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猫的椎间盘炎的临床特征、治疗和转归。

Clinical features, treatment and outcome of discospondylitis in cats.

机构信息

Dovecote Veterinary Hospital, Castle Donington, Derby, UK.

Vet Oracle Teleneurology, Diss, UK.

出版信息

J Feline Med Surg. 2022 Apr;24(4):311-321. doi: 10.1177/1098612X211020159. Epub 2021 Jun 8.

Abstract

OBJECTIVES

There is a paucity of information on feline discospondylitis. This study aimed to describe the signalment, clinical and laboratory findings, aetiological agents, treatment and outcome in cats affected by discospondylitis.

METHODS

This was a retrospective review of the medical records of cats diagnosed with discospondylitis at four referral institutions.

RESULTS

A total of 17 cats were identified. Most were domestic shorthair cats (76.5%) and male (58.8%), with a median age of 9 years (range 0.9-14) and a median duration of clinical signs of 3 weeks (range 0.3-16). All cats presented with spinal hyperaesthesia; 3/17 had pyrexia. Neurological dysfunction was found in 64.7% of cats, which was indicative of a T3-L3 or L4-S2 spinal segment, associated nerve root or associated nerve neurolocalisation. Haematology, serum biochemistry and urinalysis revealed occasional inconsistent non-specific changes. All cats underwent urine culture; 9/17 cats also had a distinct tissue cultured. Positive bacterial cultures were obtained in two cats (11.8%) for species (urine, blood and intradiscal fine-needle aspirate) and (urine); both presented with multifocal discospondylitis. Treatment was non-surgical in all cats, with sustained antibiotic therapy for a median of 3 months (range 1-9). Analgesia provided included non-steroidal anti-inflammatory drugs, alone or in combination with gabapentin. Restricted exercise was advised for a minimum of 4 weeks. Outcome information available in 12 cats was excellent in terms of pain control and neurological function in 10 cats (83.3%) at the time of stopping antibiotics. Recurrence occurred in one case, which had received a single antibiotic for 6 weeks, and relapsed 4 months after presentation. One other case failed to improve and was euthanased during the course of hospitalisation.

CONCLUSIONS AND RELEVANCE

Feline discospondylitis is uncommon and no obvious signalment predisposition was found in this study. Spinal hyperaesthesia was universally present, with neurological dysfunction also highly prevalent. Bacterial culture was unrewarding in most cases. Amoxicillin-clavulanic acid or cephalosporins are reasonable choices for first-line antibiotics. Prognosis was favourable, with no long-term evidence of recurrence in cats on sustained antibiotic therapy, for a mean duration of 3 months.

摘要

目的

有关猫的椎间盘炎的信息十分有限。本研究旨在描述在四家转诊机构被诊断为椎间盘炎的猫的一般情况、临床和实验室检查结果、病因、治疗和预后。

方法

这是对四家转诊机构被诊断为椎间盘炎的猫的病历进行的回顾性研究。

结果

共确定了 17 只猫。大多数是短毛家猫(76.5%)和雄性(58.8%),中位年龄为 9 岁(范围 0.9-14 岁),中位临床症状持续时间为 3 周(范围 0.3-16 周)。所有猫均出现脊柱超敏反应;17 只猫中有 3 只为发热。64.7%的猫存在神经功能障碍,提示 T3-L3 或 L4-S2 脊柱节段、相关神经根或相关神经神经定位存在病变。血液学、血清生化和尿液分析显示偶尔存在非特异性变化。所有猫均进行了尿液培养;17 只猫中有 9 只还进行了特定组织培养。两只猫(11.8%)的尿液、血液和椎间盘细针抽吸物的 种和尿液的 种细菌培养阳性;两者均表现为多灶性椎间盘炎。所有猫均采用非手术治疗,持续使用抗生素治疗,中位数为 3 个月(范围 1-9 个月)。镇痛包括非甾体抗炎药,单独使用或联合使用加巴喷丁。建议限制运动至少 4 周。12 只猫中有 10 只(83.3%)在停止抗生素治疗时,疼痛控制和神经功能均表现良好。1 例仅接受 6 周单一抗生素治疗的猫复发,在发病后 4 个月复发。另 1 例猫病情未见改善,在住院期间被安乐死。

结论和相关性

猫的椎间盘炎并不常见,本研究未发现明显的易患信号。普遍存在脊柱超敏反应,神经功能障碍也很常见。大多数情况下,细菌培养无明显结果。阿莫西林克拉维酸或头孢菌素是一线抗生素的合理选择。在接受持续抗生素治疗的猫中,平均持续 3 个月,没有长期复发的证据,预后良好。

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