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Cerquetella M, Mangiaterra S, Pinnella F, Rossi G, Marchegiani A, Gavazza A, Serri E, Di Cerbo A, Marini C, Cecconi D, Sorio D, Marchetti V, Vincenzetti S. Fecal Proteome Profile in Dogs Suffering from Different Hepatobiliary Disorders and Comparison with Controls. Animals (Basel) 2023; 13:2343. [PMID: 37508119 PMCID: PMC10376375 DOI: 10.3390/ani13142343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
In the present study, the fecal proteomes of clinically healthy dogs (HD = n. 10), of dogs showing clinical, ultrasonographic, and/or laboratory evidence of different hepatobiliary dysfunction (DHD = n. 10), and of dogs suffering from chronic hepatitis (CHD = n. 10) were investigated with an Ultimate 3000 nanoUPLC system, coupled to an Orbitrap Fusion Lumos Tribrid mass spectrometer. Fifty-two different proteins of canine origin were identified qualitatively in the three study groups, and quantitative differences were found in 55 proteins when comparing groups. Quantitatively, a total of 41 and 36 proteins were found differentially abundant in the DHD and CHD groups compared to the control HD, and 38 proteins resulted dysregulated in the CHD group as compared to the DHD group. Among the various proteins, differently abundant fecal fibronectin and haptoglobin were more present in the feces of healthy and DHD dogs than in chronic ones, leading us to hypothesize its possible diagnostic/monitoring role in canine chronic hepatitis. On the other hand, the trefoil factor 2 was increased in DHD dogs. Our results show that the analysis of the fecal proteome is a very promising field of study, and in the case of dogs suffering from different hepatobiliary disorders, it was able to highlight both qualitative and quantitative differences among the three groups included. Results need to be confirmed with western blotting and in further studies.
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Affiliation(s)
- Matteo Cerquetella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Sara Mangiaterra
- Futuravet Veterinary Referral Center, 62029 Tolentino, MC, Italy
| | - Francesco Pinnella
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Giacomo Rossi
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Andrea Marchegiani
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Alessandra Gavazza
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Evelina Serri
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Alessandro Di Cerbo
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Carlotta Marini
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
| | - Daniela Cecconi
- Department of Biotechnology, University of Verona, Strada le Grazie 15, 37134 Verona, VR, Italy
| | - Daniela Sorio
- Centre for Technological Platforms (CPT), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, VR, Italy
| | - Veronica Marchetti
- Department of Veterinary Sciences, University of Pisa, Via Livornese, San Piero a Grado, 56122 Pisa, PI, Italy
| | - Silvia Vincenzetti
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Circonvallazione 93/95, 62024 Matelica, MC, Italy
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2
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Roizen JD, Levine MA. Vitamin D Therapy and the Era of Precision Medicine. J Clin Endocrinol Metab 2020; 105:dgz120. [PMID: 31665328 PMCID: PMC7112971 DOI: 10.1210/clinem/dgz120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 10/10/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Jeffrey D Roizen
- Division of Endocrinology and Diabetes, The Children’s Hospital of Philadelphia and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Michael A Levine
- Division of Endocrinology and Diabetes, The Children’s Hospital of Philadelphia and the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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3
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Kather S, Grützner N, Kook PH, Dengler F, Heilmann RM. Review of cobalamin status and disorders of cobalamin metabolism in dogs. J Vet Intern Med 2019; 34:13-28. [PMID: 31758868 PMCID: PMC6979111 DOI: 10.1111/jvim.15638] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/25/2019] [Indexed: 12/04/2022] Open
Abstract
Disorders of cobalamin (vitamin B12) metabolism are increasingly recognized in small animal medicine and have a variety of causes ranging from chronic gastrointestinal disease to hereditary defects in cobalamin metabolism. Measurement of serum cobalamin concentration, often in combination with serum folate concentration, is routinely performed as a diagnostic test in clinical practice. While the detection of hypocobalaminemia has therapeutic implications, interpretation of cobalamin status in dogs can be challenging. The aim of this review is to define hypocobalaminemia and cobalamin deficiency, normocobalaminemia, and hypercobalaminemia in dogs, describe known cobalamin deficiency states, breed predispositions in dogs, discuss the different biomarkers of importance for evaluating cobalamin status in dogs, and discuss the management of dogs with hypocobalaminemia.
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Affiliation(s)
- Stefanie Kather
- Department for Small Animals, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Niels Grützner
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Peter H Kook
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Franziska Dengler
- Institute of Veterinary Physiology, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Romy M Heilmann
- Department for Small Animals, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany.,School of Veterinary Science, Massey University, Palmerston North, New Zealand
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4
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Kook PH, Hersberger M. Daily oral cyanocobalamin supplementation in Beagles with hereditary cobalamin malabsorption (Imerslund-Gräsbeck syndrome) maintains normal clinical and cellular cobalamin status. J Vet Intern Med 2018; 33:751-757. [PMID: 30554416 PMCID: PMC6430909 DOI: 10.1111/jvim.15380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/13/2018] [Indexed: 12/25/2022] Open
Abstract
Background Efficacy of PO cobalamin (Cbl) supplementation in dogs with hereditary Cbl malabsorption (Imerslund‐Gräsbeck syndrome, IGS) is unknown. Objectives To evaluate PO Cbl supplementation in Beagles with IGS previously treated parenterally. We hypothesized that 1 mg cyano‐Cbl daily PO would maintain clinical and metabolic remission. Animals Three client‐owned Beagles with IGS and 48 healthy control dogs. Methods Prospective study. Daily PO cyanocobalamin (cyano‐Cbl; 1 mg) supplementation was monitored for 13 (2 dogs) and 8 months (1 dog). Health status was assessed by owner observations. Methylmalonic acid (MMA)‐to‐creatinine concentrations were measured using an ultra‐performance liquid chromatography‐tandem mass spectrometry (UPLC‐TMS) method on urine samples collected monthly. Concurrent measurements of serum MMA concentration (n = 7; UPLC‐TMS) were available for 1 dog. Results All dogs remained in excellent health during PO supplementation. Urine MMA remained consistently low in 2 dogs (median, 2.5 mmol/mol creatinine; range, 1.2‐9; healthy dogs [n = 30], median, 2.9 mmol/mol creatinine; range, 1.3‐76.5). Urine MMA ranged from 38.9‐84.9 mmol/mol creatinine during the first 6 months in 1 dog already known to excrete comparable amounts when supplemented parenterally. Brief antibiotic treatment for an unrelated condition after 6 months resulted in low urine MMA (median, 2.8 mmol/mol creatinine; range, 1.9‐4.8) for the next 7 months. All concurrent serum MMA concentrations (median, 651 nmol/L; range, 399‐919) before and after month 6 were within the established reference interval (393‐1476 nmol/L; n = 48). Conclusions and Clinical Importance One milligram of cyano‐Cbl daily PO appears efficacious for maintaining normal clinical status and normal cellular markers of Cbl metabolism in Beagles with IGS.
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Affiliation(s)
- Peter H Kook
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Martin Hersberger
- Department of Clinical Chemistry, University Children's Hospital Zurich, Zurich, Switzerland
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Toresson L, Steiner JM, Spodsberg E, Olmedal G, Suchodolski JS, Lidbury JA, Spillmann T. Effects of oral versus parenteral cobalamin supplementation on methylmalonic acid and homocysteine concentrations in dogs with chronic enteropathies and low cobalamin concentrations. Vet J 2018; 243:8-14. [PMID: 30606444 DOI: 10.1016/j.tvjl.2018.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 01/02/2023]
Abstract
The objective of this study was to compare the effects of parenteral (PE) versus oral (PO) cobalamin supplementation on serum methylmalonic acid (MMA) and homocysteine (HCY) concentrations in dogs with hypocobalaminaemia. Thirty-six dogs with serum cobalamin concentrations below 285ng/L (reference interval (RI): 244-959ng/L) were treated with PO (0.25-1.0mg daily) or PE cobalamin (0.25-1.2mg/injection) using a block-randomized schedule. Serum MMA and HCY concentrations were analysed at day 0, 28 and 90 after start of supplementation. There was no significant difference between the PO and PE group regarding serum MMA or HCY concentrations at any time point. Median (range, P comparing baseline and 28 days, P comparing 28days and 90 days) serum MMA concentrations (nmol/L; RI 415-1193) were 932 (566-2468) in the PO and 943 (508-1900) in the PE group at baseline, respectively, 705 (386-1465, P<0.0001) and 696 (377-932, P<0.0001) after 28 days, and 739 (450-1221, P=0.58) and 690 (349-1145, P=0.76) after 90 days. Serum HCY concentrations (median (range), P comparing baseline and 28 days, P comparing 28days and 90 days, μmol/L; RI 5.9-31.9) in the PO and PE groups were 12.2 (3.3-62.2) and 8.4 (3.7-34.8) at baseline, 12.5 (5.0-45.0, P=0.61) and 8.0 (3.8-18.3, P=0.28) after 28 days, and 17.7 (7.3-60.0 P=0.07) and 12.4 (6.3-33.1, P=0.0007) after 90 days, respectively. Oral and parenteral cobalamin supplementation had the same effect on serum MMA concentrations in this group of dogs.
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Affiliation(s)
- L Toresson
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, Agnes Sjobergin katu 2, 00014 Helsinki, Finland; Evidensia Specialist Animal Hospital, Bergavagen 3, 25466 Helsingborg, Sweden.
| | - J M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| | - E Spodsberg
- Evidensia Specialist Animal Hospital, Bergavagen 3, 25466 Helsingborg, Sweden
| | - G Olmedal
- Evidensia Specialist Animal Hospital, Bergavagen 3, 25466 Helsingborg, Sweden
| | - J S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| | - J A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
| | - T Spillmann
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, Helsinki University, Agnes Sjobergin katu 2, 00014 Helsinki, Finland
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Kook PH, Reusch CE, Hersberger M. Prospective long-term evaluation of parenteral hydroxocobalamin supplementation in juvenile beagles with selective intestinal cobalamin malabsorption (Imerslund-Gräsbeck syndrome). J Vet Intern Med 2018; 32:1033-1040. [PMID: 29572946 PMCID: PMC5980559 DOI: 10.1111/jvim.15090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/24/2018] [Accepted: 01/31/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Prospective studies on maintenance treatment for Beagles with hereditary selective cobalamin (Cbl) malabsorption (Imerslund-Gräsbeck syndrome, IGS) are lacking. In our experience, measurement of methylmalonic acid (MMA), a Cbl-dependent metabolite, seems more helpful to monitor Cbl status as compared with serum Cbl concentrations. OBJECTIVES To evaluate a standardized Cbl supplementation scheme in Beagles with IGS. We hypothesized that a single parenteral dose of 1 mg hydroxocobalamin (OH-Cbl) would maintain clinical and metabolic remission for up to 2 months. ANIMALS Six client-owned juvenile Beagles with genetically confirmed IGS and 28 healthy control dogs. METHODS Prospective study. Monthly IM OH-Cbl (1 mg) supplementation was done over a median of 9 months (range, 6-13) in 6 dogs, followed by bimonthly (every 2 months) injections in 5 dogs over a median of 6 months (range, 3-10). Health status was assessed by routine clinical examinations at injection time points and owner observations. Voided urine samples were collected immediately before OH-Cbl injections for measurement of MMA-to-creatinine concentrations using a gas-liquid chromatography-tandem mass spectrometry (GC-MS) method. RESULTS All dogs were clinically healthy while receiving monthly and bimonthly OH-Cbl supplementation. Urinary MMA results in healthy dogs ranged from 1.3 to 76.5 mmol/mol creatinine (median, 2.9). Median urinary MMA concentrations did not differ between dogs with IGS receiving monthly (n = 49; 5.3 mmol/mol creatinine; range, 2.3-50.4) and bimonthly (n = 31; 5.3 mmol/mol creatinine; range, 1.6-50) injections. CONCLUSIONS AND CLINICAL IMPORTANCE A maintenance parenteral dose of 1 mg OH-Cbl monthly or bimonthly appears adequate in Beagles with IGS monitored by metabolic testing.
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Affiliation(s)
- Peter Hendrik Kook
- Department for Small Animals, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, Switzerland
| | - C E Reusch
- Department for Small Animals, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, Switzerland
| | - M Hersberger
- Department of Clinical Chemistry, University Children's Hospital Zurich, Zurich, Switzerland
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McCallum KE, Watson PJ. Hereditary selective cobalamin malabsorption and concurrent pancreatitis in a young Border collie. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2017-000568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Penny J Watson
- Department of Veterinary MedicineCambridge Veterinary SchoolCambridgeUK
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Carloni A, Paninarova M, Cavina D, Romanucci M, Salda LD, Teodori S, Vignoli M. Negative hepatic computed tomographic attenuation pattern in a dog with vacuolar hepatopathy and hepatic fat accumulation secondary to cushing's syndrome. Vet Radiol Ultrasound 2017; 60:E54-E57. [PMID: 28994151 DOI: 10.1111/vru.12568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 07/28/2017] [Accepted: 08/04/2017] [Indexed: 12/27/2022] Open
Abstract
This report describes an unusual computed tomographic (CT) hepatic pattern, characterized by negative attenuation values (from -19.59 to -28.85 Hounsfield Units, HU) in a canine patient with severe Cushing's syndrome. Attenuation values of the splenic parenchyma (63.26 HU) and abdominal fat (-118.34 HU) were within normal limits. The negative hepatic attenuation values allowed a CT diagnosis of severe hepatic fatty infiltration that was subsequently confirmed by tissue-core biopsy and histopathological examination.
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Affiliation(s)
- Andrea Carloni
- Veterinary Hospital "I Portoni Rossi", Zola Predosa (BO), 40069, Italy
| | | | - Damiano Cavina
- Veterinary Clinic Modena Sud, Spilamberto (MO), 41057, Italy
| | - Mariarita Romanucci
- Diagnostic Imaging (Vignoli) & Pahology (Della Salda, Romanucci), University of Teramo, Piano d'Accio (TE), 64100, Italy
| | - Leonardo Della Salda
- Diagnostic Imaging (Vignoli) & Pahology (Della Salda, Romanucci), University of Teramo, Piano d'Accio (TE), 64100, Italy
| | - Simone Teodori
- Veterinary Clinic Modena Sud, Spilamberto (MO), 41057, Italy
| | - Massimo Vignoli
- Diagnostic Imaging (Vignoli) & Pahology (Della Salda, Romanucci), University of Teramo, Piano d'Accio (TE), 64100, Italy
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Erles K, Mugford A, Barfield D, Leeb T, Kook PH. Systemic Scedosporium prolificans infection in an 11-month-old Border collie with cobalamin deficiency secondary to selective cobalamin malabsorption (canine Imerslund-Gräsbeck syndrome). J Small Anim Pract 2017; 59:253-256. [PMID: 28390190 DOI: 10.1111/jsap.12678] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/09/2016] [Accepted: 09/17/2016] [Indexed: 11/28/2022]
Abstract
An 11-month-old Border collie presented collapsed and continued to deteriorate rapidly despite supportive treatment. The dog had a history of failure to thrive and recurring respiratory infection. Laboratory abnormalities included neutrophilic leucocytosis, Heinz body anaemia, hyperammonaemia, hyperbilirubinaemia, proteinuria and hypocobalaminaemia. Post-mortem examination revealed multi-focal necrosis within the heart, kidneys, pancreas, liver, meninges and cerebral cortex. Fungal hyphae in lesions were identified as Scedosporium prolificans following culture. Subsequent genotyping confirmed that the dog carried the CUBN:c.8392delC mutation in a homozygous state, verifying hereditary cobalamin deficiency (a.k.a. Imerslund-Gräsbeck syndrome). Cobalamin deficiency may have been a predisposing factor for the development of systemic fungal infection in this dog.
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Affiliation(s)
- K Erles
- Department of Pathology and Pathogen Biology, The Royal Veterinary College, Hatfield AL9 7TA, UK
| | - A Mugford
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield AL9 7TA, UK
| | - D Barfield
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield AL9 7TA, UK
| | - T Leeb
- Institute of Genetics, Vetsuisse Faculty, University of Berne, 3012 Berne, Switzerland
| | - P H Kook
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
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Murtagh K, Batchelor D, German A, Piviani M, Silvestrini P. Congenital cobalamin malabsorption (Imerslund‐Gräsbeck syndrome) in two Beagles in the UK. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kevin Murtagh
- Internal Medicine DepartmentSmall Animal Teaching HospitalLeahurst campusUniversity of LiverpoolNestonUK
| | - Daniel Batchelor
- Internal Medicine DepartmentSmall Animal Teaching HospitalLeahurst campusUniversity of LiverpoolNestonUK
| | - Alex German
- Internal Medicine DepartmentSmall Animal Teaching HospitalLeahurst campusUniversity of LiverpoolNestonUK
| | - Martina Piviani
- Clinical pathology and Clinical skills DepartmentSmall Animal Teaching HospitalLeahurst campusUniversity of LiverpoolNestonUK
| | - Paolo Silvestrini
- Internal Medicine DepartmentSmall Animal Teaching HospitalLeahurst campusUniversity of LiverpoolNestonUK
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11
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Kook PH, Drögemüller M, Leeb T, Hinden S, Ruetten M, Howard J. Hepatic fungal infection in a young beagle with unrecognised hereditary cobalamin deficiency (Imerslund-Gräsbeck syndrome). J Small Anim Pract 2014; 56:138-41. [PMID: 25131805 DOI: 10.1111/jsap.12251] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 05/16/2014] [Accepted: 06/07/2014] [Indexed: 12/24/2022]
Abstract
A 12-month-old beagle presented for anorexia, pyrexia and vomiting. The dog had been treated intermittently with antibiotics and corticosteroids for inappetence and lethargy since five months of age. Previous laboratory abnormalities included macrocytosis and neutropenia. At presentation, the dog was lethargic, febrile and thin. Laboratory examination findings included anaemia, a left shift, thrombocytopenia, hypoglycaemia and hyperbilirubinaemia. Multiple, small, hypoechoic, round hepatic lesions were observed on abdominal ultrasound. Cytological examination of hepatic fine needle aspirates revealed a fungal infection and associated pyogranulomatous inflammation. The dog's general condition deteriorated despite supportive measures and treatment with fluconazole, and owners opted for euthanasia before hypocobalaminaemia was identified. Subsequent genomic analysis revealed a CUBN:c.786delC mutation in a homozygous state, confirming hereditary cobalamin malabsorption (Imerslund-Gräsbeck syndrome). Similar to human infants, dogs with Imerslund-Gräsbeck syndrome may rarely be presented for infectious diseases, distracting focus from the underlying primary disorder.
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Affiliation(s)
- P H Kook
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, 8057, Zurich, Switzerland
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