Drug-Induced Liver Injury

Area of Science:

• Veterinary Medicine
• Toxicology
• Hepatology

Background:

• Drug-induced liver injury (DILI) is an underrecognized cause of hepatic disease in small animals.
• Accurate diagnosis relies on veterinary suspicion, comprehensive drug exposure history, and knowledge of drug toxicity.
• This review addresses DILI in dogs and cats, covering pathogenesis, classification, and diagnosis.

Purpose of the Study:

• To review the pathogenesis, classification, and diagnosis of DILI in small animals.
• To discuss the clinical presentation, prevalence, and outcomes of DILI associated with specific veterinary drugs.
• To evaluate the toxic potential of nutraceuticals and herbal preparations in causing DILI.

Main Methods:

• Literature review of DILI in veterinary medicine.
• Analysis of clinical presentations, prevalence, and outcomes for various drugs.
• Assessment of toxicological data for common veterinary drugs, nutraceuticals, and herbs.

Main Results:

• DILI is a significant concern in veterinary medicine, often linked to specific medications.
• Key drugs implicated include azathioprine, azole antifungals, carprofen, diazepam, doxycycline, lomustine, methimazole, phenobarbital, rifampin, sulfonamides, and zonisamide.
• Nutraceuticals and herbal products also pose a risk for DILI.

Conclusions:

• Early recognition and understanding of drug toxicity are crucial for managing DILI in pets.
• Veterinarians must consider DILI when diagnosing hepatic disease, especially after drug administration.
• Further research into DILI mechanisms and safer drug alternatives is warranted.