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食用食源性肝毒性黄曲霉毒素的犬的临床及临床病理特征:72例病例(2005 - 2006年)

Clinical and clinicopathologic features of dogs that consumed foodborne hepatotoxic aflatoxins: 72 cases (2005-2006).

作者信息

Dereszynski Diane M, Center Sharon A, Randolph John F, Brooks Marjory B, Hadden Alice G, Palyada Kiran S, McDonough Sean P, Messick Joanne, Stokol Tracy, Bischoff Karyn L, Gluckman Stuart, Sanders Sara Y

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.

出版信息

J Am Vet Med Assoc. 2008 May 1;232(9):1329-37. doi: 10.2460/javma.232.9.1329.

Abstract

OBJECTIVE

To characterize clinical signs, clinicopathologic features, treatments, and survival in dogs with naturally acquired foodborne aflatoxicosis.

DESIGN

Retrospective case series.

ANIMALS

72 dogs that consumed aflatoxin-contaminated commercial dog food.

PROCEDURES

Medical records of affected dogs were reviewed. Between December 2005 and March 2006, dogs were identified as having foodborne aflatoxin hepatotoxicosis on the basis of the history of consumption of contaminated food or characteristic histopathologic lesions (subject dog or a recently deceased dog in the same household or kennel). Recorded information included signalment, clinical features, clinicopathologic test results, treatments, and survival. Data were analyzed by survival status.

RESULTS

Most dogs were of large breeds from breeding kennels. No significant differences were found in age or weight between 26 (36%) survivor dogs and 46 (64%) nonsurvivor dogs. Severity of clinical signs varied widely; 7 dogs died abruptly. In order of onset, clinical features included anorexia, lethargy, vomiting, jaundice, diarrhea (melena, hematochezia), abdominal effusion, peripheral edema, and terminal encephalopathy and hemorrhagic diathesis. Common clinicopathologic features included coagulopathic and electrolyte disturbances, hypoproteinemia, increased serum liver enzyme activities, hyperbilirubinemia, and hypocholesterolemia. Cytologic hepatocellular lipid vacuolation was confirmed in 11 dogs examined. In comparisons of clinicopathologic test results between survivor and nonsurvivor dogs, only granular cylindruria (7/21 dogs) consistently predicted death. Best early markers of aflatoxicosis were low plasma activities of anticoagulant proteins (protein C, antithrombin) and hypocholesterolemia. Despite aggressive treatment, many but not all severely affected dogs died.

CONCLUSIONS AND CLINICAL RELEVANCE

Serum liver enzyme activities and bilirubin concentration were unreliable early markers of aflatoxin hepatotoxicosis in dogs. Hypocholesterolemia and decreased plasma protein C and antithrombin activities may function as exposure biomarkers.

摘要

目的

描述自然发生食源性黄曲霉毒素中毒犬的临床体征、临床病理特征、治疗方法及存活情况。

设计

回顾性病例系列研究。

动物

72只食用了受黄曲霉毒素污染的商业犬粮的犬。

方法

查阅患病犬的病历。在2005年12月至2006年3月期间,根据食用受污染食物的病史或特征性组织病理学病变(受试犬或同一家庭或犬舍中最近死亡的犬),确定犬患有食源性黄曲霉毒素肝中毒。记录的信息包括信号转导、临床特征、临床病理检查结果、治疗方法及存活情况。按存活状态对数据进行分析。

结果

大多数犬为来自繁殖犬舍的大型犬种。26只(36%)存活犬和46只(64%)非存活犬在年龄或体重上未发现显著差异。临床体征的严重程度差异很大;7只犬突然死亡。按发病顺序,临床特征包括厌食、嗜睡、呕吐、黄疸、腹泻(黑便、便血)、腹腔积液、外周水肿以及终末期脑病和出血素质。常见的临床病理特征包括凝血功能障碍和电解质紊乱、低蛋白血症、血清肝酶活性升高、高胆红素血症和低胆固醇血症。在接受检查的11只犬中证实有肝细胞脂质空泡化。在比较存活犬和非存活犬的临床病理检查结果时,只有颗粒管型尿(21只犬中的7只)始终可预测死亡。黄曲霉毒素中毒的最佳早期标志物是抗凝蛋白(蛋白C、抗凝血酶)的低血浆活性和低胆固醇血症。尽管进行了积极治疗,但许多但并非所有严重受影响的犬死亡。

结论及临床意义

血清肝酶活性和胆红素浓度在犬黄曲霉毒素肝中毒中并非可靠的早期标志物。低胆固醇血症以及血浆蛋白C和抗凝血酶活性降低可能作为暴露生物标志物。

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