回顾性评估猫复食综合征：11 例病例报告（2013-2019 年）。
Retrospective evaluation of refeeding syndrome in cats: 11 cases (2013-2019).
机构信息
Department of Clinical Science and Services, The Royal Veterinary College, London, UK.
Vets Now, Glasgow, UK.
出版信息
J Feline Med Surg. 2021 Oct;23(10):883-891. doi: 10.1177/1098612X20979706. Epub 2021 Jan 6.
OBJECTIVES
The aim of this study was to describe the clinicopathological findings, management and outcome of cats with refeeding syndrome (RS) following prolonged starvation.
METHODS
Records from four referral hospitals were searched between May 2013 and November 2019 and retrospectively evaluated. Inclusion criteria were the presence of a risk factor for RS, such as severe weight loss or emaciation following a period of presumed starvation, hypophosphataemia or a delta phosphorous exceeding 30% reduction following refeeding, being treated on the basis of a clinical diagnosis of RS and one or more derangement of hypokalaemia, hypoglycaemia or hyperglycaemia.
RESULTS
Eleven cats were identified, which had been missing for a median of 6 weeks (range 3-104 weeks). Mean ± SD percentage weight loss was 46% ± 7% (n = 8). Eight of 11 cats developed hypophosphataemia with a mean delta phosphorous of -47% ± 9%. All cats were documented to be hypokalaemic. During hospitalisation, 10/11 cats developed hyperglycaemia and 7/11 cats developed hypoglycaemia. Cardiovascular, gastrointestinal and neurological signs were common. Eight of 11 cats displayed new or progressive neurological deficits after refeeding, including mentation changes and cerebellar dysfunction. All cats became anaemic and seven cats required a blood transfusion. Eight cats survived to discharge after a mean of 14 ± 4 days of hospitalisation. Six cats developed acute kidney injury (AKI; International Renal Interest Society stage 1). The presence of AKI ( = 0.024) was associated with non-survival and maximum bilirubin concentration was significantly higher in non-survivors ( = 0.018).
CONCLUSIONS AND RELEVANCE
Cats with RS in this cohort had been missing, presumed starved, for more than 3 weeks. In addition to hypophosphataemia and hypokalaemia, altered glucose homeostasis and organ damage involving the liver and kidneys were common. Cats with RS appear to have a good prognosis, but prolonged intensive care is required.
目的
本研究旨在描述长期饥饿后出现再喂养综合征（RS）的猫的临床病理发现、治疗方法和结果。
方法
检索了 2013 年 5 月至 2019 年 11 月期间四家转诊医院的病历，并进行了回顾性评估。纳入标准为存在 RS 的危险因素，如严重体重减轻或消瘦，伴有长期饥饿，或再喂养后血磷降低或降低超过 30%，基于 RS 的临床诊断进行治疗，以及低钾血症、低血糖或高血糖等一项或多项异常。
结果
共发现 11 只猫，平均失踪时间为 6 周（范围 3-104 周）。8 只猫的体重减轻百分比为 46%±7%。11 只猫中有 8 只出现低磷血症，平均血磷降低幅度为-47%±9%。所有猫均有低钾血症。住院期间，10/11 只猫出现高血糖，7/11 只猫出现低血糖。心血管、胃肠道和神经症状很常见。8 只猫在再喂养后出现新的或进行性神经功能障碍，包括精神状态改变和小脑功能障碍。所有猫都出现贫血，7 只猫需要输血。8 只猫在平均住院 14±4 天后存活出院。6 只猫出现急性肾损伤（AKI；国际肾脏协会分期 1 期）。AKI 的存在（=0.024）与非存活相关，并且非存活者的最大胆红素浓度显著更高（=0.018）。
结论
本队列中 RS 的猫已经失踪，推测已经饥饿超过 3 周。除了低磷血症和低钾血症外，葡萄糖代谢异常和涉及肝脏和肾脏的器官损伤也很常见。RS 猫的预后似乎良好，但需要长时间的强化护理。
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