Liver Lobe Torsion and Abscess

Degner, Daniel A.; Bhandal, Jitender

doi:10.1002/9781118997505.ch44

Cited by 1 publication

(5 citation statements)

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“…Hepatic abscessation is an uncommon disease process in dogs that can be challenging to diagnose. Literature on canine hepatic abscesses is limited to case reports and small case series; causes reported include extrahepatic infections (specifically biliary, urinary, respiratory, cardiac, omphalogenic) and damage to hepatic parenchyma (e.g., trauma, torsion, neoplasia, previous biopsy) 1–8 . Underlying preexisting endocrine disorders and concurrent glucocorticoid administration have also been associated with the development of hepatic abscesses 4,9 …”

Section: Introductionmentioning

confidence: 99%

“…Literature on canine hepatic abscesses is limited to case reports and small case series; causes reported include extrahepatic infections (specifically biliary, urinary, respiratory, cardiac, omphalogenic) and damage to hepatic parenchyma (e.g., trauma, torsion, neoplasia, previous biopsy). [1][2][3][4][5][6][7][8] Underlying preexisting endocrine disorders and concurrent glucocorticoid administration have also been associated with the development of hepatic abscesses. 4,9 Diagnosis of presumed hepatic abscessation, although historically made based on physical examination followed by clinicopathological findings confirmed at the time of surgery, is now generally made based on ultrasonographic findings.…”

Section: Introductionmentioning

confidence: 99%

“…4,9 Diagnosis of presumed hepatic abscessation, although historically made based on physical examination followed by clinicopathological findings confirmed at the time of surgery, is now generally made based on ultrasonographic findings. 4,7,8 Prognosis is variable throughout the literature; some texts suggest a guarded prognosis, 6 but multiple case series report survival rates ranging from 70% to 100%. 4,5,7,8 Surgical and medical treatments have been described for both single and multiple abscesses of various sizes, but no management method has been shown to be superior.…”

Section: Introductionmentioning

confidence: 99%

“…4,7,8 Prognosis is variable throughout the literature; some texts suggest a guarded prognosis, 6 but multiple case series report survival rates ranging from 70% to 100%. 4,5,7,8 Surgical and medical treatments have been described for both single and multiple abscesses of various sizes, but no management method has been shown to be superior. 4,5,9,10 Given the paucity of veterinary literature, currently no prognostic indicators are available to assist clinicians and owners in making informed decisions regarding treatment options.…”

Section: Introductionmentioning

confidence: 99%

“…All dogs were treated with antibiotics, either single (1), double (4), or triple (3) antimicrobial therapy. The most common antimicrobial used was enrofloxacin(7), followed by ampicillin (or ampicillin/sulbactam) (6); metronidazole use was also reported in 4 dogs but not as a sole therapy. In 2 cases, antibiotics were changed after receipt of culture results: 1 was changed to chloramphenicol and another to meropenem.…”

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confidence: 99%

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Hepatic abscessation in dogs: A multicenter study of 56 cases (2010–2019)

Burke,

Hess,

McEntee

et al. 2023

J Vet Emergen Crit Care

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ObjectiveTo investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation.DesignRetrospective cohort study from 2010 to 2019.SettingMulticenter study.AnimalsFifty‐six client‐owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology.Measurements and Main ResultsDogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56). Abnormal physical examination findings included increased temperature (41/56) and abdominal pain (22/54). CBCs revealed neutrophilia (31/49), toxic changes (25/49), anemia (28/49), and thrombocytopenia (23/49). Biochemical analyses revealed increased alkaline phosphatase (45/50), increased alanine aminotransferase (40/50), hypoalbuminemia (25/48), and hyperbilirubinemia (19/49). Hypoglycemia was found in 13 of 49 dogs. Hepatic abscesses ranging from 0.5 to 15 cm in diameter were identified ultrasonographically in 37 of 48 dogs; 19 of 37 had solitary abscesses, and 18 of 37 had multifocal abscessation. Escherichia coli was the most commonly cultured organism, isolated in 18 of 42 cases. Histopathology revealed underlying hepatic neoplasia in 10 of 47 dogs. Surgical management was performed in 41 of 49 dogs, and 35 of 41 survived to discharge. Medical management was performed in 8 of 49 dogs, and 5 of 8 survived to discharge. With univariate analysis, hypoglycemia and multifocal abscessation were associated with decreased odds of survival (odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.03–0.9, P = 0.04; OR: 0.07, 95% CI: 0.01–0.6, P = 0.02, respectively). With multivariate analysis, only multifocal abscessation was associated with decreased odds of survival (OR: 0.09, 95% CI: 0.01–0.87, P = 0.04).ConclusionsHepatic abscessation, although rare, should remain a differential diagnosis for dogs presenting with nonspecific clinical signs and increase liver enzyme activities, especially with concurrent increased temperature and neutrophilia. Rate of survival to discharge for dogs in this study was consistent with previously reported survival rates, with 40 of 56 (71%) of the total population surviving to discharge. No variables assessed were able to predict survival to discharge; however, hypoglycemia and multifocal abscessation should be assessed in larger populations to determine prognostic significance.

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Section: Introductionmentioning

confidence: 99%