Hepatic lipidosis in nine African white-bellied pangolins (

Introduction: The African white-bellied pangolin ( Methods: This report describes hepatic lipidosis in these pangolins (clinical presentation, diagnostic imaging, clinicopathologic and postmortem findings) and summarizes clinically relevant predictors of disease. Results: The time from the onset of illness to death ranged from 2 to 75 days (median 23 days). Obesity was noted prior to clinical presentation for illness in 4/9 animals. All pangolins had anorexia and lethargy; other common clinical signs included constipation (6/9), vomiting or regurgitation (6/9), and/or dyspnea (5/9). Increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were observed in 7/9 animals, hyperbilirubinemia in 5/9, and increased bile acids in 5/9. Serum selenium was low in 3/9 animals, but vitamin E concentrations were normal. Hypertriglyceridemia was uncommon during illness (1/9). Evidence of renal dysfunction was also common, and included glucosuria (6/6), proteinuria (7/7), and azotemia (6/9). Ultrasound was the most reliable imaging technique at identifying hepatic lipidosis as evidenced by hepatomegaly and increased echogenicity. Despite variable treatment including assisted feeding, hepatoprotectants, fluid therapy, gastroprotectants, antibiotics, and/or antiemetics, all cases were ultimately fatal. Each of the animals had comorbidities or an inciting reason for anorexia that led to negative energy balance. In 5/9, resultant hepatic lipidosis was severe and deemed the primary cause of death or euthanasia. Discussion: This case series suggests that white-bellied pangolins are prone to developing hepatic lipidosis following a period of anorexia secondary to other underlying disease processes. Elevated AST, ALT, bilirubin, and bile acids in an anorectic and lethargic pangolin should provide a high index of suspicion for hepatic lipidosis. Further study is needed to evaluate pangolins for potential unique polyunsaturated fatty acid or other species-specific dietary requirements.