College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia.
Vet Imaging Specialists, The Animal Hospital at Murdoch University, Perth, Western Australia, Australia.
Aust Vet J. 2021 Dec;99(12):505-512. doi: 10.1111/avj.13114. Epub 2021 Sep 19.
To describe the clinical features of dogs treated for suspected anaphylaxis in Perth, Western Australia.
Single-centre observational case series with retrospective and prospective phases.
This was a two-phase study of dogs with clinical suspicion of anaphylaxis presenting to the emergency service of a university teaching hospital. Dogs required evidence of, and appropriate treatment of, a type 1 hypersensitivity reaction as well as two or more organs affected (or cardiovascular signs alone) to be included. Phase 1 includes retrospective case series of 186 dogs (March 2006-December 2018). Phase 2 includes prospective descriptive case series of 46 dogs (October 2017-July 2018) focused on clinical signs.
In phase 1, 88 (47%) dogs had evidence of insect exposure prior to the acute event. One hundred forty (75%) dogs had dermatological signs, 141 (76%) had gastrointestinal signs and 129 (69%) had cardiovascular signs. Ninety-two (49%) dogs had vasoconstrictive shock (5 with bradycardia), 24 (13%) had vasodilatory shock, 8 (4%) had mixed vasodilatory and vasoconstrictive shock and 5 (3%) had unclassifiable shock. On focused abdominal ultrasound, 42 of 71 (59%) dogs had gallbladder wall oedema and 3 of 71 (4%) dogs had peritoneal free fluid. In phase 2, the distributions of insect exposure, organ dysfunction and sonographic abnormalities were similar to phase 1.
Dogs presenting with suspected anaphylaxis showed a broad range of presentations. Dermatological signs were absent in a proportion of dogs, vasoconstrictive shock was more frequent than vasodilatory and unique features of shock were identified. This study highlights the challenges of diagnosis based on presenting features alone.
描述在澳大利亚西部珀斯因疑似过敏而接受治疗的犬的临床特征。
回顾性和前瞻性阶段的单中心观察性病例系列。
这是一项针对怀疑患有过敏反应的犬的两阶段研究,这些犬在一所大学教学医院的急诊处就诊。纳入的犬需要有 1 型过敏反应的证据,且接受了适当的治疗,并且有两个或更多器官受到影响(或仅心血管体征受到影响)。第 1 阶段包括 186 只犬的回顾性病例系列(2006 年 3 月至 2018 年 12 月)。第 2 阶段包括 46 只犬的前瞻性描述性病例系列(2017 年 10 月至 2018 年 7 月),重点关注临床症状。
在第 1 阶段,88 只(47%)犬在急性事件发生前有昆虫暴露的证据。141 只(76%)犬有皮肤病变,141 只(76%)犬有胃肠道症状,129 只(69%)犬有心血管症状。92 只(49%)犬有血管收缩性休克(5 只伴心动过缓),24 只(13%)犬有血管扩张性休克,8 只(4%)犬有混合性血管扩张性和血管收缩性休克,5 只(3%)犬休克无法分类。在重点腹部超声检查中,71 只犬中有 42 只(59%)胆囊壁水肿,71 只犬中有 3 只(4%)有腹腔游离液体。在第 2 阶段,昆虫暴露、器官功能障碍和超声异常的分布与第 1 阶段相似。
因疑似过敏而就诊的犬表现出广泛的表现。部分犬无皮肤病变,血管收缩性休克比血管扩张性休克更常见,并确定了休克的独特特征。本研究强调了仅根据临床表现进行诊断的挑战。