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奶牛胆管肝炎:13例

Cholangiohepatitis in Dairy Cattle: 13 Cases.

作者信息

Gomez D E, Doré E, Francoz D, Desrochers A, Pierre H, Fecteau G

机构信息

Department of Health Management, Atlantic Veterinary College (AVC), University of Prince Edward Island, Charlottetown, PE, Canada.

Centre Hospitalier Universitaire Vétérinaire, Saint-Hyacinthe, Faculté de Médecine Vétérinaire, Université de Montréal, Montréal, QC, Canada.

出版信息

J Vet Intern Med. 2017 May;31(3):922-927. doi: 10.1111/jvim.14675. Epub 2017 Mar 16.

Abstract

BACKGROUND

The signalment, clinicopathologic, bacteriological, histopathological, ultrasonographic characteristics, and the treatment and outcomes of adult cattle with cholangiohepatitis are poorly defined.

ANIMALS

Thirteen Holstein cows with cholangiohepatitis.

METHODS

Retrospective study of medical records of cattle admitted to the CHUV and the AVC between 1992 and 2012 and 2000 and 2012, respectively, for cattle older than 3 months of age with a histopathological diagnosis of cholangiohepatitis. Cholangiohepatitis was defined as the presence of portal inflammation surrounding or infiltrating bile ducts, with or without epithelial damage, and extending into the adjacent lobules.

RESULTS

At the time of diagnosis of cholangiohepatitis, cows had decreased appetite (n = 7) or were anorectic (n = 6), had fever (n = 5), and had tachycardia (n = 8). Icterus was detected in 5 cows. Yellow discoloration was identified on the skin of the udder (n = 3), conjunctiva (n = 2), and vulva (n = 1). There was leukocytosis (n = 6), neutrophilia (n = 9), and hyperfibrinogenemia (n = 8). Alteration in the serum biochemistry profile included hyperglobulinemia (n = 8), hypoalbuminemia (n = 10), increased activity of GGT (n = 12), AST (n = 8), and ALP (n = 10), and hyperbilirubinemia (n = 10). Histopathological diagnosis included mild, subacute, nonsuppurative cholangiohepatitis (n = 4), mild suppurative cholangiohepatitis (n = 4), mild mixed (neutrophilic and lymphocytic) cholangiohepatitis (n = 3), and moderate, chronic, nonsuppurative cholangiohepatitis (n = 1). Six cows were discharged from the hospital, and 7 were euthanized.

CONCLUSIONS AND CLINICAL IMPORTANCE

Cholangiohepatitis is a rare condition in adult cattle. Antemortem diagnosis can be challenging because clinical signs are unspecific.

摘要

背景

成年牛胆管肝炎的发病情况、临床病理特征、细菌学特征、组织病理学特征、超声特征以及治疗方法和预后情况尚不明确。

动物

13头患有胆管肝炎的荷斯坦奶牛。

方法

分别对1992年至2012年期间入住CHUV以及2000年至2012年期间入住AVC的年龄超过3个月且组织病理学诊断为胆管肝炎的奶牛病历进行回顾性研究。胆管肝炎定义为围绕或浸润胆管的门静脉炎症,伴有或不伴有上皮损伤,并延伸至相邻小叶。

结果

在诊断胆管肝炎时,奶牛出现食欲减退(n = 7)或厌食(n = 6)、发热(n = 5)以及心动过速(n = 8)。5头奶牛出现黄疸。在乳房皮肤(n = 3)、结膜(n = 2)和外阴(n = 1)发现皮肤发黄。存在白细胞增多(n = 6)、中性粒细胞增多(n = 9)和高纤维蛋白原血症(n = 8)。血清生化指标改变包括高球蛋白血症(n = 8)、低白蛋白血症(n = 10)、γ-谷氨酰转移酶(GGT)活性升高(n = 12)、天冬氨酸氨基转移酶(AST)活性升高(n = 8)、碱性磷酸酶(ALP)活性升高(n = 10)以及高胆红素血症(n = 10)。组织病理学诊断包括轻度、亚急性、非化脓性胆管肝炎(n = 4)、轻度化脓性胆管肝炎(n = 4)、轻度混合性(中性粒细胞和淋巴细胞性)胆管肝炎(n = 3)以及中度、慢性、非化脓性胆管肝炎(n = 1)。6头奶牛出院,7头实施安乐死。

结论及临床意义

胆管肝炎在成年牛中较为罕见。生前诊断具有挑战性,因为临床症状不具特异性。

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