, G, H, and K belonged to the same country and used common sources of grains and meat meal. The dogs fed with these commercial foods showed remarkable increases in hepatobiliary enzymes. Liver tissue damage and increased liver enzymes are among the expected complications of mycotoxin poisoning, including aflatoxins [ 33 ]. The results of a research study showed that 88.28 of the meat & bone meal samples and 33.3 of the fish meal samples contain aflatoxins [ 34 ]. However, other ingredients such as corn, sorghum, rice, wheat, oats, and barley can also be contaminated by some forms of mycotoxins [ 33 ]. As pets usually consume only one type of food continuously over extended periods, if the food is contaminated with toxins such as aflatoxins, the toxins gradually accumulate in the body to a significant extent and cause tissue damage. Therefore, paying attention to the quality of pet food can prevent long-term and irreversible damage. Furthermore, in patients fed with low or unbalanced dietary intakes, hepatic failure and loss of liver storage capacity may exacerbate the micronutrient deficiencies [ 35 ]. Unbalanced diets with high fat content can be a risk factor for hepatopathy in dogs. Hyperlipidemia is common in dogs and can be caused by high-fat diets. These patients are susceptible to other disorders such as liver diseases, pancreatitis, atherosclerosis, ocular disease, and seizures [ 36 ]. The antioxidant capacity of commercial foods is another important factor that can have a pivotal role in the prevention or induction of hepatobiliary disorders. A diet with an unbalanced oxidant–antioxidant status negatively affects liver function and health. The liver is the primary site for the synthesis of glutathione and oxidative stress is often involved in liver disease development. Food supplements containing S-acetyl-glutathione (SAG), silybin, and other antioxidant ingredients in dogs can be helpful in managing dogs with hepatopathy [ 37 ]. A diet polluted with heavy metals may induce hepatic toxicity and oxidative stress. Since heavy metals are non-degradable, stay and accumulate in the body tissues for a very long time [ 38 ]. Prior studies have shown that exposure to heavy metals such as lead, cadmium, and mercury is associated with liver disorders [ 38 ]. In the present study, 101 dogs were examined by ultrasound, and liver hyperechoic sign as the most common finding on ultrasonography was recorded in 52.94% of cases. The most important differential diagnoses for diffuse hyperechoic liver are steroid hepatopathy (Cushing's or iatrogenic), chronic hepatitis, cirrhosis, and lymphosarcoma in dogs. A recent study in dogs showed 71% of livers with steroid hepatopathy, 41% of livers with lipidosis and 38% of livers with fibrosis were hyperechogenic in ultrasound [ 39 ]. Our findings indicate that ultrasound findings including liver hyperechoic signs, liver enlargement, and gallbladder dilatation, were associated with elevated serum liver enzymes. Ultrasonography has a significant role in the diagnosis of canine liver disease [ 40 ]. However, in some previous studies, no definitive correlation has been observed between liver ultrasound findings and accurate disease diagnosis [ 39 , 41 ]. Conclusion The prevalence of remarkable hepatopathy in dogs aged 1–17 years, fed commercial pet food was estimated to be 3.7%. Aging is probably a risk factor for increasing hepatopathy. The average age in the affected dogs was 6.9 ± 2.69. Furthermore, our study raises the possibility that dietary factors may be important determinants of liver disorder progression in dogs. Declarations Ethics approval and consent to participate All methods are reported in accordance with Arrive guidelines (https://ariveguidelines.org) for the reporting of animal experiments. All phases of this study were approved by the Animal Ethical Guidelines of the Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran (No: 8509019.7.47). Consent for publication Not applicable. Availability of data and materials The data used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests All the authors approved the final manuscript and they have no competing interests to declare. Funding This research received no specific grant from any funding agency. Authors' contributions HM: Conceptualization, Data curation, Formal analysis, Software, Writing—original draft, Writing—review and; editing. SR and SJ: Data curation, Formal analysis, MF: Writing—review and; editing, and all authors read, edited, and approved the final manuscript. Acknowledgements The authors would like to appreciate plasma veterinary laboratory personnel for their support and collaboration in this study References Guyton A, Hall J. Textbook of medicinal physiology. In. 2000, Philadelphia: WB Saunders Company. Boyd J. 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Edwardsville, Kan(USA): Veterinary medicine; 1998. Feeney DA, Anderson KL, Ziegler LE, Jessen CR, Daubs BM, Hardy RM. Statistical relevance of ultrasonographic criteria in the assessment of diffuse liver disease in dogs and cats. Am J Vet Res. 2008;69(2):212–21. Tables Table 1 A three-point scale for grading the severity of liver and bile enzyme elevation A. Liver Enzyme Score ALT 100–150 1+ 150–300 2+ > 300 3+ AST 70–100 1+ 100–200 2+ > 200 3+ B. Bile Duct Enzyme score GGT 10–15 1+ 15–20 2+ > 20 3+ ALP 150–200 1+ 200–400 2+ > 400 3+ C. Total Liver Score 1,2 Mild 3,4 Moderate 5,6 Severe D. Total Bile duct Score 1,2 Mild 3,4 Moderate 5,6 Severe E. Total Bile and Liver Score 1–4 Mild 5–8 Moderate 9–12 Severe Table 2 Composition and typical analysis of different commercial dog foods (Adult dog food ), based on the information provided by the manufacturer evaluated in the present study Diet brand Composition Typical analysis A Dehydrated Poultry Meat, Maize, Rice, Maize Flour, Animal Fats, Maize Gluten, Vegetable Protein Isolate, Hydrolysed Animal Proteins, Beet Pulp, Minerals, Fish Oil, Egg Powder, Yeasts, Soya Oil, Fructo-Oligo-Saccharides, Borage Oil, Green Tea and Grape Extracts (Source of Polyphenols), Hydrolysed Crustaceans (Source of Glucosamine), Hydrolysed Cartilage (Source of Chondroitin Antioxidants. Protein 26.0%, Fat 17.0%, Fibre 1.2%, Ash 5.2%, Moisture 8.0%. B Cereals, Meat and Animal Derivatives (Including min 14% Beef, 4% Lamb), Oils and Fats, Vegetables (min 4%). Protein 22.0%, Fat 8.0%, Fibre 3.0%, Ash 8.5%, Moisture 8.0%. C Chicken protein, corn protein, rice flour, animal fat, soybean hulls, cellulose, beet pulp, sunflower hulls, wheat, barley, rice, monocalcium phosphate. Protein 25.0%, Fat 14%, Fibre 8.0%, Ash 9.5%, Moisture 8.0%. D Whole Maize, Meat Meal, Soya Oil, Vitamins and Minerals, Artificial Beef Flavour. Protein 23.5%, Fat 9.0%, Fibre 3.5%, Ash 10.0%, Moisture 8.0%. E Whole Wheat, Beef Meat Meal, Maize, Maize Gluten, Rice, Oats, Chicken Fat, Bran, Vitamins, Minerals and Trace Elements, EC Permitted Antioxidant. Protein 23.0%, Fat 10.0%, Fibre 3.0%, Ash 8.5%, Moisture 8.0%. F Chicken and beef meal, plant protein, fish oil, soybean oil, animal fat, corn gluten meal, plant fiber, rice flour, beet pulp, omega 3 and 6, minerals and trace elements. Protein 26.0%, Fat 21.0%, Fibre 4.0%, Ash 8.0% G Chicken, chicken liver, vegetables, egg powder, fish and corn meal, wheat, soy, and fish oil. Protein 30%, Fat 16%, Fibre 2.0%, Ash 8.5%. H Fresh chicken meat, beef liver, egg powder, beef meal. Protein 29%, Fat 13.5%, Fibre 2.5%, Ash 8.0%, Moisture 8.0%,. P Whole Wheat, Maize, Chicken Meat Meal, Barley, Chicken Fat, Beet Pulp, Vitamins, Minerals and Trace Elements Protein 19.0%, Fat 11.0%, Fibre 2.4%, Ash 5.5%, Moisture 8.0%. J Wheat, Poultry Meal , Beef Meal, Maize, Wheat Feed, Soya, Poultry Fat, Chicken Liver Digest, Minerals, Salt, Peas, Dicalcium Phosphate, Protein 25.0%, Fat 9.0%, Fibre 2.5%, Ash 8.0%, Moisture 8.0%. C Poultry meal, corn protein, rice flour, Poultry fat, soybean hulls, cellulose, beet pulp, sunflower hulls, wheat, barley, rice. Protein 22.0%, Fat 18.0%, Fibre 6%, Ash 6.0%, Moisture 8.0%, L Wheat, Meat and Bone Meal, Syrup, Pasta (6%), Barley, Poultry Fat, Poultry Meat Meal, Minerals, Fish Meal, Yucca Extract. Protein 19.0%, Fat 8.0%, Fibre 3.0%, Ash 8.0%, Carbs 54.0%, Moisture 8.0%, Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3885448","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":268749771,"identity":"5e519da8-bf2f-4265-80e0-bc4dfc3fef78","order_by":0,"name":"Hamidreza Moosavian","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAyklEQVRIiWNgGAWjYBACAxiDjYGB8QGEydhAtBZmA4YEUrSAdElAtBAA5tKnEx98+GOX2Md+9lg17w8Gef4G5rYP+LRY9uVuNpzZlpzYxpOXdpsngcFwxgHG5hl4HXaGd5s0bwOzMRtDjhlIC+MGBsZm/H4BaeH5U2/Mxv/GrBioxZ5ILWyH5dgkcsyYgVoSidEC8stxoJY3xpJz0iSSZxwmrGUjMMSqeeT7cww/vLGxse1vb3+MVws6kADGKEkaRsEoGAWjYBRgAwCTAj4sweWvzgAAAABJRU5ErkJggg==","orcid":"","institution":"University of Tehran","correspondingAuthor":true,"prefix":"","firstName":"Hamidreza","middleName":"","lastName":"Moosavian","suffix":""},{"id":268749772,"identity":"3b367c84-1731-446a-81b4-9802af748912","order_by":1,"name":"Sajad Rezaei","email":"","orcid":"","institution":"University of Tehran","correspondingAuthor":false,"prefix":"","firstName":"Sajad","middleName":"","lastName":"Rezaei","suffix":""},{"id":268749773,"identity":"6ec96742-9fe5-4454-8273-76cbf0e7979d","order_by":2,"name":"Shahram Jamshidi","email":"","orcid":"","institution":"University of Tehran","correspondingAuthor":false,"prefix":"","firstName":"Shahram","middleName":"","lastName":"Jamshidi","suffix":""},{"id":268749774,"identity":"f5f8f644-88cd-4461-9994-8ae7790ca742","order_by":3,"name":"Mahsa Fazli","email":"","orcid":"","institution":"Islamic Azad University","correspondingAuthor":false,"prefix":"","firstName":"Mahsa","middleName":"","lastName":"Fazli","suffix":""}],"badges":[],"createdAt":"2024-01-21 17:59:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3885448/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3885448/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":50117539,"identity":"144fb3f3-8317-42b7-8931-66587af51eea","added_by":"auto","created_at":"2024-01-24 18:59:03","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":57276,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe prevalence of hepatopathy based on the ALT and/or GGT elevation in dogs fed with various commercial foods\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3885448/v1/c4f095db48041507b0a5ec17.jpg"},{"id":50117540,"identity":"8766ba2c-31ca-429e-8db2-4af86c0d5939","added_by":"auto","created_at":"2024-01-24 18:59:03","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":114781,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of some biochemical factors in dogs with different diets. In all cases, significant differences were seen between food type and biochemical factors.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3885448/v1/7750d85e6fb1ed630a9e0d9e.jpg"},{"id":70391536,"identity":"32634abc-96df-4d54-8803-5fb0cda882cc","added_by":"auto","created_at":"2024-12-02 17:30:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":836183,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3885448/v1/f0b81fcc-97aa-41e7-b787-6b569ecfd754.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of canine hepatopathy among a clinic population fed commercial dry food: Age and Dietary factors influence the disease prevalence","fulltext":[{"header":"Background","content":"\u003cp\u003eThe liver as the second largest organ in the body, performs over 500 vital functions. These include breaking down poisonous substances and removing waste products, protein, and bile production, regulating blood sugar and lipid levels, producing clotting coagulants, vitamins, and minerals storage, and as part of the reticuloendothelial system, it plays an important role in host immunity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Primary and secondary agents can involve the liver. Due to the important role of the liver in removing a variety of drugs, toxins, and waste materials and also the proximity of the liver to organs such as the intestine and pancreas and receiving blood from the portal vein, there is a possibility of secondary liver damage in a variety of other diseases, including intestinal and pancreatic diseases. Also, a variety of diets can have a direct effect on liver function [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. It seems that the prevalence of liver diseases in dogs is higher than previously reported. A recent study showed the prevalence of liver diseases in dogs was about three times higher than in cats [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Primary, mostly chronic hepatitis comprised 0.5% of all the patients presented to the hospital [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] and the risk of chronic hepatitis in several dog breeds has been increased [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Therefore, it is necessary to carry out more studies to evaluate the prevalence of liver diseases and related risk factors in dogs. One of the important known risk factors in the occurrence of liver diseases in humans is diet [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Several studies have reported that different dietary patterns are associated with the progression of obesity, type 2 diabetes mellitus, and components of the metabolic syndrome, particularly insulin resistance, and finally nonalcoholic fatty liver disease as the most common causes of chronic liver disease worldwide in humans [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Similarly, the quality of pet food and feed management can have a pivotal role in the healthy status and the prevention of diseases in animals. Therefore, in recent years, pet owners pay more attention to the quality of food for their pet's health. Unfortunately, for assessing liver function in critically ill patients, no ideal tool is currently available, [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In patients, a series of tests such as liver enzyme and function tests, microbial tests, histopathology, indocyanine green plasma disappearance rate and lidocaine metabolism, and imaging are used to evaluate liver injury and function [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. However, it is not possible to evaluate all these tests in a large population of patients. Liver enzyme tests are widely available, easily performed, and are the most commonly used paraclinical methods for determining liver health [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Although liver function can not be reliably assessed based on enzyme activities, elevation of liver enzymes may be a sign of damage to the liver [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT), are the enzyme used in small animal veterinary practice. The most important problem in liver assessment by liver enzyme profile is that these enzymes are not specific to the liver and are also found in other tissues and organs. However, some liver enzymes such as ALT and GGT have higher specificity for liver diseases and marked elevations of these enzymes are observed most often in persons with diseases that affect primarily liver and bile ducts [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Enzyme activities are often the first abnormal finding that leads a clinician to suspect a liver disease in the patient and are useful in the diagnostic process [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Furthermore, a strong correlation has been observed between the increase of liver enzymes and the presence of histopathological injuries in the liver of dogs, so most dogs with cholangitis and cholangiohepatitis have shown an increase in liver enzymes [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The aims of this study include 1: To evaluate the prevalence of hepatopathy in dogs fed commercial dry food based on biochemical results and enzyme changes and compare it with ultrasound findings.2. The other aim of this study was to ascertain whether there was any association between changes in liver enzymes and type of diet in dogs.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSample size\u003c/h2\u003e \u003cp\u003ePrevalence of all liver diseases according to the previous studies is 1.24% in dogs [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This prevalence was utilized to calculate an appropriate sample size using the formula:\u003c/p\u003e \u003cp\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\(\\text{Sample size}=\\frac{{Z}^{2}P(P-1)}{{d}^{2}}\\)\u003c/span\u003e \u003c/span\u003e,Where Z\u0026thinsp;=\u0026thinsp;confidence interval, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;estimated prevalence, d\u0026thinsp;=\u0026thinsp;precision. Where the estimated prevalence is less than 5%, a precision of less than 5% is advised [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In the present study sample size was calculated to be approximately 670 dogs, for a prevalence of 1.24% and 95% confidence interval (CI), with a predicted precision of 2%.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eThe present study was a cross\u003cem\u003e-\u003c/em\u003esectional study carried out on 720 dogs presented at a veterinary hospital between 2017 and 2022. The patients who met the inclusion criteria were selected for more evaluation. Inclusion criteria included dogs that were older than 1 year and consistently were fed with a commercial diet at least for 6 months. Dogs that did not feed with a fixed diet, or used several types of diets and commercial foods were excluded from the study. A complete physical examination, laboratory survey, and abdominal ultrasonography were performed on each subject. For hematology and biochemistry analysis, three milliliters of blood samples were collected during the cephalic vein and immediately aliquoted into K2EDTA (Xinel, China) and clot activator tube (Vacutest\u0026reg;, Arzergrande, Italy). A complete blood count was conducted on an Automated hematology analyzer (Nihon Kohden, Cell tac-α, Japan) immediately after the blood collection The serum level of glucose, cholesterol, triglyceride, total and direct bilirubin, urea, creatinine, total protein, albumin, calcium, inorganic phosphate, and the activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatine kinase(CK) and gamma-glutamyl transferase(GGT) were measured by commercial kits [Pars Azmoon, Tehran, Iran] using an autoanalyzer (Global 240, BPC Co., Italy). Control serum (Trulab N sera, DiaSys Diagnostic System GmbH, Germany) was used for controlling measurement accuracy.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eDiet classification\u003c/h2\u003e \u003cp\u003e To evaluate the relationship between the type of nutrition and liver health, 12 types of common commercial food were selected, and the dogs were placed in one of the above groups according to what type of nutrition they had during the last six months.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eLiver injury grading scale\u003c/h2\u003e \u003cp\u003eA modified 3-point scale for grading the severity of liver and bile duct injuries based on the liver enzyme elevation was developed [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was performed using PASW Statistics for Windows release 21 (SPSS Inc., Chicago, IL, USA). The One-way ANOVA followed by Tukey post hoc tests, T-test, and chi-square test were used. p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered significant. All data are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;Standard Error.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eDiet information\u003c/h2\u003e \u003cp\u003eThe studied dogs were divided into 12 groups based on the commercial food consumed during at least the last six months. Dogs that did not have a fixed diet were excluded from the study. In each group, there were at least 50 dogs with equal gender distribution, and the average age range in the groups was 5.8 to 6.1 years. The analysis of commercial foods based on the information given by the respective manufacturer is given in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eRelationship between age and sex with increased liver-biliary enzymes\u003c/h2\u003e \u003cp\u003eResults of the 720 dogs (age: 1\u0026ndash;17 years and median age 5.92\u0026thinsp;\u0026plusmn;\u0026thinsp;0.18 years) showed, there was no obvious sex predisposition in dogs with hepatopathy. However, a significant relationship was observed between age and ALT (Odd ratio: 1.121, CI: 1.064\u0026ndash;1.181) and GGT (Odd ratio: 1.056, CL: 1.008\u0026ndash;1.105). According to the results, aging is probably a risk factor for increasing liver enzymes and liver diseases. The average age in the affected dogs was 6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSubclassification of dogs based on the liver enzyme alteration\u003c/h2\u003e \u003cp\u003eBased on the increase of liver parenchyma enzymes (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003eC), dogs were divided into six groups from 0 (normal) to 6 (severe increase of liver enzymes). Based on the obtained results, 77.1% (score: 0), of dogs were within the normal range for liver enzymes, and 14.5% (score: 1, 2), 5.7% (score: 3, 4), and 8.8% (score:5, 6), of dogs, showed a mild, moderate and severe increase of liver enzymes, respectively.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSubclassification of dogs based on the bile duct enzyme alteration\u003c/h2\u003e \u003cp\u003eBased on the increase of bile duct enzymes (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003eD), dogs were divided into six groups from 0 (normal) to 6 (severe increase of bile duct enzymes). Based on the obtained results, 43.5% (score: (score: 0), of dogs were within the normal range, and 32.7%(score: 1\u0026ndash;2), 18.4% (score: 3\u0026ndash;4), and 3.3% (score: 1\u0026ndash;2) of dogs, showed a mild, moderate and severe increase of bile duct enzymes, respectively.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSubclassification of dogs based on the liver and bile duct enzyme alteration\u003c/h2\u003e \u003cp\u003eBased on the increase of liver parenchyma and bile duct enzymes (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003eE), patients were divided into thirteen groups from 0 (normal) to 12 (severe increase of liver and/or bile duct enzymes). Based on the obtained results, 38.7% of dogs were in the normal range (score: 0), 48.8% (score: 1\u0026ndash;4)of patients had a mild increase in liver-biliary enzymes, and 8.8% (score: 5\u0026ndash;8)of patients had a moderate increase in liver-biliary enzymes, and 3.7% (score: 9\u0026ndash;12) of patients showed a strong increase in liver-biliary enzymes.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSubclassification of dogs based on abnormal ALT and/or GGT.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eConsidering that ALT and GGT enzymes are more specific for liver and bile duct diseases rather than AST and ALP, in this classification, only dogs with ALT above 100 IU/L and/or GGT IU/L above 10 were considered liver patients. 259 of the studied cases (36%) had ALT above 100 IU/L and/or GGT above 10 IU/L. The average age in this group was 6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69 years. This population was again divided into 12 groups from 1 to 12 according to the severity of the increase in bile ducts and liver parenchyma enzymes, and based on this, 66.4% (172/259), 23.2% (60/259) and 10.4% (27/259)of patients had a mild, moderate and severe increase in liver-biliary enzymes. Based on the total population 23.8% (172/720), 8.3% (60/720), and 3.7% (27/720) of dogs showed mild, moderate, and marked increase in liver-biliary enzymes. Figure\u0026nbsp;1, showed the prevalence of hepatopathy based on the ALT and/or GGT elevation in dogs fed with various commercial foods.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eRelationship between the increases of hepatobiliary enzymes with diet\u003c/h2\u003e \u003cp\u003eThere was a significant relationship between commercial food brands and biochemical factors including ALT, AST, GGT, ALP, Chol, T.B. (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), (Fig.\u0026nbsp;2). However, in post hoc comparisons, there was no significant difference in multiple pairwise comparisons.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eRelationship between increased liver-biliary enzymes and ultrasound findings\u003c/h2\u003e \u003cp\u003eOut of all referred patients, 101 dogs were examined by ultrasound. The liver hyperechoic sign was recorded in 52.94% of cases. In dogs showing liver hyperechoic signs on ultrasonography, significant increases in triglyceride, ALT, ALP, GGT, and total bilirubin were observed compared to dogs with normal hepatic echogenicity. Liver enlargement was seen in 46.53% of patients. These patients had significant elevation in terms of white blood cells, monocytes, cholesterol, AST, ALT, ALP, GGT, and total bilirubin. Gallbladder enlargement was seen in 29.70% of patients. These patients had significant elevation in terms of monocytes, cholesterol, triglycerides, AST, ALT, ALP, GGT, and total bilirubin with the group that did not show signs of gallbladder dilatation in ultrasound.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study identified a prevalence of 3.7% of remarkable biliary-hepatopathy in 720 dogs fed commercial foods based on the marked elevation of hepatobiliary enzymes in which at least one of the ALT and/or GGT was abnormal. Based on these criteria, 23.8% and 8.3% of patients had a mild and moderate increase in liver-biliary enzymes, respectively. This study also gives a unique insight into the correlation between hepatopathy with sex, age, diet, and ultrasound findings. Although other evaluations such as histopathological studies are needed to diagnose the type of liver damage, liver enzyme profile can be reliable in diagnosing the presence of many hepatopathies such as necrotic, inflammatory, and cholestatic diseases. Especially, the initial diagnosis of hepatopathy based on enzymes that are more specific for the liver will increase the accuracy of the results. The use of histopathology is not only not possible and practical in a large population of patients, but it will be more useful for diffuse diseases when it is sampled blindly from one lobe of the liver [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Acute and chronic hepatitis are considered the most common liver disease in dogs and liver enzyme elevations are common findings in these patients [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The other common and important hepatic disorder in dogs is copper-associated hepatopathy. The prevalence of this disease has increased over time and is related to the changes in copper content in commercial dog foods [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. In dogs with copper-associated hepatopathy, asymptomatic elevations in liver enzyme activity are often present that later progress to liver failure [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. It seems that the prevalence of liver and biliary diseases in dogs has increased in recent years [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Poldevaart et al., (2009) recorded 0.5% of the incidence of hepatic disorders among the clinical cases [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. A retrospective study showed the prevalence of all hepatic diseases from 2007 to 2010 was 1.24% [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Furthermore based on some other research studies the prevalence of hepatic disorders has been reported as 1\u0026ndash;2%. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. However, some other studies showed the prevalence of liver diseases in dogs was higher. Vijayakumar et al., (2003) reported that the prevalence of hepatic disorders in dogs was 3.01% [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. A previous study on 200 unselected canine post-mortem examinations showed the prevalence of chronic hepatitis was 12% [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In the present study, the dogs affected by hepatopathy were predominantly middle-aged to older animals, and the average age in the dogs was 6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69. The findings are in partial agreement with Morozenko et al., and Poldervaart et al., (2009) who reported the median age of dogs with hepatitis as 6 and 7.7 years, respectively [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Bexfield et al., (2012) reported the average age of chronic hepatitis in dogs as 8 years [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Pet food quality has received increasing attention among pet owners in recent years. There are concerns that commercial pet foods might contain unbalanced nutrition and unlisted food sources which may influence the progression of various pathologies in pets [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. In the present study, the results showed the negative effects of some commercial foods on liver health. Diet has a pivotal role in the induction, prevention, and treatment of various liver diseases. On the other hand, some degrees of maldigestion and malabsorption are respectable in patients with liver diseases. These changes are multifactorial and can be caused by decreased bile salt solubilization, and secondary pancreatic or intestinal damage [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Based on the analysis reported by the manufacturing analysis, no remarkable differences were observed in the comparison of the composition of commercial pet foods. The comparison showed that different foods contained 19 to 30 percent protein, 8 to 21 percent fat, 1.2 to 8 percent fiber, 5.2 to 10 percent ash, and 8 to 8.5 percent moisture, and were enriched with various mineral, vitamin, and antioxidant supplements. On the other hand, In all cases the primary food sources were similar. The most important point that likely has a significant impact on food quality is the quality of raw materials. Meat meal was used in many cases in the production of food. However, the quality of meat meals varies depending on the processing, raw materials, and storage conditions, and if processing and storage are not properly managed, it can become contaminated with various bacterial agents and fungal toxins. Interestingly in the present study, foods C, F, G, H, and K belonged to the same country and used common sources of grains and meat meal. The dogs fed with these commercial foods showed remarkable increases in hepatobiliary enzymes. Liver tissue damage and increased liver enzymes are among the expected complications of mycotoxin poisoning, including aflatoxins [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. The results of a research study showed that 88.28 of the meat \u0026amp; bone meal samples and 33.3 of the fish meal samples contain aflatoxins [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. However, other ingredients such as corn, sorghum, rice, wheat, oats, and barley can also be contaminated by some forms of mycotoxins [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. As pets usually consume only one type of food continuously over extended periods, if the food is contaminated with toxins such as aflatoxins, the toxins gradually accumulate in the body to a significant extent and cause tissue damage. Therefore, paying attention to the quality of pet food can prevent long-term and irreversible damage. Furthermore, in patients fed with low or unbalanced dietary intakes, hepatic failure and loss of liver storage capacity may exacerbate the micronutrient deficiencies [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Unbalanced diets with high fat content can be a risk factor for hepatopathy in dogs. Hyperlipidemia is common in dogs and can be caused by high-fat diets. These patients are susceptible to other disorders such as liver diseases, pancreatitis, atherosclerosis, ocular disease, and seizures [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. The antioxidant capacity of commercial foods is another important factor that can have a pivotal role in the prevention or induction of hepatobiliary disorders. A diet with an unbalanced oxidant\u0026ndash;antioxidant status negatively affects liver function and health. The liver is the primary site for the synthesis of glutathione and oxidative stress is often involved in liver disease development. Food supplements containing S-acetyl-glutathione (SAG), silybin, and other antioxidant ingredients in dogs can be helpful in managing dogs with hepatopathy [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. A diet polluted with heavy metals may induce hepatic toxicity and oxidative stress. Since heavy metals are non-degradable, stay and accumulate in the body tissues for a very long time [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Prior studies have shown that exposure to heavy metals such as lead, cadmium, and mercury is associated with liver disorders [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. In the present study, 101 dogs were examined by ultrasound, and liver hyperechoic sign as the most common finding on ultrasonography was recorded in 52.94% of cases. The most important differential diagnoses for diffuse hyperechoic liver are steroid hepatopathy (Cushing's or iatrogenic), chronic hepatitis, cirrhosis, and lymphosarcoma in dogs. A recent study in dogs showed 71% of livers with steroid hepatopathy, 41% of livers with lipidosis and 38% of livers with fibrosis were hyperechogenic in ultrasound [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. Our findings indicate that ultrasound findings including liver hyperechoic signs, liver enlargement, and gallbladder dilatation, were associated with elevated serum liver enzymes. Ultrasonography has a significant role in the diagnosis of canine liver disease [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. However, in some previous studies, no definitive correlation has been observed between liver ultrasound findings and accurate disease diagnosis [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of remarkable hepatopathy in dogs aged 1\u0026ndash;17 years, fed commercial pet food was estimated to be 3.7%. Aging is probably a risk factor for increasing hepatopathy. The average age in the affected dogs was 6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69. Furthermore, our study raises the possibility that dietary factors may be important determinants of liver disorder progression in dogs.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll methods are reported in accordance with Arrive guidelines (https://ariveguidelines.org) for the reporting of animal experiments. All phases of this study were approved by the Animal Ethical Guidelines of the Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran (No: 8509019.7.47).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the authors approved the final manuscript and they have no competing interests to declare.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received \u003cem\u003eno\u003c/em\u003e specific \u003cem\u003egrant\u003c/em\u003e from any \u003cem\u003efunding\u003c/em\u003e agency.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHM: Conceptualization, Data curation, Formal analysis, Software, Writing\u0026mdash;original draft, Writing\u0026mdash;review and; editing. SR and SJ: Data curation, Formal analysis, MF: Writing\u0026mdash;review and; editing, and all authors read, edited, and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to appreciate plasma veterinary laboratory personnel for their \u0026nbsp;support and collaboration in this study\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGuyton A, Hall J. Textbook of medicinal physiology. In. 2000, Philadelphia: WB Saunders Company.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoyd J. Introduction to Veterinary Anatomy and, Physiology V, Aspinall M, O\u0026rsquo;Reilly E. (2004), p. 236\u0026pound; 22.99 (soft), ISBN: 0750687827. In. 2005, WB Saunders.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStricker BHC. 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Prevalence of hepatic lesions at post-mortem examination in dogs and association with pancreatitis. J Small Anim Pract. 2010;51(11):566\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWatson P. Chronic hepatitis in dogs: a review of current understanding of the aetiology, progression, and treatment. Veterinary journal (London, England: 1997) 2004; 167(3):228\u0026ndash;241.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMorozenko D, Dotsenko R, Vashchyk Y, Zakhariev A, Nataliia S, Zemlianskyi A, Gliebova K, Kostyshyn L-M, PREVALENCE OF INTERNAL DISEASES OF DOGS AND CATS. : A RETROSPECTIVE ANALYSIS (1994\u0026ndash;2014). ScienceRise: Biol Sci 2022; 31(2).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStrickland JM, Buchweitz JP, Smedley RC, Olstad KJ, Schultz RS, Oliver NB, Langlois DK. Hepatic copper concentrations in 546 dogs (1982\u0026ndash;2015). 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Hepatic ultrasonography: a valuable tool in small animals. Edwardsville, Kan(USA): Veterinary medicine; 1998.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeeney DA, Anderson KL, Ziegler LE, Jessen CR, Daubs BM, Hardy RM. Statistical relevance of ultrasonographic criteria in the assessment of diffuse liver disease in dogs and cats. Am J Vet Res. 2008;69(2):212\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA three-point scale for grading the severity of liver and bile enzyme elevation\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eA. Liver Enzyme Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eALT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u0026ndash;150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e150\u0026ndash;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAST\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70\u0026ndash;100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eB. Bile Duct Enzyme score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGGT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026ndash;15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eALP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e150\u0026ndash;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e200\u0026ndash;400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3+\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eC. Total Liver Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3,4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eD. Total Bile duct Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1,2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3,4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5,6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eE. Total Bile and Liver Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e5\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e9\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e Composition and typical analysis of different commercial dog foods (Adult dog food ), based on the information provided by the manufacturer evaluated in the present study\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiet brand\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eComposition\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTypical analysis\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDehydrated Poultry Meat,\u0026nbsp;Maize,\u0026nbsp;Rice,\u0026nbsp;Maize Flour,\u0026nbsp;Animal Fats,\u0026nbsp;Maize Gluten,\u0026nbsp;Vegetable Protein Isolate,\u0026nbsp;Hydrolysed Animal Proteins,\u0026nbsp;Beet Pulp,\u0026nbsp;Minerals,\u0026nbsp;Fish Oil,\u0026nbsp;Egg\u0026nbsp;Powder,\u0026nbsp;Yeasts,\u0026nbsp;Soya Oil,\u0026nbsp;Fructo-Oligo-Saccharides,\u0026nbsp;Borage Oil,\u0026nbsp;Green Tea\u0026nbsp;and\u0026nbsp;Grape Extracts\u0026nbsp;(Source of Polyphenols),\u0026nbsp;Hydrolysed Crustaceans\u0026nbsp;(Source of\u0026nbsp;Glucosamine), Hydrolysed Cartilage (Source of\u0026nbsp;Chondroitin\u0026nbsp;Antioxidants.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 26.0%, Fat 17.0%, Fibre 1.2%, Ash 5.2%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCereals,\u0026nbsp;Meat and Animal Derivatives\u0026nbsp;(Including min 14%\u0026nbsp;Beef, 4%\u0026nbsp;Lamb),\u0026nbsp;Oils and Fats,\u0026nbsp;Vegetables (min 4%).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 22.0%, Fat 8.0%, Fibre 3.0%, Ash 8.5%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eC\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChicken protein, corn protein, rice flour, animal fat, soybean hulls, cellulose, beet pulp, sunflower hulls, wheat, barley, rice, monocalcium phosphate.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 25.0%, Fat 14%, Fibre 8.0%, Ash 9.5%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWhole Maize,\u0026nbsp;Meat Meal,\u0026nbsp;Soya Oil,\u0026nbsp;Vitamins and Minerals,\u0026nbsp;Artificial Beef Flavour.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 23.5%, Fat 9.0%, Fibre 3.5%, Ash 10.0%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eE\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWhole Wheat,\u0026nbsp;Beef Meat Meal,\u0026nbsp;Maize,\u0026nbsp;Maize Gluten,\u0026nbsp;Rice,\u0026nbsp;Oats,\u0026nbsp;Chicken Fat, Bran,\u0026nbsp;Vitamins,\u0026nbsp;Minerals and Trace Elements,\u0026nbsp;EC Permitted Antioxidant.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 23.0%, Fat 10.0%, Fibre 3.0%, Ash 8.5%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eF\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChicken and beef meal, plant protein, fish oil, soybean oil, animal fat, corn gluten meal, plant fiber, rice flour, beet pulp, omega 3 and 6, minerals and trace elements.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 26.0%, Fat 21.0%, Fibre 4.0%, Ash 8.0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChicken, chicken liver, vegetables, egg powder, fish and corn meal, wheat, soy, and fish oil.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 30%, Fat 16%, Fibre 2.0%, Ash 8.5%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eH\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFresh chicken meat, beef liver, egg powder, beef meal.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 29%, Fat 13.5%, Fibre 2.5%, Ash 8.0%, Moisture 8.0%,.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWhole Wheat,\u0026nbsp;Maize,\u0026nbsp;Chicken Meat Meal,\u0026nbsp;Barley,\u0026nbsp;Chicken Fat,\u0026nbsp;Beet Pulp,\u0026nbsp;Vitamins,\u0026nbsp;Minerals and Trace Elements\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 19.0%, Fat 11.0%, Fibre 2.4%, Ash 5.5%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eJ\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWheat,\u0026nbsp;Poultry Meal\u0026nbsp;,\u0026nbsp;Beef Meal,\u0026nbsp;Maize,\u0026nbsp;Wheat Feed, Soya,\u0026nbsp;Poultry Fat,\u0026nbsp;Chicken Liver Digest,\u0026nbsp;Minerals,\u0026nbsp;Salt,\u0026nbsp;Peas,\u0026nbsp;Dicalcium Phosphate,\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 25.0%, Fat 9.0%, Fibre 2.5%, Ash 8.0%, Moisture 8.0%.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eC\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePoultry meal, corn protein, rice flour, Poultry fat, soybean hulls, cellulose, beet pulp, sunflower hulls, wheat, barley, rice.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 22.0%, Fat 18.0%, Fibre 6%, Ash 6.0%, Moisture 8.0%,\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eL\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWheat,\u0026nbsp;Meat and\u0026nbsp;Bone Meal,\u0026nbsp;Syrup, Pasta (6%),\u0026nbsp;Barley,\u0026nbsp;Poultry Fat,\u0026nbsp;Poultry Meat Meal,\u0026nbsp;Minerals,\u0026nbsp;Fish Meal,\u0026nbsp;Yucca Extract.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eProtein 19.0%, Fat 8.0%, Fibre 3.0%, Ash 8.0%, Carbs 54.0%, Moisture 8.0%,\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e "}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Hepathopathy, Dry food, Prevelence, Dog","lastPublishedDoi":"10.21203/rs.3.rs-3885448/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3885448/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: The quality of pet food and feed management can have a pivotal role in the healthy status and the prevention of diseases in animals. The objective of this study was to explore the prevalence of hepatopathy in dogs based on the liver enzyme profile and the association between liver enzyme alterations with diet.\u003c/p\u003e\n\u003cp\u003eResults: This was a hospital-based, cross-sectional study. We analyzed the history and medical records of all dogs fed commercial dry food presented at a veterinary hospital. A complete physical examination, laboratory survey, and abdominal ultrasonography were performed on each subject. 720 dogs were included in this study. The patients consisted of 385 male dogs (53.5%) and 335 female dogs (46.5%) and the mean age ± SE was 5.92 ± 0.18 years (range, 1 to 17). The overall prevalence of hepatopathy in all dogs fed commercial dry food was 23.8%, 8.3%, and 3.7% based on the mild, moderate, and marked liver enzyme activity elevation (ALT and/or GGT), respectively and statistical analysis exhibited that the factors significantly related to hepatopathy were increasing age and diet type. A significant relationship was observed between age and ALT (Odd ratio: 1.121, CI: 1.064-1.181) and GGT (Odd ratio: 1.056, CI: 1.008-1.105). There was a significant relationship between commercial food brands and some biochemical factors including ALT, AST, GGT, ALP, Chol, and total bilirubin.\u003c/p\u003e\n\u003cp\u003eConclusion: In summary, our findings suggest that hepatopathy in dogs appears to be more common than previously thought, and aging and type of diet are risk factors for liver disease in dogs. Therefore, using good-quality diets will likely play an essential role in preventing liver disorders in dogs.\u003c/p\u003e","manuscriptTitle":"Prevalence of canine hepatopathy among a clinic population fed commercial dry food: Age and Dietary factors influence the disease prevalence","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-24 18:58:58","doi":"10.21203/rs.3.rs-3885448/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"44451eed-ff44-49da-93f7-16e263307b9e","owner":[],"postedDate":"January 24th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-12-02T17:28:26+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-24 18:58:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3885448","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3885448","identity":"rs-3885448","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}