Battersby I A, Murphy K F, Tasker S, Papasouliotis K
School of Clinical Veterinary Science, Division of Companion Animals, University of Bristol, Langford, UK.
J Small Anim Pract. 2006 Jul;47(7):370-6. doi: 10.1111/j.1748-5827.2006.00042.x.
To analyse the demographic information of dogs referred for investigation of fever, to determine the usefulness of various diagnostic investigations and to assess the effect of treatment before referral on the presence of fever at referral, the duration of the investigation and the ability to reach a final diagnosis.
The clinical records of 66 dogs, in which fever was part of the clinical signs documented by the referring veterinary surgeon, were reviewed. The effects of treatment 24 hours before referral on temperature at initial consultation and on time to diagnosis were evaluated. The effect of body temperature at initial consultation on cost and on time to diagnosis was also determined. The effect of insurance on costs incurred was assessed. The utility of different diagnostic investigations was recorded, and cases were classified according to the final diagnosis.
Only 34.8 per cent of dogs were diagnosed with immune-mediated disease, with most frequent diagnoses being steroid-responsive meningitis and polyarthritis. Treatment 24 hours before referral significantly increased the time to diagnosis (P = 0.004) and affected the presence of fever at referral (P = 0.006). Insurance status did not significantly affect cost incurred by the owner.
This study documents a high incidence of immune-mediated disease in dogs referred for investigation of fever. It also documents a higher incidence of inflammatory central nervous system disease in febrile dogs than that reported previously. Of the diagnostic modalities employed in the majority of cases, radiography, cytology and bacteriological and fungal cultures (fluids/tissues) were the most useful. It is suggested that treatment is withdrawn or withheld before commencing diagnostic investigation of fever.
分析因发热转诊来进行检查的犬只的人口统计学信息,确定各种诊断检查的效用,并评估转诊前的治疗对转诊时发热情况、检查持续时间以及最终确诊能力的影响。
回顾了66只犬的临床记录,这些犬的发热是转诊兽医记录的临床症状之一。评估了转诊前24小时的治疗对初诊时体温及诊断时间的影响。还确定了初诊时体温对费用及诊断时间的影响。评估了保险对所产生费用的影响。记录了不同诊断检查的效用,并根据最终诊断对病例进行分类。
仅34.8%的犬被诊断为免疫介导性疾病,最常见的诊断是类固醇反应性脑膜炎和多关节炎。转诊前24小时的治疗显著增加了诊断时间(P = 0.004),并影响了转诊时的发热情况(P = 0.006)。保险状况对主人产生的费用没有显著影响。
本研究记录了因发热转诊的犬只中免疫介导性疾病的高发病率。还记录了发热犬中炎症性中枢神经系统疾病的发病率高于先前报道。在大多数病例中使用的诊断方法中,放射学、细胞学以及细菌学和真菌培养(体液/组织)最为有用。建议在开始对发热进行诊断检查之前停止或暂停治疗。