title: Serum bile acid concentrations, histopathological features, and short-, and long-term survival in horses with hepatic disease.
abstract: BACKGROUND
  Serum bile acid concentrations (SBA) and a histopathological biopsy score [Equine Vet J 35 (2003) 534] are used prognostically in equine hepatic disease.
  
  
  OBJECTIVE
  Histopathologic features and scores, but not SBA, differ between survivors and nonsurvivors and correlate with histopathologic evidence of hepatic inflammation and fibrosis.
  
  
  METHODS
  Retrospective study. Records (1999-2011) of horses with hepatic disease diagnosed by biopsy and with concurrent measurements of SBA.
  
  
  METHODS
  Retrospective cohort study. Biopsies were examined for inflammatory cell infiltration including type and distribution, fibrosis, irreversible cytopathology affecting hepatocytes, hemosiderin, or other pigment deposition and bile duct proliferation. SBA, histopathological findings and a histological score [Equine Vet J 35 (2003) 534] were compared between short- (survival to discharge) and long-term (>6 months) survivors and correlations between SBA and histopathological findings investigated.
  
  
  RESULTS
  Of 81 cases 90% survived short-term and 83% long-term. Short-term and long-term nonsurvival were associated with SBA (P = .009; P = .006), overall (P = .001; P = .002) and parenchymal (short-term only; P = .01) inflammation, portal and bridging fibrosis (all P < .001), apoptosis or single cell necrosis (P < .001; P = .008), hemosiderin deposition in hepatocytes (P = .011; P = .028), biliary (both P < .001), vascular (P = .003; P = .045) and endothelial (P < .001; P = .02) hyperplasia, nucleic changes (P = .004; P < .001) and the histopathological score (both P < .001). SBA were significantly and positively correlated with overall (P = .001), parenchymal (P < .001) and portal (P = .004) inflammation and portal (P = .036) and bridging (P = .002) fibrosis.
  
  
  CONCLUSIONS
  SBA, histopathological findings and scores differ between survivors and nonsurvivors. SBA concentrations are associated with inflammation and fibrosis suggesting interference with hepatic function. A histopathological score >2 and, less so, SBA >20 μmol/L are specific but not sensitive indicators of nonsurvival.
authors.affiliation: Department of Clinical Science and Services, Royal Veterinary College, North Mymms, UK.
authors.forename: B
authors.initials: B
authors.lastname: Dunkel
authors.forename: S A
authors.initials: SA
authors.lastname: Jones
authors.forename: M J
authors.initials: MJ
authors.lastname: Pinilla
authors.forename: A K
authors.initials: AK
authors.lastname: Foote
mesh_terms: D000818:Animals; D001647:Bile Acids and Salts / Q000097:blood*; D001706:Biopsy / Q000662:veterinary; D006734:Horse Diseases / Q000097:blood* / Q000473:pathology; D006736:Horses; D008107:Liver Diseases / Q000097:blood / Q000473:pathology / Q000662:veterinary*; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D001647:Bile Acids and Salts
keywords: Hepathopathy; Hepatic failure; Hepatitis; Liver biopsy
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