猫发热：106例转诊病例的品种、临床检查、诊断及既往治疗影响的回顾性分析
Pyrexia in cats: Retrospective analysis of signalment, clinical investigations, diagnosis and influence of prior treatment in 106 referred cases.
作者信息
Spencer Sarah E, Knowles Toby, Ramsey Ian K, Tasker Séverine
机构信息
1 School of Veterinary Sciences, University of Bristol, Langford, Bristol, UK.
2 School of Veterinary Medicine, University of Glasgow, Bearsden Road, Glasgow, UK.
出版信息
J Feline Med Surg. 2017 Nov;19(11):1123-1130. doi: 10.1177/1098612X17733624. Epub 2017 Sep 7.
OBJECTIVES
The main aim of the study was to describe the features and diagnoses of a population of cats referred with pyrexia. Other aims were to report and evaluate the utility of clinical investigations performed, and describe any effect of treatment before referral on temperature at presentation and ability to make a diagnosis.
METHODS
Clinical records of cats with pyrexia (⩾39.2°C) documented at least twice were retrospectively reviewed. Cases were assigned to disease categories (infectious, inflammatory, immune-mediated, neoplastic, miscellaneous and no diagnosis [pyrexia of unknown origin, PUO]) based on diagnosis. The overall value of clinical investigations was assessed by classifying them as 'enabling', 'assisting' or 'no assistance' in achieving each diagnosis. The effect of treatment before referral was assessed for any association with temperature at presentation and ability to make a diagnosis (PUO vs other disease categories).
RESULTS
One hundred and six cases were identified. The most common cause of pyrexia was feline infectious peritonitis (22 cats, 20.8%) and the largest disease category was infectious (41/106, 38.7%). Inflammatory conditions were found in 19 (17.9%) cats, neoplasia in 13 (12.3%), miscellaneous causes in 11 (10.4%) and immune-mediated disease in six (5.7%). No diagnosis was reached in 16 (15.0%) cats, often despite extensive diagnostic investigations. Cytology and histopathology most often 'enabled' or 'assisted' in obtaining a diagnosis. Most cats (91, 85.8%) received treatment before referral, with antimicrobial treatment given to 87 (82.1%). Prior treatment before referral was not associated with temperature at presentation nor with success in establishing a diagnosis.
CONCLUSIONS AND RELEVANCE
This is the first study investigating causes of pyrexia in cats. Infectious diseases were most common and immune-mediated diseases were comparatively rare.
目的
本研究的主要目的是描述因发热而转诊的猫群的特征和诊断情况。其他目的是报告和评估所进行的临床检查的效用，并描述转诊前的治疗对就诊时体温及诊断能力的任何影响。
方法
对记录有至少两次发热（≥39.2°C）的猫的临床记录进行回顾性审查。根据诊断结果将病例分为疾病类别（感染性、炎症性、免疫介导性、肿瘤性、杂项及未确诊[不明原因发热，PUO]）。通过将临床检查分类为在实现每种诊断中“有帮助”、“辅助”或“无帮助”来评估其总体价值。评估转诊前治疗与就诊时体温及诊断能力（PUO与其他疾病类别）之间的任何关联。
结果
共识别出106例病例。发热最常见的原因是猫传染性腹膜炎（22只猫，20.8%），最大的疾病类别是感染性（41/106，38.7%）。19只（17.9%）猫患有炎症性疾病，13只（12.3%）患有肿瘤，11只（10.4%）有杂项病因，6只（5.7%）患有免疫介导性疾病。16只（15.0%）猫未得出诊断结果，通常是尽管进行了广泛的诊断检查。细胞学和组织病理学在获得诊断方面最常“有帮助”或“辅助”。大多数猫（91只，85.8%）在转诊前接受了治疗，其中87只（82.1%）接受了抗菌治疗。转诊前的先前治疗与就诊时体温及确诊成功率均无关联。
结论及意义
这是第一项调查猫发热原因的研究。传染病最为常见，免疫介导性疾病相对少见。
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