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2016年至2022年东部拟眼镜蛇咬伤犬猫的临床特征、治疗及预后的回顾性分析

A retrospective analysis of clinical features, management and outcomes in dogs and cats with Eastern Brown Snake envenomation (2016-2022).

作者信息

Day S K, Nash K J, Midwinter M J, Goodwin W A

机构信息

School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.

School of Biomedical Sciences, The University of Queensland, Gatton, Queensland, Australia.

出版信息

Aust Vet J. 2025 Mar;103(3):77-87. doi: 10.1111/avj.13399. Epub 2024 Dec 3.

Abstract

Australian Eastern brown snakes (Pseudonaja textilis) can cause venom-induced consumptive coagulopathy (VICC) in envenomated dogs and cats due to toxin-induced consumption of clotting factors. The objective of this study was to describe presenting clinical signs, prevalence of VICC and haemorrhage, VICC resolution timelines and patient outcomes in a population of dogs and cats with Eastern brown snake envenomation (EBSE). Data from dogs and cats presenting with EBSE were retrospectively evaluated. Univariable and multivariable analyses were performed to test predictor variable effects on outcomes. Animals who were euthanased for financial reasons on presentation were excluded from treatment and outcome analysis. Two-hundred and forty dogs and 98 cats were included. On presentation, 66% (159/240) of dogs had lower motor neuropathy (LMN), 31% (74/240) had preparalytic collapse and 30% (72/240) had signs of haemorrhage. In cats, 94% (92/98) had LMN, and only 5% (5/98) had haemorrhage. Ninety-two percent of dogs (209/226) and cats (81/88) were diagnosed with VICC on presentation and median time to normalisation of coagulation tests was 24 hours. Median hospitalisation length was 1.5 days for dogs (lower quartile [LQ]-upper quartile [UQ]: 1.0-3.0) and 2 days for cats (LQ - UQ: 1.0-2.5). Dogs presenting with LMN and no history of preparalytic collapse had significantly longer hospitalisation times (median 2.25 vs. 1.0 days, P-value <0.001; median 2.0 vs. 1.0 days, P-value <0.001 respectively). Odds of survival was lower in dogs with LMN (odds ratio [OR]: 0.23) and in the pooled multivariable analysis of dogs and cats with haemorrhage (OR: 0.39). The administration of antivenom overall was found to confer a survival advantage; however analysis failed to show increased odds of survival with administration of more than 4000 units. Overall, 89% (187/210) of dogs and 75% (58/77) of cats survived to discharge.

摘要

澳大利亚东部棕蛇(伪眼镜蛇)可因毒素诱导凝血因子消耗,导致被其毒液咬伤的犬猫出现毒液诱导的消耗性凝血病(VICC)。本研究的目的是描述东部棕蛇毒液中毒(EBSE)的犬猫群体的临床表现、VICC和出血的发生率、VICC缓解时间线及患者预后。对出现EBSE的犬猫数据进行回顾性评估。进行单变量和多变量分析以测试预测变量对结果的影响。因经济原因就诊时实施安乐死的动物被排除在治疗和结果分析之外。纳入了240只犬和98只猫。就诊时,66%(159/240)的犬有下运动神经元病(LMN),31%(74/240)有麻痹前期虚脱,30%(72/240)有出血迹象。猫中,94%(92/98)有LMN,只有5%(5/98)有出血。92%的犬(209/226)和猫(81/88)就诊时被诊断为VICC,凝血试验恢复正常的中位时间为24小时。犬的中位住院时间为1.5天(下四分位数[LQ]-上四分位数[UQ]:1.0-3.0),猫为2天(LQ-UQ:1.0-2.5)。出现LMN且无麻痹前期虚脱病史的犬住院时间显著更长(中位时间分别为2.25天对1.0天,P值<0.001;2.0天对1.0天,P值<0.001)。有LMN的犬的存活几率较低(比值比[OR]:0.23),在对有出血的犬猫进行的汇总多变量分析中也是如此(OR:0.39)。总体而言,发现使用抗蛇毒血清可带来生存优势;然而分析未能显示使用超过4000单位抗蛇毒血清会增加存活几率。总体而言,89%(187/210)的犬和75%(58/77)的猫存活至出院。

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