具有肝胆综合征或肝胆相关肝病犬的治疗和预后。

Treatment and outcomes of dogs with hepatocutaneous syndrome or hepatocutaneous-associated hepatopathy.

机构信息

Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, New York, USA.

Department of Biomedical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, New York, USA.

出版信息

J Vet Intern Med. 2022 Jan;36(1):106-115. doi: 10.1111/jvim.16323. Epub 2021 Nov 25.

DOI:10.1111/jvim.16323

PMID:34820906

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8783367/

Abstract

BACKGROUND

Superficial necrolytic dermatitis (SND) in dogs is a rare disorder most commonly associated with hepatocutaneous syndrome. Although often reported as fatal, sporadically reported long-term remissions might be more common than previously believed and linked to treatment regimens.

HYPOTHESIS/OBJECTIVES: Evaluate treatments and associated outcomes in dogs with hepatocutaneous-associated hepatopathy (HCH) with or without SND, designated collectively aminoaciduric canine hypoaminoacidemic hepatopathy syndrome (ACHES).

ANIMALS

Forty-one dogs of various breeds and ages diagnosed with ACHES.

METHODS

Retrospective study. Electronic surveys, medical records (2014-2019), and communication with veterinarians provided data. Three treatment categories were each dichotomized: IV amino acid (IV-AA) infusions (≥2 vs <2), supplements including S-adenosylmethionine (SAMe), arginine with ornithine, glutathione, lysine, proline, omega-3 fatty acids, or zinc (≥3 vs <3), and diet type (home-cooked vs commercial). Optimal treatment was defined as receiving ≥2 IV-AA treatments, ≥3 nutritional supplements, and a home-cooked diet.

RESULTS

Most dogs (29/41, 71%) received IV-AA infusions (23/29, ≥2 infusions). Twenty-one dogs (51%) were fed commercial diets; 17/41 (41%) were fed home-cooked diets. Most dogs received SAMe (32/41, 78%) and a median of 3 supplements. In 4 dogs, HCH remission occurred. Overall all-cause median survival time (MST) was 359 days, and disease-specific MST was 557 days (range, 1-1783 days). Optimally treated dogs (n = 9) lived significantly longer (MST, >1783 days, P = .02) than variably treated dogs (MST, 214 days).

CONCLUSIONS AND CLINICAL IMPORTANCE

Optimized ACHES management can resolve SND and HCH and confer long-term survival.

摘要

背景

犬类浅层坏死性皮炎（SND）是一种罕见的疾病，通常与肝皮肤病综合征有关。尽管这种疾病通常被报道为致命的，但偶尔也有报道称长期缓解的情况可能比以前认为的更为常见，并且与治疗方案有关。

假设/目的：评估患有肝皮肤病相关肝病（HCH）的犬（无论是否患有 SND）的治疗方法和相关结果，这些犬被统称为氨基酸尿性犬低氨基酸血症肝肝病综合征（ACHES）。

动物

41 只不同品种和年龄的犬被诊断为 ACHES。

方法

回顾性研究。电子调查、病历（2014-2019 年）和与兽医的沟通提供了数据。将三种治疗类别分别分为两类：静脉内氨基酸（IV-AA）输注（≥2 次与<2 次）、包括 S-腺苷甲硫氨酸（SAMe）、精氨酸与鸟氨酸、谷胱甘肽、赖氨酸、脯氨酸、ω-3 脂肪酸或锌（≥3 次与<3 次）在内的补充剂，以及饮食类型（自制与商业）。最佳治疗定义为接受≥2 次 IV-AA 治疗、≥3 种营养补充剂和自制饮食。

结果

大多数犬（29/41，71%）接受了 IV-AA 输注（23/29，≥2 次输注）。21 只犬（51%）喂食商业饮食；41 只犬中的 17 只（41%）喂食自制饮食。大多数犬接受了 SAMe（32/41，78%）和中位数为 3 种补充剂。4 只犬的 HCH 缓解。总体而言，所有原因的中位总生存期（MST）为 359 天，疾病特异性 MST 为 557 天（范围，1-1783 天）。接受最佳治疗的犬（n=9）的生存期明显更长（MST，>1783 天，P=0.02），而接受可变治疗的犬（MST，214 天）的生存期更短。