A dog with severe cholestasis secondary to chronic hepatitis was treated with ursodeoxycholic acid (UDCA) PO. After 2 weeks of daily treatment, the dog was more active and had an improved appetite. Monthly serum biochemical determinations and analysis of individual bile acid profiles documented improvement in hepatobiliary tests and a marked reduction in the concentrations of potentially hepatotoxic endogenous bile ne consequence of cholestasis is the retention of con-0 stituents in bile.
Case ReportA 9-year-old spayed female miniature schnauzer was referred for evaluation of icterus, decreased appetite, and occasional vomiting of approximately 3 weeks' duration. Prior management with a lowprotein diet and antibiotics was not associated with clinical or biochemical improvement. A small liver was observed on radiographic and ultrasonographic examinations. Microscopic examination of a needle biopsy specimen of the liver was considered nondiagnostic. A patent common bile duct and a small liver with an irregular surface were noted while performing a celiotoiny to obtain a second liver biopsy specimen. Histopathologically, severe fibrosis distorted the lobular architecture of the liver, and occasional portal-to-portal bridging was present. A mixed population of inflammatory cells was scattered throughout the fibrous tissue, and there was marked accumulation of yellow pigment. There was no growth of either aerobic or anaerobic bacteria after culture of hepatic tissue and bile.Ursodeoxycholic acid (Actigal, Summit Pharmaceuticals, Division of CIBA-GEIGY, Summit, NJ) was given at a dosage of IS mglkg body weight PO sid. Serum samples were collected at monthly intervals before (2 months) and during (8 months) treatment. Prior to storage, samples were analyzed for activities of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase and concentrations of albumin, cholesterol, and total bilirubin. Results are presented in Table 1 of samples were frozen at -20°C for later analysis of serum bile acid concentrations. Serum sample preparation and analytic method have been described and validated for determination of concentrations of individual bile acids in canine Results for serum concentrations of selected bile acids are presented in Table 2.
ResultsApproximately 2 weeks after beginning treatment with UDCA, the owner reported an improvement in the dog's appetite and activity, which was maintained for approximately 6 months. By the seventh month, serum aminotransferase activities and bilirubin concentration began to increase, and there was a progressive reduction in the serum albumin concentration (Table I ). Increasing lethargy and inappetence resulted in a request for euthanasia. Histopathologic findings in the liver were similar to those described for the biopsy specimen.Two months before and at the start of treatment, serum concentrations of total bile acids were markedly increased (608 and 808 molL, respectively) ( Table 2). Predominant forms were the more hydrophobic primary bile acids, taurocho...
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