犬肝脓肿:一项对56例病例的多中心研究(2010-2019)。

IF 1.1 3区 农林科学 Q3 VETERINARY SCIENCES Journal of veterinary emergency and critical care Pub Date : 2023-11-09 DOI:10.1111/vec.13340
Jasper E. Burke VMD, DACVECC, Rebecka S. Hess DVM, MSCE, DACVIM, Elisa P. McEntee DVM, DACVIM, Maureen A. Griffin DVM, DACVS, Selimah M. Harmon DVM, Deborah C. Silverstein DVM, DACVECC
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引用次数: 0

摘要

目的:探讨确诊肝脓肿的犬的临床表现、治疗策略和结果。设计:2010年至2019年的回顾性队列研究。设置:多中心研究。动物:56只客户饲养的狗,经培养、细胞学或组织病理学证实有肝脓肿。测量和主要结果:狗表现为嗜睡(39/56)、低食欲(31/56)和呕吐(26/56)。异常体检结果包括体温升高(41/56)和腹痛(22/54)。CBC显示中性粒细胞增多症(31/49)、毒性变化(25/49)、贫血(28/49)和血小板减少症(23/49)。生化分析显示碱性磷酸酶增加(45/50)、丙氨酸氨基转移酶增加(40/50)、低白蛋白血症(25/48)和高胆红素血症(19/49)。49只狗中有13只出现低血糖。48只狗中有37只经超声检查发现肝脓肿直径在0.5至15cm之间;37例中有19例为孤立性脓肿,18例为多灶性脓肿。大肠杆菌是最常见的培养物,42例中分离出18例。组织病理学显示47只狗中有10只有潜在的肝脏肿瘤。49只狗中有41只接受了手术治疗,41只中有35只存活出院。49只狗中有8只进行了医疗管理,8只中有5只存活出院。单因素分析显示,低血糖症和多灶性脓肿与生存几率降低有关(比值比[OR]:0.2,95%可信区间[CI]:0.03-0.9,P=0.04;比值比=0.07,95%置信区间0.01-0.6,P=0.02)。通过多变量分析,只有多灶性脓肿与生存几率降低有关(OR:0.09,95%CI:0.01-0.87,P=0.04)。在这项研究中,狗的出院存活率与之前报道的存活率一致,56只狗中有40只(71%)存活出院。没有评估的变量能够预测出院后的存活率;然而,低血糖和多灶性脓肿应该在更大的人群中进行评估,以确定预后的意义。
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Hepatic abscessation in dogs: A multicenter study of 56 cases (2010–2019)

Objective

To investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation.

Design

Retrospective cohort study from 2010 to 2019.

Setting

Multicenter study.

Animals

Fifty-six client-owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology.

Measurements and Main Results

Dogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56). Abnormal physical examination findings included increased temperature (41/56) and abdominal pain (22/54). CBCs revealed neutrophilia (31/49), toxic changes (25/49), anemia (28/49), and thrombocytopenia (23/49). Biochemical analyses revealed increased alkaline phosphatase (45/50), increased alanine aminotransferase (40/50), hypoalbuminemia (25/48), and hyperbilirubinemia (19/49). Hypoglycemia was found in 13 of 49 dogs. Hepatic abscesses ranging from 0.5 to 15 cm in diameter were identified ultrasonographically in 37 of 48 dogs; 19 of 37 had solitary abscesses, and 18 of 37 had multifocal abscessation. Escherichia coli was the most commonly cultured organism, isolated in 18 of 42 cases. Histopathology revealed underlying hepatic neoplasia in 10 of 47 dogs. Surgical management was performed in 41 of 49 dogs, and 35 of 41 survived to discharge. Medical management was performed in 8 of 49 dogs, and 5 of 8 survived to discharge. With univariate analysis, hypoglycemia and multifocal abscessation were associated with decreased odds of survival (odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.03–0.9, P = 0.04; OR: 0.07, 95% CI: 0.01–0.6, P = 0.02, respectively). With multivariate analysis, only multifocal abscessation was associated with decreased odds of survival (OR: 0.09, 95% CI: 0.01–0.87, P = 0.04).

Conclusions

Hepatic abscessation, although rare, should remain a differential diagnosis for dogs presenting with nonspecific clinical signs and increase liver enzyme activities, especially with concurrent increased temperature and neutrophilia. Rate of survival to discharge for dogs in this study was consistent with previously reported survival rates, with 40 of 56 (71%) of the total population surviving to discharge. No variables assessed were able to predict survival to discharge; however, hypoglycemia and multifocal abscessation should be assessed in larger populations to determine prognostic significance.

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来源期刊
CiteScore
2.50
自引率
15.40%
发文量
121
审稿时长
18-36 weeks
期刊介绍: The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.
期刊最新文献
Fabio Viganó Jennifer J. Devey Issue Information - Prelim AUTHOR INDEX Abstracts from the International Veterinary Emergency and Critical Care Symposium and the European Veterinary Emergency and Critical Care Annual Congress 2024
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