A review of the hepatotoxic plant Lantana camara

Lantana (Lantana camara Linn) is a noxious weed that grows in many tropical and subtropical parts of the world. Ingestion of lantana foliage by grazing animals causes cholestasis and hepatotoxicity. Both ruminants and nonruminant animals such as guinea pigs, rabbits, and female rats are susceptible to the hepatotoxic action of lantana toxins. The hepatotoxins are pentacyclic triterpenoids called lantadenes. Molecular structure of lantadenes has been determined. Green unripe fruits of the plant are toxic to humans. Lantana spp. exert allelopathic action on the neighboring vegetation. The allelochemicals have been identified as phenolics, with umbelliferone, methylcoumarin, and salicylic acid being the most phytotoxic. In addition to phenolics, a recent report indicates lantadene A and B as more potent allelochemicals. Management of lantana toxicosis in animals is achieved by drenching with activated charcoal and supportive therapy. Recent reports on the bilirubin clearance effect of Chinese herbal tea Yin Zhi Huang (decoction of the plant Yin Chin, Artemisia capillaries, and three other herbs) or its active ingredient 6,7-dimethylesculetin, in jaundice are very exciting and warrant investigations on its, possible, ameliorative effects in lantana intoxicated animals. Research is being conducted on new drug discovery based on natural products in different parts of the lantana plant.

Ultrasonography of pancreatic neoplasia in the dog: a retrospective review of 16 cases

The history, clinical signs and radiographic and ultrasonographic findings in 16 dogs with pancreatic neoplasia were reviewed retrospectively. Thirteen of the dogs had islet cell carcinoma compatible with insulinoma, one had a pancreatic adenocarcinoma and two had secondary invasion of the pancreas, one by a gastric carcinoma and one by an intestinal lymphoma. The clinical signs in the 13 dogs with insulinoma included collapse in 10 dogs, ataxia in seven, weakness in five, and seizures in two. Two of the 16 dogs had jaundice due to biliary obstruction by the primary tumour or metastases. The sensitivities for pancreatic neoplasia were three of 16 (19 per cent) for radiography and 12 of 16 (75 per cent) for ultrasonography; the sensitivities for metastasis were two of 11 (18 per cent) for radiography and six of 11 (55 per cent) for ultrasonography. Biliary obstruction was detected by ultrasonography in both affected dogs.

Therapeutic percutaneous ultrasound-guided cholecystocentesis in three dogs with extrahepatic biliary obstruction and pancreatitis

Three dogs were examined because of acute pancreatitis. In all 3, distension of the gallbladder was seen ultrasonographically, and extrahepatic biliary tract obstruction (EHBO) was diagnosed on the basis of ultrasonographic findings and serum biochemical abnormalities (i.e., high serum bilirubin and cholesterol concentrations and increased hepatic enzyme activities). In all 3 dogs, percutaneous ultrasound-guided cholecystocentesis (PUCC) was used to decompress the gallbladder, with cholecystocentesis performed multiple times in 1 dog. Serum bilirubin concentration was substantially decreased following the procedure in all 3 dogs. Two of the 3 dogs did not require surgery to resolve the obstruction. In the third dog, an exploratory laparotomy was performed because of concerns about development of abdominal effusion following the procedure. Bile staining of the mesenteric fat was seen during the laparotomy, but no defect in the gallbladder wall could be identified. In most dogs with EHBO secondary to pancreatitis, the obstruction resolves spontaneously as the acute pancreatitis improves so that surgery is not required. In those few dogs in which EHBO does not resolve or in which EHBO results in complications, therapeutic PUCC may be useful in relieving gallbladder distension.

Severe Cholestatic Liver Disease Secondary to Liver Fluke (Platynosomum concinnum) Infection in Three Cats

Three middle-aged domestic cats were presented for vomiting, lethargy, anorexia, and jaundice. Complete blood counts, serum biochemical profiles, and abdominal ultrasounds were suggestive of extrahepatic biliary obstruction in all of the cats. Infection with the liver fluke Platynosomum concinnum was confirmed by intraoperative bile cytology in three cases and by histopathology in two cases. All three cats were euthanized in the postoperative period because of complications. These cases illustrate the severity of signs and complications that can occur with liver fluke infection in cats.

Cholestasis associated with extrahepatic bacterial infection in five dogs

Intrahepatic cholestasis associated with severe extrahepatic bacterial infection is well recognized in humans. A similar syndrome is not well characterized in veterinary medicine. Five dogs with severe extrahepatic bacterial infection that developed histologically confirmed intrahepatic cholestasis were selected from the authors' case files. The types of infections included pneumonia, peritonitis secondary to a rectal tear, urinary tract infection, bite wounds, and vegetative endocarditis. Escherichia coli was involved in two of the dogs, mixed infection in one dog, and a gram-positive cocci in the other two dogs. Total bilirubin concentrations ranged from 3.5 to 33.5 mg/dl. Serum liver enzyme activities showed only mild to moderate increases: alkaline phosphatase (ALP, 41-750 IU/l), alanine aminotransferase (ALT, 25-235 IU/l), and aspartate aminotransferase (AST, 99-255 IU/l). Fasting serum bile acids concentration was markedly elevated in the one dog in which it was measured (259 mumol/l). Histologically, the cholestasis was characterized by bile pigment accumulation in hepatocytes, canaliculi, and/or Kupffer's cells. Inflammatory parenchymal changes, when present, were minimal. The findings of hyperbilirubinemia, only a slight increase in the liver enzyme activities, and minimal inflammatory changes in liver tissue specimens in the five dogs with extrahepatic bacterial infections are similar to the findings in intrahepatic cholestasis associated with extrahepatic bacterial infection in humans.

Common bile duct obstruction due to a duodenal gastrinoma in a dog

In dogs gastrinomas are rare endocrine neoplasms that have always been reported to arise from the pancreas. We report here what we believe to be the first case of a duodenal gastrinoma in a dog. A nine-year-old, male, Pekinese dog was presented with a three-day history of anorexia, vomiting and mucous diarrhoea. Clinical examination and laboratory findings suggested the presence of a severe hepatobiliary disorder. Abdominal ultrasonography showed a diffuse increase in echogenicity of the liver, with severe gallbladder dilation and marked dilation of the cystic duct, common bile duct and extrahepatic bile ducts. Based on these findings, an extrahepatic biliary tract obstruction (EBTO) of unknown cause was suspected. At laparotomy, the gallbladder and the extrahepatic bile ducts appeared severely dilated. The gallbladder was tense and could not be compressed suggesting an outflow obstruction. The duodenum at the level of the common duct orifice appeared slightly thickened and severely hardened for a length of 1 cm. Biopsies from the duodenum and liver were obtained and a cholecystoduodenostomy was performed. The duodenal biopsy revealed severe fibrosis of the submucosa and a infiltrate of small pockets and cords of round to polygonal cells with granular cytoplasm. Based on this appearance the differential diagnoses included neuroendocrine tumours and poorly differentiated carcinoma. Despite surgery and supportive therapy the dog continued to be anorexic and to vomit 3-6 times daily. After euthanasia and necropsy, histopathology showed the presence of a neuroendocrine neoplasia involving the duodenal wall with focal invasion of the adjacent pancreas and small liver metastases. On immunohistochemistry, the cytoplasm of approximately 90% of neoplastic cells intensely expressed neuron specific enolase and gastrin. These findings were consistent with a diagnosis of gastrinoma.

Lantadene A toxicity in sheep. A model for cholestasis

Liver injury occurred after sheep were injected intravenously with the triperpene acid lantadene A, the toxic principle of the tropical plant Lantana camara. A single dose of 1--3 mg/kg of the compound caused mild hepatocellular injury characterized by transient rises in serum enzymes, with or without hyperbilirubinaemia. Higher doses resulted in hepatic necrosis. When low doses of the triterpene were given repeatedly over several days a cholestatic syndrome developed which appeared identical with that caused by consumption of the plant. This is a disease model which may be of value in experimental studies of intrahepatic cholestasis. This study provides evidence that lantadene A is hepatotoxic and does not require metabolism in the alimentray tract for toxicity in sheep.

Use of ursodeoxycholic acids in a dog with chronic hepatitis: effects on serum hepatic tests and endogenous bile acid composition

A dog with severe cholestasis secondary to chronic hepatitis was treated with ursodeoxycholic acid (UDCA) PO. After 2 weeks of daily treatment, the dog was more active and had an improved appetite. Monthly serum biochemical determinations and analysis of individual bile acid profiles documented improvement in hepatobiliary tests and a marked reduction in the concentrations of potentially hepatotoxic endogenous bile acids. These effects were maintained for approximately 6 months. The findings in this dog are similar to those reported for human patients treated with UDCA and provide preliminary evidence in support of its continued evaluation in the treatment of cholestatic liver disease in the dog.

Extrahepatic biliary atresia in a border collie

Progressive lameness and leg pain were the predominant clinical signs in a 17-week-old male border collie presented for examination. On clinical investigation, extrahepatic cholestasis in association with rickets due to inadequate vitamin D resorption was diagnosed. The dog was treated parenterally with vitamin D and a cholecystoduodenostomy was performed. At 25 days postsurgery the lameness had resolved and bone structure was radiographically normal. However, at six weeks postsurgery, the dog's condition deteriorated rapidly and euthanasia was finally performed at eight weeks postsurgery. At postmortem examination, Toxocara canis nematodes were found to have invaded the biliary system via the anastomosis between the gallbladder and duodenum, causing biliary and hepatic toxocariasis. The cause of the primary extrahepatic cholestasis was atresia of the common bile duct at the hepatic end. The liver tissue showed microscopic lesions of chronic extrahepatic cholestasis as well as acute inflammation associated with the nematode invasion. There was no postmortem evidence of bone lesions. Extrahepatic biliary atresia is extremely rare in animals and has not been described before in dogs. In contrast, it represents the most common cause of congenital cholestasis in children, occurring in approximately one per 10,000 to 15,000 live births.

Ultrasonographic findings in cows with cholestasis

Four cows with cholestasis, whose general condition was moderately to severely disturbed, were examined. Two of them had signs of colic, and one had severe pruritus. All of them had jaundice and three had dermatitis solaris. Bilirubinuria occurred in three of the cows and they all had increased concentrations of serum bilirubin and serum bile acids and increased activities of hepatic enzymes. An ultrasonographic examination of the liver and gallbladder revealed that in one cow only the extrahepatic bile ducts were dilated, in another only the intrahepatic bile ducts were dilated and in the other two both the intrahepatic and extrahepatic bile ducts were dilated. In three of the cows the gallbladder was severely dilated and the wall was thickened. Ultrasonographically, the bile appeared either anechoic or echogenic. Surgical or post mortem examinations revealed that the cholestasis in one cow was attributable to obstruction of the common hepatic duct in the area of the hepatic hilus, in two it was caused by obstruction of the common bile duct near the duodenal papilla, and in the fourth cow, the common bile duct was compressed by adhesions, resulting from peritonitis, which involved the liver, gallbladder and abdominal wall.

Biochemical alterations in the blood plasma of rats associated with hepatotoxicity induced by Eupatorium adenophorum

Eupatorium adenophorum (Crofton weed), a native of Central America. has appeared as a major weed in several areas in different parts of the world. Horses that eat this plant are poisoned on prolonged exposure. Toxicity due to consumption of this plant by other grazing animals is not clear. Administration of freeze-dried leaf powder to mice results in hepatotoxicity. Earlier attempts to produce toxicity in rats using the leaves of this plant were not successful. In the present study, administration of oven-dried E. adenophorum leaves collected at the flowering stage elicited hepatotoxicity in rats. The affected animals had a marked increase in the concentration of plasma bilirubin and in the activities of 5'-nucleotidase, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase. There were no significant differences in plasma creatinine, urea or total protein values in the affected animals compared to controls. The livers of the affected animals had focal areas of necrosis throughout the parenchyma and hepatocytes showed megalocytosis. The bile ducts were dilated and the epithelium showed degenerative to necrotic changes. The alterations in bilirubin, enzymes and histopathological changes imply cholestasis and liver injury.

Cellular proliferation of bile ductules and gamma-glutamyl transpeptidase in livers and sera of young cattle following a single infection with Fasciola hepatica

During the course of experimental single infection with Fasciola hepatica in calves, the origin of the increased concentration of gamma-glutamyl transpeptidase (gamma-GT) found to be present in the serum during the biliary stage of the disease, was studied. The enzyme originates from the liver after flukes have caused intermittent and selective cholestasis in the bile-duct system. The enzyme which normally is present in the bile ducts can under these circumstances enter the surrounding interstitial tissues through broken-up junctions of the bile drainage system or be added to these from proliferating bile-ductule epithelium. The multiplication of bile-ductule cells can be looked upon as a neogenesis of cholangioles, which becomes essential when newly formed perilobular connective tissues prevent restoration of the anatomical connections of the bile capillaries with the biliary tree. The connective tissue growth is induced by bile fluid. An initially regional perilobular fibrosis is eventually distributed diffusely through the liver by migration of flukes. The continued and extending fibrosis is due to the constant recurrence of intermittent and selective cholestasis. The transient occlusions of branches of the bile ducts are very likely to be attributable to persistent cholangitis. The growth of connective tissues has a considerable effect on the gain in weight of the liver.

A series of six cases of sphincter of Oddi pathology in the cat (2008-2009)

The sphincter of Oddi (SO) is located within the wall of the duodenum as the terminal part of the common bile duct. Six cats are reported with obstructive processes within their SO. Three of them may have had some form of sphincter dysfunction associated with the pre-existing complex known as 'inflammatory bowel disease' (IBD), two may have had the equivalent of the infant human condition known as 'bile plug syndrome' and the sixth had sphincter dysfunction associated with a tumour at the confluence of the common and right hepatic duct. In all six cases, the sphincter obstructions were surgically managed. The outcomes for 4/6 were favourable but 1/6 was euthanased intraoperatively, and 1/6 had a metastatic neoplasia and was euthanased 2 months postoperatively.

Hepatobiliary scintigraphy in the evaluation of feline liver disease

Hepatobiliary scintigraphy (HBS) was performed in 10 cats with histologically documented hepatobiliary disease. The scintigraphic patterns were classified into one of 5 categories: normal, primary hepatocellular dysfunction, primary intrahepatic cholestasis, mixed hepatocellular and intrahepatic cholestasis, and extrahepatic obstructive patterns. Initial attempts were made to correlate specific disease entities with HBS patterns, but a consistent relationship could not be determined. A correlation between the histological severity of a given hepatic disease and the HBS pattern was made. All cats (n = 5) with a mixed hepatocellular and intrahepatic cholestasis scintigraphic pattern with normal gallbladder function had a histologically severe form of their individual hepatic disease. Three of the 4 cats with an intrahepatic cholestasis pattern and normal hepatocellular and gallbladder function had histologically mild or moderate forms of their individual hepatic diseases. One cat had an extrahepatic obstructive pattern where no radiopharmaceutical was identified in the gallbladder or small intestine by 3 hours postinjection. This study suggests that HBS can be useful in cats with hepatobiliary disease to assess the severity of hepatic dysfunction, and to determine if extrahepatic biliary obstruction is present. Correlation between HBS patterns and specific disease entities such as hepatic lipidosis or cholangitis-cholangiohepatitis syndrome could not be made in this study.

Gastroduodenal intussusception in a young dog

A 21-month-old German shepherd crossbreed presented with a nine-month history of intermittent vomiting, anorexia and melaena interspersed with periods of clinical normality. Investigations suggested recurrent pancreatitis and the vomiting resolved with supportive therapy but recurred two weeks later. Abdominal radiographs revealed evidence of an intermittent abdominal mass which, on ultrasonography, had the typical appearance of an intussusception. At laparotomy, a gastroduodenal intussusception was found obstructing the pancreatic and bile duct outflows with perforation of the duodenal wall. The dog was euthanased. Postmortem examination and histology showed no obvious cause for the intussusception but confirmed pancreatic involvement. This is believed to be the first case of gastroduodenal intussusception reported in an animal.

Cholestasis

Cholestasis can be caused by extrahepatic and intrahepatic pathogenic mechanisms that affect cellular and subcellular functions. The retention of bile results in numerous biochemical abnormalities, some of which are useful as clinical tests. The clinicopathologic findings are often suggestive of the underlying hepatobiliary disorder but are seldom diagnostic.

Parenchymal injury and biliary obstruction in relation to photosensitization in sporidesmin-intoxicated lambs

The hepatic changes were compared in lambs photosensitized or not photosensitized after exposure to sporidesmin. Injury to both the parenchyma and the biliary system was more severe in the photosensitized than in the non-photosensitized lambs. The activities of gamma-glutamyltransferase and glutamate dehydrogenase, and the total, conjugated and unconjugated bilirubin concentrations were significantly higher in sera from the photosensitized than from the non-photosensitized lambs. Hepatic glycogen levels were decreased in both the photosensitized and the non-photosensitized lambs, but were significantly lower in the former. Hence it is possible that lesions in hepatocytes contribute to retention of phylloerythrin and so to photosensitization.

Simian neonatology. II. Neonatal pathology

Spontaneous gross and microscopic lesions were studied in 82 perinatal and neonatal monkeys of various species. Ninety-seven lesions were found in the body systems examined. The system at greatest risk was the respiratory system (33 lesions), at the least risk, the cardiovascular system (four lesions). Lesions were inflammatory, degenerative, vascular, and of other types, such as intrauterine aspiration and congenital anomalies. Differences in the type and distribution of lesions in the various systems were found between premature and mature infants.

High-performance liquid chromatographic analysis of bilirubin and biliverdin from jaundiced broilers

A sensitive and rapid high-performance liquid chromatographic (HPLC) method was developed and used for the simultaneous determination of bilirubin and biliverdin in pericardial fluid samples collected from broilers at a poultry inspection site. A photodiode array detector distinguishing the bilirubin (UV 450 nm) and biliverdin (365 nm) was used as an analytical detector for HPLC system. An internal-surface reversed-phase silica support column was used, and the mobile phase consisted of acetonitrile: 0.5 M Tris HCl buffer (20:80, pH 7.2). Bilirubin was detected from all of the jaundiced pericardial fluid samples, and a small amount of biliverdin was detected with bilirubin in some samples. These jaundiced broilers had hepatic or bile duct lesions similar to those found in edible animals. From these results, a working definition of jaundiced broilers for poultry inspection sites was suggested: bilirubin is detectable from pericardial fluid and the carcass is in a state of yellow color change.

Interpretation of canine liver biopsy. A clinician's perspective

Proper evaluation of hepatic biopsies is essential for the proper management of dogs with liver disease. The clinician must have some basic knowledge of hepatic anatomy and histopathologic nomenclature in order to establish an accurate prognosis and therapeutic plan.