IV chenodeoxycholate prevents calcium bilirubinate gallstones during total parenteral nutrition in the prairie dog

Background: The purpose of this study was to determine whether IV chenodeoxycholate (CDC) could prevent total parenteral nutrition (TPN)-associated pigmented gallstones in the prairie dog. Methods: Twelve prairie dogs were divided into two equal groups, each receiving an identical TPN regimen. Each animal received 92 kcal/d with 61% of the calories horn carbohydrate. The total volume of infusate delivered to each animal was 59 mL/d. Animals in one group, termed the TPN + CDC group, received a daily bolus injection of CDC at a dose of 15 mg/kg. Prairie dogs in the second group, termed the TPN group, received water (vehicle carrier) 1 ml/kg/d. The TPN and TPN + CDC groups received TPN for 40.3 +/- 1.3 and 42.5 +/- 0.6 days, respectively. Results: There was no statistical difference in the initial and final weights between the two groups. None of the TPN + CDC-treated animals had gallstones or calcium bilirubinate crystals. In contrast, all of the TPN-treated animals had calcium bilirubinate crystals (p = .002), and five of six had macroscopic black pigmented gallstones (p = .015). Cholesterol crystals were not observed in either group of animals. The amount of biliary bilirubin and ionized calcium was significantly greater in the TPN group (both p < .001); however, both groups had a similar total biliary calcium concentration. Conclusion: IV CDC is effective in preventing TPN-associated gallstones in the prairie dog.