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专家对气管塌陷的处理方法:基于调查的诊断、医疗管理和合并症意见。

Specialists' approach to tracheal collapse: survey-based opinions on diagnostics, medical management, and comorbid diseases.

机构信息

1College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO.

2College of Veterinary Medicine, University of Missouri, Columbia, MO.

出版信息

J Am Vet Med Assoc. 2022 Sep 27;261(1):80-86. doi: 10.2460/javma.22.03.0108.

Abstract

OBJECTIVE

To describe the current standard of care among specialists for the routine diagnostic evaluation and medical management of stable tracheal collapse in dogs, identifying gaps between practice and scientific evidence to facilitate the development of future prospective studies. A secondary objective was to describe the perceived incidence of selected comorbid disorders in dogs with tracheal collapse and the diagnostic tests performed to evaluate for those disorders.

SAMPLE

180 veterinary specialists in 22 countries.

PROCEDURES

An electronic survey was sent to 4 specialty listservs to target diplomates. Respondents completed multiple-choice and free-response questions related to the diagnostic evaluation and treatment of a theoretical stable dog with suspected tracheal collapse.

RESULTS

Most respondents routinely utilized radiography, tracheobronchoscopy, and fluoroscopy to diagnose tracheal collapse and performed airway sampling, sedated airway examination, and echocardiograms to rule out comorbidities. The most frequently perceived comorbid disorders included chronic bronchitis, bronchomalacia, and myxomatous mitral valve disease. Respondents most often prescribed opioid antitussives, glucocorticoids, anxiolytics, and antibiotics as treatments. Less frequently, they utilized bronchodilators and nonopioid medications for cough.

CLINICAL RELEVANCE

Despite a lack of published guidelines, specialists have similar approaches in their diagnostic and therapeutic approach to a stable dog with suspected tracheal collapse and believe evaluating for comorbid disorders is important. A description of a typical diagnostic approach and knowledge of realistic treatment goals will assist the general practitioner managing dogs with stable tracheal collapse. Additionally, gaps between current practices established via this survey and data supporting those practices exist, specifically concerning the use of antibiotics and nonopioid medications for cough, representing areas for further study.

摘要

目的

描述专家在稳定型气管塌陷犬的常规诊断评估和医学管理方面的当前标准护理,以确定实践与科学证据之间的差距,从而促进未来前瞻性研究的开展。次要目的是描述患有气管塌陷犬的一些选定合并症的发病率以及用于评估这些疾病的诊断测试。

样本

22 个国家的 180 名兽医专家。

程序

向 4 个专业名录服务组发送了电子调查,以针对专科医生。受访者完成了与疑似稳定型气管塌陷犬的诊断评估和治疗相关的多项选择题和自由回答问题。

结果

大多数受访者通常使用放射学、气管支气管镜检查和荧光透视术来诊断气管塌陷,并进行气道采样、镇静气道检查和超声心动图检查以排除合并症。最常被认为的合并症包括慢性支气管炎、支气管软化症和黏液瘤性二尖瓣疾病。受访者最常开的治疗药物包括阿片类镇咳药、皮质类固醇、镇静剂和抗生素。他们较少使用支气管扩张剂和非阿片类药物治疗咳嗽。

临床相关性

尽管缺乏已发表的指南,但专家在对疑似稳定型气管塌陷犬的诊断和治疗方法上有相似的方法,并认为评估合并症很重要。描述一种典型的诊断方法和了解现实的治疗目标将有助于管理稳定型气管塌陷犬的一般从业者。此外,通过这项调查确定的当前实践与支持这些实践的数据之间存在差距,特别是关于咳嗽使用抗生素和非阿片类药物的问题,这代表了进一步研究的领域。

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