Rossmeisl John H, Inzana Karen D
Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA.
J Am Vet Med Assoc. 2009 Jun 1;234(11):1425-31. doi: 10.2460/javma.234.11.1425.
To evaluate clinical signs, risk factors, and outcomes associated with bromide toxicosis (bromism) in dogs with idiopathic epilepsy treated with potassium or sodium bromide.
Retrospective case-control study.
83 clinically ill epileptic dogs with (cases; n = 31) and without (controls; 52) bromism.
Medical records were reviewed for information regarding signalment, epilepsy history, treatment, diet, clinicopathologic test results, concurrent diseases, clinical signs, and outcome. Case and control dogs were matched by the veterinary hospitals from which they were referred and by month of admission. A presumptive diagnosis of bromism was made in case dogs when treatment for primary clinical signs was limited to induction of diuresis or reduction in the dose of bromide administered, and this diagnosis was supported by serum bromide concentrations. Potential risk factors for bromism were identified via univariate and subsequent multivariate logistic regression analyses.
Common clinical signs of bromism included alterations in consciousness, ataxia, and upper and lower motor neuron tetraparesis and paraparesis. The multivariate analysis identified bromide dose at admission to the hospital as the only factor significantly associated with bromism. In all dogs with bromism, treatment via dose reduction or facilitated renal excretion of bromide resulted in rapid clinical improvement, although breakthrough seizures happened during treatment in 8 of 31 (26%) dogs.
Bromism is a clinically heterogeneous, dose-dependent neurotoxicosis that is largely reversible with treatment. Regular serial monitoring of serum bromide concentrations is recommended to optimize anticonvulsant treatment in dogs with idiopathic epilepsy.
评估用溴化钾或溴化钠治疗的特发性癫痫犬溴中毒（溴剂中毒）的临床体征、危险因素及预后。
回顾性病例对照研究。
83只临床患病的癫痫犬，其中患有溴中毒的犬（病例组；n = 31）和未患溴中毒的犬（对照组；52只）。
查阅病历，获取有关信号、癫痫病史、治疗、饮食、临床病理检查结果、并发疾病、临床体征及预后的信息。病例组和对照组犬按转诊的兽医医院及入院月份进行匹配。当针对主要临床体征的治疗仅限于诱导利尿或减少溴化物给药剂量，且血清溴化物浓度支持该诊断时，对病例组犬做出溴中毒的推定诊断。通过单因素及随后的多因素逻辑回归分析确定溴中毒的潜在危险因素。
溴中毒的常见临床体征包括意识改变、共济失调以及上下运动神经元性四肢轻瘫和截瘫。多因素分析确定入院时的溴化物剂量是与溴中毒显著相关的唯一因素。在所有患溴中毒的犬中，通过减少剂量或促进溴化物经肾排泄进行治疗，临床症状迅速改善，尽管31只犬中有8只（26%）在治疗期间出现了突破性癫痫发作。
溴中毒是一种临床异质性、剂量依赖性神经中毒，经治疗大多可逆转。建议定期连续监测血清溴化物浓度，以优化特发性癫痫犬的抗惊厥治疗。
