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诊断和成功治疗犬肾皮质髓质脓肿。

Diagnosis and successful medical management of a renal corticomedullary abscess in a dog.

机构信息

Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, 1900 Coffey Road, Columbus, Ohio 43210, USA.

出版信息

Can Vet J. 2024 Sep;65(9):900-905.

Abstract

A 10-year-old spayed female mixed-breed dog was brought to the Ohio State University Veterinary Medical Center because of a suspected mass located to the right kidney. The mass was diagnosed by abdominal ultrasound following a recurrent lower urinary tract infection. Abdominal computed tomography revealed 2 isoattenuating, peripherally hypoattenuating, and centrally non-contrast-enhancing nodules in the right kidney; the larger one measured 1.9 cm. Initial attempts at fine-needle aspiration were unsuccessful. The dog was returned and the mass was aspirated using ultrasound guidance under heavy sedation. Cytology confirmed the presence of septic inflammation, consistent with a renal corticomedullary abscess. The dog was administered oral enrofloxacin (15 mg/kg, q24h) after diagnosis. Ultrasound guidance was used 2 wk later, under general anesthesia, to achieve percutaneous drainage of ~0.25 mL of fluid and instillation of 5.7 mg (0.25 mL) of enrofloxacin into the abscess capsule. Two weeks after percutaneous drainage, ultrasound examination showed complete resolution of the renal corticomedullary abscess. Urine culture confirmed resolution of the urinary tract infection. To the authors' knowledge, kidney-sparing medical management has never been successfully reported in a dog with a renal corticomedullary abscess. Key clinical message: Renal corticomedullary abscesses occur infrequently in dogs. Medical management is feasible and can result in complete resolution of clinical signs and imaging abnormalities.

摘要

一只十岁已绝育的雌性混种犬因右肾疑似肿块而被带到俄亥俄州立大学兽医学院。在反复出现下尿路感染后,通过腹部超声诊断出肿块。腹部计算机断层扫描显示右肾有 2 个等密度、周边低衰减、中央无增强的结节;较大的一个结节大小为 1.9 厘米。尝试进行细针抽吸的初步尝试没有成功。在重度镇静下,使用超声引导将狗带回并对肿块进行抽吸。细胞学检查证实存在化脓性炎症,与肾皮质髓质脓肿一致。诊断后,狗口服恩诺沙星(15mg/kg,q24h)。2 周后,在全身麻醉下使用超声引导,对约 0.25 毫升的液体进行经皮引流,并向脓肿囊内注入 5.7 毫克(0.25 毫升)的恩诺沙星。经皮引流后 2 周,超声检查显示肾皮质髓质脓肿完全消退。尿液培养证实尿路感染已得到解决。据作者所知,犬肾皮质髓质脓肿的保肾药物治疗从未成功报道过。主要临床信息:狗中很少发生肾皮质髓质脓肿。可以进行药物治疗,并且可以导致临床症状和影像学异常完全消退。

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