Webb Craig B
Veterinary Teaching Hospital, Small Animal Medicine, Colorado State University, 300 West Drake Road, Fort Collins, Colorado, 80523, USA.
J Feline Med Surg. 2018 Mar;20(3):217-227. doi: 10.1177/1098612X18758591.
Practical relevance: Hepatic lipidosis (HL) is the most common form of liver dysfunction in cats. If recognized early and treated appropriately, the prognosis is good; if not, the prognosis is grave. Clinical challenges: Distinguishing HL as idiopathic or secondary is critical since the presence of a concurrent disease affects the therapeutic plan and the prognosis.
Despite the unique and severe nature of a cat's response to anorexia and the complexity of the metabolic changes underlying this condition, the clinical acumen and technical ability to effectively diagnose and treat HL are readily available to all small animal practitioners. Patient group: Although many species develop a 'fatty liver', the cat is one of relatively few species that suffer from HL. The classic presentation is that of an overweight cat that stops eating for days to weeks, losing weight in the process. Equipment: Abdominal ultrasound is frequently employed in the diagnostic work-up of an anorectic cat; ultrasonographic findings often support a presumptive diagnosis, provide samples for cytology and, perhaps most importantly, help identify concurrent conditions that must be addressed for therapeutic success. All of the equipment necessary for essential nutritional intervention in an anorectic cat is readily available and easily affordable. Evidence base: The material for this review draws heavily on a relatively large number of original studies, excellent reviews by recognized experts, and informative communication with experienced clinicians, hence the term 'collective effort'.
实际相关性:肝脂肪变性(HL)是猫肝功能障碍最常见的形式。如果早期识别并得到适当治疗,预后良好;否则,预后严重。临床挑战:区分HL是特发性还是继发性至关重要,因为并发疾病的存在会影响治疗方案和预后。
尽管猫对厌食的反应具有独特性和严重性,且这种情况背后的代谢变化复杂,但所有小动物从业者都具备有效诊断和治疗HL的临床敏锐度和技术能力。患者群体:虽然许多物种都会出现“脂肪肝”,但猫是相对较少患HL的物种之一。典型表现是一只超重的猫停止进食数天至数周,并在此过程中体重减轻。设备:腹部超声经常用于厌食猫的诊断检查;超声检查结果通常支持初步诊断,提供细胞学样本,也许最重要的是,有助于识别为取得治疗成功必须解决的并发疾病。厌食猫进行基本营养干预所需的所有设备都很容易获得且价格低廉。证据基础:本综述的材料大量借鉴了相对大量的原始研究、知名专家的优秀综述以及与经验丰富的临床医生的信息交流,因此称为“集体努力”。