{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T01:04:07Z","timestamp":1772327047606,"version":"3.50.1"},"reference-count":56,"publisher":"American Animal Hospital Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"ABSTRACT<\/jats:title>\n Manganese is a common component of human joint supplements and may be a source of ingestion and subsequent toxicosis in dogs. Although hepatotoxicity secondary to manganese toxicosis has been reported in dogs before, no descriptions of successful management of manganese toxicosis has been reported in veterinary literature. A 5 yr old spayed female Shetland sheepdog and a 5 yr old female Shetland sheepdog were evaluated following accidental ingestion of a joint supplement. Consultation with a toxicologist revealed concern for manganese toxicosis resulting in hepatic injury. Both dogs developed subsequent acute liver injury, despite decontamination and initial management with N-acetylcysteine and cholestyramine. The patients were managed with calcium ethylenediaminetetraacetic acid, paraaminosalicylic acid, allopurinol, Vitamin E, ginkgo biloba, and S-adenosylmethionine\/silybin. Liver values returned to normal in both dogs. Manganese exposure was confirmed with urine manganese analysis in one dog and fecal examination in the other dog. A previous case report detailed the fatal manganese toxicosis in a dog; this case report describes the successful management of severe acute hepatic injury secondary to manganese toxicosis. The combination of medications used above may be used for successful treatment of manganese toxicosis in dogs.<\/jats:p>","DOI":"10.5326\/jaaha-ms-7348","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T13:02:05Z","timestamp":1683810125000},"page":"152-157","source":"Crossref","is-referenced-by-count":3,"title":["Successful Management of Severe Manganese Toxicosis in Two Dogs"],"prefix":"10.5326","volume":"59","author":[{"given":"Jacob","family":"Wolf","sequence":"first","affiliation":[{"name":"From the College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.W., C.S.); and the United States Army, San Antonio, Texas (L.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Levi","family":"Hoffman","sequence":"additional","affiliation":[{"name":"From the College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.W., C.S.); and the United States Army, San Antonio, Texas (L.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Southern","sequence":"additional","affiliation":[{"name":"From the College of Veterinary Medicine, University of Florida, Gainesville, Florida (J.W., C.S.); and the United States Army, San Antonio, Texas (L.H.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3280","reference":[{"issue":"5","key":"i1547-3317-59-3-152-b1","series-title":"J Vet Diagn Invest","first-page":"658","article-title":"Acute enteral manganese intoxication with hepatic failure due to ingestion of a joint supplement overdose","volume":"26","year":"2014","unstructured":"Borchers\n A,\n \n \n Epstein\n SE,\n \n \n Gindiciosi\n B,\n \n \n .\n\t\t\t\t\tAcute enteral manganese intoxication with hepatic failure due to ingestion of a joint supplement overdose.\n\t\t\t\t\tJ Vet Diagn 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Pathol1997;\n\t\t\t\t\t25(\n\t\t\t\t\t4):\n\t\t\t\t\t344\u2013\n\t\t\t\t\t50."},{"issue":"5","key":"i1547-3317-59-3-152-b12","series-title":"J Am Anim Hosp Assoc","first-page":"e55502","article-title":"Successful management of severe bromethalin toxicosis in a dog","volume":"55","year":"2019","unstructured":"Lyons\n BM,\n \n \n Poppenga\n RH,\n \n \n Thawley\n VJ,\n \n \n .\n\t\t\t\t\tSuccessful management of severe bromethalin toxicosis in a dog.\n\t\t\t\t\tJ Am Anim Hosp Assoc2019;\n\t\t\t\t\t55(\n\t\t\t\t\t5):\n\t\t\t\t\te55502."},{"issue":"4","key":"i1547-3317-59-3-152-b13","series-title":"J Neurogastroenterol Motil","first-page":"407","article-title":"Advantages of azithromycin over erythromycin in improving the gastric emptying half-time in adult patients with gastroparesis","volume":"16","year":"2010","unstructured":"Larson\n JM,\n \n \n Tavakkoli\n A,\n \n \n Drane\n WE,\n \n \n .\n\t\t\t\t\tAdvantages of azithromycin over erythromycin in improving the gastric emptying half-time in adult patients with gastroparesis.\n\t\t\t\t\tJ Neurogastroenterol Motil2010;\n\t\t\t\t\t16(\n\t\t\t\t\t4):\n\t\t\t\t\t407\u2013\n\t\t\t\t\t13."},{"issue":"2","key":"i1547-3317-59-3-152-b14","series-title":"J Vet Intern Med","first-page":"508","article-title":"Ultrasonographic evaluation of the effects of azithromycin on antral motility and gastric emptying in healthy cats","volume":"36","year":"2022","unstructured":"Rutherford\n S,\n \n \n Gaschen\n F,\n \n \n Husnik\n R,\n \n \n .\n\t\t\t\t\tUltrasonographic evaluation of the effects of azithromycin on antral motility and gastric emptying in healthy cats.\n\t\t\t\t\tJ Vet Intern Med2022;\n\t\t\t\t\t36(\n\t\t\t\t\t2):\n\t\t\t\t\t508\u2013\n\t\t\t\t\t14."},{"issue":"1","key":"i1547-3317-59-3-152-b15","series-title":"V Clin Small Anim","first-page":"43","article-title":"Gastric motility disorders in dogs and cats","volume":"51","year":"2021","unstructured":"Husnik,\n R,\n \n \n Gaschen,\n F.\n \n \n Gastric motility disorders in dogs and cats.\n\t\t\t\t\tV Clin Small Anim2021;\n\t\t\t\t\t51(\n\t\t\t\t\t1):\n\t\t\t\t\t43\u2013\n\t\t\t\t\t59."},{"key":"i1547-3317-59-3-152-b16","series-title":"Vet Clin Small Anim","first-page":"631","article-title":"Therapeutic use of cytoprotective agents in canine and feline hepatobiliary disease","volume":"39","year":"2009","unstructured":"Webster\n CRL\n \n \n Cooper\n J.\n \n \n Therapeutic use of cytoprotective agents in canine and feline hepatobiliary disease.\n\t\t\t\t\tVet Clin Small Anim2009;\n\t\t\t\t\t39:\n\t\t\t\t\t631\u2013\n\t\t\t\t\t52."},{"issue":"11","key":"i1547-3317-59-3-152-b17","series-title":"Aust Vet J","first-page":"555","article-title":"The characterization of cycad palm toxicosis and treatment effects in 130 dogs","volume":"98","year":"2020","unstructured":"Lake\n BB,\n \n \n Edwards\n T,\n \n \n Atiee\n G,\n \n \n .\n\t\t\t\t\tThe characterization of cycad palm toxicosis and treatment effects in 130 dogs.\n\t\t\t\t\tAust Vet 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role of Ginkgo biloba against hepatotoxicity and nephrotoxicity in uranium-treated mice.\n\t\t\t\t\tJ Med Food2010;\n\t\t\t\t\t13(\n\t\t\t\t\t1):\n\t\t\t\t\t179\u2013\n\t\t\t\t\t88."},{"issue":"2","key":"i1547-3317-59-3-152-b22","series-title":"Beni-Suef Univ J Basic Appl Sci","first-page":"223","article-title":"The protective effect of grape seed and Ginkgo biloba against hepatotoxicity induced by the antidysrhythmic drug \u201camiodarone\u201d in male albino rats","volume":"7","year":"2018","unstructured":"Abdul-Hamid\n M,\n \n \n Galaly\n SR,\n \n \n Mahmoud\n H,\n \n \n .\n\t\t\t\t\tThe protective effect of grape seed and Ginkgo biloba against hepatotoxicity induced by the antidysrhythmic drug \u201camiodarone\u201d in male albino rats.\n\t\t\t\t\tBeni-Suef Univ J Basic Appl Sci2018;\n\t\t\t\t\t7(\n\t\t\t\t\t2):\n\t\t\t\t\t223\u2013\n\t\t\t\t\t30."},{"issue":"2","key":"i1547-3317-59-3-152-b23","series-title":"Neurosci Lett","first-page":"73","article-title":"Allopurinol protects 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Biomed2004;\n\t\t\t\t\t17(\n\t\t\t\t\t8):\n\t\t\t\t\t544\u2013\n\t\t\t\t\t53."},{"issue":"2","key":"i1547-3317-59-3-152-b27","series-title":"Neurotoxicology","first-page":"240","article-title":"Chelation therapy of manganese intoxication with para-aminosalicylic acid (PAS) in Sprague-Dawley rats","volume":"30","year":"2009","unstructured":"Zheng\n W,\n \n \n Jiang\n YM,\n \n \n Zhang\n Y,\n \n \n .\n\t\t\t\t\tChelation therapy of manganese intoxication with para-aminosalicylic acid (PAS) in Sprague-Dawley rats.\n\t\t\t\t\tNeurotoxicology2009;\n\t\t\t\t\t30(\n\t\t\t\t\t2):\n\t\t\t\t\t240\u2013\n\t\t\t\t\t8."},{"issue":"2","key":"i1547-3317-59-3-152-b28","series-title":"J Ren Hep Disord","first-page":"1","article-title":"Manganese-induced nephrotoxicity is mediated through oxidative stress and mitochondrial impairment","volume":"4","year":"2020","unstructured":"Niknahad\n AM,\n \n \n Mehdi Ommati\n M,\n \n \n Farshad\n O,\n \n \n .\n\t\t\t\t\tManganese-induced nephrotoxicity is mediated through oxidative stress and mitochondrial impairment.\n\t\t\t\t\tJ Ren Hep Disord2020;\n\t\t\t\t\t4(\n\t\t\t\t\t2):\n\t\t\t\t\t1\u2013\n\t\t\t\t\t10."},{"issue":"5","key":"i1547-3317-59-3-152-b1","series-title":"J Vet Diagn Invest","first-page":"658","article-title":"Acute enteral manganese intoxication with hepatic failure due to ingestion of a joint supplement overdose","volume":"26","year":"2014","unstructured":"Borchers\n A,\n \n \n Epstein\n SE,\n \n \n Gindiciosi\n B,\n \n \n .\n\t\t\t\t\tAcute enteral manganese intoxication with hepatic failure due to ingestion of a joint supplement overdose.\n\t\t\t\t\tJ Vet Diagn Invest2014;\n\t\t\t\t\t26(\n\t\t\t\t\t5):\n\t\t\t\t\t658\u2013\n\t\t\t\t\t3."},{"issue":"3","key":"i1547-3317-59-3-152-b2","series-title":"Curr Environ Health Rep","first-page":"315","article-title":"Manganese toxicity upon overexposure: a decade in review","volume":"2","year":"2015","unstructured":"O\u2019Neal\n SL\n \n \n Zheng\n W.\n \n \n Manganese toxicity upon overexposure: a decade in review.\n\t\t\t\t\tCurr Environ Health Rep2015Sep;\n\t\t\t\t\t2(\n\t\t\t\t\t3):\n\t\t\t\t\t315\u2013\n\t\t\t\t\t28."},{"key":"i1547-3317-59-3-152-b3","series-title":"Encyclopedia of human nutrition","first-page":"148","article-title":"Manganese","year":"2013","unstructured":"Keen\n CL,\n \n \n Ensunsa\n JL,\n \n \n Lonnerdal\n B,\n \n \n .\n\t\t\t\t\tManganese.\n\t\t\t\t\tIn:CaballeroB,ed.Encyclopedia of human nutrition.\n\t\t\t\t\t3rd ed.\n\t\t\t\t\tCambridge, MA:\n\t\t\t\t\tAcademic Press;\n\t\t\t\t\t2013:\n\t\t\t\t\t148\u2013\n\t\t\t\t\t54."},{"issue":"8","key":"i1547-3317-59-3-152-b4","series-title":"NMR Biomed","first-page":"544","article-title":"Manganese toxicity upon overexposure","volume":"17","year":"2004","unstructured":"Crossgrove\n J\n \n \n Zheng\n W.\n \n \n Manganese toxicity upon overexposure.\n\t\t\t\t\tNMR Biomed2004;\n\t\t\t\t\t17(\n\t\t\t\t\t8):\n\t\t\t\t\t544\u2013\n\t\t\t\t\t53."},{"issue":"1","key":"i1547-3317-59-3-152-b5","series-title":"J Vet Intern Med","first-page":"90","article-title":"Whole blood manganese concentrations in dogs with congenital portosystemic shunts","volume":"24","year":"2010","unstructured":"Gow\n AG,\n \n \n Marques\n AI,\n \n \n Yool\n DA,\n \n \n .\n\t\t\t\t\tWhole blood manganese concentrations in dogs with congenital portosystemic shunts.\n\t\t\t\t\tJ Vet Intern Med2010;\n\t\t\t\t\t24(\n\t\t\t\t\t1):\n\t\t\t\t\t90\u2013\n\t\t\t\t\t6."},{"issue":"5","key":"i1547-3317-59-3-152-b6","series-title":"J Small Anim Pract","first-page":"241","article-title":"Whole blood manganese concentrations in dogs with primary hepatitis","volume":"55","year":"2014","unstructured":"Kilpatrick\n S,\n \n \n Jacinto\n A,\n \n \n Foale\n RD,\n \n \n .\n\t\t\t\t\tWhole blood manganese concentrations in dogs with primary hepatitis.\n\t\t\t\t\tJ Small Anim Pract2014;\n\t\t\t\t\t55(\n\t\t\t\t\t5):\n\t\t\t\t\t241\u2013\n\t\t\t\t\t6."},{"issue":"4","key":"i1547-3317-59-3-152-b7","series-title":"Metab Brain Dis","first-page":"311","article-title":"Role of manganese in the pathogenesis of portal-systemic encephalopathy","volume":"13","year":"1998","unstructured":"Layrargues\n GP,\n \n \n Rose\n C,\n \n \n Spahr\n L,\n \n \n .\n\t\t\t\t\tRole of manganese in the pathogenesis of portal-systemic encephalopathy.\n\t\t\t\t\tMetab Brain Dis1998;\n\t\t\t\t\t13(\n\t\t\t\t\t4):\n\t\t\t\t\t311\u2013\n\t\t\t\t\t7."},{"issue":"4","key":"i1547-3317-59-3-152-b8","series-title":"Open Vet J","first-page":"360","article-title":"Investigation of manganese homeostasis in dogs with anaemia and chronic enteropathy","volume":"7","year":"2017","unstructured":"Ferreira,\n MDF,\n \n \n Aylor\n AE,\n \n \n Mellanby\n RJ,\n \n \n .\n\t\t\t\t\tInvestigation of manganese homeostasis in dogs with anaemia and chronic enteropathy.\n\t\t\t\t\tOpen Vet J2017;\n\t\t\t\t\t7(\n\t\t\t\t\t4):\n\t\t\t\t\t360\u2013\n\t\t\t\t\t6."},{"issue":"4","key":"i1547-3317-59-3-152-b9","series-title":"Can Vet J","first-page":"361","article-title":"Multiorgan dysfunction syndrome secondary to joint supplement overdosage in a dog","volume":"56","year":"2015","unstructured":"Nobles\n IJ\n \n \n Khan\n S.\n \n \n Multiorgan dysfunction syndrome secondary to joint supplement overdosage in a dog.\n\t\t\t\t\tCan Vet J2015;\n\t\t\t\t\t56(\n\t\t\t\t\t4):\n\t\t\t\t\t361\u2013\n\t\t\t\t\t4."},{"issue":"3","key":"i1547-3317-59-3-152-b10","series-title":"J Vet Emerg Crit Care","first-page":"432","article-title":"The successful treatment of multiple organ dysfunction syndrome and severe hypernatremia, secondary to joint supplement toxicity in a dog","volume":"31","year":"2021","unstructured":"Weatherson\n HO,\n \n \n Bellis\n T,\n \n \n Tse\n Y.\n \n \n The successful treatment of multiple organ dysfunction syndrome and severe hypernatremia, secondary to joint supplement toxicity in a dog.\n\t\t\t\t\tJ Vet Emerg Crit Care2021;\n\t\t\t\t\t31(\n\t\t\t\t\t3):\n\t\t\t\t\t432\u2013\n\t\t\t\t\t8."},{"issue":"4","key":"i1547-3317-59-3-152-b11","series-title":"Toxicol Pathol","first-page":"344","article-title":"Toxicity of subacute intravenous manganese chloride administration in beagle dogs","volume":"25","year":"1997","unstructured":"Khan\n KN,\n \n \n Andress\n JM,\n \n \n Smith\n PF.\n \n \n Toxicity of subacute intravenous manganese chloride administration in beagle dogs.\n\t\t\t\t\tToxicol Pathol1997;\n\t\t\t\t\t25(\n\t\t\t\t\t4):\n\t\t\t\t\t344\u2013\n\t\t\t\t\t50."},{"issue":"5","key":"i1547-3317-59-3-152-b12","series-title":"J Am Anim Hosp Assoc","first-page":"e55502","article-title":"Successful management of severe bromethalin toxicosis in a dog","volume":"55","year":"2019","unstructured":"Lyons\n BM,\n \n \n Poppenga\n RH,\n \n \n Thawley\n VJ,\n \n \n .\n\t\t\t\t\tSuccessful management of severe bromethalin toxicosis in a dog.\n\t\t\t\t\tJ Am Anim Hosp Assoc2019;\n\t\t\t\t\t55(\n\t\t\t\t\t5):\n\t\t\t\t\te55502."},{"issue":"4","key":"i1547-3317-59-3-152-b13","series-title":"J Neurogastroenterol Motil","first-page":"407","article-title":"Advantages of azithromycin over erythromycin in improving the gastric emptying half-time in adult patients with gastroparesis","volume":"16","year":"2010","unstructured":"Larson\n JM,\n \n \n Tavakkoli\n A,\n \n \n Drane\n WE,\n \n \n .\n\t\t\t\t\tAdvantages of azithromycin over erythromycin in improving the gastric emptying half-time in adult patients with gastroparesis.\n\t\t\t\t\tJ Neurogastroenterol Motil2010;\n\t\t\t\t\t16(\n\t\t\t\t\t4):\n\t\t\t\t\t407\u2013\n\t\t\t\t\t13."},{"issue":"2","key":"i1547-3317-59-3-152-b14","series-title":"J Vet Intern Med","first-page":"508","article-title":"Ultrasonographic evaluation of the effects of azithromycin on antral motility and gastric emptying in healthy cats","volume":"36","year":"2022","unstructured":"Rutherford\n S,\n \n 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Biol2015;\n\t\t\t\t\t31:\n\t\t\t\t\t260\u2013\n\t\t\t\t\t6."},{"issue":"8","key":"i1547-3317-59-3-152-b26","series-title":"NMR Biomed","first-page":"544","article-title":"Manganese toxicity upon overexposure","volume":"17","year":"2004","unstructured":"Crossgrove\n J\n \n \n Zheng\n W.\n \n \n Manganese toxicity upon overexposure.\n\t\t\t\t\tNMR Biomed2004;\n\t\t\t\t\t17(\n\t\t\t\t\t8):\n\t\t\t\t\t544\u2013\n\t\t\t\t\t53."},{"issue":"2","key":"i1547-3317-59-3-152-b27","series-title":"Neurotoxicology","first-page":"240","article-title":"Chelation therapy of manganese intoxication with para-aminosalicylic acid (PAS) in Sprague-Dawley rats","volume":"30","year":"2009","unstructured":"Zheng\n W,\n \n \n Jiang\n YM,\n \n \n Zhang\n Y,\n \n \n .\n\t\t\t\t\tChelation therapy of manganese intoxication with para-aminosalicylic acid (PAS) in Sprague-Dawley 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