Severe Hepatic and Neurologic Complications Secondary to Inflammatory Bowel Disease in an Amur Tiger (Panthera tigris altaica)
Inflammatory bowel disease (IBD) is starting to be recognized in the captive tiger population. This report outlines a case of controlled IBD that decompensated into acute liver failure and neurologic disease. An adult 5-year-old intact male Amur tiger (Panthera tigris altaica) with intermittent loose fetid feces with undigested food was diagnosed with marked chronic lymphoplasmacytic colitis. Oral prednisolone (0.88 mg/kg BID) and metronidazole (18.9 mg/kg BID) improved his condition. After he was switched from horsemeat (Classic feline diet, Nebraska Brand, North Platte, NE, USA) to beef (Premium beef, Nebraska Brand), the metronidazole was discontinued and the prednisolone tapered off.
Approximately 1 year later, the diet was changed to a different beef product (Special beef, Nebraska Brand). The feces became abnormal again and metronidazole was prescribed. He became anorexic and lethargic with acute severe bilirubinuria and had a short seizure prior to emergency immobilization. He had marked icterus, bilirubinemia (17.4 mg/dl), and elevated bile acids (>300 µmol/l). Moderate lymphoplasmacytic cholangiohepatitis was diagnosed via percutaneous liver biopsies. Following the procedure, he had abdominal pain, mental dullness, severe ataxia, and several small seizures but was compliant with all supportive medicines prescribed. The ataxia and weakness improved after 2 weeks. Due to 7 weeks of intermittent epistaxis, Yunnan Baiyao (Prince of Peace Enterprises, Hayward, CA, USA), a Chinese herb, was given for its hemostatic properties. Maintenance therapy consists of oral prednisolone (0.55 mg/kg q 48 h), metronidazole (5.5 mg/kg SID) and Ursodiol (6.5 mg/kg 2x/week) and the Premium beef diet.