高钙饲粮致糖尿病宠物兔碳酸钙尿石症的因果效应研究及外科治疗

C. M. Tarif, Subhasish Roy, P. Mukherjee, Kazem, Anyam Vijay Kishore, C. Saha, S. Nandi
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摘要

病例描述-一只9岁的新西兰白色雌性糖尿病兔(血糖水平~300 mg/dl)被送往印度加尔各答兽医临床综合门诊部,该兔在过去10天内有慢性减肥史,伴有食欲不振、多尿和血尿。喂养史表明,该动物采用富含钙的混合饮食。临床发现-手动检查显示,尾部附近有中度疼痛,膀胱附近有坚硬肿块,腹部直侧位X线片显示存在放射性致密膀胱结石。治疗和结果-进行了膀胱切开术,兔子顺利康复。对这块石头的分析表明碳酸钙是主要成分。临床相关性-本文描述了兔子尿石症的成功手术治疗,并提供了充分的证据,证明高钙饮食、特殊的钙代谢以及易患糖尿病的更多碳水化合物可能会引发尿石症。本研究还强调,糖尿病患者Na+-K+-ATP酶活性降低在导致膀胱功能障碍的外周血管和神经并发症的发病机制中起着关键作用,因此,糖尿病兔尿流量的减少导致了窝的形成,从而钙盐在窝内和周围的进一步积累导致了尿石症的形成。
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Calcium Carbonate Urolithiasis in a Diabetic Pet Rabbit Fed with High Dietary Calcium - Causal Effect Study and its Surgical Management
Case Description- A nine years old New Zealand white female diabetic rabbit (blood glucose level~300 mg/dl) was presented to the Department of Veterinary Clinical Complex OPD, Kolkata, India with a history of chronic weight loss along with inappetence, polyuria, haematuria from last 10 days. Feeding history revealed that the animal was maintained with a mixed diet that is rich in calcium (Ca). Clinical Findings- Manual examination revealed moderate pain near the caudal region and a hard mass was felt near the bladder region and a straight lateral radiograph of the abdomen revealed the presence of a radiodense cystolith.Treatment and Outcome- Cystotomy was done and the rabbit was recovered uneventfully. The analysis of the stone revealed calcium carbonate as the major content. Clinical Relevance- The present article describes successful surgical management of urolith in a rabbit and confers ample evidence that a high calcium diet, peculiar Ca metabolism along with more carbohydrate predisposing to diabetes may setup urolithiasis. The present study also emphasizes the fact that diminished Na+-K+-ATPase activity in diabetes can play a pivotal role in the pathogenesis of peripheral vascular and neural complications leading to the development of bladder dysfunction, hence diminished urine flow in diabetic rabbits results in the development of nidus formation and thereby further accumulation of calcium salts in and around nidus leads to the formation of urolithiasis.
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