Duration of increased serum alkaline phosphatase activity in dogs receiving different glucocorticoid doses

Prednisolone therapy for chronic hepatitis in English springer spaniels: a prospective study of 12 cases

Background

English springer spaniels (ESS) show an increased risk of chronic hepatitis (CH). In a previous study of 68 ESS with CH, in which only one dog received corticosteroids, a median survival time of 189 days was noted. Some ESS with CH appear to improve with prednisolone treatment; therefore, we aimed to investigate the response to prednisolone in this breed.

Participants

ESS with histologically confirmed idiopathic CH were treated with prednisolone 1–2 mg/kg/day. Nine female and three male ESS were enrolled (median age at diagnosis of five years). Patients were monitored clinically and had biochemistry samples taken to assess markers of hepatocellular damage and function.

Results

The mean starting dose of prednisolone was 1.1 mg/kg/day. All symptomatic patients showed an initial clinical improvement. Two cases were euthanased while receiving prednisolone. The median time since diagnosis is 1715 days (range: 672–2105 days) and the remaining patients are clinically well, with seven patients still receiving a mean dose of 0.4 mg/kg prednisolone every other day. Statistical analysis demonstrated significant (P<0.05) reductions in serum alkaline phosphatase, alanine aminotransferase and bilirubin following 2–4 weeks of prednisolone treatment.

Conclusion

This study demonstrates improved clinical and biochemical parameters when some ESS with CH are managed with prednisolone and standard supportive treatments.

Pneumatosis Coli in a Dog

The objective of this report is to document a case of pneumatosis coli in an immunosuppressed dog successfully treated with supportive care that included hyperbaric oxygen. A 9 yr old, neutered male Maltese was presented for hematochezia of ∼36 h duration. The dog had a history of immune-mediated thrombocytopenia that was well managed with prednisone and azathioprine. Initial evaluation was unremarkable except for increased rectal temperature and hematochezia on digital rectal examination. Abdominal radiographs revealed diffuse gas within the colonic wall consistent with pneumatosis coli. Scant-free air was also appreciated in the peritoneal and retroperitoneal cavities. The dog was managed for 4 days in hospital with broad spectrum antibiotic, anthelminthic, and gastroprotectant therapy. He received one session of hyperbaric oxygen therapy while in hospital. Repeat abdominal radiographs after 72 hr of medical management showed improvement of the pneumatosis coli. After 4 days of hospitalization, he was discharged with resolution of clinical signs. Pneumatosis coli is rarely diagnosed in dogs but should be considered in cases with clinical signs of colorectal disease.

Changes in the Canine Plasma Lipidome after Short- and Long-Term Excess Glucocorticoid Exposure

Glucocorticoids (GCs) are critical regulators of metabolic control in mammals and their aberrant function has been linked to several pathologies. GCs are widely used in human and veterinary clinical practice as potent anti-inflammatory and immune suppressive agents. Dyslipidaemia is a frequently observed consequence of GC treatment, typified by increased lipolysis, lipid mobilization, liponeogenesis, and adipogenesis. Dogs with excess GC show hyperlipidaemia, hypertension, and a higher risk of developing type 2 diabetes mellitus, but the risk of developing atherosclerotic lesions is low as compared to humans. This study aimed to examine alterations in the canine plasma lipidome in a model of experimentally induced short-term and long-term GC excess. Both treatments led to significant plasma lipidome alterations, which were more pronounced after long-term excess steroid exposure. In particular, monohexosylceramides, phosphatidylinositols, ether phosphatidylcholines, acyl phosphatidylcholines, triacylglycerols and sphingosine 1-phosphates showed significant changes. The present study highlights the hitherto unknown effects of GCs on lipid metabolism, which will be important in the further elucidation of the role and function of GCs as drugs and in metabolic and cardiovascular diseases.

Body weight, blood pressure, and systemic changes following low-dosage prednisolone administration in dogs

OBJECTIVE To investigate systemic changes following low-dosage prednisolone administration in dogs. ANIMALS 4 healthy purpose-bred adult male Beagles. PROCEDURES Dogs were administered prednisolone PO at a dosage of 2 mg/kg/d for 2 weeks, 1 mg/kg/d for 4 weeks, and 0.5 mg/kg/d for 3 weeks. Body weight, blood pressure, hepatic size and echogenicity, percentage of vacuolated hepatocytes, serum hepatic enzyme activities and glucose concentration, adrenal gland size, and pancreatic echogenicity were evaluated weekly for 9 weeks. RESULTS The only significant change identified was an increase in hepatic echogenicity, assessed by measuring liver-kidney contrast on ultrasonographic images. Increases in hepatic size and percentage of vacuolated hepatocytes were identified, but values did not differ from baseline values. Similarly, serum hepatic enzyme activities increased, but changes were mild and not significantly different from baseline values. Body weight, pancreatic echogenicity, and serum glucose concentration did not show noticeable changes. Mild systemic hypertension was seen, but blood pressure was not significantly different from the baseline value. Similarly, adrenal gland size steadily decreased during the first 6 weeks and increased again after the prednisolone dosage was decreased to 0.5 mg/kg/d. However, mean adrenal gland size was not significantly different from the baseline value at any time. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in dogs, administration of prednisolone at a low dosage was associated with minimal systemic effects.

Alkaline phosphatase: beyond the liver

The alkaline phosphatases comprise a heterogeneous group of enzymes that are widely distributed in mammalian cells. They often are associated with cell membranes, but their exact physiologic function is unknown. Despite this, alkaline phosphatase activity is a very useful serum biochemical indicator of liver disease, particularly cholestatic disease. However, increases in the activity of alkaline phosphatase in serum and other body fluids may reflect physiologic or pathologic changes beyond those of hepatic origin. For example, nonhepatic increases in serum alkaline phosphatase activity are found in young animals, in pregnant and lactating females, and in association with high fat diets. Bone disease, endocrine disease, neoplasia, and other disorders can result in increased alkaline phosphatase activity. In addition, alkaline phosphatase activity may be increased due to induction by certain drugs such as glucocorticoids and anticonvulsants. In this article, we will review the physiologic and pathologic factors influencing the activity of alkaline phosphatase in serum and other body fluids, with an emphasis on disorders beyond liver disease.

Effects of otic betamethasone on intradermal testing in normal dogs

Otitis externa is common in atopic dogs and is frequently treated using potent glucocorticoids topically. These preparations can cause adrenal suppression and affect skin test reactivity. The purpose of this study was to determine if an otic product containing betamethasone could decrease skin reactivity in normal dogs. Sixteen laboratory beagles were used in a cross-over, blinded trial. Dogs were enrolled in two groups; one received placebo and the other a betamethasone-containing otic preparation (Otomax) twice daily for 2 weeks. After a 4-week wash-out period, treatments were switched. Dogs were intradermally tested on days 0 and 14 of each treatment period with histamine phosphate (1 : 100,000 and 1 : 200,000 w/v) and allergens common in the area. Adrenocorticotropic hormone (ACTH) stimulation tests were done before and after treatment to investigate adrenal suppression. After 2 weeks of otic betamethasone, Dermatophagoides farinae (P = 0.0034), Cynodon dactylon (P = 0.0459) and histamine 1 : 100,000 w/v (P = 0.0028) reactions were significantly reduced. Pre-treatment post-ACTH serum cortisol levels and those obtained after both treatments did not differ statistically (P = 0.6362). Betamethasone induced a slight but statistically significant elevation (P = 0.0002) of serum alkaline phosphatase. Despite the increase, values were within normal range. It is concluded that, although otic betamethasone did not suppress adrenal glands, it mildly suppressed intradermal reactions to 1 : 100,000 w/v histamine, D. farinae and C. dactylon.

Effects of different glucocorticoid treatments on serum acute phase proteins in dogs

The serum concentrations of haptoglobin, caeruloplasmin, C-reactive protein and serum amyloid A were measured in three groups of seven healthy dogs. Group 1 received a single dose of 1.1 mg/kg methylprednisolone acetate, administered subcutaneously; group 2 received 1 mg/kg per day of prednisone administered orally for three weeks; and group 3 received 2.2 mg/kg per day of prednisone administered orally for seven days. Before the administration of the glucocorticoids the serum concentrations of all the acute phase proteins were within the authors' laboratory reference ranges. After the administration of the drugs there were significant increases in the concentration of haptoglobin in all three groups, the increases being larger in groups 2 and 3. In contrast, the concentrations of C-reactive protein, caeruloplasmin and serum amyloid A were not affected.