Schwartz Malte, Muñana Karen R, Olby Natasha J
Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA..
J Vet Med Sci. 2011 Nov;73(11):1505-8. doi: 10.1292/jvms.11-0164. Epub 2011 Jun 30.
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.
一只9岁已绝育的雌性罗威纳犬被诊断为隐源性癫痫，开始接受唑尼沙胺单药治疗（8.3毫克/千克，口服，每12小时一次）。在首次服用唑尼沙胺三周后，这只狗出现呕吐、食欲不振和黄疸。血清生化检查显示肝酶显著升高，符合肝细胞损伤和胆汁淤积。未发现肝脏疾病的潜在病因，怀疑是药物性肝病。停用唑尼沙胺，换用溴化钾。支持性治疗包括静脉输液、止吐药、抗生素和肝保护剂。这只狗完全康复，在停用唑尼沙胺8周后，系列血清生化检查显示肝脏参数完全恢复正常。根据人类药物性肝损伤诊断量表，唑尼沙胺引起肝病的可能性被分类为“可能”。兽医从业者和犬主应接受关于唑尼沙胺发生特异质性药物反应可能性的教育。如果早期识别出肝毒性迹象并停用唑尼沙胺，完全康复是可能的。
