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与阻塞性尿路结石的小型反刍动物生存相关的初始检查和临床管理变量。

Variables of initial examination and clinical management associated with survival in small ruminants with obstructive urolithiasis.

作者信息

Riedi Anna-Katharina, Nathues Christina, Knubben-Schweizer Gabriela, Nuss Karl, Meylan Mireille

机构信息

Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

出版信息

J Vet Intern Med. 2018 Nov;32(6):2105-2114. doi: 10.1111/jvim.15336. Epub 2018 Oct 11.

Abstract

BACKGROUND

Obstructive urolithiasis is a common disease associated with a guarded prognosis in small ruminants.

HYPOTHESIS/OBJECTIVE: The results of physical examination, laboratory analyses, and clinical management of male small ruminants presented to 2 referral clinics were investigated to identify variables significantly associated with disease outcome, so as to provide better recommendations to animal owners regarding the management of these patients.

ANIMALS

Two-hundred ten small ruminants (130 sheep and 80 goats) with confirmed diagnosis of obstructive urolithiasis.

METHODS

Clinical findings (including diagnostic imaging) and laboratory results of the 210 animals were reviewed, and relevant information regarding clinical and laboratory variables recorded upon admission and clinical management was retrieved. The association of the different variables with nonsurvival was investigated by univariable and multivariable logistic regression models.

RESULTS

Only 39% of all patients considered for treatment and 52% of those undergoing tube cystostomy survived to be released from the clinic. Nonsurvival was strongly associated with a very poor clinical condition upon presentation, obesity, castration, and evidence of uroperitoneum. Among blood variables, abnormal PCV, severely increased serum creatinine concentrations, and increased activity of the creatine kinase were associated with increased risk of nonsurvival. Presence of signs of colic or macroscopic appearance of urine was not significantly associated with outcome.

CONCLUSIONS AND CLINICAL IMPORTANCE

The prognosis of obstructive urolithiasis was guarded with survival rates of 39% (overall) to 52% (after tube cystostomy). Intact young males with normal body condition presented early in the course of disease had the best chances of survival.

摘要

背景

阻塞性尿路结石是一种常见疾病,在小型反刍动物中预后不佳。

假设/目的:对转诊至两家诊所的雄性小型反刍动物的体格检查、实验室分析及临床治疗结果进行调查,以确定与疾病转归显著相关的变量,从而就这些患病动物的管理向动物主人提供更好的建议。

动物

210只确诊为阻塞性尿路结石的小型反刍动物(130只绵羊和80只山羊)。

方法

回顾了这210只动物的临床检查结果(包括诊断性影像学检查)和实验室结果,并获取了入院时记录的有关临床及实验室变量以及临床治疗的相关信息。通过单变量和多变量逻辑回归模型研究不同变量与未存活的相关性。

结果

所有考虑接受治疗的病畜中只有39%存活至出院,接受膀胱造瘘术的病畜中有52%存活至出院。未存活与就诊时临床状况极差、肥胖、去势及尿腹的证据密切相关。在血液变量中,红细胞压积异常、血清肌酐浓度严重升高及肌酸激酶活性升高与未存活风险增加相关。腹痛体征或尿液外观肉眼可见与转归无显著相关性。

结论及临床意义

阻塞性尿路结石的预后不佳,总体存活率为39%,膀胱造瘘术后为52%。疾病早期就诊、身体状况正常的未去势年轻雄性动物存活几率最高。

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