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采用人工挤压、留置导尿或间歇性导尿管理的患有胸腰椎间盘突出症和膀胱功能障碍的犬的尿路感染

Urinary tract infection in dogs with thoracolumbar intervertebral disc herniation and urinary bladder dysfunction managed by manual expression, indwelling catheterization or intermittent catheterization.

作者信息

Bubenik Loretta, Hosgood Giselle

机构信息

Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.

出版信息

Vet Surg. 2008 Dec;37(8):791-800. doi: 10.1111/j.1532-950X.2008.00452.x.

Abstract

OBJECTIVE

To evaluate risk factors for lower urinary tract infection (UTI) in dogs with intervertebral disc disease (IVDD) that had manual expression (ME), indwelling catheterization (IDC) or intermittent catheterization (ITC) for urinary bladder management.

STUDY DESIGN

Randomized-clinical trial.

ANIMALS

Dogs (n=62) treated with urinary bladder dysfunction requiring surgery for IVDD and control dogs (n=30) that had surgery for reasons other than IVDD.

METHODS

Treated dogs were randomly assigned to ME, IDC, or ITC. Urine was collected for culture and antimicrobial susceptibility testing before and after treatment. Incidence and risk factors for UTI were evaluated. Bacterial isolates and antimicrobial resistance patterns were described.

RESULTS

Mean (+/-SD) time to urination was significantly longer for IDC dogs (7.4+/-2.75 days) than ME dogs (4.2+/-2.63) and ITC dogs (4.9+/-3.12). Thirteen treated dogs (21%) and no control dogs developed UTI: 4/25 (16%) ME, 8/25 (32%) IDC, and 1/12 (8%) ITC. Enterobacter sp. was most frequently isolated (4/13; 31%). Duration of treatment was the only risk factor for UTI and each additional day of treatment increased the risk of UTI 1.5 times.

CONCLUSION

For dogs with acute IVDD, the duration of required urinary bladder management establishes the risk of UTI, not the urinary bladder management technique.

CLINICAL RELEVANCE

Duration of treatment for urinary bladder dysfunction is a risk factor for UTI in dogs recovering from acute IVDD. Treatment for urinary bladder management should be limited where possible and no method of treatment is preferred. For dogs managed by IDC, voluntary urination might occur before clinically suspected.

摘要

目的

评估因椎间盘疾病(IVDD)而需进行膀胱管理(包括手法排尿(ME)、留置导尿(IDC)或间歇性导尿(ITC))的犬下尿路感染(UTI)的危险因素。

研究设计

随机临床试验。

动物

因膀胱功能障碍接受IVDD手术治疗的犬(n = 62)和因IVDD以外原因接受手术的对照犬(n = 30)。

方法

将接受治疗的犬随机分为ME组、IDC组或ITC组。在治疗前后收集尿液进行培养和抗菌药敏试验。评估UTI的发病率和危险因素。描述细菌分离株和抗菌耐药模式。

结果

IDC组犬(7.4±2.75天)排尿的平均(±标准差)时间显著长于ME组犬(4.2±2.63天)和ITC组犬(4.9±3.12天)。13只接受治疗的犬(21%)发生UTI,对照犬无UTI发生:ME组4/25(16%),IDC组8/25(32%),ITC组1/12(8%)。肠杆菌属最常分离到(4/13;31%)。治疗持续时间是UTI的唯一危险因素,治疗每增加一天,UTI风险增加1.5倍。

结论

对于急性IVDD犬,所需膀胱管理的持续时间决定UTI风险,而非膀胱管理技术。

临床意义

膀胱功能障碍的治疗持续时间是急性IVDD恢复犬UTI的危险因素。膀胱管理治疗应尽可能受限,且无首选治疗方法。对于接受IDC管理的犬,可能在临床怀疑之前就出现自主排尿。

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