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猫尿道梗阻伴严重贫血:17例(2002 - 2011年)

Severe anemia in cats with urethral obstruction: 17 cases (2002-2011).

作者信息

Beer Kari Santoro, Drobatz Kenneth J

机构信息

Section of Critical Care, Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2016 May;26(3):393-7. doi: 10.1111/vec.12437. Epub 2016 Jan 8.

Abstract

OBJECTIVE

To characterize clinical parameters of cats with severe anemia due to suspected urinary bladder hemorrhage associated with urethral obstruction.

DESIGN

Retrospective case-control study.

SETTING

University teaching hospital.

ANIMALS

Seventeen cats with urethral obstruction and severe anemia (group "UO-A") that required transfusion were identified via medical record database search. Thirty cats with urethral obstruction and mild or no anemia (group "UO") were included as controls.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The median PCV of all cases at presentation was 28% (range, 9%-47%). Seven cats had PCV ≤20% at presentation, and all transfused cats had PCV ≤20% at the time of transfusion. Three cats did not receive a transfusion despite PCV ≤18%. Cats in the UO-A group had a significantly longer duration of clinical signs (P = 0.001), and were more likely to have a history of previous urethral obstruction (P = 0.011), have a heart murmur (P = 0.002), have a gallop rhythm (P = 0.005), and have lower blood pressure (P = 0.007) compared to those in the UO group. Additionally, UO-A cats had significantly lower pH, more negative base excess, higher BUN, and higher creatinine compared to UO cats. Duration of urinary catheterization was significantly (P = 0.016) longer in UO-A cats. All UO cats survived to discharge, whereas 4/17 (23.5%) UO-A cats were euthanized (P = 0.013).

CONCLUSIONS

A history of previous urethral obstruction and longer duration of clinical signs may be important risk factors for severe anemia in UO cats. Additionally, UO-A cats appeared to be more severely affected, as evidenced by lower blood pressure, more severe metabolic acidosis, higher BUN and creatinine, and worse outcome.

摘要

目的

描述因怀疑膀胱出血伴尿道梗阻导致严重贫血的猫的临床参数。

设计

回顾性病例对照研究。

地点

大学教学医院。

动物

通过病历数据库搜索,确定了17只患有尿道梗阻和严重贫血(“UO-A”组)且需要输血的猫。将30只患有尿道梗阻且轻度贫血或无贫血(“UO”组)的猫作为对照。

干预措施

无。

测量指标及主要结果

所有病例就诊时的红细胞压积中位数为28%(范围为9%-47%)。7只猫就诊时红细胞压积≤20%,所有输血的猫在输血时红细胞压积≤20%。3只猫尽管红细胞压积≤18%但未接受输血。与“UO”组相比,“UO-A”组猫的临床症状持续时间显著更长(P = 0.001),更有可能有既往尿道梗阻史(P = 0.011)、有心脏杂音(P = 0.002)、有奔马律(P = 0.005)且血压较低(P = 0.007)。此外,与“UO”组猫相比,“UO-A”组猫的pH值显著更低、碱剩余更负、血尿素氮更高且肌酐更高。“UO-A”组猫的导尿持续时间显著更长(P = 0.016)。所有“UO”组猫均存活至出院,而17只“UO-A”组猫中有4只(23.5%)实施了安乐死(P = 0.013)。

结论

既往尿道梗阻史和较长的临床症状持续时间可能是尿道梗阻猫发生严重贫血的重要危险因素。此外,“UO-A”组猫似乎受影响更严重,表现为血压较低、代谢性酸中毒更严重、血尿素氮和肌酐更高以及预后更差。

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