Bilderback Ann L, Faissler Dominik
Long Island Veterinary Specialists, Plainview, NY 11803, USA.
J Vet Emerg Crit Care (San Antonio). 2009 Oct;19(5):507-12. doi: 10.1111/j.1476-4431.2009.00467.x.
To describe the successful surgical management of a brain abscess in a dog secondary to bite wound.
A 10-year-old neutered female Welsh Corgi/Chihuahua, weighing 5.3 kg, was presented for evaluation of seizures, ataxia, and falling to the left 8 days after a presumptive fight with another dog. On examination at presentation, the dog was alert, responsive, and ambulatory with tetra-ataxia, falling to the left, left-sided postural deficits, and absent left menace response. Within 24 hours, the dog progressed to nonambulatory tetraparesis with minimal motor, absent postural reactions of all limbs, left nasal hypalgesia, reduced gag reflex, and depressed mentation. Computed tomographic images of the brain were suggestive of a bite wound fracture of the right parietal bone with secondary meningoencephalitis, right parietal lobe abscessation, and white matter edema adjacent to the bone fracture. A modified right rostrotentorial craniectomy was performed, the abscess was identified, contents of the abscess were removed, and the surgical site was flushed extensively before closing. Corynebacterium spp. was cultured from within the abscess. Within hours of surgery, the dog was quiet but alert, responsive, and sitting up in her cage. In addition to surgical intervention, intensive care, broad-spectrum IV antimicrobials, and supportive therapy led to significant neurologic improvement with only occasional seizures and mild postural reaction deficits of the left hindlimb remaining.
Abscess formation within the CNS is uncommon in dogs and cats and is associated with a high mortality rate. In veterinary medicine the management of brain abscesses is controversial with limited information available regarding treatment. This is the first case report that demonstrates surgical intervention in combination with antimicrobial therapy can be used successfully in the treatment of a canine brain abscess.
描述一只因咬伤继发脑脓肿的犬的成功手术治疗。
一只10岁已绝育的雌性威尔士柯基/吉娃娃犬，体重5.3千克，在与另一只犬推测发生打斗8天后，因癫痫发作、共济失调和向左摔倒前来评估。就诊时检查发现，该犬警觉、反应灵敏且能行走，但有四肢共济失调、向左摔倒、左侧姿势缺陷以及左侧威胁反射消失。在24小时内，该犬进展为非行走性四肢轻瘫，运动极少，所有肢体均无姿势反应，左侧鼻部痛觉减退，咽反射减弱，精神沉郁。脑部计算机断层扫描图像提示右顶骨咬伤骨折继发脑膜脑炎、右顶叶脓肿形成以及骨折邻近白质水肿。实施改良右侧经额颞部颅骨切除术，确定脓肿位置，清除脓肿内容物，在关闭手术部位前广泛冲洗。从脓肿内培养出棒状杆菌属。术后数小时，该犬安静但警觉、反应灵敏，在笼中坐起。除手术干预外，重症监护、广谱静脉用抗菌药物和支持治疗使神经功能有显著改善，仅偶尔发生癫痫，左后肢仅有轻度姿势反应缺陷。
中枢神经系统内脓肿形成在犬猫中不常见，且死亡率高。在兽医学中，脑脓肿的治疗存在争议，关于治疗的可用信息有限。这是首例证明手术干预联合抗菌治疗可成功用于治疗犬脑脓肿的病例报告。
