Klainbart Sigal, Agi Limor, Bdolah-Abram Tali, Kelmer Efrat, Aroch Itamar
J Am Vet Med Assoc. 2017 Nov 1;251(9):1025-1034. doi: 10.2460/javma.251.9.1025.
OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge). Differences between cats with and without sepsis and associations between variables of interest and death were analyzed statistically. RESULTS The sepsis group included cats with pyothorax (n = 10), septic peritonitis (7), panleukopenia virus infection (5), bite wounds (5), abscesses and diffuse cellulitis (3), and pyometra (1). Common clinical abnormalities included dehydration (21 cats), lethargy (21), anorexia (18), pale mucous membranes (15), and dullness (15). Numerous clinicopathologic abnormalities were identified in cats with sepsis; novel findings included metarubricytosis, hypertriglyceridemia, and high circulating muscle enzyme activities. Median activated partial thromboplastin time and plasma D-dimer concentrations were significantly higher, and total protein C and antithrombin activities were significantly lower, in the sepsis group than in healthy control cats. Disseminated intravascular coagulopathy was uncommon (4/22 [18%] cats with sepsis). None of the clinicopathologic abnormalities were significantly associated with death on multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE Cats with sepsis had multiple hematologic, biochemical, and hemostatic abnormalities on hospital admission, including several findings suggestive of hemostatic derangement. Additional research including larger numbers of cats is needed to further investigate these findings and explore associations with outcome.
目的 描述自然发生败血症的猫的临床和实验室检查结果,重点关注与止血相关的结果,并评估这些变量与患者预后的关联。 设计 前瞻性、观察性临床研究。 动物 31 只患有败血症的猫和 33 只健康对照猫。 程序 收集的数据包括病史、临床症状、血液学、血清生化和止血检查结果、诊断以及预后(住院期间或出院后≤30 天内的存活与死亡)。对患有和未患有败血症的猫之间的差异以及感兴趣的变量与死亡之间的关联进行统计学分析。 结果 败血症组包括患有脓胸的猫(n = 10)、化脓性腹膜炎(7 只)、泛白细胞减少症病毒感染(5 只)、咬伤(5 只)、脓肿和弥漫性蜂窝织炎(3 只)以及子宫积脓(1 只)。常见的临床异常包括脱水(21 只猫)、嗜睡(21 只)厌食(18 只)、黏膜苍白(15 只)和精神沉郁(15 只)。在患有败血症的猫中发现了许多临床病理异常;新发现包括晚幼红细胞增多、高甘油三酯血症和循环肌肉酶活性升高。与健康对照猫相比,败血症组的活化部分凝血活酶时间中位数和血浆 D - 二聚体浓度显著更高,而总蛋白 C 和抗凝血酶活性显著更低。弥散性血管内凝血并不常见(22 只患有败血症的猫中有 4 只 [18%])。在多变量分析中,没有一种临床病理异常与死亡显著相关。 结论及临床意义 患有败血症的猫在入院时存在多种血液学、生化和止血异常,包括一些提示止血紊乱的发现。需要进行更多包括大量猫的研究,以进一步调查这些发现并探索与预后的关联。