Bersan E, Volk H A, Ros C, De Risio L
Department of Veterinary Science, Small Animal Teaching Hospital, University of Liverpool, Wirral, UK Animal Health Trust, Lanwades Park, Kentford, Newmarket, UK.
Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK.
Vet Rec. 2014 Sep 13;175(10):247. doi: 10.1136/vr.102158. Epub 2014 May 16.
The aim of this retrospective study was to assess prevalence, risk factors, clinical presentation and outcome of phenobarbitone induced haematological abnormalities (PBIHA) in dogs. The medical records of two veterinary referral institutions were searched for dogs diagnosed with idiopathic epilepsy and treated with PB as monotherapy or polytherapy between March 2003 and September 2010. Sixteen dogs had PBIHA; the median age at diagnosis was 69.5 months. Phenobarbitone was administered at a median dose of 3 mg/kg twice a day for a median period of 100.5 days and the median serum phenobarbitone level was 19 μg/ml. Two dogs had neutropenia, three had anaemia and thrombocytopenia, two had anaemia and neutropenia; the remaining nine had pancytopenia. All dogs were referred for non-specific clinical signs. Phenobarbitone was discontinued after diagnosis, and the median time to resolution of PBIHA was 17 days. The prevalence and risk factors for PBIHA were evaluated from a questionnaire survey of referring practices to obtain more detailed follow-up on cases diagnosed with idiopathic epilepsy. The prevalence rate of PBIHA was 4.2%, and the condition occurred in dogs treated with standard therapeutic doses often within the first three months after starting treatment. Serial haematological evaluations should be therefore considered from the beginning of phenobarbitone therapy to allow early diagnosis and treatment of PBIHA.
本回顾性研究的目的是评估犬苯巴比妥诱导的血液学异常（PBIHA）的患病率、危险因素、临床表现及预后。检索了两家兽医转诊机构2003年3月至2010年9月期间诊断为特发性癫痫并接受苯巴比妥单药或联合治疗的犬的病历。16只犬患有PBIHA；诊断时的中位年龄为69.5个月。苯巴比妥的中位给药剂量为3mg/kg，每日两次，中位给药时间为100.5天，血清苯巴比妥中位水平为19μg/ml。2只犬出现中性粒细胞减少，3只犬出现贫血和血小板减少，2只犬出现贫血和中性粒细胞减少；其余9只犬出现全血细胞减少。所有犬均因非特异性临床症状前来就诊。诊断后停用苯巴比妥，PBIHA缓解的中位时间为17天。通过对转诊机构的问卷调查评估PBIHA的患病率和危险因素，以获取对诊断为特发性癫痫病例更详细的随访信息。PBIHA的患病率为4.2%，该病症常见于接受标准治疗剂量的犬，通常在开始治疗后的前三个月内出现。因此，从苯巴比妥治疗开始就应考虑进行系列血液学评估，以便早期诊断和治疗PBIHA。
