Thiacetarsamide in dogs with Dirofilaria immitis: influence of decreased liver function on drug efficacy

The influence that decreased functional hepatic mass had on blood arsenic concentrations in dogs after they were treated with thiacetarsamide, on the clearance of indocyanine green (ICG), on arsenic concentrations in the heartworm (Dirofilaria immitis), and on drug efficacy was studied. Dogs which were partially hepatectomized and treated with thiacetarsamide (1.76 mg/kg, 2 times a day for 2 days) had a significantly (P less than 0.01) reduced ICG clearance, significantly (P less than 0.01) higher arsenic levels in heartworms, and a significantly (P less than 0.01) higher proportion of heartworms killed than did dogs that were sham operated and treated with thiacetarsamide or sham operated and untreated. There were no significant differences in blood arsenic (thiacetarsamide) concentrations 2 minutes after injection between hepatectomized and nonhepatectomized groups. More male heartworms were killed than were female worms in the thiacetarsamide-treated groups. Indocyanine green half-life was longer (12.43 minutes) in the hepatectomized group than it was in the nonhepatectomized sham-operated groups (5.09 and 4.94 minutes). Indocyanine green clearance rate was lower in the hepatectomized group (0.54 ml/min/kg) than that in the nonhepatectomized groups (1.36 and 1.56 ml/min/kg). A parallel seemed to exist between ICG and thiacetarsamide removal from the blood by the liver. This parallel also was suggested in the higher worm arsenic (thiacetarsamide) concentrations for the hepatectomized group vs that for nonhepatectomized groups. Apparently, the slower the removal of thiacetarsamide from the blood by the liver, the higher the worm arsenic level and, consequently, the higher the worm kill.