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约克夏梗犬蛋白丢失性肠病的临床特征、肠道组织病理学及预后

Clinical features, intestinal histopathology, and outcome in protein-losing enteropathy in Yorkshire Terrier dogs.

作者信息

Simmerson S M, Armstrong P J, Wünschmann A, Jessen C R, Crews L J, Washabau R J

机构信息

Internal Medicine, Dogs and Cats Veterinary Referral and Emergency Hospital, Bowie, MD.

出版信息

J Vet Intern Med. 2014 Mar-Apr;28(2):331-7. doi: 10.1111/jvim.12291. Epub 2014 Jan 27.

Abstract

BACKGROUND

A poorly understood protein-losing enteropathy (PLE) disorder has been reported in Yorkshire Terrier dogs.

OBJECTIVES

To describe clinical features, intestinal histopathology, and outcome in Yorkshire Terrier dogs with PLE, and to identify variables predictive of outcome.

ANIMALS

Thirty client-owned Yorkshire Terrier dogs with PLE.

METHODS

Retrospective study. Records of dogs with a diagnosis of PLE were reviewed. Intestinal histopathology was interpreted using the World Small Animal Veterinary Association gastrointestinal histopathology classification system. Discriminate analysis techniques were used to identify variables predictive of outcome.

RESULTS

Females outnumbered males (20/30). Median age was 7 years (range 1-12). Common clinical signs were diarrhea (20/30), vomiting (11), ascites and abdominal distension (11), and respiratory difficulty (8). Histopathologic abnormalities included villous lymphatic dilatation, crypt lesions, villous stunting, and variable increases in cellularity of the lamina propria. All dogs were treated with glucocorticoids. Of 23 dogs with long-term follow-up, 9 had complete, and 3 had partial, resolution of signs, and 11 failed to respond to treatment. Median survival of responders was 44 months and of nonresponders was 12 months, with 4 dogs experiencing peracute death. Vomiting, monocytosis, severity of hypoalbuminemia, low blood urea nitrogen concentration, and villous blunting were predictive of survival <4 months.

CONCLUSIONS

In addition to classic GI signs, Yorkshire Terriers with PLE often show clinical signs associated with hypoalbuminemia and low oncotic pressure. Lymphatic dilatation, crypt lesions, and villous stunting are consistent histopathologic findings. Clinical outcomes are variable, but many dogs experience remission of clinical signs and prolonged survival.

摘要

背景

据报道,约克夏梗犬存在一种人们了解甚少的蛋白丢失性肠病(PLE)。

目的

描述患有PLE的约克夏梗犬的临床特征、肠道组织病理学及预后情况,并确定可预测预后的变量。

动物

30只客户拥有的患有PLE的约克夏梗犬。

方法

回顾性研究。对诊断为PLE的犬只记录进行回顾。肠道组织病理学采用世界小动物兽医协会胃肠组织病理学分类系统进行解读。采用判别分析技术确定可预测预后的变量。

结果

雌性犬数量多于雄性犬(20/30)。中位年龄为7岁(范围1 - 12岁)。常见临床症状为腹泻(20/30)、呕吐(11例)、腹水和腹胀(11例)以及呼吸困难(8例)。组织病理学异常包括绒毛淋巴扩张、隐窝病变、绒毛发育不良以及固有层细胞数量不同程度增加。所有犬只均接受糖皮质激素治疗。在23只接受长期随访的犬只中,9只症状完全缓解,3只部分缓解,11只对治疗无反应。有反应者的中位生存期为44个月,无反应者为12个月,4只犬发生急性死亡。呕吐、单核细胞增多、低白蛋白血症严重程度、低血尿素氮浓度以及绒毛变钝可预测生存期<4个月。

结论

除了典型的胃肠道症状外,患有PLE的约克夏梗犬常表现出与低白蛋白血症和低胶体渗透压相关的临床症状。淋巴扩张、隐窝病变和绒毛发育不良是一致的组织病理学表现。临床预后各不相同,但许多犬只临床症状缓解且生存期延长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80a0/4857982/ebdc94487d6f/JVIM-28-331-g001.jpg

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