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犬慢性腹泻——136例回顾性研究

Chronic Diarrhea in Dogs - Retrospective Study in 136 Cases.

作者信息

Volkmann M, Steiner J M, Fosgate G T, Zentek J, Hartmann S, Kohn B

机构信息

Clinic for Small Animals, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany.

Gastrointestinal Laboratory, Texas A&M University, College Station, TX.

出版信息

J Vet Intern Med. 2017 Jul;31(4):1043-1055. doi: 10.1111/jvim.14739.

Abstract

BACKGROUND

Chronic diarrhea (CD) is common in dogs, and information on frequency and distribution of primary and secondary causes is lacking.

OBJECTIVES

To evaluate underlying causes and predictors of outcome in dogs with CD.

ANIMALS

One hundred and thirty-six client-owned dogs with CD (≥3 weeks duration).

METHODS

Retrospective review of medical records (Small Animal Clinic, Freie Universität Berlin, Germany, 09/2009-07/2011). Quantification of final diagnoses and comparison of clinical aspects including disease severity and clinicopathological abnormalities among dogs with clinical remission (either complete [gastrointestinal signs absent] or partial [clinical improvement of gastrointestinal signs and reduced episodes with shortened duration]), and those without recovery.

RESULTS

Ninety percent of dogs were diagnosed with a primary enteropathy: inflammatory (71%; of those 66% dietary responsive, 23% idiopathic, 11% antibiotic responsive), infectious (13%), neoplastic (4%), and in one dog each mechanical disease or systemic vasculitis. Secondary causes were diagnosed in 10% of dogs: exocrine pancreatic (6%), endocrine (2%), and in one dog each hepatic, renal, and cardiac disease. In total, 87% of dogs had clinical remission, whereas 13% died or did not respond to treatment: Lack of recovery was frequently recorded for dogs with primary inflammatory (idiopathic) or neoplastic disease and was significantly associated with increased disease severity scores (P = .005), anemia (hematocrit < 40%, P < .001), severe hypoalbuminemia (serum albumin <2.0 g/dL, P = .008), and severe hypocobalaminemia (serum cobalamin concentration <200 pg/mL, P = .006).

CONCLUSIONS AND CLINICAL IMPORTANCE

Inflammatory enteropathies and particularly those of dietary origin were the most common causes of CD in dogs. Findings support the usefulness of hematocrit, and serum albumin and cobalamin concentration as prognostic markers in dogs with CD.

摘要

背景

慢性腹泻(CD)在犬类中很常见,但缺乏关于原发性和继发性病因的频率及分布的信息。

目的

评估患有CD的犬类的潜在病因及预后预测因素。

动物

136只客户拥有的患有CD(持续时间≥3周)的犬。

方法

回顾性查阅病历(德国柏林自由大学小动物诊所,2009年9月 - 2011年7月)。对最终诊断进行量化,并比较临床方面,包括临床缓解(完全缓解[无胃肠道症状]或部分缓解[胃肠道症状临床改善且发作次数减少、持续时间缩短])的犬与未恢复的犬之间的疾病严重程度和临床病理异常情况。

结果

90%的犬被诊断为原发性肠病:炎症性(71%;其中66%对饮食有反应,23%为特发性,11%对抗生素有反应)、感染性(13%)、肿瘤性(4%),另有一只犬患机械性疾病或系统性血管炎。10%的犬被诊断有继发性病因:外分泌性胰腺疾病(6%)、内分泌疾病(2%),另有一只犬分别患有肝脏、肾脏和心脏疾病。总体而言,87%的犬有临床缓解,而13%死亡或对治疗无反应:原发性炎症性(特发性)或肿瘤性疾病的犬经常记录为未恢复,且与疾病严重程度评分增加(P = .005)、贫血(血细胞比容<40%,P < .001)、严重低白蛋白血症(血清白蛋白<2.0 g/dL,P = .008)和严重低钴胺素血症(血清钴胺素浓度<200 pg/mL,P = .006)显著相关。

结论及临床意义

炎症性肠病,尤其是饮食源性炎症性肠病是犬类CD最常见的病因。研究结果支持血细胞比容、血清白蛋白和钴胺素浓度作为患有CD的犬的预后标志物的有用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71ec/5508351/9e870317d2f8/JVIM-31-1043-g001.jpg

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