Mealey K L, Boothe D M
Department of Veterinary Physiology, Pharmacology, and Toxicology, College of Veterinary Medicine, Texas A&M University, College Station 77843-4466.
J Am Vet Med Assoc. 1994 Jun 15;204(12):1919-21.
A 4-year-old cat was referred for treatment of a large, open wound. The wound had been lavaged twice, approximately 12 hours apart, with approximately 10 ml of 5% gentamicin solution prior to referral, because of infection caused by Pseudomonas spp. Results of initial serum biochemical analyses were within reference ranges, and the cat was anesthetized for surgical wound debridement and closure. Two days later, the cat was azotemic (SUN concentration, 113 mg/dl; serum creatinine, concentration, 9.8 mg/dl) and had a urine specific gravity of 1.008. Granular casts were seen in the urine. The azotemia became more severe over the next 2 1/4 hours, despite treatment for acute renal failure, and the cat was euthanatized. Severe acute proximal tubular necrosis, consistent with gentamicin-induced nephrotoxicosis, was diagnosed histologically. Retrospectively, serum samples obtained for biochemical analyses were assayed for gentamicin concentration. Serum concentration of gentamicin 8 hours after topical lavage was 58.07 micrograms/ml. This was approximately 6 times greater than the desired peak concentration for gentamicin and suggested that gentamicin had been absorbed systemically following topical application.
一只4岁的猫因一处大的开放性伤口被转诊治疗。在转诊前，由于铜绿假单胞菌属感染，该伤口已用约10毫升5%庆大霉素溶液冲洗了两次，冲洗间隔约12小时。初次血清生化分析结果在参考范围内，该猫被麻醉以进行手术伤口清创和缝合。两天后，这只猫出现氮质血症（血尿素氮浓度，113毫克/分升；血清肌酐浓度，9.8毫克/分升），尿比重为1.008。尿液中可见颗粒管型。尽管对急性肾衰竭进行了治疗，但在接下来的2.25小时内氮质血症变得更加严重，这只猫被实施了安乐死。组织学诊断为严重的急性近端肾小管坏死，符合庆大霉素诱导的肾毒性。回顾性分析，对用于生化分析的血清样本检测庆大霉素浓度。局部冲洗8小时后的血清庆大霉素浓度为58.07微克/毫升。这大约是庆大霉素预期峰值浓度的6倍，提示局部应用后庆大霉素已被全身吸收。
