Disseminated cryptococcosis causing liver dysfunction in a pug

Abstract

A nearly 2-year-old, male, neutered pug was referred for a 1-month duration of progressive gastrointestinal signs and lethargy, and possible seizure activity. Blood analyses before referral had shown marked increases in hepatocellular and hepatobiliary enzymes and increased pre-prandial and post-prandial bile acids, with normal bilirubin. Physical exam revealed a quiet mentation and blood analyses at the time of presentation found persistent increases in hepatic enzymes, and hypoalbuminaemia. Abdominal ultrasound identified intra-abdominal free fluid and ileocolic lymphadenopathy. Cytology of the abdominal effusion, liver and abdominal lymph nodes identified organisms of the Cryptococcus genus. The dog had a positive Cryptococcus antigen lateral flow assay titre of 1:>10,000, confirming cryptococcosis. The dog was euthanased following diagnosis. This is the first report describing a case of disseminated cryptococcosis causing liver dysfunction in a veterinary species. Cryptococcus infection should be considered in a young dog presenting with gastrointestinal signs and liver enzymopathy.