The clinical manifestations in diffuse parenchymal disorders with ascites like abdominal pain, limb edema, vomition, ascites weight gain, respiratory distress, inappetance and anorexia, lethargy and anemia started disappearing early in I b with complete recovery in 5-20 days, while it took 6-22 days for the resolution of clinical signs in I a affected dogs (Table 1) and death was seen in three dogs after initiation of therapy and remaining 13 dogs of sub group I a showed improvement in clinical signs (Fig 1- 4).
In the present study, there was a significant increase in the mean levels of hemoglobin, total erythrocyte count and non significant increase in the packed cell volume. While, a significant decrease in the total leucocyte count, neutrophils with no significant change with respect to lymphocytes, monocytes, eosinophils and basophils was observed in both the subgroups after the treatment. Though there was improvement in both the subgroups, the comparative means of hematological parameters of healthy, sub group I a and I b revealed that the treatment given to subgroup I b was more effective (Table 2). These findings were in accordance with
Saravanan et al. (2014) and
Bhadesiya et al., (2015), who observed improvement in the hematological parameters after therapy and may be due to the combined effects of hematinics and neutraceuticals.
S-adenosyl methionine (SAMe) is synthesized and degraded in the liver and methionine is actively transported into the liver and converted to SAMe by the enzyme methionine adenosyl transferase, which is impaired in the liver injury and thus SAMe becomes a conditionally essential nutrient. Administration of SAMe in cirrhosis and intrahepatic cholestasis replenishes hepatic GSH reserves, thereby improving their tolerance for free radical and re-perfusion type cell damage
(Centre, 2004). Silymarin or Silibinin is a naturally occurring flavanoids extracted from milk thistle (
Silibum marianum), has shown beneficial effects that includes anti oxidant effect, protective influence on membrane phospholipids, hepatic GSH, hepatocellular regeneration, suppression of fibrogenesis and promotion of fibrolysis
(Centre, 2000).
These findings are in concurrence with
Chaudhary et al., (2008), who reported that fluid therapy, nutritional support, neutraceuticals, anti emetics, H2 blockers, diuretics and anti-fibrinolytic drugs can be employed in the therapeutic management of hepatic disorders. Oral supplementation of nutraceuticals like S- adenosyl methionine and milk thistle along with antibiotics in the treatment of chronic hepatitis in dogs has been recommended by
Shih et al., (2007) and
Maddison (2016). Liver support in the form of supplementation with antioxidants like S-adenosyl methionine, milk thistle and vitamin E in dogs had a protective role particularly in inflammatory hepatopathies
(Marks, 2012).
In the present study, there was a significant decrease in the mean serum levels of ALT, AST, ALP, GGT, globulin and a non-significant decrease in total bilirubin, direct bilirubin, cholesterol, BUN and creatinine. While, a significant increase in the mean levels of total protein, albumin, glucose and a non-significant increase in the mean serum levels of sodium, potassium and chloride along with no significant change in CKMb activity was observed in both the subgroups after the treatment. Though, there was improvement in both the subgroups, the comparative means of biochemical parameters of healthy, sub group I a and I b revealed that the treatment given to I b was more effective (Table 3). Decrease in the mean values of ALT, AST, ALP, GGT, globulins, total bilirubin, direct bilirubin, cholesterol, BUN and creatinine after treatment is in agreement with
Saravanan et al., (2014) and
Elhiblu et al., (2015). Increase in the mean values of serum electrolytes after treatment was probably due to the supplementation of ions through fluid therapy and normal appetite. These findings were in agreement with
Ramprabhu et al., (2002).
Ultrasonography on the diffuse parenchymal disorders with ascites affected dogs of the therapeutic trial revealed hyperchoic liver parenchyma with anechoic ascetic fluid in between the hepatic lobes or in the abdomen on day 0, which showed consistent decline in their severity towards day 15 of therapy and day 30 after therapy in both the I a and I b sub groups (Fig 5-8), although the effect of therapy was more pronounced in I b subgroup compared to I a subgroup (Table 4).