Suspected hepatic amyloidosis in a horse

• Published in: Equine veterinary education Vol. 32; no. 9; pp. e147 - e151
• Main Authors: Dias Moreira, A. S., Dreyfus, J. M., Peek, S. F.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc 01-09-2020
• Subjects: Amyloidosis; Biopsy; Dexamethasone; Energy levels; Fibrosis; haemoabdomen; horse; Horses; Leukocytes (neutrophilic); Leukocytosis; Liver; Parenchyma; Peritoneal fluid; Peritoneum; serum amyloid A; Sulfamethoxazole; Trimethoprim; Weight loss
• ISSN: 0957-7734; 2042-3292
• DOI: 10.1111/eve.13087

Summary
A 9‐year‐old Saddlebred gelding was referred to the University of Wisconsin Veterinary Care for decreased energy levels, weight loss, persistently elevated liver enzymes, hyperglobulinaemia and leukocytosis. Abdominal ultrasonography showed a large volume of peritoneal fluid of mixed echogenicity, and the presence of focally distributed, circular to oval (approximately 1–2 cm), hyperechoic areas within the parenchyma of an enlarged liver. Cytological analysis of the peritoneal fluid revealed sterile neutrophilic/macrophagic inflammation, with haemosiderophages. A liver biopsy confirmed the presence of hepatic amyloidosis and focal fibrosis. Medical therapy with trimethoprim‐sulfamethoxazole for 30 days and long‐term dexamethasone was associated with both a clinical and biochemical response for 7 months, at which time the horse died from presumed hepatic rupture. To the authors’ knowledge, this is the first report describing potential successful management of hepatic amyloidosis in a horse.