Nevins Jonathan R, Mai Wilfried, Thomas Emily
Section of Radiology, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
Section of Emergency and Critical Care, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
Vet Radiol Ultrasound. 2015 Jul-Aug;56(4):439-47. doi: 10.1111/vru.12259. Epub 2015 Apr 8.
Urethral obstruction is a life-threatening form of feline lower urinary tract disease. Ultrasonographic risk factors for reobstruction have not been previously reported. Purposes of this retrospective cross-sectional study were to describe urinary tract ultrasound findings in cats following acute urethral obstruction and determine whether ultrasound findings were associated with reobstruction. Inclusion criteria were a physical examination and history consistent with urethral obstruction, an abdominal ultrasound including a full evaluation of the urinary system within 24 h of hospitalization, and no cystocentesis prior to ultrasound examination. Medical records for included cats were reviewed and presence of azotemia, hyperkalemia, positive urine culture, and duration of hospitalization were recorded. For medically treated cats with available outcome data, presence of reobstruction was also recorded. Ultrasound images were reviewed and urinary tract characteristics were recorded. A total of 87 cats met inclusion criteria. Common ultrasound findings for the bladder included echogenic urine sediment, bladder wall thickening, pericystic effusion, hyperechoic pericystic fat, and increased urinary echoes; and for the kidneys/ureters included pyelectasia, renomegaly, perirenal effusion, hyperechoic perirenal fat, and ureteral dilation. Six-month postdischarge outcomes were available for 61 medically treated cats and 21 of these cats had reobstruction. No findings were associated with an increased risk of reobstruction. Ultrasonographic perirenal effusion was associated with severe hyperkalemia (P = 0.009, relative risk 5.75, 95% confidence interval [1.54-21.51]). Findings supported the use of ultrasound as an adjunct for treatment planning in cats presented with urethral obstruction but not as a method for predicting risk of reobstruction.
尿道梗阻是猫下泌尿道疾病中一种危及生命的形式。此前尚未报道过再梗阻的超声危险因素。这项回顾性横断面研究的目的是描述急性尿道梗阻后猫的泌尿系统超声检查结果,并确定超声检查结果是否与再梗阻有关。纳入标准为体格检查和病史与尿道梗阻相符、住院24小时内进行腹部超声检查且对泌尿系统进行全面评估、超声检查前未进行膀胱穿刺术。对纳入研究的猫的病历进行回顾,并记录氮质血症、高钾血症、尿培养阳性情况及住院时间。对于有可用结局数据的接受药物治疗的猫,还记录再梗阻情况。对超声图像进行回顾并记录泌尿系统特征。共有87只猫符合纳入标准。膀胱常见的超声检查结果包括尿液回声增强、膀胱壁增厚、膀胱周围积液、膀胱周围高回声脂肪及尿液回声增加;肾脏/输尿管的常见超声检查结果包括肾盂积水、肾肿大、肾周积液、肾周高回声脂肪及输尿管扩张。61只接受药物治疗的猫有出院后6个月的结局数据,其中21只猫发生了再梗阻。没有发现与再梗阻风险增加相关的因素。超声检查发现的肾周积液与严重高钾血症相关(P = 0.009,相对风险5.75,95%置信区间[1.54 - 21.51])。研究结果支持将超声作为尿道梗阻猫治疗计划的辅助手段,但不能作为预测再梗阻风险的方法。