Martinez Stephen A, Hostutler Roger A
Department of Internal Medicine, MedVet Medical and Cancer Centers for Pets, Worthington, OH.
J Am Anim Hosp Assoc. 2014 May-Jun;50(3):203-8. doi: 10.5326/JAAHA-MS-5993. Epub 2014 Mar 21.
A 9 yr old spayed female boxer was presented for evaluation of vomiting, lethargy, anorexia, and weight loss. Initial laboratory evaluation revealed a hyperchloremic normal anion gap metabolic acidosis with alkaline urine that was consistent with a diagnosis of distal renal tubular acidosis (RTA). Targeted therapy was initiated with Na bicarbonate (HCO3) and potassium (K) gluconate. Leptospirosis was subsequently diagnosed with paired microagglutination testing (MAT), and doxycycline was added to the other treatments. Clinical signs resolved, and 6 mo after diagnosis, although the dog remained on alkali therapy (i.e., NaHCO3 and K gluconate) and a mild metabolic acidosis persisted, the dog remained otherwise healthy with a good quality of life. To the authors' knowledge, this is the first report to describe the concomitant association of those two disorders. Leptospirosis should be considered for any case of RTA in dogs.
一只9岁已绝育的雌性拳师犬因呕吐、嗜睡、厌食和体重减轻前来接受评估。初步实验室检查显示为高氯性正常阴离子间隙代谢性酸中毒且尿液呈碱性,这与远端肾小管酸中毒(RTA)的诊断相符。开始采用碳酸氢钠(HCO3)和葡萄糖酸钾(K)进行靶向治疗。随后通过双份微量凝集试验(MAT)诊断出钩端螺旋体病,并在其他治疗基础上加用了强力霉素。临床症状得到缓解,诊断6个月后,尽管该犬仍在接受碱疗法(即碳酸氢钠和葡萄糖酸钾)且轻度代谢性酸中毒持续存在,但犬只在其他方面保持健康,生活质量良好。据作者所知,这是第一份描述这两种疾病并存关联的报告。对于犬类的任何RTA病例都应考虑钩端螺旋体病。