Sensitivity and Specificity of Plasma ALT, ALP, and Bile Acids for Hepatitis in Labrador Retrievers

Serum miR-30b is increased in Labrador Retrievers with elevated hepatic copper levels

Copper-associated hepatitis is a hereditary disease in Labrador Retrievers with a complex genetic background. Currently, liver biopsies are needed for diagnosis and treatment monitoring. A serum-based biomarker for hepatic copper levels could provide a less invasive diagnostic approach. Circulating microRNAs are increasingly studied for their diagnostic potential in hepatobiliary disease and could be utilized in assessing hepatic copper levels. Currently, information on the potential use of copper specific microRNAs in dogs is lacking. The aim of this pilot study was to identify microRNAs associated with elevated hepatic copper levels in Labrador Retrievers. Client-owned Labrador Retrievers with normal (n = 15) and elevated hepatic copper levels (n = 21) were retrospectively selected from a patient database. We performed a microRNA screening array of 277 microRNAs in blood serum of Labrador Retrievers with normal (n = 5) and elevated hepatic copper levels (n = 5). MicroRNAs upregulated in Labrador Retrievers with elevated hepatic copper were subsequently analyzed with qPCR in a replication cohort of Labrador Retrievers with normal (n = 13) and elevated (n = 18) hepatic copper levels. Results showed that six out of the 277 serum microRNAs were significantly upregulated in dogs with elevated hepatic copper and these were analyzed in the replication cohort. After Bonferroni correction, cfa-miR-30b (fold-change 2.17, p-value .002) was significantly upregulated in the replication cohort. In this exploratory study, cfa-miR-30b is increased in Labrador Retrievers with elevated hepatic copper levels. This result justifies validation in a larger cohort of dogs with and without hepatic copper accumulation, including those with different forms of liver disease and other breeds affected by copper-associated hepatitis.

Deciphering of differences in gut microbiota and plasma metabolites profile between non-obese and obese Golden Retrievers dogs

Introduction

Golden Retrievers have a high risk of obesity, which is prevalent in dogs and is associated with inflammation and cancer, impairing the health and life expectancy of companion animals. Microbial and metabolite biomarkers have been proposed for identifying the presence of obesity in humans and rodents. However, the effects of obesity on the microbiome and metabolome of Golden Retrievers remains unknown. Therefore, this study was designed to evaluate the signatures of serum biochemistry indexes, gut microbiota and plasma metabolites in non-obese and obese Golden Retrievers, aiming to recognize potential biomarkers of canine obesity.

Methods

A total of 8 non-obese (Ctrl group) and 8 obese (Obe group) Golden Retrievers were included in the present study to collect blood and feces samples for measurements. The fecal microbiome and plasma metabolome were determined using 16S rRNA amplicon sequencing and liquid chromatography-mass spectrometry, respectively.

Results

Results showed that the alanine aminotransferase activity and total bilirubin concentration, which have been measured using serum biochemistry analysis, were higher in the Obe group than in the Ctrl group (p < 0.05). Moreover, there was a significant difference in gut microbiota composition between the two groups (p < 0.05). The phyla Proteobacteria, Fusobacteriota, and Bacteroidota as well as genera Fusobacterium, Prevotella, Faecalibacterium, Escherichia-Shigell, and Alloprevotella were more abundant, while phylum Firmicutes and genera Peptoclostridium, Blautia, Turicibacter, Allobaculum, and Erysipelatoclostridium were less abundant in the Obe group compared to the Ctrl group (p < 0.05). Plasma concentrations of citrulline and 11-dehydrocorticosterone were significantly higher in the Obe group than those in the Ctrl group (p < 0.05). Close correlations between serum biochemistry parameters, gut microbiome, and plasma metabolites were observed in the current study.

Conclusion

The obesity-induced shifts in serum biochemistry indexes, gut microbiota, and plasma metabolites profiles suggest that obese Golden Retrievers exhibit a different microbiome and metabolome than non-obese ones, and the certain metabolites like citrulline and 11-dehydrocorticosterone could be considered as potential biomarkers to recognize obese Golden Retrievers.

Long-term clinical outcomes of healthy dogs with increased alanine aminotransferase

OBJECTIVES

To define a reference interval for alanine aminotransferase for the practice laboratory and then identify and longitudinally follow the clinical health and alanine aminotransferase levels in a cohort of clinically healthy dogs with increased alanine aminotransferase levels documented during wellness screening.

MATERIALS AND METHODS

Alanine aminotransferase levels of 125 clinically healthy dogs were used to define a reference interval for the practice laboratory. The electronic records of 315 clinically healthy dogs which had undergone wellness screening including assessment of alanine aminotransferase levels at a first-opinion veterinary hospital in the UK were reviewed between January 2012 and January 2023. Clinically healthy dogs with increased alanine aminotransferase levels relative to the top of the reference interval determined for the practice on at least one test during the study period were identified. These were longitudinally followed through electronic medical records to determine their long-term clinical outcomes over a period of up to 11 years.

RESULTS

The reference interval for alanine aminotransferase in the practice laboratory was calculated as 10.6 to 181.8 U/L. Nineteen clinically healthy dogs were identified as having increased alanine aminotransferase levels. One dog from the group with increased alanine aminotransferase levels was diagnosed with chronic hepatitis and died of liver failure, while the other 18 dogs died of other causes, or were still alive at the end of the study, with no clinical signs associated with liver disease. One dog in the group with consistently normal alanine aminotransferase levels also died from clinical signs attributed to liver disease.

CLINICAL SIGNIFICANCE

Only a small proportion of clinically healthy dogs with increased alanine aminotransferase levels documented on wellness screening developed clinically relevant liver dysfunction over long-term follow-up.

[Acute poisonings in dogs - a retrospective case study over 5 years]

OBJECTIVE

The aim of this retrospective study was to analyze the clinical signs, confirmed or suspected toxicants, treatments and outcomes of poisoning cases in dogs presented over a 5-year period to the emergency service of a small animal referral center.

MATERIAL AND METHODS

Medical records of 634 dogs were evaluated for a history of confirmed or presumed poisoning, suspected toxicant, clinical signs, treatment, and patient outcome. The probability of poisoning was graded based on the patient history, clinical findings, toxicologic examination and - in some cases - investigation of gastrointestinal contents.

RESULTS

Most dogs were hospitalized (77%) due to poisoning with mostly unknown toxicants (33%), food residues (18%), rodenticides (10%), tremorgenic mycotoxins (8%), medications (7%) and various plants (7%), followed by recreational drugs (5%), chemicals (4%), molluscicides (3%), antiparasitics (2%), feces (2%), nuts (2%), or toxins of animal origin (1%). Patients were presented predominantly showing neurologic signs (56%), reduced general condition (39%), and cardiovascular or hydration status abnormalities (26%). The survival rate was 97%. Most dogs were clinically unremarkable at the time of hospital discharge (70%). An additional 18% of the survivors had no apparent complications by the time of discharge. Toxicant-related complications (20.5%) included hemorrhage (4%), hepatic (4%), renal (4%), respiratory (3%), gastrointestinal (3%), cardiovascular (3%), and/or central nervous system (3%) complications, or clinically relevant hypoglycemia (0.3%).

CONCLUSION AND CLINICAL RELEVANCE

In the present study, poisoning in dogs was mostly associated with the ingestion of food residues, but the causative toxicant remained unidentified in many cases. Neurological signs were the major clinical presentation. The survival rate (97%) in this study was higher compared to those reported by other investigators.

Clinical enzymology of the dog and cat

Clinical enzymology studies the enzyme activity in serum or other body fluids for the diagnosis, prognosis or monitoring of a variety of diseases. Clinical enzymology has greatly benefited from advances in technology and is now an integral part of laboratory analysis. However, to maximise the clinical benefits of serum enzyme measurement, clinicians and clinical pathologists must have a good understanding of the pathophysiology behind serum enzyme alterations. They must also be aware of the preanalytical and analytical factors that can affect the accuracy of serum enzyme activity measurement. This review article first covers the basic concepts of clinical enzymology and the general mechanisms related to serum enzyme alterations. Then, the review discusses the potential effects of various preanalytical and analytical factors on enzyme activity measurement. Lastly, it explores the pathophysiology and clinical use of various serum enzymes in canine and feline medicine. The present review article aims to be a comprehensive one-stop source for clinical pathologists and small animal practitioners.

Mycophenolate mofetil as a treatment for presumed idiopathic chronic hepatitis in dogs: Six cases (2010-2022)

OBJECTIVES

The objectives of this study were to describe the clinical findings, treatment and outcomes of six dogs with presumed idiopathic chronic hepatitis treated with mycophenolate mofetil (MMF).

MATERIALS AND METHODS

Medical records were retrospectively searched to identify dogs in which idiopathic chronic hepatitis was diagnosed on histopathology between January 2010 and June 2022 that were treated with MMF for at least two weeks with >2 follow-up examinations. Data recorded from each dog included signalment, clinical signs, diagnostic test results and treatment.

RESULTS

Six dogs were treated with MMF at a median initial dosage of 9.6 mg/kg PO q 12 h. Reported adverse effects from MMF included decreased appetite, vomiting and diarrhoea. In all six dogs, MMF was used successfully long term for the treatment of idiopathic chronic hepatitis as determined by 46% or greater improvement of alanine aminotransferase (ALT) between 4 and 18 weeks of starting MMF. Three dogs were also temporarily treated for 4-6 months on a tapering dose of prednisone. In two dogs, ALT remained within the reference interval, and in one dog, it was very mildly elevated when on MMF alone. In all six dogs, owners reported that the medication was well tolerated.

CLINICAL SIGNIFICANCE

To the authors' knowledge, this is the first report describing the use of MMF with and without a tapering dose of prednisone for the treatment of idiopathic chronic hepatitis in six dogs. Based on the outcomes of the dogs in this report, MMF can be effective for the long-term treatment of idiopathic chronic hepatitis as measured by reduction in ALT and improvement of clinical signs.

Predictive Factors for Two-Year Survival in Dogs with Hepatobiliary Diseases: Importance of Clinical and Laboratory Monitoring

Long-term outcomes and survival predictors for different clinicopathologies (idiopathic chronic hepatitis, liver fibrosis, vacuolar hepatopathy) in dogs with hepatobiliary diseases are poorly described. In this study, ninety dogs were followed up for up to five years to investigate clinical factors that predict two-year survival in canine patients after liver biopsy. Univariate and multivariate analyses were performed based on clinical and laboratory data to determine the association between clinical and laboratory data and mortality rates. Overall, the one-, two-, and five-year mortality rates were 28.9%, 45.6%, and 78.9%, respectively. Univariate analysis indicated that male gender, ascites, elevated serum gamma-glutamyl transpeptidase (GGT), hypercholesterolemia, hypoalbuminemia, prolonged activated partial thromboplastin clotting time (aPTT), and prolonged thrombin clotting time (TT) were associated with an increased two-year mortality rate. Results from multivariate analysis demonstrated a significant association between male gender (p = 0.022), elevated serum GGT (p < 0.001), hypoalbuminemia (p < 0.001), and prolonged aPTT (p < 0.001) and an increased two-year mortality rate, regardless of the specific type of liver pathology. Elevated GGT was associated with the highest risk for increased two-year mortality (95% CI: hazard ratio 6.02-41.21). In conclusion, various clinical factors in dogs with liver diseases are useful for prognosis prediction.

Effectiveness of the pomegranate extract in improving hepatokines and serum biomarkers of non-alcoholic fatty liver disease: A randomized double blind clinical trial

BACKGROUND AND AIM

Pomegranate as a functional food has various properties and effects on health. The aim of the study was to evaluate the effect of pomegranate extract on serum levels of liver enzymes, hepatokines, interleukin-6 (IL-6), and total antioxidant capacity in non-alcoholic fatty liver disease (NAFLD).

METHODS

In this double-blind randomized clinical trial, 44 patients with NAFLD were divided into two groups: pomegranate extract tablets and placebo. The intervention period was 12 weeks. At the beginning and end of the study, serum levels of alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), fetuin-A, fibroblast growth factor 21 (FGF-21), interleukin-6 (IL-6), and total antioxidant capacity were assessed in both groups.

RESULTS

Pomegranate extract reduced the level of ALT (P < 0.001), AST (P < 0.001), GGT (P < 0.001), fetuin-A (P < 0.001), FGF-21(P < 0.001) and IL-6 (P = 0.04) compared to the placebo. Pomegranate extract also led to an increase in total antioxidant capacity (P˂0.001) but had no effect on ALP.

CONCLUSION

It seems that the pomegranate extract improves several markers of NAFLD, and can be useful as a treatment supplement. The clinical trial approved by Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences (grant No. NRC-9811).

TRIAL REGISTRATION

Iranian Registry of Clinical Trials (IRCT), IRCT20140107016123N14, https://www.irct.ir/trial/42739.

Atypical Lesions in Canine Leishmaniosis: Description of New Cases

Simple Summary

Canine leishmaniosis is a zoonotic disease caused mainly by the protozoan Leishmania infantum that is endemic in the Mediterranean basin. The clinical signs and pathological characteristics have been extensively described; however, atypical lesions leading to clinical and pathological misdiagnosis have been sporadically reported. This study presents three cases of dogs experimentally infected with Leishmania infantum that showed gross lesions considered atypical of canine leishmaniosis and not previously reported. Macroscopic lesions were observed in the liver, spleen, and peritoneal cavity that corresponded to tan to whitish nodular lesions in all organs and multifocal irregular and linear whitish lesions in one of the livers that mimicked tumors. Microscopically, a marked granulomatous inflammation with a relative scarcity of parasites was observed in all the organs. In conclusion, microscopic and parasitological studies should be performed on atypical lesions observed in Leishmania-infected and non-infected dogs, especially in endemic regions. In addition, due to its zoonotic importance, leishmaniosis should be considered when atypical nodular lesions are observed in dogs from non-endemic regions with a history of travel to endemic regions.

Abstract

Pathological characteristics are well described in canine leishmaniosis (CanL). However, atypical lesions that can be confused with other pathologies or trigger unusual clinical signs are sporadically reported. Atypical lesions were observed during routine postmortem examination in three Leishmania-infected dogs and samples were taken for histopathological and immunohistochemical studies. Clinical signs, biochemical parameters, level of antibodies, and parasite detection by PCR were also evaluated. Atypical lesions were found in the peritoneal cavity, liver, and spleen. Splenomegalia and hepatomegalia were observed in all dogs. In addition, multifocal dark to white nodules of variable size were observed in the peritoneal cavity, liver, and spleen of one dog and in the spleen of the other two dogs. One dog presented diffuse irregular whitish lines with a threadlike appearance and another an intense fibrotic depression in the intermediate lobe. Microscopically, an intense granulomatous inflammation with abundant macrophages, a variable number of lymphocytes, and a low to moderate number of parasites was observed. This study represents the first description of granulomatous peritonitis associated with Leishmania in dogs. It also shows atypical macroscopic expression of hepatitis in CanL. In the absence of an adequate clinical history and laboratory analyses, certain lesions observed in CanL could admit alternative diagnoses.

Investigation of a relationship between serum concentrations of microRNA-122 and alanine aminotransferase activity in hospitalised cats

OBJECTIVES

Current blood tests to diagnose feline liver diseases are suboptimal. Serum concentrations of microRNA (miR)-122 have been shown in humans, dogs and rodents to be a sensitive and specific biomarker for liver injury. To explore the potential diagnostic utility of measuring serum concentrations of miR-122 in cats, miR-122 was measured in a cohort of ill, hospitalised cats with known serum alanine aminotransferase (ALT) activity.

METHODS

In this retrospective study, cats were grouped into those with an ALT activity within the reference interval (0-83 U/l; n = 38) and those with an abnormal ALT activity (>84 U/l; n = 25). Serum concentrations of miR-122 were measured by real-time quantitative PCR and the relationship between miR-122 and ALT was examined.

RESULTS

miR-122 was significantly higher in the group with high ALT activity than the ALT group, within normal reference limits (P <0.0004). There was also a moderately positive correlation between serum ALT activity and miR-122 concentrations (P <0.001; r = 0.52).

CONCLUSIONS AND RELEVANCE

Concentrations of miR-122 were reliably quantified in feline serum and were higher in a cohort of cats with increased ALT activity than in cats with normal ALT activity. This work highlights the potential diagnostic utility of miR-122 as a biomarker of liver damage in cats and encourages further investigation to determine the sensitivity and specificity of miR-122 as a biomarker of hepatocellular injury in this species.

Screening and validation of biomarkers for cadmium-induced liver injury based on targeted bile acid metabolomics

Although cadmium (Cd) is a toxic heavy metal that reportedly causes liver injury, few studies have investigated biomarkers of Cd-induced liver injury. The purpose of this study is to investigate the role of bile acid (BA) in Cd-induced liver injury and determine reliable and sensitive biochemical parameters for the diagnosis of Cd-induced liver injury. In this study, 48 Sprague-Dawley rats were randomly divided into six groups and administered either normal saline or 2.5, 5, 10, 20, and 40 mg/kg/d cadmium chloride for 12 weeks. A total of 403 subjects living in either a control area (n = 135) or Cd polluted area (n = 268) of Dongdagou-Xinglong (DDGXL) cohort were included, a population with long-term low Cd exposure. The BA profiles in rats' liver, serum, caecal contents, faeces, and subjects' serum were detected using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Changes in rats' and subjects' liver injury indices, rats' liver pathological degeneration, and rats' liver and subjects' blood Cd levels were also measured. Cadmium exposure caused cholestasis and an increase in toxic BAs, leading to liver injury in rats. Among them, glycoursodeoxycholic acid (GUDCA), glycolithocholic acid (GLCA), taurolithocholic acid (TLCA), and taurodeoxycholate acid (TDCA) are expected to be potential biomarkers for the early detect of Cd-induced liver injury. Serum BAs can be used to assess Cd-induced liver injury as a simple, feasible, and suitable method in rats. Serum GUDCA, GLCA, TDCA, and TLCA were verified to be of value to evaluate Cd-induced liver injury and Cd exposure in humans. These findings provided evidence for screening and validation of additional biomarkers for Cd-induced liver injury based on targeted BA metabolomics.

Protective Effects of α-Lipoic Acid and Chlorogenic Acid on Cadmium-Induced Liver Injury in Three-Yellow Chickens

Simple Summary

Cadmium (Cd) exerts pernicious influences on global health. We evaluated the protective effects of α-lipoic acid (α-LA) or chlorogenic acid (CGA) and their combination on counteracting Cd toxicity in vivo in three-yellow chickens. Administration of Cd (50 mg/L) alone lowered the production performance and resulted in biochemical, histologic and enzyme changes within the liver consistent with hepatic injury induced by oxidative stress and apoptosis of hepatocytes. However, the above variations of the Cd group were partially or fully reversed by administration of either α-LA or CGA; their combination showed an even better effect in attenuating Cd-induced hepatotoxicity. This study provided a practical and feasible approach to rescuing Cd intoxication in animal production.

Abstract

Cadmium (Cd) is a type of noxious heavy metal that is distributed widely. It can severely injure the hepatocytes and cause liver dysfunction by inducing oxidative stress and mitochondrial damage. We evaluated the protective effects of α-lipoic acid (α-LA) or chlorogenic acid (CGA) and their combination on counteracting cadmium toxicity in vivo in three-yellow chickens. For three months, CdCl₂ (50 mg/L) was administrated through their drinking water, α-LA (400 mg/kg) was added to feed and CGA (45 mg/kg) was employed by gavage. The administration of Cd led to variations in growth performance, biochemical markers (of the liver, kidney and heart), hematological parameters, liver histopathology (which suggested hepatic injury) and ultrastructure of hepatocytes. Some antioxidant enzymes and oxidative stress parameters showed significant differences in the Cd-exposure group when compared with the control group. The groups treated with Cd and administrated α-LA or CGA showed significant amelioration with inhibited mitochondrial pathway-induced apoptosis. Combining both drugs was the most effective in reducing Cd toxicity in the liver. In summary, the results demonstrated that α-LA and CGA may be beneficial in alleviating oxidative stress induced by oxygen free radicals and tissue injury resulting from Cd-triggered hepatotoxicity.

Peripheral markers of oxidative stress in Labrador retrievers with copper-associated hepatitis

OBJECTIVES

To evaluate biomarkers of oxidative stress in dogs with copper-associated hepatitis (CAH) as compared with healthy controls, and to evaluate if these markers correlate with hepatic copper concentrations and hepatic histopathologic features.

MATERIALS AND METHODS

Prospective study. Plasma reactive metabolite concentrations, plasma antioxidant potential, and plasma and urine isoprostane concentrations were determined in Labrador retrievers with copper-associated hepatitis (n=9) as well as in breed- and sex-matched (n=9) and age- and sex-matched (n=9) healthy control populations. Possible correlations between markers of oxidative stress and hepatic histopathological features also were investigated.

RESULTS

Reactive metabolites (median, range) were over twofold greater in dogs with copper-associated hepatitis (87.2 RFU/μL, 60.9 to 185.6 RFU/μL) as compared to breed- and sex-matched (38.2 RFU/μL, 22.4 to 116.8 RFU/μL) and age- and sex-matched controls (32.0 RFU/μL, 18.5 to 127.4 RFU/μL). Antioxidant potential was decreased in copper-associated hepatitis dogs (6.5 TE/μL, 5.1 to 7.7 TE/μL) as compared to breed- and sex-matched controls (8.2 TE/μL, 5.3 to 11.8 TE/μL). Both reactive metabolite concentrations and the reactive metabolite to antioxidant potential ratio were positively correlated with hepatic copper concentrations. Plasma and urine isoprostanes were variable and not significantly different between populations.

CLINICAL SIGNIFICANCE

Labrador retrievers with copper-associated hepatitis have altered oxidant status. Plasma reactive metabolite concentrations and the reactive metabolite to antioxidant potential ratio could be useful biomarkers. However, neither plasma nor urine isoprostanes were useful biomarkers for copper-associated hepatitis.

Mefepronic acid is associated with a decrease in serum liver enzyme activities in dogs with suspected hepatopathy

Although suspected hepatopathy in dogs can be assessed by the blood levels of both liver enzyme activities and functional liver parameters, very often the precise diagnosis of primary or secondary hepatobiliary diseases can remain uncertain. Therefore, in a number of patients, the therapeutic intervention has the purpose of slowing the progression of fibrosis and provide for optimal hepatic support. Recently the PPARs (peroxisome proliferator‐activated receptors) have been identified as a family of hepatic nuclear hormonal receptors, involved in the regulation of lipid and glucose metabolism. The aim of this work is to assess the effect of mefepronic acid (PMPA), a PPAR agonist, on liver enzyme markers in blood samples of dogs with suspected hepatopathies. Twenty dogs, with suspected hepatopathies, were divided into two groups: ten of them received subcutaneously daily 10 mg/kg of PMPA for 7 days (treated, group T), while the remaining dogs were treated with a conventional supportive treatment for hepatopathies consisting of ursodeoxycholic acid (UDCA) 10 mg/kg PO SID for 45 days (control, group C). PMPA yielded a faster decrease in liver enzyme activities compared to UDCA, that in most cases was maintained after the suspension of the treatment. These data suggest that PMPA might be considered as supportive treatment for dogs with suspected hepatopathy.

Resting and postprandial serum bile acid concentrations in dogs with liver disease

Background

Serum bile acids (SBAs) are frequently measured in dogs. However, there is limited data comparing SBAs in different liver diseases diagnosed according to standardized histological criteria.

Objectives

To compare resting and postprandial SBAs, and determine their sensitivity and specificity, for various liver diseases in dogs.

Animals

Three hundred and forty‐one client‐owned dogs with suspected liver disease that had a liver biopsy and SBAs measured.

Methods

Multicenter retrospective study. Cases were classified according to standardized histological criteria. The sensitivity and specificity of resting and postprandial SBAs for the diagnosis of each liver disease, and all liver diseases combined, were calculated.

Results

The median resting SBAs were highest in dogs with cirrhosis (98.8 μmol/L; range, 6‐135) and congenital circulatory anomalies (CCa; 79.45 μmol/L; 0.3‐705). The highest median postprandial concentrations were found in CCa (126 μmol/L; 0‐726) and chronic hepatitis (CH; 54.3 μmol/L; 0‐260). Using the cut‐off value of 10 μmol/L, the highest sensitivities of resting SBAs were recorded in dogs with CCa (87.5%; 95% confidence interval, 76.8‐94.4) and CH (81.1%; 71.5‐88.6). The sensitivities of postprandial SBAs were the highest in cholangitis (100%; 47.8‐100.0) and CCa (91.1%; 78.8‐97.5). The specificities of resting and postprandial SBAs for all diseases were 49.3% (37.6‐61.1) and 29.7% (15.9‐47.0), respectively.

Conclusions and Clinical Importance

Postprandial SBAs are more sensitive but less specific than resting SBAs for the diagnosis of liver disease. There were dogs in all categories of liver disease with resting SBAs <10 and >90 μmol/L. Therefore, careful interpretation of both normal and elevated values is required.

The combined adverse effects of cis-bifenthrin and graphene oxide on lipid homeostasis in Xenopus laevis

Simultaneous exposure to multiple pollutants has received great concerns considering that the interactions between pollutants can alter the environment fate and bioavailability of pollutants with potentially deleterious effects. Graphene oxide (GO) has been widely used in many areas including environmental remediation, biology and agriculture. However, researchers have largely ignored the combined toxicity of GO with coexisting toxicants. Cis-bifenthrin (cis-BF), a typical synthetic pyrethroid insecticide, was frequently detected in the environment, which raised the possibility of interaction between cis-BF and GO. Our study investigated the toxic effects of cis-BF alone or combined with GO on the lipid homeostasis in Xenopus laevis. Tadpoles at 51 stage were exposed to cis-BF (0, 12, 60 and 300 ng/L) or in their combination with GO (0.1 mg/L) for 21 days. Coexposure to cis-BF and GO deteriorated the lipid homeostasis disruption in tadpoles. The up- or down-regulation of lipogenesis genes expression and enzymes activity were amplified in the coexposure groups. Furthermore, the presence of GO enhanced the deleterious impacts of cis-BF on the hepatic function in tadpoles. This study uniquely shows that GO promotes the lipotoxicity and hepatic function deficit caused by cis-BF exposure in frog.

Hematological and Biochemical Changes in Dogs Naturally Infected With Dirofilaria repens

Subcutaneous dirofilariosis is a zoonotic disease emerging throughout Europe caused by the filarial nematode Dirofilaria repens. Despite its increasing prevalence, there is a large gap in knowledge of the impact of the parasite on the host. Currently classified as being non-pathogenic, recent evidence suggests that skin dirofilariosis is associated with dermatological conditions including concomitant pruritus, neoplastic processes, inflammation, and even blindness in dogs and humans. The aim of this study was to determine if natural canine D. repens infection leads to biological changes in the canine host. In a real-life veterinary clinic setting, animals are often presented to clinicians for unrelated issues, and D. repens is incidentally identified during inspection. As such, we compared hematological and biochemical parameters of 218 uninfected and 197 dogs naturally infected with D. repens. Interestingly, animals infected with D. repens had lower numbers of lymphocytes (p < 0.001), red blood cells (p < 0.001), and thrombocytes (p = 0.025), decreased hematocrit (p < 0.001), and increased alkaline phosphatase (p = 0.016) and creatinine activity (p = 0.023) compared to uninfected dogs. We further selected a subpopulation of 214 dogs having prima facie hematological and biochemical results within normal reference ranges to evaluate the effect of D. repens infections in seemingly healthy dogs. Among these patients, 93 dogs infected with D. repens had lower numbers of lymphocytes (p = 0.031), red blood cells (p = 0.025), and hematocrit (p = 0.002), higher glucose levels (p = 0.023), and border line elevated alkaline phosphatase levels (p = 0.054) compared to 121 uninfected animals. Despite being categorized as asymptomatic, we have observed hematological and biochemical changes associated with D. repens infections in dogs, and our data suggest that dirofilariosis may induce a state of chronic stress. These results link the presence of skin dirofilariosis to biological changes in the canine host, suggesting a mechanism for pathogenicity and shedding new light on the host–parasite relationship.

A descriptive study of the histopathologic and biochemical liver test abnormalities in dogs with liver disease in Thailand

The present study describes the serum biochemical alterations and histopathological abnormalities in the liver tissue of dogs with liver disease. A survey of hepatic lesions was conducted using ultrasound-guided percutaneous needle biopsies. The hematologic and biochemical changes in dogs with liver lesions were recorded. Chronic hepatitis was the most common liver histopathologic finding (37.9%). Other common findings included liver fibrosis (19.5%), vacuolar hepatopathy (10.3%), cholangiohepatitis (9.2%), hepatocellular carcinoma (4.6%), cholangitis (3.4%), cholangiocarcinoma (2.3%), and congestive hepatopathy (2.3%). Greater than 2-fold elevation of serum alanine aminotransferase (ALT) was a useful indicator, with a sensitivity of 40% to 65% for diagnosing all liver pathologies. Greater than 2-fold elevation of serum alkaline phosphatase (ALP) without significant elevation of ALT was useful for diagnosing liver diseases affected by inflammatory or regressive changes (sensitivity of 40% to 50%). Elevation of ALT, ALP, or a combination of ALT and ALP had a high sensitivity of up to 90% for identifying dogs with liver pathology. Hepatic injury and cholestasis enzymes should be interpreted together with patient history, clinical signs, and liver ultrasonographic appearance before performing a liver biopsy.

Retrospective evaluation of cyclosporine in the treatment of presumed idiopathic chronic hepatitis in dogs

Background

The etiology of idiopathic chronic hepatitis (ICH) in dogs is poorly understood, but evidence supports an immune‐mediated pathogenesis in some dogs.

Objectives

To describe a case series of dogs with presumed ICH treated with cyclosporine (CsA) with or without concurrent medications and to document the incidence of biochemical remission and factors associated with failure to attain remission.

Animals

Forty‐eight client‐owned dogs diagnosed with presumed ICH, treatment of which included CsA.

Methods

Two‐institution, retrospective case series of dogs between 2010 and 2017. All dogs were treated with CsA with or without concurrent medications for ≥2 weeks. Data were collected from medical records.

Results

Biochemical remission (<1.1 times the upper limit of normal for alanine aminotransferase activity) was attained in 79% of dogs (38/48). Median dose of CsA at remission was 7.9 mg/kg/d (range, 2.5‐12.7 mg/kg/d) and median time to remission was 2.5 months (range, 0.75‐18 months). Concurrent hepatoprotectant treatment was not associated with likelihood of remission. Clinical score, ascites, hypoalbuminemia, hyperbilirubinemia, prolonged coagulation times, dose, and duration of treatment were not associated with the probability of remission or time to remission. Common adverse effects of CsA were gastrointestinal signs in 38% (18/48) and gingival hyperplasia in 25% (12/48) of treated dogs.

Conclusion and Clinical Importance

A treatment regimen including CsA and frequent hepatoprotectant use resulted in biochemical remission of ICH in most dogs. None of the evaluated factors, including hepatoprotectant use, were significantly associated with likelihood of remission. Future prospective studies are indicated to evaluate CsA monotherapy in ICH dogs.

ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs

This consensus statement on chronic hepatitis (CH) in dogs is based on the expert opinion of 7 specialists with extensive experience in diagnosing, treating, and conducting clinical research in hepatology in dogs. It was generated from expert opinion and information gathered from searching of PubMed for manuscripts on CH, the Veterinary Information Network for abstracts and conference proceeding from annual meetings of the American College of Veterinary Medicine and the European College of Veterinary Medicine, and selected manuscripts from the human literature on CH. The panel recognizes that the diagnosis and treatment of CH in the dog is a complex process that requires integration of clinical presentation with clinical pathology, diagnostic imaging, and hepatic biopsy. Essential to this process is an index of suspicion for CH, knowledge of how to best collect tissue samples, access to a pathologist with experience in assessing hepatic histopathology, knowledge of reasonable medical interventions, and a strategy for monitoring treatment response and complications.

Association of circulating microRNA-122 and microRNA-29a with stage of fibrosis and progression of chronic hepatitis in Labrador Retrievers

BACKGROUND

Chronic hepatitis (CH) in dogs is common and has the tendency to progress to liver cirrhosis (LC). Circulating microRNAs might have the potential as markers for disease progression.

OBJECTIVES

To investigate whether concentration of specific microRNAs in serum correlate with the stage and grade of CH in Labrador Retrievers.

ANIMALS

Twenty-two Labrador Retrievers with histological CH (n = 8), LC (n = 7), and normal liver (NL, n = 7).

METHODS

In this retrospective study, serum concentrations of miR-122, miR-29a, miR-133a, miR-181b, and miR-17-5p were measured by quantitative real-time PCR and evaluated using univariate linear regression in dogs. A multivariate model was fit including the grade of hepatitis and the stage of fibrosis.

RESULTS

Of the 5 microRNAs, only circulating miR-122 and miR-29a were significantly associated with the grade of hepatitis and the stage of fibrosis. A positive correlation was identified between the grade of hepatitis with miR-122 (r_s  = 0.79, P < .001) and miR-29a (r_s  = 0.78, P < .001). Both miR-122 (r_s  = 0.81, P < .001) and miR-29a (r_s  = 0.67, P < .001) showed a significant positive correlation with the stage of fibrosis. MiR-122 concentrations were significantly higher in the CH (P < .01) and LC groups (P < .001) compared to the NL group. MiR-29a concentrations were significantly higher in the CH (P < .001) and LC (P < .001) groups compared to the NL group.

CONCLUSIONS AND CLINICAL IMPORTANCE

Circulating miR-122 and miR-29a concentrations might be useful for monitoring the response to treatment and progression of canine CH.

Proteomic analysis of liver tissue from dogs with chronic hepatitis

Chronic hepatitis is the most common hepatic disease in dogs. Copper accumulation is an important cause of chronic hepatitis in dogs; however, the etiology in most dogs cannot be determined. Clinical signs of chronic hepatitis are often non-specific; therefore, this disease is frequently diagnosed in an advanced stage that makes successful intervention less likely. Early diagnosis of chronic hepatitis in dogs would thus be beneficial. The identification of proteins that are differentially expressed in dogs with chronic hepatitis could contribute to the development of novel diagnostic markers for this disease and provide insight into its pathogenesis. The objective of this study was to identify novel proteins that are differentially expressed in the liver of dogs with chronic hepatitis. Hepatic tissue was collected from 8 healthy dogs during ovariohysterectomy and from 8 dogs with histologically confirmed chronic hepatitis. The proteome of the liver samples was extracted by mechanical disruption and detergent-based cell lysis and differentially labeled prior to analysis by 2-dimensional fluorescence difference gel electrophoresis. Spots with an absolute fold change value > 2.0 were selected for further analysis. Protein identification was achieved by nanoflow liquid chromatography tandem mass spectrometry. Differential expression of select proteins was validated by Western blot. Five protein spots were differentially expressed between patients with chronic hepatitis and healthy control dogs. From these 5 protein spots 11 proteins were identified. Differential expression of cytokeratin 18 and annexin 5 were confirmed by Western blot analysis. Differential protein expression was shown between dogs with chronic hepatitis and healthy control dogs. Upregulation of cytokeratin 18 in chronic hepatitis may suggest increased hepatocellular apoptosis and necrosis, whereas upregulation of annexin 5A suggests increased hepatocellular apoptosis. Further studies are needed to determine whether either protein has diagnostic utility.

Hepatocyte expression and prognostic importance of senescence marker p21 in liver histopathology samples from dogs with chronic hepatitis

BACKGROUND

Chronic hepatitis (CH) occurs commonly in dogs but is associated with a variable and largely unpredictable prognosis. p21, a cell-cycle inhibitor and marker of cellular senescence, is upregulated in human liver disease and is a better prognostic marker than histological or clinical scoring systems.

OBJECTIVE

To quantify hepatocyte p21 immunopositivity in histopathology samples from dogs with CH and determine its association with outcome.

ANIMALS

Twenty-six client-owned dogs with histologically confirmed CH, and 15 dogs with normal liver histology.

METHODS

Medical records and liver histopathology samples were retrospectively reviewed to identify cases of CH. Immunohistochemistry for p21 was performed on all samples and hepatocyte immunopositivity was visually quantified. Relationships between p21 and dog age and dog survival time were statistically evaluated.

RESULTS

Hepatocyte p21 immunopositivity in dogs with CH was high (median percentage of positive hepatocytes: 90%, range: 20%-98%) and exceeded 70% in 23/26 cases with no association with age. In control dogs, p21 immunopositivity was low (≤15% positive hepatocytes in 12/15 cases) and was positively correlated with age (rs  = 0.63; P = .011). Dogs with p21 immunopositivity exceeding 91.8% (upper tercile) had significantly shorter survival compared to dogs with less than 88.9% immunopositivity (lowest tercile; 218 versus 874 days, P = .006). Increasing hepatocyte p21 immunopositivity was significantly negatively associated with survival time (HR 4.12; 95% CI 1.34-12.63; P = .013).

CONCLUSIONS AND CLINICAL IMPORTANCE

Marked p21 immunopositivity in dogs with CH might be indicative of widespread hepatocellular senescence. A significant association with survival time also suggests a potential value for p21 quantification in determining prognosis.

Sensitivity and specificity of microRNA-122 for liver disease in dogs

BACKGROUND

Current tests for diagnosing liver disease in dogs are sub-optimal. MicroRNA-122 (miR-122) is a sensitive and specific biomarker of liver injury in humans and rodents. Circulating miR-122 could have utility in identifying dogs with liver disease.

OBJECTIVE

Establish the reference interval for miR-122 in healthy dogs and determine performance in a range of dog breeds with liver disease and control animals with non-liver disease.

ANIMALS

Stored serum from 120 healthy dogs, 100 dogs with non-liver diseases, and 30 dogs with histologically confirmed liver disease was analyzed.

METHODS

Retrospective study. Medical records of dogs with liver disease, non-liver disease and healthy dogs were reviewed. Serum miR-122 concentrations were measured by PCR and compared with the characteristics of the dogs and their conventional clinical measurements.

RESULTS

In healthy dogs the 2.5th, 50th, and 97.5th quartiles of miR-122 were 110 (90% CI 80-114), 594 (505-682), and 3312 (2925-5144) copies/μL, respectively. There was no difference between healthy dogs and dogs with non-liver disease (median ± IQR: healthy dogs 609 [327-1014] copies/μL; non-liver disease 607 [300-1351] copies/μL). miR-122 was higher in dogs with liver disease (11 332 [4418-20 520] copies/μL, P < .001 compared to healthy dogs). miR-122 identified dogs with liver disease with high accuracy (receiver operating characteristic area under curve for comparison with healthy dogs: 0.93 [95% CI 0.86-0.99]). The upper limit of normal for healthy dogs (3312 copies/μL) had a sensitivity of 77% and specificity of 97% for identifying liver disease.

CONCLUSION AND CLINICAL IMPORTANCE

Liver disease can be sensitively and specifically diagnosed in dogs by measurement of miR-122.

Evaluation of potential serum biomarkers of hepatic fibrosis and necroinflammatory activity in dogs with liver disease

Background

Serum interleukin 6 (IL‐6), chemokine ligand 2 (CCL2), C‐reactive protein (CRP), and the ratio of aspartate transaminase to alanine transaminase (AST:ALT) have been correlated with fibrosis and necroinflammatory activity in humans with various hepatopathies.

Hypothesis/Objectives

To determine whether increases in serum IL‐6, CCL2, CRP, or AST:ALT were associated with moderate to severe fibrosis or necroinflammatory activity in dogs with various hepatopathies.

Animals

Forty‐four client‐owned dogs with clinical evidence of liver disease and 10 healthy purpose‐bred dogs, all undergoing liver biopsies by laparoscopy or laparotomy.

Methods

Measurement of serum IL‐6, CCL2, CRP, AST, and ALT before scheduled liver biopsy and evaluation of liver histopathology using the METAVIR scoring system used in human medicine, blinded to clinical presentation.

Results

Median serum IL‐6 was approximately twice as high in dogs with high fibrosis scores (15.5 pg/mL; range, 1.4 to 235 pg/mL) compared to dogs with low fibrosis scores (7.6 pg/mL; range, 1.4 to 148.1 pg/mL), with marginal significance (P = .05). Median serum CCL2 was significantly higher in dogs with active necroinflammation (444 pg/mL; range, 144 to 896 pg/mL) compared to dogs without detectable necroinflammation (326 pg/mL; range, 59 to 1692 pg/mL; P = .008), but with considerable overlap between groups. Neither serum CRP nor AST:ALT ratios were significantly different based on fibrosis or necroinflammatory scores.

Conclusions and Clinical Importance

Because of substantial variability among dogs, single measurements of IL‐6 and CCL2 have limited diagnostic utility for identifying fibrosis or necroinflammation, respectively, in dogs with various chronic liver diseases. The value of these biomarkers should be explored further in monitoring response to treatment in individual dogs with chronic hepatopathies.