Ployngam Trasida, Tobias Anthony H, Smith Stephanie A, Torres Sheila M F, Ross Sheri J
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, MN 55108, USA.
Am J Vet Res. 2006 Apr;67(4):583-7. doi: 10.2460/ajvr.67.4.583.
To investigate the mechanisms by which corticosteroid administration may predispose cats to congestive heart failure (CHF).
12 cats receiving methylprednisolone acetate (MPA) for the treatment of dermatologic disorders.
The study was conducted as a repeated-measures design. Various baseline variables were measured, after which MPA (5 mg/kg, IM) was administered. The same variables were then measured at 3 to 6 days and at 16 to 24 days after MPA administration. Evaluations included physical examination, systolic blood pressure measurement, hematologic analysis, serum biochemical analysis, thoracic radiography, echocardiography, and total body water and plasma volume determination.
MPA resulted in a substantial increase in serum glucose concentration at 3 to 6 days after administration. Concurrently, RBC count, Hct, and hemoglobin concentration as well as serum concentrations of the major extracellular electrolytes, sodium and chloride, decreased. Plasma volume increased by 13.4% (> 40% in 3 cats), whereas total body water and body weight slightly decreased. All variables returned to baseline by 16 to 24 days after MPA administration.
These data suggest that MPA administration in cats causes plasma volume expansion as a result of an intra to extracellular fluid shift secondary to glucocorticoid-mediated extracellular hyperglycemia. This mechanism is analogous to the plasma volume expansion that accompanies uncontrolled diabetes mellitus in humans. Any cardiovascular disorders that impair the normal compensatory mechanisms for increased plasma volume may predispose cats to CHF following MPA administration.
研究给予皮质类固醇使猫易患充血性心力衰竭(CHF)的机制。
12只接受醋酸甲基泼尼松龙(MPA)治疗皮肤病的猫。
本研究采用重复测量设计。测量各种基线变量,之后给予MPA(5mg/kg,肌肉注射)。然后在给予MPA后的3至6天以及16至24天测量相同的变量。评估包括体格检查、收缩压测量、血液学分析、血清生化分析、胸部X线摄影、超声心动图以及全身水和血浆容量测定。
MPA导致给药后3至6天血清葡萄糖浓度大幅升高。同时,红细胞计数、血细胞比容、血红蛋白浓度以及主要细胞外电解质钠和氯的血清浓度降低。血浆容量增加了13.4%(3只猫中超过40%),而全身水和体重略有下降。在给予MPA后的16至24天,所有变量均恢复至基线水平。
这些数据表明,猫给予MPA后,由于糖皮质激素介导的细胞外高血糖继发的细胞内至细胞外液转移,导致血浆容量扩张。该机制类似于人类未控制的糖尿病所伴随的血浆容量扩张。任何损害血浆容量增加的正常代偿机制的心血管疾病,都可能使猫在给予MPA后易患CHF。