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1.
REASONS FOR PERFORMING STUDY: The diagnostic value of several investigative procedures commonly used during the evaluation of suspected equine hepatopathy cases has not been specifically quantified in previous studies. HYPOTHESIS: No noninvasive procedures would clearly discriminate between horses with and without significant liver disease. METHODS: Histopathology of biopsy samples was used as the 'gold standard' technique for definitive diagnosis of the presence or absence of significant liver disease. Clinical, ultrasonographic and clinicopathological data obtained during the investigation of 82 suspected cases of hepatopathy in mature horses were compared with the results of subsequent biopsy in order to quantify the diagnostic value of each test. RESULTS: Of the 82 cases, 61 were confirmed to have significant liver disease and 21 were not. Only serum concentrations of gamma-glutamyltransferase (gammaGT), globulins and alkaline phosphatase (AP) were found to be significantly different between the 2 groups of horses. Clinical and ultrasonographic abnormalities were found, when present, to be good indicators of the presence of liver disease. Certain single serum biochemical tests and combinations thereof were found to have high values for sensitivity (SN), specificity (SP), positive predictive value (PPV) and/or negative predictive value (NPV), but none showed high values for all 4 parameters leading to important limitations in their practical diagnostic application. Of all serum biochemical tests studied, the PPVs of only gammaGT and globulins could be clearly improved by considering especially high positive results. CONCLUSIONS: The single positive test results of greatest diagnostic value were presence of hepatic encephalopathy (HE), increased gammaGT, hyperglobulinaemia, hypoalbuminaemia, increased AP, increased total bile acids (TBA) and increased total bilirubin (TBil). Increased aspartate aminotransferase (AST) and increased glutamate dehydrogenase (GLDH) were also of good diagnostic value, but only when used in combination with the above tests. However, no single, combination or sequential test was able to discriminate fully between horses with and without biopsy-confirmed liver disease and reliance on the use of noninvasive tests for the prediction of the presence or absence of significant liver disease may lead to frequent diagnostic errors. Although certain positive results did reliably predict the presence of liver disease, negative test results were invariably poor predictors of the absence of liver disease. POTENTIAL RELEVANCE: Application of the findings in this study may not be directly applicable to other case populations. However, the results may help clinicians with their selection and interpretation of appropriate test results in cases of suspected liver disease.  相似文献   

2.
REASONS FOR PERFORMING STUDY: The study was designed to investigate the prognostic value of liver biopsy during investigation of cases of suspected liver disease in mature horses. HYPOTHESIS: That liver biopsy is the most prognostically useful technique in common usage in the investigation of suspected liver disease. METHODS: This study examined the prognostic value of liver biopsy during the investigation of suspected liver disease in 73 mature horses. Histopathological variables comprising fibrosis, irreversible cytopathology, inflammatory infiltration, haemosiderin accumulation and biliary hyperplasia were found to be significant predictors of nonsurvival and were used to formulate a weighted biopsy score representing a prognostically useful broad comparative index of histopathological severity. Minimum and maximum possible scores were 0 and 14 points, respectively. RESULTS: Retrospective application of the biopsy scoring system to the study population indicated that horses with scores of 0 or 1 were equally likely to survive to 6 months with a combined mortality of 4%. Horses with biopsy scores between 2 and 6 had a combined mortality of 33% and were at a 12-fold increased risk of nonsurvival within 6 months (hazard ratio = 12.04, 95% CI 134-107.81, P = 0.026) compared to horses with a biopsy score of 0. Horses with biopsy scores between 7 and 14 had a combined mortality of 86% and were at a 46-fold increased risk of nonsurvival (hazard ratio = 46.01, 95% CI 5.92-357.5, P < 0.001) compared to horses with biopsy score 0. CONCLUSIONS: Application of the biopsy scoring system to histopathological findings in liver biopsy specimens was very useful in predicting survival of cases of suspected liver disease. POTENTIAL RELEVANCE: Application of the findings in this study may not be directly applicable to other case populations. However, liver biopsy appears to be the most valuable prognostic technique employed during the investigation of suspected cases of liver disease in mature horses.  相似文献   

3.
This study was undertaken to ascertain if the isoelectric focusing pattern of serum alkaline phosphatase (AP) from sick horses with high activity is useful for determining its tissue origin. The effect of oral prednisolone and phenylbutazone therapy on this enzyme in healthy horses was also investigated. The sick horses were divided into three groups: hepatic, intestinal and miscellaneous. All sera had approximately thirteen bands of AP activity when focused on agarose gels with a pH gradient of 3.5 to 9.5. All the horses in the liver disease group had greater than 65% of enzyme activity in bands 3 to 7 (counted from the anode) whereas the other two groups had at least 30% and up to 80% of activity in bands 8 to 13. This was true even in the several cases of primary intestinal disease that had additional biochemical evidence of liver damage. All bands were heat sensitive indicating that little if any AP was of small intestinal or renal origin. Oral prednisolone and phenylbutazone for 20 and 12 days respectively had no affect on serum AP activity or isoelectric pattern. We concluded that the AP in bands 3 to 7 is of liver origin but the origin of bands 8 to 13 remains undetermined although small intestinal or renal origin is unlikely. Isoelectric focusing of serum AP shows promise in differentiating cases of primary from secondary liver disease but further studies are required correlating serum patterns and tissue patterns in animals with diseases.  相似文献   

4.
The medical approach to treatment of cholangiohepatitis and cholelithiasis in 9 horses is described. Seven horses were treated successfully and returned to normal use, with a minimum follow-up period of 12 months. Long-term antimicrobial therapy was believed to be critical in those cases that survived, with a median treatment duration of 51 days (range 17-124 days). Treatment failure was associated with severe periportal and bridging hepatic fibrosis from biopsy material obtained at admission in 2 horses, one of whom also presented with hyperammonaemic hepatic encephalopathy. Transabdominal ultrasound was used diagnostically in each case to obtain hepatic biopsy material for histopathology and bacterial culture, to evaluate hepatic size and echogenicity and to identify and monitor the dissolution of hepatoliths. Histologically, all horses had evidence of suppurative cholangiohepatitis with varying degrees of periportal and bridging fibrosis. Discrete hyperechoic calculi were identified in 4 cases, but all horses had ultrasonographic evidence of biliary obstruction with numerous dilated bile ducts. Aerobic and anaerobic cultures of liver biopsy material were negative from 7 horses, but 2 different species of Escherichia coli were obtained from one horse, and Bacteroides vulgatus and Escherichia coli were isolated from another. In all 7 horses that survived, clinical recovery was seen before normalisation of biochemical indices of hepatobiliary function including gammaglutamyl transaminopeptidase (GGT), alkaline phosphatase (AP), bile acids and serum bilirubin. Serum GGT levels were monitored extensively as a marker of hepatobiliary disease and actually increased during the initial period of clinical improvement in horses that recovered. Supportive medical therapy with i.v. fluids was also a critical part of the therapy of several cases in this report, both acutely and in the management of chronic cases that deteriorated clinically during treatment. Previous therapeutic failures may well be related to treatment periods of inadequate duration, and the authors recommend that antimicrobial therapy should be continued until GGT values are normal.  相似文献   

5.
BACKGROUND: Liver biopsy is useful in the diagnosis of liver disease in horses. However, bleeding is the major complication. Liver dysfunction can result in abnormalities in coagulation, although there is no definitive association between risk of hemorrhage after biopsy and coagulopathy in humans. Frequency of coagulopathies in horses with liver disease and the nature and frequency of complications after liver biopsy are not reported. HYPOTHESIS/OBJECTIVES: To determine whether there is an association between coagulopathy and hemorrhage after liver biopsy in horses. ANIMALS: Horses with suspected liver disease from which a liver biopsy had been obtained. METHODS: Retrospective study. Variables indicative of coagulation were recorded. The frequency and nature of complications after biopsy were assessed using clinical and hematologic data. The association between abnormal coagulation variables and complications was assessed. RESULTS: Seventy biopsies were obtained from 66 horses. At least 1 coagulation profile abnormality was identified in 58% of the 43 horses with histopathologically confirmed liver disease. Complications were observed in 4/32 monitored horses (33 biopsies). Three horses had a decrease in the packed cell volume suggestive of subclinical bleeding, and 1 horse developed a diaphragmatic hematoma. There was no association between coagulation profile abnormality and complications. CONCLUSION AND CLINICAL IMPORTANCE: Abnormalities of coagulation are common in horses with liver disease. Liver biopsy appears to be a safe procedure in the horse. An abnormal coagulation profile is not clearly associated with an increased risk of complications after biopsy.  相似文献   

6.
In 18 horses there was no effect of age or sex on plasma activities of gamma-glutamyl transferase (gamma-GT), 5'-nucleotidase (5'-NT) and leucine aminopeptidase (LAP). All the enzymes were equally stable after storage for one month at -20 degrees C and there was no significant difference between their activities in serum and plasma in clinically normal horses. The pattern of release of gamma-GT, 5'-NT and LAP into plasma was studied in 114 horses which had a variety of orthopaedic, gastrointestinal, cardiovascular and hepatic (necrosis, lipidosis, neoplasia and cirrhosis) conditions. A definitive diagnosis of hepatic disease was established by histological examination of the liver. gamma-GT and 5'-NT were leaked into plasma in hepatic disease and gamma-GT was the more sensitive indicator of liver damage. There was some evidence that gamma-GT and 5'-NT plasma activities may increase in hepatic necrosis as well as in biliary obstruction. LAP was insensitive and not hepatic specific in the horse.  相似文献   

7.
Cholelithiasis and/or obstructive biliary tract disease was diagnosed ultrasonographically in 8 horses, 5 to 15 years old. Ultrasonographic findings revealed greater than normal amount of hepatic parenchyma in the right side of the abdomen in 8 horses and in the left side in 3 horses. The echogenicity of the liver was greater than normal, and thick distended bile ducts were seen in all horses. Choleliths were imaged ultrasonographically in 6 horses. Subsequently, postmortem findings in 6 horses revealed periportal and intralobular fibrosis, moderate bile duct dilatation, proliferation, and cholestasis. One or more choleliths were found in all horses. Ultrasonographic findings accurately depicted the histologic changes in the hepatic parenchyma in horses with cholelithiasis.  相似文献   

8.
The aim of this retrospective, cross‐sectional, study was to evaluate clinical findings and outcomes for different ultrasonographic patterns of hepatic emphysema in dogs and cats. Dogs and cats with an ultrasonographic diagnosis of hepatic emphysema and a known outcome, from January 2010 to January 2018, were enrolled. The following data were recorded from medical and ultrasonographic records: ultrasonographic patterns of hepatic emphysema (parenchymal, portal venous, biliary), clinical signs, laboratory findings, and outcomes (favorable, poor). A total of 33 dogs and four cats met the inclusion criteria. Among these, 23 cases were classified as hepatic portal venous gas, 10 as parenchymal emphysema, and four as biliary emphysema. Clinical diagnosis categories were as follows: infection/sepsis (9), gastro‐intestinal disease (9), iatrogenic (9), trauma (5), and liver neoplasia (5). An increase in serum liver enzymes was significantly associated with parenchymal emphysema (P = .03). Other clinical and laboratory findings were not associated with the type of hepatic emphysema. Hepatic portal venous gas was mostly transient in patients with ultrasonographic follow‐up. The overall mortality was 40.5%. A significant difference was found between mortality by portal venous gas (21.7%) and mortality by parenchymal emphysema (90%) (P = .003). In conclusion, the ultrasonographic differentiation of hepatic emphysema between hepatic portal venous gas and parenchymal emphysema may be important for the prognosis of hepatic emphysema. The presence of parenchymal emphysema may be a poor prognostic indicator, while hepatic portal venous gas may be more benign. However, ultrasound findings should be carefully evaluated in the context of clinical findings.  相似文献   

9.
Chronic eosinophilic pancreatitis and ulcerative colitis in a horse   总被引：2，自引：0，他引：2  
A generalized debilitating disease in a horse was believed to be related to hypersensitivity to migrating strongyle larvae. The clinical signs included weight loss, diarrhea, and ulcers on all 4 coronary bands. The mare's condition deteriorated rapidly, so the mare was euthanatized and necropsied. The major histopathologic findings were chronic multifocal eosinophilic pancreatitis, hepatic portal fibrosis, biliary hyperplasia, and chronic ulcerative eosinophilic colitis. This case was similar to previously reported cases of chronic eosinophilic gastroenteritis in horses. Although the etiologic agent was not evident, the distribution and character of the lesions were consistent with a hypersensitivity response to migrating parasitic larvae, most probably Strongylus equinus.  相似文献   

10.
OBJECTIVE: To evaluate the potential of excess dietary iron to cause hepatic lesions similar to those described in horses with suspected iron toxicosis or hemochromatosis. DESIGN: Prospective study. ANIMALS: 6 adult male ponies. PROCEDURE: 4 ponies received 50 mg of iron/kg (22.7 mg/lb) of body weight each day by oral administration of ferrous sulfate, which contained 20% elemental iron; 2 ponies received only the carrier (applesauce). Complete blood counts, serum biochemical analyses, and hepatic tissue biopsies were performed, and serum iron concentrations were measured. Blood and tissue samples were obtained at days 0 and 2, and at the end of weeks 1, 3, 6, and 8 after administration of iron was initiated. Treatment was discontinued after 8 weeks, and hepatic iron concentrations were measured at 28 weeks. RESULTS: Hepatic iron concentrations, serum iron concentrations, percentage saturation of transferrin, and serum ferritin concentrations were increased, compared with baseline and control concentrations, by week 8. Adverse clinical signs or histologic lesions in the liver were not detected in any ponies. At 28 weeks, hepatic iron concentrations had decreased. CONCLUSIONS AND CLINICAL RELEVANCE: Histologic lesions were not seen in the hepatic biopsy specimens obtained from the ponies treated with ferrous sulfate. It was concluded that it would be unlikely for iron toxicosis to develop in adult ponies or horses during a period of < 8 weeks when food or water contained increased amounts of iron. It is suspected that previous reports of hepatopathies in animals with hemosiderin accumulation may represent a primary hepatopathy with secondary hemosiderin accumulation, especially if the only source of iron is via oral consumption.  相似文献   

11.
Reasons for performing the study: Intestinal hyperammonaemia (HA) has been infrequently reported in individual horses; however, there have been no studies describing clinical and laboratory data as well as short‐ and long‐term outcome in a larger number of cases. Objectives: To describe clinical and laboratory data and short‐ and long‐term outcome in a large group of horses with intestinal HA. Methods: Multi‐centred, retrospective study; case records of horses with HA were reviewed and any horse with a clinical or post mortem diagnosis of intestinal HA was included. Hyperammonaemia was defined as a blood ammonium (NH4+) concentration ≥60 µmol/l and horses with a diagnosis of primary hepatic disease were excluded. Relevant data were recorded and, if appropriate, data from survivors were compared to nonsurvivors to identify potential prognostic indicators. Results: Thirty‐six cases, 26 mature horses and 10 foals with intestinal HA were identified. Case histories included diarrhoea, colic and neurological signs and the most common clinical diagnosis was colitis and/or enteritis. The most common clinical and laboratory abnormalities included tachycardia, increased packed cell volume, hyperlactataemia and hyperglycaemia. Fourteen horses (39%) survived to discharge; NH4+ concentration on admission was the only parameter significantly associated with survival. All surviving horses and foals for which follow‐up information was available recovered completely and returned to their intended use without further complications. Conclusions and potential relevance: Intestinal HA occurs in mature horses and foals and can be associated with severe clinical and laboratory abnormalities; further studies are required to investigate predisposing factors and delineate possible differences in aetiologies.  相似文献   

12.
Primidone, phenytoin, or phenytoin and primidone in combination were given to healthy Beagle dogs for 6 months. Serum biochemical changes in dogs given primidone alone or phenytoin and primidone in combination for the entire 6-month test period included increased activities of alanine aminotransferase, alkaline phosphatase (AP), and gamma-glutamyltransferase, and decreased concentrations of albumin and cholesterol. Changes in dogs given phenytoin alone were limited to increased AP activity and decreased albumin concentration. Sulfobromophthalein excretion and conjugated bile acid concentration were within normal limits. All dogs given primidone alone or phenytoin alone remained clinically healthy throughout the treatment period. Three of 8 dogs given both drugs in combination became clinically ill after 9, 14, and 15 weeks of treatment, and were euthanatized. Two of the dogs developed clinical jaundice. In addition to the serum biochemical abnormalities observed in clinically healthy dogs, these dogs developed hyperbilirubinemia, delayed sulfobromophthalein excretion, and increased conjugated bile acid concentrations. Histologic examination of the liver showed intracanalicular casts of bile pigment typical of intrahepatic cholestasis in all 3 dogs. Histologic findings characteristic of treated dogs included hepatocellular hypertrophy attributable to hyperplasia of the smooth endoplasmic reticulum. Single-cell necrosis and multifocal lipidosis were observed in individuals of all treatment groups. Electron microscopy of the liver showed dilated bile canaliculi and damaged sinusoidal epithelium in dogs given both drugs. The elevated serum AP activity, associated with anticonvulsant drug therapy, was found to be exclusively the liver isoenzyme by cellulose acetate electrophoresis. The hepatic AP was localized to primarily the canalicular membranes by enzyme histochemistry. There was a statistically significant positive correlation between the AP activities of liver and serum. The results of this study indicate that long-term administration of anticonvulsant drugs to dogs is associated with clinical, serum biochemical, and histologic evidence of hepatic dysfunction. High drug dosage contributed most to abnormal serum biochemical test results, and combining phenytoin with primidone was responsible for more severe electron microscopic lesions of the liver of surviving dogs and for the death of 3 dogs.  相似文献   

13.
The activities of serum alkaline phosphatase (serum ALP), leucine aminopeptidase (serum LAP), and alanine aminotransferase (serum ALT) were determined in 15 cats before and after treatment by 3 methods: common bile duct occlusion, left hepatic duct(s) occlusion, and carbon tetrachloride administration. Significant increases in serum ALP, LAP, and ALT activities occurred in all cats in the 3 groups. Sustained mean increases of ninefold in ALP and 13-fold in LAP occurred in the cats with common bile duct occlusion. Lesser mean increases of these enzymes (fourfold) occurred in the cats with partial biliary occlusion. Transient mean increases (100-fold) in ALT occurred in the carbon tetrachloride-treated cats. Urine ALP excretion was measured in 3 cats with common bile duct occlusion. There was no significant difference between rates of urine ALP excretion before and after common bile duct occlusion. Specific ALP activities of hepatic extracts from normal cats and biliary-obstructed cats were compared. Mean specific activity was onefold higher in liver from cats with common bile duct occlusion of 21 days' duration. The findings in the present studies were interpreted to indicate that serum ALP and LAP are useful to detect biliary occlusive disease in cats and, in conjunction with serum ALT, may be used to differentiate primary hepatodegenerative disease and biliary occlusive disease.  相似文献   

14.
Reasons for performing study: There is little scientific information available about the ability of ocular disease to cause a systemic inflammatory response. Horses are frequently affected with ocular disease and ensuring their systemic health prior to performing vision saving surgery under anaesthesia is essential for the successful treatment of ophthalmic disease. Hypothesis: Ocular disease will cause elevations in the concentration of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. Methods: Whole blood and serum samples were obtained from 38 mature horses with ulcerative keratitis or uveitis and no evidence of systemic disease, 9 mature horses with no evidence of ocular or systemic disease (negative controls) and 10 mature horses with systemic inflammatory disease and no evidence of ocular disease (positive controls). Blood samples were assayed for concentrations of the acute phase proteins fibrinogen and serum amyloid A. Results: Fibrinogen and serum amyloid A were significantly different in the positive control group compared to the negative control, corneal disease and uveitis groups (P<0.126). There was no significant difference between the negative control, corneal disease and uveitis groups (P<0.001). Conclusions: Ulcerative keratitis and anterior uveitis are not associated with elevated concentrations of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. Potential relevance: When the clinician is presented with a patient with ocular disease and elevated plasma fibrinogen or serum amyloid A concentrations, a nonocular inflammatory focus should be suspected.  相似文献   

15.
BACKGROUND: Reference ranges for serum bile acids (SBA) concentration are well established in healthy adult horses. Increased values are indicative of hepatic disease. HYPOTHESES: SBA concentrations are significantly greater in the neonatal period compared with mature horses, and illness in the neonatal period will further increase SBA. ANIMALS: Ten healthy mature horses, 12 healthy foals, and 31 clinically ill foals. METHODS: Prospective cross-sectional study. Blood samples were obtained once from the mature horses, from healthy foals immediately after birth, at 2 days, and at 1, 2, 3, 4, and 6 weeks of age; and from ill foals less than 1 month of age at the time of admission to the Veterinary Teaching Hospital. SBA concentrations were determined enzymatically and by radioimmunoassay. Total and direct bilirubin and triglyceride concentrations were measured, as well as sorbitol dehydrogenase (SDH) and gamma-glutamyltransferase (GGT) activities. RESULTS: There was a significant negative correlation between age and SBA concentration. Compared with mature horses, SBA concentrations were significantly greater in healthy foals at each collection time over the first 6 weeks of life. Radioimmunoassay values were lower than enzymatic SBA values, with increasing bias as the mean difference between values increased. When comparing age-matched values between healthy and ill foals, there were no significant differences in SBA. None of the ill foals had a primary diagnosis of hepatic disease. There was no significant correlation between the SBA concentration and the bilirubin or triglyceride concentrations or the GGT activity. There was a significant direct correlation between increased SBA and serum SDH activity in healthy foals only. CONCLUSION AND CLINICAL IMPORTANCE: SBA concentrations in foals are significantly higher in the early neonatal period, underscoring the importance of using age-matched references when evaluating clinical pathology values during the neonatal period.  相似文献   

16.
REASONS FOR PERFORMING STUDY: Liver disease is fairly common in horses and, although previous literature suggests that fatality rates are high, impressions gained from current clinical practice suggest that this is no longer the case. OBJECTIVES: A case-control study was undertaken in 2 hospitals to investigate whether age, gender or breed type predisposed horses to developing hepatic disease, with the additional aim of determining whether these factors and disease category had any effect on outcome. METHODS: Eighty-eight cases were identified by review of computerised archives at 2 hospitals. Three cases admitted immediately before and after the cases were used as controls. Multivariant models were developed to explore the relationship between age, breed type and gender and the development of liver disease, and within the clinical cases, to identify whether any of these factors or specific forms of liver disease were associated with fatality rate. RESULTS: Ponies were more likely to develop hepatic disease than light riding horses, but neither age nor gender were significant risk factors. Overall, the fatality rate was fairly low; horses with unclassified hepatopathies had the lowest fatality rate and those with cholangiohepatitis, pyrrolizidine alkaloid toxicity and chronic active hepatitis had significantly higher fatality rates in comparison. However, age, breed type and gender had no detectable effect on outcome. CONCLUSIONS AND POTENTIAL RELEVANCE: Such data could be of particular value to equine practitioners, as the cases were drawn from both primary and referral practice, and were all seen within the last 5 years.  相似文献   

17.
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18.
The starry sky hepatic pattern is an unusual ultrasonographic appearance of equine liver characterized by numerous small, hyperechoic foci, some of which cast an acoustic shadow, distributed randomly throughout the hepatic parenchyma. Our objectives were to describe the signalment, clinical signs, clinicopathological findings, primary disease process, and ultrasonographic findings of horses with this ultrasonographic pattern, as well as determine the associated gross and histologic changes. The starry sky pattern was identified in 18 adult horses of mixed gender and breed. The horses had various clinical signs, with weight loss and anorexia reported most commonly. Liver size and parenchymal echogenicity were normal in most horses. The hyperechoic foci frequently caused acoustic shadowing. Biliary dilation was noted rarely. The ultrasonographic pattern was the result of numerous fibrosing hepatic granulomas in all horses evaluated histologically. γ‐Glutamyltransferase was the most commonly elevated hepatic enzyme, though it was increased in fewer than half the horses. Fifteen horses had an additional disease that was identified as the apparent cause of clinical signs. Three horses had primary hepatic disease while 12 had diseases of other body systems. Therefore, the starry sky ultrasonographic pattern is likely incidental in most horses and not clinically significant. Improved recognition of this pattern and further investigation of affected horses may help refine the etiology and clinical significance of the granulomas.  相似文献   

19.
REASONS FOR PERFORMING STUDY: Sporadic measurement of serum triglycerides in depressed and inappetant clinically ill horses revealed severe hypertriglyceridaemia without visible evidence of lipaemia on several occasions, leading to the inclusion of serum triglyceride concentrations in the routine serum biochemistry evaluation of our hospital. Since then, more cases have been identified and treated for hypertriglyceridaemia, raising questions about the prevalence, predisposing factors and significance of these findings. HYPOTHESES: 1) Severe hypertriglyceridaemia without visible opacity of the serum occurs more commonly in clinically ill and inappetant horses than previously described and 2) appropriate treatment using i.v. dextrose and/or partial parenteral nutrition would decrease serum triglycerides to normal limits and might result in improved appetite and attitude of the patient. METHODS: The laboratory computer database from 2000 and 2001 was searched for increased serum triglycerides (> 5.65 mmol/l) in any horse breed, ponies and miniature breeds excluded. Data analysed included subject details, diagnosis, clinical and laboratory parameters, treatment, response to treatment and outcome. RESULTS: Severe hypertriglyceridaemia was identified in 13 horses, with serum triglyceride concentrations 6.17-18.29 mmol/l, while none showed visible lipaemia. All horses had clinical and laboratory findings consistent with systemic inflammatory response syndrome and all but one had an increased serum creatinine concentration. Treatment with i.v. dextrose and/or partial parenteral nutrition resulted in decrease of the serum triglycerides to normal limits. CONCLUSIONS: Severe hypertriglyceridaemia occurs in inappetant and clinically ill horses without evidence of serum opacity more commonly than previously described. The presence of systemic inflammatory response syndrome might predispose horses to hypertriglyceridaemia, while the increased creatinine concentration might be a predisposing factor or result of the condition. Horses identified in our study readily responded to treatment and appetite and attitude improved coincident with decrease of the serum triglycerides to normal limits. POTENTIAL RELEVANCE: Hypertriglyceridaemia could perpetuate inappetance and depression in clinically ill horses and potentially predispose to fatty infiltration of the liver and other organ systems.  相似文献   

20.
Phenobarbital (PB) therapy is frequently associated with elevated serum alanine aminotransferase (ALT) and alkaline phosphatase (AP) activities in dogs without clinical signs of liver disease. The goal of this study was to determine if increased serum ALT and AP activities in clinically healthy PB-treated epileptic dogs are due to hepatic enzyme induction or to subclinical liver injury. Liver biopsies were obtained from 12 PB-treated dogs without clinical signs of liver disease but with elevated serum ALT and/or AP activities or both. Liver biopsies were obtained from eight healthy control dogs not receiving PB. Biopsies were evaluated histopathologically (all dogs) and liver homogenates were assayed for ALT (all dogs) and AP (six treated dogs, all controls) activities. As a positive control, liver cytochrome P4502B, an enzyme known to be induced by PB, was measured by benzyloxyresorufin-O-dealkylase activity and immunoblotting (five treated dogs, all controls). Serum AP isoenzyme analyses were performed. Results showed that ALT and AP activities in liver homogenates were not increased in treated dogs compared with controls, whereas the positive control for induction, CYP2B, was dramatically increased in treated dogs. Histopathological examination of liver biopsies revealed more severe and frequent abnormalities in treated dogs compared to controls, but similar types of abnormalities were found in both groups. Serum AP isoenzyme analyses in treated dogs demonstrated increased corticosteroid-induced and liver isoenzyme activities compared to controls. Results do not support induction of ALT or AP in the liver as the cause of elevated serum activities of these enzymes due to PB.  相似文献   

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