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病例报告:犬双侧肾膨结线虫病与严重尿毒症是否等同于安乐死?如今并非如此。

Case report: Is bilateral renal dioctophymosis and severe uremia in a dog synonymous of euthanasia? Not today.

作者信息

Caye Pâmela, Gasparotto Jean Carlos, Hörbe Anna Vitória, Andrade Letícia Rodrigues Leitao, Reinstein Rainer da Silva, Mangini Luiza Tonietto, Müller Daniel Curvello de Mendonça, Brun Maurício Veloso

机构信息

Postgraduate Program in Veterinary Medicine, Center for Rural Sciences, Federal University of Santa Maria, Santa Maria, Brazil.

Residency Program in Veterinary Medicine, University Veterinary Hospital, Federal University of Santa Maria, Santa Maria, Brazil.

出版信息

Front Vet Sci. 2024 May 22;11:1396467. doi: 10.3389/fvets.2024.1396467. eCollection 2024.

Abstract

A dog with bilateral renal dioctophymosis presented with stage 5 acute kidney injury, weight loss, vomiting, apathy, and hematuria. Laboratory tests showed creatinine of 17.2 mg/dL and eggs in the urine. It underwent a 30-min session of hyperbaric oxygen preconditioning at a pressure of 2 ATA. Subsequently, bilateral nephroscopy was performed, without warm ischemia, using Amplatz-type renal dilators. Five parasites were removed, three females from the right kidney, one female from the left kidney, and one male from the abdominal cavity. After surgery, the patient continued doing daily hyperbaric oxygen therapy (HBOT) sessions and clinical therapy. Postoperative care consisted of analgesics, antimicrobials, antioxidants, gastric protector and fluid therapy. Ultrasound monitoring showed a reduction in the area of renal dilation and the hematological and biochemical tests showed rapid recovery from acute kidney injury. There was no bacterial growth in the urine sample collected directly from the kidneys. The patient had an excellent clinical progression and was discharged from hospital 7 days postoperatively, with creatinine values of 2.9 mg/dL. This is the first report of the use of nephroscopy in the treatment of dioctophymosis and indicates excellent chances of cure even in severe cases of bilateral parasitosis. HBOT was shown to be an ally in the clinical therapy of patients with by helping with stabilization and postoperative recovery.

摘要

一只患有双侧肾膨结线虫病的狗出现了5期急性肾损伤、体重减轻、呕吐、冷漠和血尿。实验室检查显示肌酐为17.2mg/dL,尿液中有虫卵。它在2个绝对大气压的压力下接受了30分钟的高压氧预处理。随后,在无热缺血的情况下,使用安普拉斯型肾扩张器进行了双侧肾镜检查。取出了5条寄生虫,3条雌虫来自右肾,1条雌虫来自左肾,1条雄虫来自腹腔。手术后,患者继续进行每日高压氧治疗(HBOT)和临床治疗。术后护理包括使用镇痛药、抗菌药、抗氧化剂、胃保护剂和液体疗法。超声监测显示肾扩张面积减小,血液学和生化检查显示急性肾损伤迅速恢复。直接从肾脏采集的尿液样本中没有细菌生长。患者临床进展良好,术后7天出院,肌酐值为2.9mg/dL。这是关于肾镜检查用于治疗膨结线虫病的首次报告,表明即使在双侧寄生虫病的严重病例中也有很好的治愈机会。高压氧治疗被证明是膨结线虫病患者临床治疗中的一个辅助手段,有助于稳定病情和术后恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e69/11150568/3e142838ad44/fvets-11-1396467-g0001.jpg

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