Toxicology Brief: The critical care of aflatoxin-induced liver failure in dogs - Veterinary Medicine
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Toxicology Brief: The critical care of aflatoxin-induced liver failure in dogs


VETERINARY MEDICINE


Nutrition

A high-protein diet combined with aflatoxin exposure has been associated with increased preneoplastic hepatic lesions in rats.48 However, while low-protein diets decrease hepatocarcinogenicity, they appear to predispose patients to a subacute toxicosis.49 Thus, recovering dogs should be fed a balanced canine diet. Avoid protein -restricted diets unless hepatoencephalopathy is suspected. In cases of hepatoencephalopathy, parenteral nutrition may be preferred.43

MONITORING

Frequently monitor the clinical signs; hepatic enzyme activities; electrolyte, cholesterol, and bilirubin concentrations; coagulation parameters; and hepatic function of patients with aflatoxicosis. Pay particular attention to any signs of DIC, hepatoencephalopathy, or severe bleeding. Recovering dogs should undergo periodic serum chemistry profiles and liver function testing (e.g. bile acid assay). Also screen dogs with a history of aflatoxin ingestion but no clinical signs for biochemical or hematologic abnormalities because clinical signs of aflatoxicosis are not always immediately apparent, and early treatment may decrease morbidity and mortality.13,16,18

LONG-TERM PATIENT OUTCOME

Dogs with aflatoxicosis can develop chronic liver disease and may be prone to developing neoplastic hepatic disorders. Hepatocarcinogenicity has been documented as a sequela to aflatoxin exposure in people, but no information is available regarding carcinogenicity in dogs.11

SUMMARY

Canine aflatoxicosis occurs from ingestion of aflatoxin-contaminated foods. Aflatoxins cause severe hepatic damage that frequently results in liver failure. The mainstays of treatment are hepatoprotective nutraceuticals, fluid therapy, blood component therapy, vitamin K1, antiemetics, and gastrointestinal protectants. While aflatoxicosis is fatal in most patients with overt signs of intoxication, some dogs may recover slowly with long-term care.

ACKNOWLEDGMENTS

The author wishes to thank Lisa Murphy, VMD, DABT, and Meredith Daly, VMD, for their contributions to this article.

"Toxicology Brief" was contributed by Eva Furrow, VMD, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-4912. The department editor is Petra Volmer, DVM, MS, DABVT, DABT.

REFERENCES

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9. Williams JH, Phillips TD, Jolly PE, et al. Human aflatoxicosis in developing countries: a review of toxicology, exposure, potential health consequences, and interventions. Am J Clin Nutr 2004;80:1106-1122.

10. Kuilman ME, Maas RF, Fink-Gremmels JF. Cytochrome P450-mediated metabolism and cytotoxicity of aflatoxin B(1) in bovine hepatocytes. Toxicol In Vitro 2000;14:321-327.

11. Wang JS, Groopman JD. DNA damage by mycotoxins. Mutat Res 1999;424:167-181.


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