Smith M Ryan, Wurlod Virginie A, Ralph Alan G, Daniels Erin R, Mitchell Mark
J Am Vet Med Assoc. 2020 May 15;256(10):1137-1144. doi: 10.2460/javma.256.10.1137.
To determine mortality rates for dogs with severe anaphylaxis and identify potential prognostic factors.
67 dogs with suspected anaphylaxis graded as severe.
Dogs were classified on the basis of outcome as survivors and nonsurvivors. Medical records were reviewed, and data were extracted including signalment, examination findings, time to hospital admission from onset of clinical signs, CBC results, serum biochemical analysis results, coagulation testing results, and findings on abdominal ultrasonography. Initial treatment within the first 6 hours after hospital admission was recorded for analysis, specifically including the use of epinephrine, diphenhydramine, corticosteroids, antimicrobials, fresh-frozen plasma, and supplemental dextrose.
The overall mortality rate was 14.9% (10/67) for dogs with anaphylaxis graded as severe. Serum phosphorus concentration and prothrombin time (PT) were significantly higher in nonsurvivors, compared with survivors. Nonsurvivors had lower presenting body temperatures than survivors. Serum phosphorus concentration ≥ 12.0 mmol/L, hypoglycemia within 6 hours after hospital admission, high PT value, concurrently high PT and partial thromboplastin time (PTT) values > 50% above the reference range limit, and the need for supplemental dextrose were associated with death. The incidences of coagulopathy and peritoneal effusion were unexpectedly high (85.2% and 65.5% of dogs, respectively) but were not indicative of survival.
Despite the poor presenting clinical condition seen in dogs with severe anaphylaxis, the rate of survival with treatment was fairly high. Coagulopathy and the presence of peritoneal effusion were common findings in dogs with severe anaphylaxis. Serum phosphorus concentration ≥ 12.0 mmol/L, high PT value, concurrent increases of PT and PTT values > 50% above reference range limits, hypoglycemia within 6 hours after hospital admission, and the need for supplemental dextrose were associated with death.
确定严重过敏反应犬的死亡率，并识别潜在的预后因素。
67只疑似严重过敏反应的犬。
根据结局将犬分为存活者和非存活者。回顾病历，并提取数据，包括特征、检查结果、从临床症状出现到入院的时间、血常规结果、血清生化分析结果、凝血检测结果以及腹部超声检查结果。记录入院后前6小时内的初始治疗情况以进行分析，具体包括肾上腺素、苯海拉明、皮质类固醇、抗菌药物、新鲜冷冻血浆和补充葡萄糖的使用情况。
严重过敏反应犬的总体死亡率为14.9%（10/67）。与存活者相比，非存活者的血清磷浓度和凝血酶原时间（PT）显著更高。非存活者的就诊体温低于存活者。血清磷浓度≥12.0 mmol/L、入院后6小时内低血糖、PT值高、PT和活化部分凝血活酶时间（PTT）值同时高于参考范围上限50%以及需要补充葡萄糖与死亡相关。凝血病和腹腔积液的发生率意外地高（分别为85.2%和65.5%的犬），但并不提示存活情况。
尽管严重过敏反应犬就诊时临床状况不佳，但经治疗后的存活率相当高。凝血病和腹腔积液是严重过敏反应犬的常见表现。血清磷浓度≥12.0 mmol/L、PT值高、PT和PTT值同时升高超过参考范围上限50%、入院后6小时内低血糖以及需要补充葡萄糖与死亡相关。
