Edwards D F, Russell R G
College of Veterinary Medicine, University of Tennessee, Knoxville 37901-1071.
J Vet Intern Med. 1987 Jul-Sep;1(3):97-101. doi: 10.1111/j.1939-1676.1987.tb01995.x.
Two cats with intestinal malabsorption developed a hemorrhagic diathesis. Although unsubstantiated, the probable cause of bleeding was a chronic malabsorption of fat and the fat-soluble vitamin K. When treated with vitamin K1 per os, one cat's clotting times were only partially corrected. Since vitamin K1 is actively absorbed in the proximal small intestine, the incomplete response of this case to orally administered vitamin K1 was predictable. The infrequent occurrence of bleeding in animals with malabsorption is, in part, attributable to the ileal and colonic absorption of bacterially derived vitamin K2. For this reason, nonspecific use of antibiotics in these animals is contraindicated. Since long-chain, polyunsaturated fats impair vitamin K absorption, dietary fat given to animals with malabsorption should be restricted to medium- and short-chain, saturated fats. Vitamin K should be administered subcutaneously to these animals if prolonged clotting times or active bleeding is present, and routinely prior to surgery. Oral supplementation with vitamin K3, which is absorbed in the colon and less lipid soluble than vitamin K1, should be given to animals with malabsorption that are maintained as outpatients. Adequate dosage levels of vitamin K3, however, are yet to be established for the cat, and dose-dependent hemolytic anemia is a probable toxic manifestation.
两只患有肠道吸收不良的猫出现了出血素质。尽管未经证实,但出血的可能原因是脂肪和脂溶性维生素K的慢性吸收不良。口服维生素K1治疗时,一只猫的凝血时间仅得到部分纠正。由于维生素K1在近端小肠中被主动吸收,因此该病例对口服维生素K1的反应不完全是可预测的。吸收不良动物中出血的发生率较低,部分原因是肠道细菌衍生的维生素K2在回肠和结肠的吸收。因此,禁止在这些动物中无差别地使用抗生素。由于长链多不饱和脂肪会损害维生素K的吸收,患有吸收不良的动物的饮食脂肪应限制为中链和短链饱和脂肪。如果存在凝血时间延长或活动性出血,应皮下注射维生素K给这些动物,并且在手术前常规注射。对于作为门诊病人饲养的吸收不良动物,应口服补充维生素K3,它在结肠中被吸收且脂溶性比维生素K1低。然而,猫的维生素K3适当剂量水平尚未确定,且剂量依赖性溶血性贫血可能是一种毒性表现。