Chan Catherine M, Frimberger Angela E, Moore Antony S
J Am Vet Med Assoc. 2016 Dec 15;249(12):1408-1414. doi: 10.2460/javma.249.12.1408.
OBJECTIVE To determine the incidence of sterile hemorrhagic cystitis (SHC) in tumor-bearing dogs concurrently treated with oral metronomic cyclophosphamide chemotherapy and furosemide. DESIGN Retrospective case series. ANIMALS 55 dogs. PROCEDURES Record databases of 2 specialty practices were searched to identify dogs treated with oral metronomic cyclophosphamide chemotherapy in conjunction with furosemide for a minimum of 28 days between January 2009 and December 2015. Information extracted from the records included signalment, tumor diagnosis, cyclophosphamide and furosemide dosages, and concurrent medications. Confirmed SHC was defined as the presence of gross or microscopic hematuria and clinical signs associated with lower urinary tract disease in the absence of infection or neoplasia of the urinary tract; the definition for suspected SHC was the same, except the absence of infection or neoplasia of the urinary tract was not confirmed. RESULTS Cyclophosphamide dosage varied from 6.5 to 18.6 mg/m once daily to 6.3 to 49.2 mg/m every other day. Median duration of cyclophosphamide administration was 272 days (range, 28 to 1,393 days). Median cumulative dose of cyclophosphamide administered was 2,898 mg/m (range, 224 to 14,725 mg/m). Median furosemide dose was 1.4 mg/kg (0.64 mg/lb). Confirmed or suspected SHC was identified in 2 of 55 (3.6%) dogs. Cyclophosphamide administration was discontinued for the dog with confirmed SHC but not the dog with suspected SHC. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that oral administration of furosemide in conjunction with oral metronomic cyclophosphamide chemotherapy was associated with a low incidence of SHC, which suggested that furosemide may protect against cyclophosphamide-induced SHC.
目的 确定同时接受口服节拍性环磷酰胺化疗和呋塞米治疗的荷瘤犬无菌性出血性膀胱炎（SHC）的发病率。 设计 回顾性病例系列。 动物 55只犬。 程序 检索2个专科诊所的记录数据库，以识别在2009年1月至2015年12月期间接受口服节拍性环磷酰胺化疗联合呋塞米治疗至少28天的犬。从记录中提取的信息包括特征、肿瘤诊断、环磷酰胺和呋塞米剂量以及同时使用的药物。确诊的SHC定义为存在肉眼或显微镜下血尿以及与下尿路疾病相关的临床症状，且不存在尿路感染或肿瘤；疑似SHC的定义相同，但未确认不存在尿路感染或肿瘤。 结果 环磷酰胺剂量从每日一次6.5至18.6 mg/m²到隔日一次6.3至49.2 mg/m²不等。环磷酰胺给药的中位持续时间为272天（范围为28至1393天）。环磷酰胺的中位累积剂量为2898 mg/m²（范围为224至14725 mg/m²）。呋塞米的中位剂量为1.4 mg/kg（0.64 mg/lb）。55只犬中有2只（3.6%）被确诊或疑似患有SHC。确诊SHC的犬停止了环磷酰胺给药，但疑似SHC的犬未停药。 结论及临床意义 结果表明，口服呋塞米联合口服节拍性环磷酰胺化疗与SHC的低发病率相关，这表明呋塞米可能预防环磷酰胺诱导的SHC。
