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一只狗因反应性支气管肺炎继发自发性气胸。

Spontaneous pneumothorax secondary to reactive bronchopneumopathy in a dog.

作者信息

Boudreau Bianca, Nelson Laura L, Carey Stephan A, Williams Kurt J

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA.

出版信息

J Am Vet Med Assoc. 2013 Mar 1;242(5):658-62. doi: 10.2460/javma.242.5.658.

Abstract

CASE DESCRIPTION

An 8-year-old 38-kg (84-lb) castrated male German Shepherd Dog cross was evaluated because of respiratory distress secondary to pneumothorax (detected radio-graphically prior to referral).

CLINICAL FINDINGS

CT of the thorax confirmed the presence of pneumothorax and revealed pulmonary blebs without evidence of infiltrative pulmonary changes. A tentative diagnosis of primary spontaneous pneumothorax was made.

TREATMENT AND OUTCOME

Exploratory median sternotomy revealed emphysematous changes along the margins of all lung lobes, with the ventral margins of the left cranial, right cranial, and right middle lung lobes most affected. Partial lobectomies of the ventral aspects of these lobes were performed. Histologic examination of tissue samples from the lung lobes revealed diffuse smooth muscle hypertrophy of the terminal and respiratory bronchioles with moderate numbers of peribronchiolar eosinophils. Mucus plugs and mucous cell metaplasia within the airway epithelium were also evident. After surgery, clinical signs resolved and the dog was discharged from the hospital 2 days later. Eight months after surgery, the dog developed a mild cough, and treatment with prednisolone (tapering dosage starting at 0.5 mg/kg [0.023 mg/lb], PO, q 12 h) was initiated. Dosage reduction resulted in recurrence of coughing; however, with continued prednisolone treatment at a dosage of 0.5 mg/kg, PO, once daily, the dog was not coughing at 10 months after surgery.

CLINICAL RELEVANCE

Reactive bronchopneumopathy should be included as a differential diagnosis for spontaneous pneumothorax in dogs.

摘要

病例描述

一只8岁、体重38千克(84磅)的去势雄性德国牧羊犬杂交犬因气胸继发呼吸窘迫前来评估(转诊前通过X光检查发现)。

临床发现

胸部CT证实存在气胸,并显示有肺大疱,无浸润性肺部改变的证据。初步诊断为原发性自发性气胸。

治疗与结果

经胸骨正中切开探查发现所有肺叶边缘有气肿改变,左前叶、右前叶和右中叶腹侧边缘受影响最严重。对这些肺叶腹侧部分进行了部分肺叶切除术。对肺叶组织样本进行组织学检查发现终末细支气管和呼吸性细支气管弥漫性平滑肌肥大,伴有中等数量的支气管周围嗜酸性粒细胞。气道上皮内的黏液栓和黏液细胞化生也很明显。术后临床症状缓解,该犬于2天后出院。术后8个月,该犬出现轻度咳嗽,开始用泼尼松龙治疗(起始剂量为0.5毫克/千克[0.023毫克/磅],口服,每12小时一次,逐渐减量)。剂量减少导致咳嗽复发;然而,以0.5毫克/千克的剂量持续口服泼尼松龙治疗,术后10个月该犬不再咳嗽。

临床意义

反应性支气管肺炎应作为犬自发性气胸的鉴别诊断之一。

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