Hepatocutaneous Syndrome in Dogs or HCS

By Yourvetplanet (Pablo M.S). November 1, 2023
Hepatocutaneous Syndrome in Dogs or HCS

See files for Dogs

Canine hepatocutaneous syndrome (HCS) is an uncommon metabolic disorder impacting both the liver and skin. It exhibits distinct characteristics such as hepatopathy, hypoaminoacidemia, aminoaciduria, and superficial necrolytic dermatitis (SND), leading to specific crusted, red, and histologically unique skin lesions.

In this article from AnimalWised, we'll delve into a detailed exploration of the symptoms, available treatment options, and diagnostic methods concerning hepatocutaneous syndrome in dogs.

What is hepatocutaneous syndrome in dogs?

Hepatocutaneous syndrome in dogs, also known as hepatocutaneous degeneration, is a rare metabolic disorder characterized by a combination of liver disease and skin lesions.

It presents as superficial necrolytic dermatitis (SND), featuring crusting, erythematous, and histologically unique skin lesions, commonly observed on extremities, ear flaps, and pressure points. The concurrent occurrence of skin abnormalities and liver dysfunction defines this syndrome. Affected dogs may exhibit signs of liver disease such as elevated liver enzymes, jaundice, weight loss, and changes in appetite.

The exact cause of hepatocutaneous syndrome in dogs remains not entirely understood, although it is thought to be related to a deficiency of essential amino acids or zinc. This syndrome is associated with unique hepatopathy, hypoaminoacidemia, and aminoaciduria. Various factors, including chronic liver disease, dietary deficiencies, and certain medications, can trigger the onset of HCS in dogs.

Management and treatment involve a comprehensive approach addressing both the liver condition and the skin lesions, often requiring veterinary intervention, specialized care, medications, and dietary adjustments tailored to the individual dog's symptoms and severity of the condition.

Hepatocutaneous syndrome is only one of several liver diseases that can affect dogs. For more information about the most prevalent liver diseases in dogs, we invite you to explore our article on this topic.

Symptoms of canine hepatocutaneous syndrome

Canine hepatocutaneous syndrome (HCS) is characterized by a blend of skin abnormalities and liver disease. Dogs affected by HCS commonly display several symptoms:

  • Skin Lesions: affected dogs often develop skin changes, including ulcers, crusts, and hair loss, predominantly found on the extremities, ear flaps, and pressure points.

  • Superficial Necrolytic Dermatitis (SND): SND is a prominent feature of HCS, presenting as crusting, erythema (redness), and distinct skin lesions.

  • Liver disease signs: dogs with HCS may exhibit symptoms of liver disease, such as elevated liver enzymes, jaundice (yellowing of the skin and eyes), weight loss, and changes in appetite.

  • Unique Hepatopathy: HCS is linked to a specific liver disorder, potentially involving irregularities in liver function tests and other hepatic issues.

  • Hypoaminoacidemia and aminoaciduria: affected dogs may demonstrate low levels of amino acids in the blood (hypoaminoacidemia) and the excretion of amino acids in the urine (aminoaciduria).

  • General signs of illness: depending on the severity of the syndrome, dogs affected by HCS might also exhibit general signs of illness, such as lethargy, weakness, and an overall decline in health.

In addition to hepatocutaneous syndrome, dry and rough paws are another common skin problem that can affect dogs. To learn more about this condition and how to keep your dog's paws healthy, read our article on dog paw care.


Hepatocutaneous Syndrome in Dogs or HCS - Symptoms of canine hepatocutaneous syndrome

Causes of hepatocutaneous syndrome in dogs

Canine hepatocutaneous syndrome (HCS) is a condition with an unclear exact cause, but it's thought to be associated with deficiencies in essential amino acids or zinc.

The syndrome can be triggered by various factors, including chronic liver disease, dietary deficiencies, and certain medications, like corticosteroids and antibiotics, which can harm the liver.

Other potential contributors to HCS involve conditions such as pancreatitis, diabetes mellitus, kidney disease, malabsorption issues, and even genetic predisposition in some dogs. These factors might lead to amino acid deficiencies, metabolic disorders, or malfunctions in nutrient absorption, exacerbating or precipitating the onset of HCS.

Understanding the precise pathways through which these factors contribute to HCS requires further research due to the complexity and rarity of this condition. Veterinary consultation and diagnosis are crucial for dogs suspected of having HCS. Early detection and appropriate management are essential to address the symptoms and underlying causes of this syndrome in affected dogs.

Hepatocutaneous syndrome is a serious condition that can lead to liver failure. To learn more about liver failure in dogs, its symptoms, and its treatments, read our article on liver failure in dogs.

Diagnosis of hepatocutaneous syndrome in dogs

Diagnosing canine hepatocutaneous syndrome (HCS) is complex and typically involves a multifaceted approach due to the absence of a single definitive test for confirmation. Diagnosis relies on a combination of clinical signs, physical examination findings, and specific laboratory tests.

Clinical signs

The most prevalent clinical sign of HCS is the appearance of skin lesions, commonly located on the face, ears, feet, and abdomen. These lesions tend to be crusty, red, and pruritic, often accompanied by additional signs like hair loss, weight loss, and lethargy.

Physical examination findings

During a physical examination, veterinarians might detect indications aligned with HCS, such as jaundice, an enlarged liver, and decreased muscle mass.

Laboratory tests

Various laboratory tests play a key role in the diagnosis of HCS, these include:

  • Complete blood count (CBC)
  • Liver function tests
  • Amino acid profile
  • Urine amino acid analysis

Hepatocutaneous syndrome can cause a variety of changes in your dog's bloodwork. To learn how to interpret your dog's blood test results, read our article on how to understand a dog's blood test.

When HCS is suspected, a veterinarian might suggest a skin biopsy to confirm the diagnosis and eliminate other possible causes of skin lesions.

As there's no single definitive test for HCS, the amalgamation of these diagnostic elements—clinical signs, physical examination findings, and specific laboratory tests—enables a more accurate diagnosis.

Treatment for hepatocutaneous syndrome in dogs

Canine hepatocutaneous syndrome (HCS) lacks a cure, but treatment aims to manage clinical signs and enhance affected dogs' quality of life. The approach typically involves a combination of strategies, including dietary modifications, medication, and supportive care.

Dietary Modifications

Veterinarians may advise a diet rich in protein and essential amino acids, aiming to prevent nutrient deficiencies that can trigger HCS. Supplementing the diet with zinc might also be recommended. Feeding your dog a healthy diet is essential for managing hepatocutaneous syndrome. To learn more about how to create a balanced and nutritious diet for your dog, read our article on healthy diet for dogs.


Various medications are employed in treating HCS:

  • Antibiotics: these address secondary bacterial infections in skin lesions.

  • Corticosteroids: they mitigate inflammation and itching related to the skin lesions.

  • Antihistamines: used to reduce itching associated with the lesions.

  • Ursodiol and S-adenosylmethionine (SAMe): these medications aim to enhance liver function and lessen the severity of skin lesions.

Supportive care

Supportive care involves several measures:

  • Regular bathing to cleanse skin lesions.

  • Application of topical ointments or creams to shield the skin and reduce inflammation.

  • Feeding the dog small, frequent meals to aid digestion and nutrient absorption.

  • Monitoring the dog's weight and body condition.

It's crucial to recognize that the treatment for HCS is a lifelong commitment. Dogs with HCS require close monitoring by a veterinarian, and treatment plans may need adjustments over time.

How to prevent canine hepatocutaneous syndrome?

Canine hepatocutaneous syndrome (HCS) is a rare metabolic disorder with no foolproof prevention method. However, several steps can be taken to potentially reduce the risk of its development:

  • Nutrition: providing a high-quality, well-balanced diet high in protein and essential amino acids may help reduce the risk of HCS. Zinc supplementation, particularly for dogs at risk of zinc deficiency due to conditions like liver disease or chronic diarrhea, can be beneficial.

  • Medication and health management: avoiding medications that could harm the liver, such as corticosteroids and antibiotics, and managing underlying medical conditions like liver disease, diabetes mellitus, and kidney disease, could reduce the risk of triggering HCS.

  • Skin care and monitoring: regularly monitoring your dog's skin for any signs of lesions and seeking immediate veterinary care if any are found can be essential for early intervention. Avoid using harsh chemicals on your dog's skin, as they can irritate the skin and increase susceptibility to infection. Regular bathing with a mild shampoo can help in keeping the skin clean and free from debris.
  • Maintaining healthy weight and regular exercise: obesity can increase the risk of liver disease, so maintaining a healthy weight and ensuring regular exercise can help prevent liver-related issues.

  • Vaccination and deworming: keeping your dog current on vaccinations and deworming can protect against infections and parasites that may damage the liver and potentially trigger HCS.

While these measures can reduce the risk of HCS and improve overall health, canine HCS remains a complex and relatively rare condition. There's no guaranteed method to prevent it entirely. Early detection, prompt veterinary care, and proper management are crucial for affected dogs.

Obesity can increase your dog's risk of developing hepatocutaneous syndrome. To learn more about how to manage your dog's weight and keep them healthy, read our article on diet and care for dogs with obesity.

This article is purely informative. AnimalWised does not have the authority to prescribe any veterinary treatment or create a diagnosis. We invite you to take your pet to the veterinarian if they are suffering from any condition or pain.

If you want to read similar articles to Hepatocutaneous Syndrome in Dogs or HCS, we recommend you visit our Skin problems category.

  • Ferrer, L. Canine hepatocutaneous syndrome: would you know how to diagnose it? Available on YouTube:
  • Hall-Fonte, DL, Center, SA, McDonough, SP, Peters-Kennedy, J., Trotter, TS, Lucy, JM, ... & Weinkle, T. (2016). Hepatocutaneous syndrome in Shih Tzus: 31 cases (1996–2014). Journal of the American Veterinary Medical Association , 248 (7), 802-813.

Write a comment

Add an image
Click to attach a photo related to your comment
What did you think of this article?
Hepatocutaneous Syndrome in Dogs or HCS
1 of 2
Hepatocutaneous Syndrome in Dogs or HCS

Back to top