Kernicterus in an adult dog

Area of Science:

• Veterinary Neurology
• Hepatology
• Toxicology

Background:

• Kernicterus, a neurological condition caused by bilirubin deposition in the brain, is rare in adult animals.
• Extreme hyperbilirubinemia in dogs typically results from severe liver disease.

Observation:

• A 7-year-old Wheaton terrier presented with jaundice, lethargy, anorexia, elevated liver enzymes, and extreme hyperbilirubinemia (609 micromol/L).
• Necropsy revealed profound icterus and liver mottling. The brain showed yellow discoloration in specific nuclei.

Findings:

• Histopathology confirmed neuronal necrosis, Purkinje cell necrosis, and Alzheimer type II astrocytes in the brain's gray matter and nuclei.
• The liver exhibited extensive necrosis in a periacinar-to-bridging pattern, indicative of fulminant hepatic failure.

Implications:

• This case highlights naturally occurring kernicterus in an adult dog secondary to fulminant hepatic failure and extreme hyperbilirubinemia.
• It expands the understanding of kernicterus beyond neonatal cases in domestic animals, suggesting potential for adult occurrence.
• The findings underscore the critical need for managing hyperbilirubinemia in severe liver disease to prevent neurological sequelae.