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猫的窗内夹伤创伤:临床、神经学及临床病理学发现与转归(70例)

Window entrapment trauma in cats: clinical, neurological and clinicopathological findings and outcome (70 cases).

作者信息

Graciolli Tomazi Fabiana, Stein Veronika M, Hauer Julia, Peters Laureen M, Steffen Frank, Farra Dima, Vidondo Beatriz, Maiolini Arianna

机构信息

Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

Department of Neurology, Small Animal Clinic Hofheim, Hofheim am Taunus, Germany.

出版信息

J Feline Med Surg. 2024 Dec;26(12):1098612X241296416. doi: 10.1177/1098612X241296416.

Abstract

OBJECTIVES

Window entrapment in cats can lead to reduced blood flow to the spinal cord, muscles and nerves, resulting in ischaemic neuromyelomyopathy. The severity and duration of entrapment greatly influence clinical and neurological outcomes, as well as prognosis. The aim of the present retrospective multicentric study (2005-2022) was to describe clinical, neurological and selected clinicopathological findings, as well as the outcome of cats trapped in bottom-hung windows, presented to both first-opinion and referral-only clinics.

METHODS

The study included cats with detailed clinical and neurological evaluations at admission, along with at least one of the following biochemical parameters: creatine kinase (CK), aspartate transaminase (AST), alanine aminotransferase (ALT) activities, urea and/or creatinine. Clinical and neurological parameters evaluated in the study included rectal temperature, femoral pulse, gait, urinary bladder function, tail function and survival to discharge. Odds ratios (ORs) were calculated for survival and each clinical, neurological and biochemical variable.

RESULTS

Of the 70 cats that met the inclusion criteria, only seven (10%) died or were euthanased during hospitalisation. Nevertheless, with the available data, we found evidence of an association between clinical and neurological status and survival, with tail function being the strongest association. Cats lacking tail sensation, motor function and/or tonus were more likely to die than cats with normal tail function or only mild abnormalities (OR = 24). Similarly, cats with severe hypothermia or an absent femoral pulse were less likely to survive (OR = 12.75 and 7.5, respectively). In this sample (with a relatively low number of deaths), we did not find evidence of an association between CK, AST and ALT activity with survival. However, the only two cats with severe increases in creatinine died.

CONCLUSIONS AND RELEVANCE

Assessment of gait, urinary bladder function, femoral pulse, rectal temperature and particularly tail function is promising for predicting outcomes in cats with window entrapment trauma.

摘要

目的

猫被困于窗户导致脊髓、肌肉和神经血流减少,从而引发缺血性神经脊髓病。被困的严重程度和持续时间对临床和神经学结果以及预后有极大影响。本项回顾性多中心研究(2005 - 2022年)的目的是描述被困于下悬窗的猫的临床、神经学及部分临床病理特征,以及这些猫在初诊和转诊诊所的治疗结果。

方法

本研究纳入入院时进行了详细临床和神经学评估的猫,以及至少一项以下生化指标:肌酸激酶(CK)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)活性、尿素和/或肌酐。研究中评估的临床和神经学参数包括直肠温度、股动脉脉搏、步态、膀胱功能、尾巴功能及出院存活率。计算了存活以及各项临床、神经学和生化变量的比值比(OR)。

结果

在符合纳入标准的70只猫中,只有7只(10%)在住院期间死亡或被安乐死。然而,根据现有数据,我们发现临床和神经学状态与存活之间存在关联,尾巴功能的关联最为显著。与尾巴功能正常或仅有轻微异常的猫相比,缺乏尾巴感觉、运动功能和/或张力的猫死亡可能性更大(OR = 24)。同样,体温过低或股动脉脉搏消失的猫存活可能性较小(分别为OR = 12.75和7.5)。在这个样本(死亡数量相对较少)中,我们未发现CK、AST和ALT活性与存活之间存在关联。然而,仅有的两只肌酐严重升高的猫死亡。

结论及意义

评估步态、膀胱功能、股动脉脉搏、直肠温度,尤其是尾巴功能,对于预测被困于窗户导致创伤的猫的预后很有前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f81/11682586/2c847702b929/10.1177_1098612X241296416-fig1.jpg

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