König Alla, Hartmann Katrin, Mueller Ralf S, Wess Gerhard, Schulz Bianka S
Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany.
J Feline Med Surg. 2019 Dec;21(12):1102-1110. doi: 10.1177/1098612X18816489. Epub 2018 Dec 17.
Pleural effusion is a common presenting cause for feline patients in small animal practice. The objectives of this study were to identify possible correlations between the aetiology of effusion and clinical and laboratory findings.
In this retrospective study of 306 cats diagnosed with pleural effusion of established aetiology, cats were divided into six major groups: cardiac disease (CD), feline infectious peritonitis (FIP), neoplasia, pyothorax, chylothorax and miscellaneous. Clinical, laboratory and radiographic parameters were compared between groups.
CD was the most common aetiology (35.3%), followed by neoplasia (30.7%), pyothorax (8.8%), FIP (8.5%), chylothorax (4.6%) and miscellaneous diseases (3.7%). In 26 (8.5%) cats, more than one underlying disease was diagnosed as a possible aetiology for pleural effusion. Cats with FIP were significantly younger than those with CD ( <0.001) and neoplasia ( <0.001). Cats with CD were presented with a significantly lower body temperature compared with cats with FIP ( = 0.022). Cats with CD had significantly higher serum alanine aminotransferase activity compared with all other cats (FIP and pyothorax, <0.001; neoplasia and chylothorax, = 0.02) and serum alkaline phosphatase activity compared with the pyothorax ( <0.001) and FIP groups ( = 0.04), and significantly lower protein concentrations (FIP, pyothorax and neoplasia, <0.001; chylothorax, = 0.04) and nucleated cell counts in the effusion than all other groups (pyothorax and neoplasia, <0.001; chylothorax, = 0.02; FIP, = 0.04). The glucose level in the effusion of cats with pyothorax was significantly lower than glucose levels in patients with CD, neoplasia and chylothorax ( <0.001). Of 249 cats with a follow-up of at least 10 days, 55.8% died or were euthanased during that time.
CD and neoplasia were the most common causes for feline pleural effusion. Age, liver enzymes, as well as cell count, protein and glucose levels in the effusion can aid in the investigation of underlying aetiologies.
胸腔积液是小动物临床中猫科动物患者常见的就诊原因。本研究的目的是确定积液病因与临床及实验室检查结果之间可能存在的相关性。
在这项对306只已确诊病因的胸腔积液猫进行的回顾性研究中，猫被分为六大组：心脏病（CD）、猫传染性腹膜炎（FIP）、肿瘤、脓胸、乳糜胸和其他杂症。对各组之间的临床、实验室和影像学参数进行了比较。
心脏病是最常见的病因（35.3%），其次是肿瘤（30.7%）、脓胸（8.8%）、猫传染性腹膜炎（8.5%）、乳糜胸（4.6%）和其他杂症（3.7%）。在26只（8.5%）猫中，不止一种潜在疾病被诊断为胸腔积液的可能病因。患有猫传染性腹膜炎的猫比患有心脏病（P<0.001）和肿瘤（P<0.001）的猫明显更年轻。与患有猫传染性腹膜炎的猫相比，患有心脏病的猫体温明显更低（P = 0.022）。与所有其他猫相比，患有心脏病的猫血清丙氨酸氨基转移酶活性显著更高（猫传染性腹膜炎和脓胸，P<0.001；肿瘤和乳糜胸，P = 0.02），与脓胸组（P<0.001）和猫传染性腹膜炎组（P = 0.04）相比，血清碱性磷酸酶活性显著更高，且积液中的蛋白质浓度显著更低（猫传染性腹膜炎、脓胸和肿瘤，P<0.001；乳糜胸，P = 0.04），有核细胞计数比所有其他组都低（脓胸和肿瘤，P<0.001；乳糜胸，P = 0.02；猫传染性腹膜炎，P = 0.04）。脓胸猫的积液葡萄糖水平显著低于患有心脏病、肿瘤和乳糜胸的猫（P<0.001）。在249只至少随访10天的猫中，55.8%在这段时间内死亡或被安乐死。
心脏病和肿瘤是猫胸腔积液最常见的病因。年龄、肝脏酶以及积液中的细胞计数、蛋白质和葡萄糖水平有助于潜在病因的调查。
