A syndrome of hepatogenous photosensitisation, resembling geeldikkop, in sheep grazing Tribulus terrestris

The aetiology, prevalence and morbidity of outbreaks of photosensitisation in livestock: A review

BACKGROUND

Photosensitisation is a clinical condition occurring in both humans and animals that causes significant injury to affected individuals. In livestock, outbreaks of photosensitisation caused by ingestion of toxic plants are relatively common and can be associated with significant economic loss.

OBJECTIVES

The agents that are most commonly implicated in outbreaks of photosensitisation have not been formally investigated on a global scale. To address this question, a systematic review of the literature was undertaken to determine the most common causative agents implicated in outbreaks of photosensitisation in livestock in Australia and globally, as well as the prevalence and morbidity of such outbreaks.

METHODS

A systematic database search was conducted to identify peer-reviewed case reports of photosensitisation in livestock published worldwide between 1900 and April 2018. Only case reports with a full abstract in English were included. Non peer-reviewed reports from Australia were also investigated. Case reports were then sorted by plant and animal species, type of photosensitisation by diagnosis, location, morbidity and mortality rate and tabulated for further analysis.

RESULTS

One hundred and sixty-six reports qualified for inclusion in this study. Outbreaks were reported in 20 countries. Australia (20), Brazil (20) and the United States (11) showed the highest number of peer-reviewed photosensitisation case reports from this analysis. Hepatogenous (Type III) photosensitisation was the most frequently reported diagnosis (68.5%) and resulted in higher morbidity. Panicum spp., Brachiaria spp. and Tribulus terrestris were identified as the most common causes of hepatogenous photosensitisation globally.

CONCLUSIONS

Hepatogenous photosensitisation in livestock represents a significant risk to livestock production, particularly in Australia, Brazil, and the United States. Management of toxic pastures and common pasture weeds may reduce the economic impact of photosensitisation both at a national and global level.

STEROIDAL SAPONIN TOXICITY IN EASTERN GREY KANGAROOS ( MACROPUS GIGANTEUS): A NOVEL CLINICOPATHOLOGIC PRESENTATION OF HEPATOGENOUS PHOTOSENSITIZATION

We describe the clinicopathologic features of a mortality event characterized by blindness and dermatitis affecting eastern grey kangaroos ( Macropus giganteus), secondary to hepatogenous photosensitization. Affected animals exhibited photophobic behavior, blindness, ataxia, recumbency, lethargy, ear shaking, and behavior consistent with distress or depression. The photophobia manifested as abnormal shade-seeking during the day, including finding refuge under or in structures used frequently by people. Severely affected kangaroos were jaundiced and had markedly elevated serum bilirubin and gamma glutamyl-transpeptidase concentrations. Blindness in affected animals was attributed to moderate to severe corneal opacity due to corneal edema and inflammation. Skin lesions were typically subtle on gross examination even in cases which had severe necrotizing dermatitis histologically. Histologic lesions in the liver of affected animals included the presence of acicular clefts typical of steroidal saponins. The outbreak was associated with pasture dominated by the invasive grass, Panicum gilvum, which is a recognized source of saponin-induced photosensitization in livestock.

Acute-onset high-morbidity primary photosensitisation in sheep associated with consumption of the Casbah and Mauro cultivars of the pasture legume Biserrula

Background

Primary photosensitisation (PS) subsequent to ingestion of the pasture legume Biserrula pelecinus L. (biserrula) has recently been confirmed in grazing livestock. Given the potential utility of this pasture species in challenging climates, a grazing trial was undertaken to examine if both varieties ‘Casbah’ and ‘Mauro’ were able to cause photosensitisation in livestock, and if this could be mitigated by grazing in winter, or in combination with other common pasture species.

Results

A controlled grazing trial was undertaken in winter in Australia with plots containing a dominant pasture of Biserrula pelecinus L. cv. ‘Casbah’ or ‘Mauro’, or mixed biserrula/perennial ryegrass populations. A photosensitisation grading system was established. 167 prime meat ewe lambs were introduced to the plots and monitored twice daily. Mild clinical signs were observed at 72 h on pasture. All animals were removed from biserrula dominant stands at this point. Four animals grazing ‘Casbah’ dominant pasture rapidly proceeded to severe photosensitisation in the following 12 h. Animals remaining on mixed biserrula/ryegrass stands did not exhibit severe PS but showed an 89% incidence of mild to moderate photosensitisation over the following 14 days. Animals on mixed lucerne showed significantly lower PS score than animals grazing biserrula varieties of any composition. The trial was halted at 14 days as only plots with low biserrula proportion still contained unaffected animals.

Necropsy revealed severe multifocal erythematous ulcerations and alopecia of the ear pinnae, severe bilateral periorbital and conjunctival oedema and variably severe subcutaneous facial oedema. No evidence of hepatopathy was present. A diagnosis of acute unseasonal primary photosensitisation caused by biserrula ingestion with no other underlying pathology was confirmed.

Conclusions

We report an unseasonal outbreak of acute photosensitisation in sheep grazing Biserrula pelecinus L cvs.’Casbah’ and ‘Mauro’ with exceedingly high morbidity. A grading system is also proposed as a tool for objective and consistent clinical appraisal of future PS outbreaks. This finding expands our definition of seasonal and temporal risk periods for biserrula photosensitisation, and is the first to identify that both commercial cultivars of biserrula can cause primary photosensitisation in sheep.

Hepatotoxicity effect of some Iranian medicinal herbal formulation on rats

Background:

The public conviction that ‘herbal remedies are safe’ has led to an increased consumption of these products. This study was performed in view of the wide distribution of herbal remedies, the risks posed by self-treatment with these products, and the existing reports about the toxic effects of some medicinal herbs.

Materials and Methods:

In this study the effect of some of the most used herbal drops of A, B, C, and D on the liver function of rats was examined at different doses, namely minimum dose, maximum dose, and 2.5 times the maximum dose indicated in the brochures. The rats were administered the said doses via a feeding tube for 50 days. The liver function parameters including aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), total serum protein, albumin, and urea were measured using the spectrophotometric method.

Results:

The animals’ liver tissues were examined pathologically. The A drop did not change the liver function parameters significantly. The B drop increased the LDH by 34% compared to the controls, at the maximum administered dose. The C and D drops increased the ALT, AST, and LDH significantly compared to the controls. The histological findings suggest the possible effect of C and D drops on the function of hepatocytes.

Conclusions:

We recommend that the herbal formulations available in pharmaceutical markets be more closely controlled in terms of quality, as well as toxicity, especially with regard to the possible effects on the hepatic function.

Crystal-associated cholangiopathy in sheep grazing Brachiaria decumbens containing the saponin protodioscin

An outbreak of hepatogenous photosensitization is reported in a flock of 28 sheep grazing Brachiaria decumbens in Mato Grosso do Sul State, Central-Western Brazil. Seven lambs and an adult sheep were affected and 6 of them died. Two surviving affected lambs and one lamb without clinical signs had increased serum values of gamma glutamyltransferase, bilirubin, and cholesterol. In two adult unaffected sheep those parameters were within normal values. An adult sheep submitted to necropsy presented moderate body condition, unilateral corneal opacity, drying of the muzzle, moderate jaundice, increased lobular pattern of the liver, and a distended gallbladder. Histological lesions were epithelial degeneration, necrosis, and hyperplasia of small bile ducts. Mild amounts of foamy macrophages were observed, mainly in the centroacinar zone. Diffuse swelling and vacuolation were observed in hepatocytes. Crystal negative images were found within bile ducts, foamy macrophages, and the lumen of some renal tubules. The heart showed multifocal areas of degeneration and necrosis of the muscle fibers. Pasture samples (Brachiaria decumbens) contained 2.36% of protodioscin. No Pithomyces chartarum spores were found in the pasture. Samples from a similar neighboring B. decumbens pasture grazed by cattle without photosensitization contained 1.63% of protodioscin isomers. Outbreaks of photosensitization caused by Brachiaria spp. are common in cattle in the Brazilian Cerrado (savanna) with about 51 million hectares of Brachiaria spp pastures. Sheep farming has been recently developed in this region, and the number of sheep is increasing significantly. Because sheep are more susceptible than cattle to lithogenic saponins, poisoning by Brachiaria should be an important limiting factor for the sheep industry.

Experimental Tribulus terrestris poisoning in sheep: clinical, laboratory and pathological findings

Eleven native sheep, 1-2 years old, of both sexes were randomly divided into two groups, 6 sheep being allocated to the experimental group and 5 serving as controls. The sheep in the experimental group were fed 80% Tribulus terrestris and 20% alfalfa hay and wheat straw, while the control sheep were given a mixture of 40% alfalfa hay and 60% wheat straw. Clinical signs of hepatogenous photosensitivity were observed from day 11, including reddening and crust formation on the muzzle, nose, ears and eyelids, depression, weight loss, icterus, conjunctivitis, and yellow discoloration of the urine. Laboratory findings on weekly samples indicated significant differences (p < 0.05) in white blood cell count, total plasma protein and fibrinogen, total and direct bilirubin, blood urea nitrogen and creatinine concentrations, and aspartate aminotransferase and alkaline phosphatase activities. There were no significant differences in the packed cell volume, in the neutrophil, lymphocyte or eosinophil counts, or in the serum calcium, phosphorus, potassium, sodium or chloride concentrations. At necropsy of the experimental animals, there were various degrees of generalized icterus and the livers were swollen and discolored by bile pigment. Histopathological examination revealed varying amounts of crystalloid material in the bile ducts and renal tubules, hepatocellular degeneration, biliary fibrosis and proliferation, renal tubular necrosis and focal necrosis of cardiac muscle.

Inventory of plants used in traditional medicine in Somalia. IV. Plants of the families Passifloraceae-Zygophyllaceae

Thirty-seven plants are listed, which are used by traditional healers in the central and southern parts of Somalia. For each species are listed: the botanical name with synonyms, collection number, vernacular name, medicinal use, preparation of remedy and dosage. Results of a literature survey are also reported including medicinal use, substances isolated and pharmacological effects. Three plants which should have been included in Part I of the series have been added and some corrections to that paper have been made. With these additions the series comprises 180 different plant species, distributed in 59 plant families.

Photosensitisation and crystal-associated cholangiohepatopathy in sheep grazing Brachiaria decumbens

Two outbreaks of photosensitivity and jaundice in sheep grazing the grass, Brachiaria decumbens. In West Java in 1983 and 1983 and 1990 are described. Aggregates of acicular clefts and crystals were present in bile canaliculi, bile ducts, Kupffer cells, hepatocytes and in kidney tubules. The number of crystals increased with the length of exposure to the plant and sheep that died had the largest accumulations. These crystalline structures have been reported before in this syndrome, but are similar to those seen in Tribulus terrestris and Panicum spp toxicities.

Crystal-associated cholangiohepatopathy and photosensitisation in lambs

Four outbreaks of hepatogenous photosensitisation occurred in weaned lambs in north eastern Victoria during the summers of 1985 and 1986. Attack rates varied between 7% and 43% and case fatality rates between 60% and 71%. Clinical signs included photosensitisation and jaundice. Serum biochemistry suggested hepatobiliary and hepatoparenchymal damage with impaired renal function. At necropsy livers were an ochre colour and kidneys a mottled brown to khaki. Histopathologically, needle-shaped to lenticular clefts were observed in and around bile ducts and in hepatocytes, hepatic sinusoidal macrophages and renal tubules. Optically active rhomboidal crystals were present in bile sediments. Panicum schinzii was identified as a possible cause in 2 of the 4 outbreaks. The clinical disease was reproduced in 2 of 6 lambs grazed on a toxic paddock. The disease was indistinguishable from geeldikkop except for the fact that Tribulus terrestris was not present on any of the 4 farms.