Icterus in Dogs

Todd Archer, DVM, MS, DACVIM (SAIM), Mississippi State University

ArticleLast Updated September 20231 min readPeer Reviewed

Following are differential diagnoses for dogs presented with increased icterus.

Pre-hepatic causes (hemolysis)

  • Immune-mediated hemolytic anemia, primary or secondary

  • Blood transfusion

  • Non-immune–mediated

  • Drug-induced

  • Erythrocyte fragmentation (eg, caval syndrome, disseminated intravascular coagulation)

  • Erythrocyte membrane or enzyme defects (eg, hypophosphatemia, phosphofructokinase deficiency)

  • Infectious disease

  • Paraneoplastic

  • Toxin (eg, zinc, onion, garlic)

Hepatic causes (hepatocellular dysfunction)

  • Fibrosis

  • Inflammatory or infectious hepatopathy (hepatitis/cholangiohepatitis)

  • Neoplasia

  • Toxin or drug hepatopathy

Post-hepatic causes (cholestasis, defective biliary excretion)

  • Diseases of the biliary system  

    • Biliary system rupture   

    • Gallbladder disease  

    • Cholelithiasis 

    • Stricture 

    • Infection 

    • Inflammation 

    • Neoplasia 

  • Diseases outside the hepatobiliary biliary system  

    • Enlarged regional lymph nodes 

    • Pancreatitis 

    • Neoplasia (pancreas, duodenum) 

    • Intestinal disease or obstruction 

*Bilirubin can be artifactually increased by lipemia and hemolysis

**Serum bilirubin values >1 mg/dL produce serum icterus; values >2 mg/dL produce tissue jaundice