Effect of N‐Acetylcysteine Supplementation on Intracellular Glutathione, Urine Isoprostanes, Clinical Score, and Survival in Hospitalized Ill Dogs

• DOI: 10.1111/jvim.12048
• Publication Date: 2013-03-04T22:58:20Z
• Authors: K.R. Viviano; B. VanderWielen
• Keywords: Male; 04 agricultural and veterinary sciences; Isoprostanes; Glutathione; Survival Analysis; Statistics, Nonparametric; 6. Clean water; Acetylcysteine; 3. Good health; 0403 veterinary science; Hospitals, Animal; Oxidative Stress; Selenium; Dogs; Case-Control Studies; Dietary Supplements; Animals; Vitamin E; Female; Dog Diseases; Prospective Studies

BackgroundAntioxidant depletion and lipid peroxidation have been correlated with disease severity and associated with poor outcomes.Hypothesis/ObjectivesSupplementing dogs with N‐acetylcysteine (NAC) during the first 48 hours of hospitalization will increase cysteine, normalize glutathione concentrations, and decrease the degree of lipid peroxidation associated with illness.AnimalsSixty systemically ill hospitalized client‐owned dogs and 14 healthy control dogs.MethodsRandomized investigator‐blinded, placebo‐controlled prospective study. Dogs were randomized to treatment with NAC (n = 30) versus placebo (n = 30). Antioxidants, urine 8‐isoprostane/creatinine (IP/Cr), and clinical score were determined before and after treatment with NAC. Glutathione, cysteine, and vitamin E concentrations were quantified using high‐performance liquid chromatography. Atomic absorption spectroscopy and enzyme‐linked immunosorbent assays were used to quantify selenium and isoprostane concentrations, respectively.ResultsIll dogs had significantly lower vitamin E concentrations (27 versus 55 μg/mL; P = .0005) as well as elevated IP/Cr ratios (872 versus 399 pg/mg; P = .0007) versus healthy dogs. NAC supplementation significantly increased plasma cysteine (8.67 versus 15.1 μM; P < .0001) while maintaining glutathione concentrations. Dogs in the placebo group experienced a statistically significant decrease in glutathione concentrations (1.49 versus 1.44 mM; P = .0463). Illness severity and survival were unchanged after short duration NAC supplementation.ConclusionsIll dogs experience systemic oxidative stress. Supplementation with NAC during the first 48 hours of hospitalization stabilized erythrocyte glutathione concentrations. The clinical impact of this supplementation and glutathione concentration stabilization was undetermined.