Hepatorenal Syndrome in Dogs with Experimental Extrahepatic Cholestasis

Abstract

Hepatorenal syndrome (HRS) is a unique form of functional and potentially reversible renal failure secondary to liver diseases. It occurs typically in kidneys that are histologically normal. In this study, the hepatorenal syndrome was observed in a model of extrahepatic biliary stasis. Seven mature male mongrel dogs were subjected to complete surgical ligation of common bile duct at the duodenal region Clinical, ultrasonographic, , histopathological examinations along with biochemical analysis for liver enzymes and urinalysis were performed before and throughout the experimental periods. Clinical observations post-surgery revealed icteric mucosa, abdominal pain, weight loss, dehydration, orange-colored urine, bilirubinurea, and clay feces. Biochemical analysis showed an abrupt increase in the mean values of serum blood urea nitrogen and creatinine from the 3 rd day till reaching the peak at the 2 nd week post-surgery. A strong positive correlation was detected between BUN and creatinine, and serum total and direct bilirubin. Ultrasonographic findings of liver revealed a progressive dilatation of gallbladder and the common bile duct from the 3 rd day post-ligation, with an increase in the echogenicty of the liver, whereas, the kidneys demonstrate normal renal parenchyma and dimensions. Histopathological examination of the kidney revealed hemorrhage, vacuolation, hyaline droplet were observed in renal tubules and edema and yellowish-brown granules were seen in the interstitial tissue, but the significant renal changes that refer to renal failure weren't detected,. In conclusion, the dogs are considered a suitable model for studying hepatorenal syndrome and also there is an association between obstructive jaundice and renal failure.

Ultrasonographic Evaluation of Liver Tissue after Surgically Induced Bile Duct Ligation in Dogs

“…The first noticed symptom in all animals was jaundice, which could be attributed to an increased bilirubin levels in blood due to impaired flow of bile following ligation of the duct and subsequent deposition of this agent in tissues, primarily in the skin as well as mucous membranes. These results are similar to those obtained by Bayoumi et.al and Vardar et al [32,33] . Long-term occlusion of the bile duct decreases enterohepatic circulation causing the feces to turn clay-colored, and shifts the kidney's role as the primary site for bilirubin clearance, which changes the urine color into orange [34,35].…”