Clarke Carolyn, Burney Derek
From the Veterinary Emergency & Referral Group South, Brooklyn, New York (C.C.); Veterinary Specialists of North Texas, Dallas, Texas (D.B.); and Gulf Coast Veterinary Specialists, Houston, Texas (D.B.).
J Am Anim Hosp Assoc. 2017 May/Jun;53(3):159-166. doi: 10.5326/JAAHA-MS-6517. Epub 2017 Mar 14.
The goal of this study is to report clinical information, diagnostic findings, and treatment modalities; assess variables that may help distinguish survivors from nonsurvivors; and review the outcome of cycad palm toxicosis in dogs. Fourteen client-owned dogs with confirmed cycad palm ingestion were identified by reviewing the medical record database at Gulf Coast Veterinary Specialists. Information on signalment, time of ingestion to presentation, clinical signs, physical examination findings, initial and peak/nadir laboratory abnormalities, radiographic and ultrasonographic findings, treatment modalities, liver histopathology, and clinical outcome was retrieved. Of the 14 dogs, nine (64%) died as a direct result of cycad palm intoxication, and three survivors had persistently elevated liver enzymes, signifying residual liver damage. Despite decontamination, patients continued to display evidence of illness, indicating rapid absorption of toxins. When evaluating initial and peak/nadir laboratory values, nadir serum albumin levels and nadir platelet counts were significantly lower in nonsurvivors compared to survivors (1.25 g/dL [0.4-2.1 g/dL] versus 2.6 g/dL [1.7-3.4 g/dL] and 21 × 10 [0-64 × 10] versus 62 × 10 [6-144 × 10], respectively). In this cohort of dogs, the case fatality rate was higher than previously reported. Nadir serum albumin levels and nadir platelet counts may help distinguish potential survivors from nonsurvivors.
本研究的目的是报告临床信息、诊断结果和治疗方式；评估可能有助于区分存活犬与非存活犬的变量；并回顾犬苏铁中毒的结局。通过查阅墨西哥湾沿岸兽医专科中心的病历数据库，确定了14只确诊摄入苏铁的客户拥有的犬。收集了有关动物特征、摄入至就诊时间、临床症状、体格检查结果、初始及峰值/最低点实验室异常、放射影像学和超声检查结果、治疗方式、肝脏组织病理学以及临床结局的信息。14只犬中，9只（64%）直接死于苏铁中毒，3只存活犬的肝酶持续升高，表明存在残留肝损伤。尽管进行了去污处理，但病犬仍持续表现出疾病迹象，这表明毒素吸收迅速。在评估初始及峰值/最低点实验室值时，非存活犬的最低点血清白蛋白水平和最低点血小板计数显著低于存活犬（分别为1.25 g/dL [0.4 - 2.1 g/dL] 对比2.6 g/dL [1.7 - 3.4 g/dL] 以及21×10 [0 - 64×10] 对比62×10 [6 - 144×10]）。在这组犬中，病死率高于先前报道。最低点血清白蛋白水平和最低点血小板计数可能有助于区分潜在的存活犬与非存活犬。
