Bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis in four dogs

O’Neill, Emma; Day, M. J.; Hall, Edward J; Holden, D. J.; Murphy, Kate; Barr, Frances; Pearson, G. R.

doi:10.1111/j.1748-5827.2006.00012.x

Cited by 42 publications

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“…However, the true prevalence might be underestimated, as many cases do not undergo liver and bile cultures. Hence, data identifying the most common pathogens obtained from bile cultures from dogs with cholangiohepatitis are also sparse, although E. coli has previously been reported to have been isolated in association with this disease (15). The data presented in the current report advances knowledge by being the first to identify ESBL-producing E. coli in a case of canine cholangiohepatitis.…”

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confidence: 64%

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Detection of Extended-Spectrum-β-Lactamase-Positive Escherichia coli in Bile Isolates from Two Dogs with Bacterial Cholangiohepatitis

et al. 2011

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This is the first report of Escherichia coli isolates producing CTX-M-15, the predominant type of extendedspectrum ␤-lactamase (ESBL) associated with clinical disease in humans in the United Kingdom, in a United Kingdom pet dog. This report also describes the first isolation of CTX-M/Tem ESBL-positive E. coli from bile in dogs with hepatobiliary disease. CASE REPORTS Case 1. A 7-year-old female spayed golden retriever was referred for exercise intolerance, vomiting, diarrhea, and panting. Previous treatment had included administration of potentiated amoxicillin, ranitidine, and maropitant. One episode of icterus was also reported before the dog was referred. Abdominal discomfort was noted upon physical examination, and in abdominal ultrasound analysis, the liver appeared normal with respect to size and echogenicity, but the gallbladder showed mildly thickened walls and sludge content. A true cut of the liver for histology and culture and bile aspiration for culture were performed. A minimal amount of inflammatory cells were present on bile cytology, but free bacteria were noted. Histology results were consistent with moderate lymphoplasmacytic and neutrophilic hepatitis (with negative copper staining results); a bile culture revealed heavy growth of two culture variants of nonhemolytic Escherichia coli, but no bacterial growth was obtained from liver tissue.Treatment was started with S-adenosyl-methionine (SAMe) and marbofloxacin (3 mg/kg of body weight orally once daily [p.o. SID]) for 6 weeks. One week after administration of the antibiotics was stopped, the dog had clinically improved and gained two kilograms in weight. Episodic lethargy was still reported. The appearance of the gallbladder remained unchanged in the ultrasound analysis. Bile culture revealed the same two culture variants (0784A and 0784B) of E. coli, which were both shown to be sensitive to imipenem and were therefore treated with that antibiotic (10 mg/kg subcutaneously [SQ] every 8 hours [q8h]) for 14 days. A follow-up 2 weeks into treatment had been scheduled to ensure efficacy of the treatment, but the owner was not able to attend. The dog was treated for a total of 4 weeks and rechecked 1 week after the end of the antibiotic treatment. Although marked clinical improvement was reported during treatment, lethargy and panting had recommenced within days of stopping it. Repeat bile cultures yielded a mixed growth consisting of the same two culture variants of E. coli (0784A and 0784B) and also yielding Enterococcus faecium. It was decided to perform a cholecystectomy at that stage. The gallbladder was sent for histology, and cystic mucinous hyperplasia was diagnosed. The dog recovered from the surgery uneventfully. Two months after surgery, the abdominal ultrasound analysis was repeated and a gastric mass was found to be present (suspected neoplasia) that had not been previously noted. The owner elected no further diagnosis or treatment at that point.Case 2. A 4.5-year-old female spayed standard poodle presented with acute onset jaundice. Th...

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confidence: 64%

“…Bacterial cholangiohepatitis is considered an uncommon disease in dogs (22) and slightly more common in cats (15). However, the true prevalence might be underestimated, as many cases do not undergo liver and bile cultures.…”

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confidence: 99%

Detection of Extended-Spectrum-β-Lactamase-Positive Escherichia coli in Bile Isolates from Two Dogs with Bacterial Cholangiohepatitis

et al. 2011

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“…A similar list of bacterial isolates has been compiled from cats and dogs diagnosed with a broader range of hepatobiliary diseases. [3][4][5][6][7][8][9][10][11][12][13] However, the overall prevalence and antimicrobial susceptibility of the different bacterial species cultured has not been evaluated in a large group of cases. Therefore, the purpose of this retrospective study was to characterize the results of biliary and liver cultures from dogs and cats evaluated for hepatobiliary disease at a veterinary teaching hospital, including the prevalence of positive cultures, the identity and antimicrobial susceptibility of common isolates, and clinical predictors of positive bacterial culture results.…”

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confidence: 99%

“…1,2 In veterinary patients, bacteria have been isolated from cases of suppurative cholangitis, hepatic abscesses, cholecystitis, choledochitis, and choleliths. [3][4][5][6][7][8][9][10][11][12][13] In humans with biliary disease, certain conditions have been associated with a higher incidence of infection, such as cholelithiasis, cholecystitis, previous biliary-tract surgery, or other causes of obstructive jaundice. [14][15][16][17][18] In these studies, the most commonly identified biliary pathogens in human patients are enteric bacteria (Escherichia coli, Enterococcus spp., Klebsiella spp., Bacteroides spp., and Clostridium spp).…”

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confidence: 99%

Bacterial Culture Results from Liver, Gallbladder, or Bile in 248 Dogs and Cats Evaluated for Hepatobiliary Disease: 1998–2003

Wagner

Hartmann

Trepanier

2007

Veterinary Internal Medicne

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Background: Information is lacking on the prevalence and susceptibility patterns of bacterial isolates in dogs and cats with suspected hepatobiliary disease.Objectives: To characterize the prevalence, identity, and antimicrobial susceptibility of common hepatobiliary isolates from such patients.Animals: Dogs and cats presented to the University of Wisconsin-Madison Veterinary Medical Teaching Hospital for which samples of bile, gallbladder, or liver were submitted for culture from 1998 to 2003, including 190 dogs (192 culture episodes) and 58 cats (61 culture episodes).Methods: Cases were identified from the microbiology laboratory database. Data from patient medical records were extracted, including the history of antimicrobial administration, the presence of fever, the results of CBC and serum biochemistry, the presence of biliary obstruction or hepatobiliary inflammation, and the results of aerobic and anaerobic bacterial cultures and aerobic antimicrobial susceptibilities.Results: Biliary cultures yielded a significantly higher percentage of positive results overall (30% [18 of 60]) than did hepatic cultures (7% [15 of 215]). In patients with cholecystitis, 62% (8 of 13) had positive biliary cultures. In patients with hepatic inflammation, 23% (7 of 30) had positive bile cultures, whereas only 6% (6 of 103) had positive hepatic cultures. Escherichia coli, Enterococcus spp., Bacteroides spp., Streptococcus spp., and Clostridium spp. were the most common true-positive isolates. More than 80% of Enterobacteriaceae were susceptible to ciprofloxacin or aminoglycosides, with only 30-67% susceptible to first-generation aminopenicillins and cephalosporins. Liver samples obtained by surgery or laparoscopy were more likely to yield positive cultures than those obtained by percutaneous needle biopsy.

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“…A neoplastic cause seems unlikely given the ultrasonographical appearance of the liver and the favourable response to non-specific therapy. An infectious cholangiohepatitis and cholecystitis causing the dog's clinical signs cannot be ruled out although this disorder is not encountered frequently in dogs [8]. In fact, this possibility prompted the decision to initiate antimicrobial therapy.…”

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confidence: 99%

Possible Drug-Induced Hepatopathy in a Dog Receiving Zonisamide Monotherapy for Treatment of Cryptogenic Epilepsy

Schwartz

Muñana

Olby

2011

The Journal of Veterinary Medical Science

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ABSTRACT. A 9-year old female spayed Rottweiler was diagnosed with cryptogenic epilepsy and started on zonisamide monotherapy (8.3 mg/kg, PO, q 12 hr). Three weeks after the 1st dose of zonisamide the dog presented for vomiting, inappetence and icterus. Serum biochemistry showed marked elevation of liver enzymes, consistent with hepatocellular damage and cholestasis. No underlying cause for liver disease was identified and a drug-induced hepatopathy was suspected. Zonisamide was discontinued and replaced by potassium bromide. Supportive therapy consisted of intravenous fluids, antiemetics, antibiotics and hepatoprotectants. The dog made a complete recovery and serial serum biochemical examinations showed complete normalisation of liver parameters 8 weeks after discontinuation of zonisamide. Based on a human Drug-induced Liver Injury Diagnostic Scale, the likelihood for zonisamide-induced hepatopathy was classified as "possible". Veterinary practitioners and owners should be educated about the potential for an idiosyncratic drug reaction to zonisamide. If signs of hepatotoxicity are recognised early and zonisamide is discontinued, complete recovery is possible.KEY WORDS: antiepileptic drug, canine, idiosyncratic drug reaction, liver, seizure.J. Vet. Med. Sci. 73(11): 1505-1508, 2011 The sulfonamide derivate zonisamide (ZNS) is a new generation antiepileptic drug (AED) that was introduced into the Japanese market in 1989 and received licensure in the US and Europe in 2000 and 2005, respectively. While the US and European approval is limited to use as an add-on AED for humans with partial seizures, the Japanese license includes utilisation as mono-and adjunctive therapy for partial and generalised seizures [5].With blockage of voltage-sensitive sodium channels and T-type calcium channels, ZNS possesses a unique mode of action among the currently available AEDs. There is evidence that ZNS also exhibits direct effects on synthesis, release and degradation of the neurotransmitters glutamate, gamma aminobutyric acid (GABA), dopamine, serotonin and acetylcholine, thereby promoting synaptic inhibition. Furthermore, ZNS has been ascribed neuroprotective effects. To date it remains uncertain as to whether the direct effects on neurotransmitters and the neuroprotective properties play a role in the clinical use as an AED [1].In contrast to many of the newly developed anticonvulsants, ZNS has a sufficiently long serum elimination halflife in dogs, to allow maintenance of therapeutic blood levels by means of twice daily dosing [2,9]. This feature in particular has raised interest in using ZNS for treatment of canine epilepsy, and assessment of its use as add-on medication in cases of refractory epilepsy provided promising results with good rates of responders [3,11].Throughout the reports on the use of ZNS in dogs, the drug appears to have a favourable adverse effect profile. Side effects, including ataxia, lethargy and vomiting, were mild and transient and never warranted discontinuation [3,11]. A study on the chronic toxici...

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Bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis in four dogs

Abstract: This report highlights the fact that bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis should be considered as a potential differential in dogs presenting with signs referable to biliary tract disease.

Cited by 42 publications

References 19 publications

Detection of Extended-Spectrum-β-Lactamase-Positive Escherichia coli in Bile Isolates from Two Dogs with Bacterial Cholangiohepatitis

Detection of Extended-Spectrum-β-Lactamase-Positive Escherichia coli in Bile Isolates from Two Dogs with Bacterial Cholangiohepatitis

Bacterial Culture Results from Liver, Gallbladder, or Bile in 248 Dogs and Cats Evaluated for Hepatobiliary Disease: 1998–2003

Possible Drug-Induced Hepatopathy in a Dog Receiving Zonisamide Monotherapy for Treatment of Cryptogenic Epilepsy

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