A 6-month-old sexually intact male Clumber Spaniel was evaluated because of small stature, recurrent dermatitis of the head, and progressive pigmentary hepatopathy.
Clinicopathologic findings included nonanemic hypochromic microcytosis, hypocholesterolemia, persistently high serum liver enzyme activities, and anicteric hyperbilirubinemia. Histologic examination of liver biopsy specimens collected when the dog was 6 months and 2 years of age revealed expansion and bridging of portal tracts, occasional centrilobular parenchymal collapse, scattered lymphoplasmacytic infiltrates, and dark red to brown pigment within large aggregates of macrophages, engorged bile canaliculi, and hepatocytes. The pigment failed to stain for the presence of iron, copper, bile, and glycoprotein and, when examined with polarized microscopy, emitted a yellow to green birefringence with occasional Maltese cross configurations. Further analyses confirmed marked porphyrin accumulation in blood, urine, feces, and liver tissue; protoporphyrin accumulation in RBCs and liver tissue; and a signature porphyrin profile and fluorescence peak consistent with erythropoietic protoporphyria. Advanced protoporphyric hepatopathy was diagnosed. The chronic dermatopathy was presumed to reflect protoporphyric photosensitivity.
TREATMENT AND OUTCOME
Management was focused on avoiding conditions known to induce heme synthesis and catabolism, administrating ursodeoxycholic acid and antioxidants S-adenosylmethionine and vitamin E, and avoiding sunlight exposure. At follow-up at 4 years of age, the dog was stable without evidence of jaundice but with probable persistent erythropoietic protoporphyria–related solar dermatopathy.
Clinical and histologic features of congenital erythropoietic protoporphyria and resultant protoporphyric hepatopathy, the diagnosis, and the successful management of a dog with these conditions over 4 years were described. Veterinarians should consider porphyric syndromes when unusual pigmentary hepatopathies are encountered.
Objective—To determine risk factors for development
of sequestra in cattle and identify factors associated
with a successful outcome.
Procedure—Medical records of cattle treated at veterinary
teaching hospitals in North America were
reviewed. To determine risk factors for osseous
sequestration, breed, age, and sex of cattle with
osseous sequestration were compared with breed,
age, and sex of all other cattle admitted during the
Results—110 cattle were included in the study. Three
had 2 sequestra; thus, 113 lesions were identified.
Most sequestra were associated with the bones of
the extremities, most commonly the third metacarpal
or third metatarsal bone. Ninety-two animals were
treated surgically (ie, sequestrectomy), 7 were treated
medically, 3 were initially treated medically and
were then treated surgically, and 8 were not treated.
Follow-up information was available for 65 animals
treated surgically and 6 animals treated medically.
Fifty-one (78%) animals treated surgically and 5 animals
treated medically had a successful outcome.
Cattle that were 6 months to 2 years old had a significantly
increased risk of developing a sequestrum,
compared with cattle < 6 months old. Cattle in which
sequestrectomy was performed with the aid of local
anesthesia were significantly more likely to undergo 2
or more surgical procedures than were cattle in which
sequestrectomy was performed with the aid of general
Conclusions and Clinical Relevance—Results suggest
that sequestrectomy will result in a successful
outcome for most cattle with osseous sequestration.
(J Am Vet Med Assoc 2000;217:376–383)