Peer-reviewed veterinary case report
Shar pei dog got stomach and muscle problems from colchicine
By McAlister, Amber et al.·Published in Journal of the American Animal Hospital Association·2014·Department of Clinical Sciences (S.C., United States·View original on PubMed →
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Original publication title: Adverse interaction between colchicine and ketoconazole in a Chinese shar pei.
- Species:
- dog
Plain-English summary
A Chinese shar pei with a 2-year history of fever, tiredness, and limping was diagnosed with familial shar pei fever and treated for skin infections with antibiotics and ketoconazole. After starting colchicine to manage the fever, the dog developed serious side effects, including stomach issues and liver problems. The treatment was stopped, and the dog's symptoms improved significantly within three months. This case highlights the importance of being cautious with certain medications, as the combination of ketoconazole and colchicine can cause harmful interactions, but the dog fully recovered after discontinuing the drugs.
People also search for: shar pei fever treatment · colchicine side effects in dogs · dog liver problems after medication
Abstract
A Chinese shar pei with a 2 yr history of episodic fever, lethargy, and shifting lameness was presumptively diagnosed with familial shar pei fever but had never been treated for the syndrome. After being presented for a superficial pyoderma with possible dermatophyte coinfection, treatment with a cephalosporin and ketoconazole were prescribed. One wk later, colchicine was initiated for familial shar pei fever using cautious dose escalation. Nevertheless, gastrointestinal toxicity, skeletal muscle myopathy, and hepatotoxicity developed within 2 wk. Abrupt resolution of gastrointestinal toxicity and myopathy followed drug withdrawal. However, escalating liver enzyme activity and hyperbilirubinemia led to liver biopsy to rule out an antecedent hepatopathy. Biopsy characterized canalicular cholestasis and colchicine-associated metaphase arrest and ring mitoses reflecting repression of mitotic spindle formation. Signs of illness completely resolved 3 mo after drug discontinuation. Although avoidable adverse interactions between ketoconazole and drugs reliant on cytochrome oxidase biotransformation and/or drug efflux mediated by multiple drug-resistant transporters are well documented in humans, these are rarely reported in veterinary patients. This case exemplifies an important and avoidable ketoconazole/colchicine drug interaction from which the patient completely recovered. The dog tested negative for the canine MDR1 loss of function mutation that also might potentiate colchicine toxicity.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/25379734/