G Caporali Evelyn H, Phillips Heidi, Underwood Lucy, Selmic Laura E
Veterinary Teaching Hospital, University of Illinois, Urbana, IL 61821.
J Am Vet Med Assoc. 2015 Mar 1;246(5):530-6. doi: 10.2460/javma.246.5.530.
To identify risk factors for urolithiasis in dogs with congenital extrahepatic portosystemic shunts (EHPSSs) and to determine whether portoazygos shunts were associated with increased risk of urolithiasis at the initial evaluation for EHPSS.
Retrospective case series.
Dogs (n = 95) with EHPSSs confirmed via CT angiography or surgery.
Medical records from 1999 to 2013 were reviewed. Variables of interest included signalment, previous medical management, and results of urinalysis, urolith analyses, and diagnostic imaging. Univariable and multivariable logistic regression analyses for assessment of risk factors for urolithiasis at the time of initial EHPSS evaluation were performed.
The dogs' median age was 0.9 years (range, 0.2 to 12.6 years). Among the 95 dogs, 27 (28.4%) and 68 (71.6%) had portoazygos and portocaval shunts, respectively. Urinalysis was performed for 79 (83.2%) dogs, 29 (36.7%) of which had crystalluria (mainly ammonium urate and struvite crystals). Uroliths were present in 34 of 95 (35.8%) dogs; 16 of 17 uroliths analyzed were composed of ammonium urate. Portoazygos shunts were not associated with significantly increased odds of urolithiasis at the time of the initial evaluation for EHPSS. However, the odds of urolithiasis was significantly increased for male dogs, older dogs, and dogs that received previous medical treatment.
In dogs with EHPSS, shunt morphology was not associated with increased odds of urolithiasis at the initial evaluation. Male dogs, older dogs, and dogs having received medical management for EHPSS prior to initial evaluation should be considered at increased risk for development of urolithiasis.
确定患有先天性肝外门体分流(EHPSS)的犬尿石症的风险因素,并确定在对EHPSS进行初次评估时,奇静脉分流是否与尿石症风险增加相关。
回顾性病例系列研究。
通过CT血管造影或手术确诊为EHPSS的犬(n = 95)。
回顾1999年至2013年的病历。感兴趣的变量包括特征、既往医疗管理以及尿液分析、尿石分析和诊断成像结果。对初次EHPSS评估时尿石症的风险因素进行单变量和多变量逻辑回归分析。
犬的中位年龄为0.9岁(范围为0.2至12.6岁)。在95只犬中,分别有27只(28.4%)和68只(71.6%)患有奇静脉分流和腔静脉分流。对79只(83.2%)犬进行了尿液分析,其中29只(36.7%)有结晶尿(主要为尿酸铵和鸟粪石晶体)。95只犬中有34只(35.8%)存在尿石;分析的17颗尿石中有16颗由尿酸铵组成。在对EHPSS进行初次评估时,奇静脉分流与尿石症几率显著增加无关。然而,雄性犬、年龄较大的犬以及接受过既往治疗的犬患尿石症的几率显著增加。
在患有EHPSS的犬中,初次评估时分流形态与尿石症几率增加无关。雄性犬、年龄较大的犬以及在初次评估前因EHPSS接受过治疗的犬应被视为患尿石症的风险增加。