Peer-reviewed veterinary case report
How often does zonisamide cause liver problems in dogs
By Smith, Tess K et al.·Published in Journal of veterinary internal medicine·2022·University of Wisconsin - Madison, United States·View original on PubMed →
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Original publication title: Incidence of hepatopathies in dogs administered zonisamide orally: A retrospective study of 384 cases.
- Species:
- dog
Plain-English summary
A group of 384 dogs was treated with zonisamide, a medication often used for seizures, and a few cases of liver problems were noted. Specifically, 2 dogs developed acute liver issues about two weeks after starting the medication, but they recovered after stopping the treatment. Unfortunately, one dog had severe liver failure and was euthanized. For those on long-term zonisamide, while some had minor liver enzyme changes, none showed signs of liver disease. Overall, serious liver problems from zonisamide appear to be rare.
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Abstract
BACKGROUND: Acute hepatopathy secondary to administration of zonisamide has been reported in 2 dogs, but overall incidence of hepatopathy is unknown. OBJECTIVE: To characterize the incidence of hepatopathy in dogs administered zonisamide PO. ANIMALS: Three hundred eighty-four dogs administered zonisamide PO. METHODS: Multicenter retrospective study. Medical records were searched for dogs prescribed zonisamide PO and which had follow-up for at least 3 months (acute exposure) and >3 months (chronic exposure). Reported clinical signs, physical examination findings, and serum biochemical panels were reviewed for possible hepatotoxicosis. Serum alanine aminotransferase (ALT) and alkaline phosphatase (ALP) activity and albumin concentration were documented for all available cases. RESULTS: Acute clinical hepatopathy was found in 2 of 384 treated dogs (0.52%, 95% confidence interval [CI], 0.06-1.9) after 13-16 days of zonisamide treatment. One additional dog had elevated serum ALT activity with no clinical signs. Of these 3 dogs, 2 recovered after administration of zonisamide was stopped, and 1 was euthanized because of liver failure. Of the 117 cases chronically administered zonisamide, 10 had an increase in ALP, 6 had an increase in ALT, and 1 had hypoalbuminemia. No clinical signs of liver disease were noted in dogs chronically treated with zonisamide (median, 20 months; range, 5-94 months). CONCLUSIONS AND CLINICAL IMPORTANCE: Acute, potentially life-threatening hepatopathy associated with oral administration of zonisamide to dogs is estimated to occur in less than 1% of dogs and was observed in the first 3 weeks of treatment. Subclinical abnormalities in ALT and ALP activity were noted in <10% of dogs during chronic administration of zonisamide, with no clinical signs of liver disease noted.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35238072/