{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:54:01Z","timestamp":1787025241245,"version":"build-2736575974"},"reference-count":77,"publisher":"American Veterinary Medical Association (AVMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"s001\">\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To characterize clinical, clinicopathologic, and hepatic histopathologic features and outcome for dogs with probable ketoconazole-induced liver injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s002\">\n                    <jats:title>ANIMALS<\/jats:title>\n                    <jats:p>15 dogs with suspected ketoconazole-induced liver injury that underwent liver biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s003\">\n                    <jats:title>PROCEDURES<\/jats:title>\n                    <jats:p>Medical record data were summarized regarding signalment, clinical signs, clinicopathologic and hepatic histopathologic findings, concurrent medications, ketoconazole dose, treatment duration, and outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s004\">\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Median age and body weight were 8.2 years (range, 5 to 15 years) and 13.0 kg (28.6 lb; range, 8.2 to 38.0 kg [18.0 to 83.6 lb]), respectively. The most common breed was Cocker Spaniel (n = 5). All dogs received ketoconazole to treat cutaneous\n                      <jats:italic>Malassezia<\/jats:italic>\n                      infections. Median daily ketoconazole dose was 7.8 mg\/kg (3.5 mg\/lb; range, 4.4 to 26.0 mg\/kg [2.0 to 11.8 mg\/lb]), PO. Treatment duration ranged from 0.3 to 100 cumulative weeks (intermittent cyclic administration in some dogs); 6 dogs were treated for \u2264 10 days. Common clinical signs included lethargy, anorexia, and vomiting. All dogs developed high serum liver enzyme activities. Hepatic histopathologic findings included variable lobular injury, mixed inflammatory infiltrates, and conspicuous aggregates of ceroid-lipofuscin\u2013engorged macrophages that marked regions of parenchymal damage. Five dogs developed chronic hepatitis, including 3 with pyogranulomatous inflammation. Of the 10 dogs reported to have died at last follow-up, survival time after illness onset ranged from 0.5 to 165 weeks, with 7 dogs dying of liver-related causes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s005\">\n                    <jats:title>CONCLUSIONS AND CLINICAL RELEVANCE<\/jats:title>\n                    <jats:p>Findings for dogs with hepatotoxicosis circumstantially associated with ketoconazole treatment suggested proactive monitoring of serum liver enzyme activities is advisable before and sequentially after initiation of such treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/javma.256.11.1245","type":"journal-article","created":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T14:52:18Z","timestamp":1589554338000},"page":"1245-1256","source":"Crossref","is-referenced-by-count":5,"title":["Clinical, clinicopathologic, and hepatic histopathologic features associated with probable ketoconazole-induced liver injury in dogs: 15 cases (2015\u20132018)"],"prefix":"10.2460","volume":"256","author":[{"given":"Luis P.","family":"Macho","sequence":"first","affiliation":[{"name":"1Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon A.","family":"Center","sequence":"additional","affiliation":[{"name":"1Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Randolph","sequence":"additional","affiliation":[{"name":"1Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee Ann","family":"Dumars","sequence":"additional","affiliation":[{"name":"3Pet Medical Center and Spa, Fresno, CA 93711."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Rush","sequence":"additional","affiliation":[{"name":"4Animal Clinic of La Plata, La Plata, MD 20646."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Kate","family":"Cameron","sequence":"additional","affiliation":[{"name":"5Cameron Veterinary Hospital, Sunnyvale, CA 94087."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Lucy","sequence":"additional","affiliation":[{"name":"6Oradell Animal Hospital, Paramus, NJ 07652."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah L.","family":"Hall-Fonte","sequence":"additional","affiliation":[{"name":"6Oradell Animal Hospital, Paramus, NJ 07652."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean P.","family":"McDonough","sequence":"additional","affiliation":[{"name":"2Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine","family":"Peters-Kennedy","sequence":"additional","affiliation":[{"name":"2Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Marinoff","sequence":"additional","affiliation":[{"name":"2Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Harrison","sequence":"additional","affiliation":[{"name":"7Dogs and Cats Veterinary Referral, Bowie, MD 20715."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Sabatino","sequence":"additional","affiliation":[{"name":"8Affiliated Veterinary Specialists, Gainesville, FL 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