Iatrogenic steroid hepatopathy in a dog

Yıl 2015, Cilt: 31 Sayı: 2, 127 - 131, 01.06.2015

Aliye Sağkan Öztürk Alper Ertürk

Öz

Steroid hepatopathy is an iatrogenic disorder developed secondary
the as a result of particularly faulty/unconscious
corticosteroids applications. In this report, clinical, radyographic
and ultrasonographic data of 18 year old male Terrier
dog suffering from steroid hepatopathy was evaluated. In
anamnesis, the owner of the dog used corticosteroid (three
months prednisolone and one month dexamethasone) in
four months. In clinical examination revealed lethargy, pale
mucosa membranes and incoordination. In laboratory analyses,
increases of alkaline phosphatase and gamma glutamyl
transferase levels ten times, alanine transaminase seven
times, aspartate aminotransferase <2 times, blood urea nitrogen
and cholesterol almost two times were increased in
laboratory analyses. In the urine sediment leucine crystals
was appeared. Increased echogenicity and heterogenic appearance
in liver and hyperechogenicity in gallbladder were
seen in the ultrasonographic examination of dog. Despite
performed the support treatment, the dog died after 45 days.
In conclusion, this case evaluated that faulty and/or long
time corticosteroids may result steroid hepatopathy, it is necessary
to monitor the corticosteroid therapy laboratory and
ultrasonographic examinations can be utilized in monitoring
and diagnostics.

Anahtar Kelimeler

Dog, steroid hepatopathy

Bir köpekte iatrojenik steroid hepatopati

Öz

Steroid hepatopati, hatalı/bilinçsiz steroid kullanımı sonucu
sekonder olarak gelişen iatrojenik bir bozukluktur. Sunulan
olguda steroid hepatopatili 18 yaşlı Terrier ırkı erkek bir
köpekte klinik, biyokimyasal, radyografi ve ultrasonografi
bulguları değerlendirildi. Anemnezde hasta sahibinin dört
ay kortikosteroid (üç ay prednizolon ve bir ay deksametazon)
kullandığı öğrenildi. Klinik muayenede halsizlik, mukoz
membranlarda solgunluk ve koordinasyon bozukluğu
gözlendi. Laboratuvar muayenelerinde alkalen fosfataz ve
gamma glutamil transferaz seviyeleri >10 kat, serum alanin
aminotransferaz 7 kat, aspartat aminotransferaz konsantrasyonunda

Anahtar Kelimeler

Köpek, steroid hepatopati

Kaynakça

• Abdou OA, Kelany WM, Torad FA, Yehia SG, 2013. Ultrasonographic, morphologic and biochemical alterations in experimentally induced steroid hepatopathy in dogs. Global Vet, 11, 123-130.
• Berk P, Korenblatt K, 2011. Approach to the patient with jaundice or abnormal liver test results, In: Cecil Medicine, Eds: Goldman L, Schafer AI, 24th edition, Saunders Elsevier, Philadelphia, USA, pp: 1098-1099.
• Biller DS, Kantrowitz B, Miyabayashi T, 1992. Ultrasonography of diffuse liver disease - A review. J Vet Intern Med, 6, 71-76.
• Center SA, 1996. Hepatic lipidosis, glucocorticoid hepatopathy, vacuolar hepatopathy, storage disorders, and iron toxicity, In: Strombeck’s Small Animal Gastroenterology 3rd edition, WB Saunders, UK, pp: 766-801.
• Dufour DR, Lott JA, Nolte FS, Gretch DR, Koff RS, Seeff LB, 2000. Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clin Chem, 46, 2027-49.
• Ettinger WH, Klinefelter HF, Kwiterovitch PO, 1987. Effect of short-term, low-dose corticosteroids on plasma lipoprotein lipids. Atherosclerosis, 63, 167-72.
• Hawthorne R, 2005. Diagnosing liver disease a roundtable discussion. Radiography sponsored by an educational grant from IDEXX Laboratories. http://www.idexx.it/pdf/ it_it/smallanimal/vetlab/catalyst/diagnosing-liver-disease.pdf, Erişim tarihi: 20.11.2014
• Jaeger JQ, Jonson S, Hinchcliff KW, Sherding R, Jensen W, Brunzell J, Murdock S, 2003. Characterization of biochemical abnormalities in idiopathic hyperlipidemia of miniature schnauzer dogs. J Vet Intern Med, 16, 394.
• Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalza J, 2012. Harrison's Principles of Internal Medicine, 18th edition, The McGraw-Hill Companies, USA, p: 611.
• Lowe AD, Graves TK, Campbell KL, Schaeffer D, 2007. A comparison of the diabetogenic effects of dexamethasone and prednisolone in cats. Vet Dermatol, 18, 184.
• Mannion P, 2013. RCVS and European Specialist in Veterinary Diagnostic Imaging. Online Imaging Day Session 3: Abdominal Ultrasound. http://www.veterinarywebinars.com/ assets/Session_3_AbdominalUS_Online_Imaging_Day.pdf, Erişim tarihi: 20.11.2014
• Meyer DJ, Harwey JW, 1998. Veterinary Laboratory Medicine (Interpretation & Diagnosis). WB Saunders Company, USA, p: 346.
• Nakagawa M, Terashima T, D’yachkova Y, Bondy GP, Hogg JC, Van Eeden SF, 1998. Glucocorticoid-induced granulocytosis: Contribution of marrow release and demargination of intravascular granulocyte. Circulation, 98, 2307-2313.
• O’Brien R, Zagzebski JA, Lu ZF, Steinberg H, 1996. Measurement of acoustic backscatter and attenuation in the liver of dogs with experimentally induced steroid hepatopathy. Am J Vet Res, 57, 1690-1694.
• Oliveira DC, Costa LAVS, Lopes BF, Lanis AB, Borlini C, Maia Junior JA, Costa FS, 2011. Computed tomography in the diagnosis of steroidal hepatopathy in a dog: Case report. Arq Bras Med Vet Zootec, 63, 36-39.
• Rhen T, Cidlowski JA, 2005. Antiinflammatory action of glucocorticoids-new mechanisms for old drugs. N Engl J Med, 353, 1711-1723.
• Sobczak-Filipiak M, Szarek J, Czopowicz M, Mieczkowska J, Lechowski R, 2014. Hepatic stellate cells in the liver of dogs with steroid-induced hepatopathy. Bull Vet Inst Pulawy, 58, 273-276.
• Syakalima M, 1998. A study of liver and corticosteroid-induced alkaline phosphatase isoenzymes activities associated with glucocorticoid hepatopathy in the dog. Jpn J Vet Sci, 46, 119-121.
• Syakalima M, Takiguchi M, Yasuda J, Mortal Y, Hashimoto A, 1998. Comparison of attenuation and liver-kidney contrast of liver ultrasonographs with histology and biochemistry in dogs with experimentally induced steroid hepatopathy. Vet Q, 20, 18-22.
• Tams TR, 2003. Handbook of Small Animal Gastroenterology, WB Saunders Company, 2nd edition, USA, pp: 335-336. Tilley LP, Simith FWK, 2011. Blackwell's Five-Minute Veterinary Consult: Canine and Feline, fifth edition, Eds: Tilley LP, Smith FWK, John Wiley & Sons, UK, pp: 1240-1241.
• Turgut K, Ok M, 2000. Kedi köpek gastroenterolojisi semptomdan teşhise. Bahçıvanlar Basım Sanayi, Konya, Türkiye, p: 885.
• Twedt D, 2013. Common causes of abnormal liver enzymes. Western Veterinary Conference. SA 128, pp: 1-4.
• Warren-Smith CMR, Andrew S, Mantis P, Lamb CR, 2012. Lack of associations between ultrasonographic appearance of parenchymal lesions of the canine liver and histological diagnosis. J Small Anim Pract, 53, 198-203.
• Webb CB, 2013. (Small Animal) Clinician’s brief. Top 5: Liver conditions in dogs. pp: 85-87.
• Webster CRL, 2004. Interpretation of serum alkaline phosphatase in dogs: Consultant on call. NAVC Clinician’s Brief, pp: 9-12.
• Wiedmeyer CE, Solter PF, Hoffman WE, 2002. Kinetics of mRNA expression of alkaline phosphatase isoenzymes in hepatic tissues from glucocorticoid-treated dogs. Am J Vet Res, 63, 1089-1095.