Suspected hepatotoxicity secondary to trazodone therapy in a dog

Abstract

Objective To describe a case of suspected hepatotoxicity in a dog secondary to administration of trazodone. Case Summary A 6‐year‐old, neutered, mixed breed dog was evaluated for a progressive increased liver enzyme activity over a 6‐week period. The patient originally presented for raisin toxicosis, and hence, was having serial blood work monitoring performed. Trazodone was initially started at that time due to severe separation anxiety while hospitalized (consistently 5 out of 7 days of the week, for a 6‐week duration). Due to continued increased liver enzyme activity, extensive workup was performed which included abdominal ultrasound, leptospirosis titers, bile acids, and liver biopsies. Histopathologic findings were consistent with acute hepatotoxicity. In the absence of other toxicants and the close proximity to drug administration, a drug‐induced hepatopathy secondary to trazodone was presumed. Following discontinuation of trazodone therapy, the hepatopathy completely resolved and the patient fully recovered. New or Unique Information Provided While acute hepatotoxicity has been reported in human medicine secondary to the administration of trazodone, this is the first reported case of suspected hepatotoxicity in a dog secondary to trazodone therapy. Veterinary professionals should be aware of the rare potential adverse effect that may be seen in canine patients secondary to trazodone therapy. Appropriate clinicopathologic monitoring should occur in patients on chronic trazodone therapy.

Suspected robenacoxib‐induced liver injury in a dog

“…11 Described patterns include hepatocellular necrosis (e.g., zonisamide, amiodarone, azathioprine, carprofen, sulfonamides, paracetamol and mebendazole), vacuolisation (e.g., zonisamide, lomustine, mitotane, trazodone and ketoconazole), intrahepatic cholestasis (e.g., azathioprine), fibrosis (e.g., lomustine, phenobarbital and ketoconazole) and inflammation (e.g., lomustine, sulfonamides, trazodone and ketoconazole). 5,[20][21][22][23][24][25][26][27][28][29][30][31][32] The histological pattern documented in this case comprised inflammation and vacuolisation.…”

The impact of single‐dose trazodone administration on plasma endogenous adrenocorticotropic hormone and serum cortisol concentrations in healthy dogs

“…3,4 Oral trazodone administration appears to be generally well-tolerated in dogs but serious adverse effects have been reported. [3][4][5][6][7] As such, trazodone is a popular drug used to mitigate stress and anxiety in dogs at home and in the hospital. 1,3,4 Conditions affecting the hypothalamic-pituitary-adrenal (HPA) axis are common in dogs.…”

“…Trazodone is frequently administered to decrease stress‐related behaviors in hospitalized dogs 3,4 . Oral trazodone administration appears to be generally well‐tolerated in dogs but serious adverse effects have been reported 3‐7 . As such, trazodone is a popular drug used to mitigate stress and anxiety in dogs at home and in the hospital 1,3,4 …”