Akol K G, Washabau R J, Saunders H M, Hendrick M J
Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Philadelphia 19104-6010.
J Vet Intern Med. 1993 Jul-Aug;7(4):205-9. doi: 10.1111/j.1939-1676.1993.tb01008.x.
The purpose of this study was to characterize the incidence, clinical features, and prognosis of acute pancreatitis in cats with hepatic lipidosis. Of 13 cats histologically diagnosed with hepatic lipidosis between July 1988, and November 1989, 5(38%) were also histologically diagnosed with acute pancreatitis. In cats with hepatic lipidosis alone, the signalment, history, physical examination, and clinicopathologic findings were generally indistinguishable from those of cats with concurrent acute pancreatitis except that cats with acute pancreatitis were more likely to be cachectic and to have coagulation abnormalities. Hepatomegaly was seen on abdominal radiographs in both groups. Of the 5 cats with concurrent acute pancreatitis, abdominal ultrasonography detected 1 cat with a hypoechoic pancreas and 5 with peritoneal effusion; those abnormalities were not seen in cats without concurrent acute pancreatitis. Cats with concurrent acute pancreatitis had only a 20% recovery rate, compared with a 50% recovery rate in cats with hepatic lipidosis alone. We conclude that cats with hepatic lipidosis should be rigorously evaluated for concurrent acute pancreatitis because of 1) the rate of disease coincidence, 2) the inability of signalment, history, physical examination, and clinicopathologic findings to adequately distinguish between hepatic lipidosis and acute pancreatitis, 3) the worse prognosis associated with concurrent acute pancreatitis, and 4) the opposing nutritional strategies for hepatic lipidosis and acute pancreatitis.
本研究的目的是描述肝脂肪变性猫急性胰腺炎的发病率、临床特征及预后。在1988年7月至1989年11月间经组织学诊断为肝脂肪变性的13只猫中,有5只(38%)同时经组织学诊断为急性胰腺炎。仅患有肝脂肪变性的猫,其信号、病史、体格检查及临床病理表现通常与并发急性胰腺炎的猫难以区分,只是并发急性胰腺炎的猫更可能消瘦且有凝血异常。两组猫的腹部X线片均可见肝脏肿大。在5只并发急性胰腺炎的猫中,腹部超声检查发现1只猫胰腺低回声,5只猫有腹腔积液;未并发急性胰腺炎的猫未见这些异常。并发急性胰腺炎的猫恢复率仅为20%,而仅患有肝脂肪变性的猫恢复率为50%。我们得出结论,由于以下原因,应对肝脂肪变性猫进行严格评估以确定是否并发急性胰腺炎:1)疾病并发率;2)信号、病史、体格检查及临床病理表现无法充分区分肝脂肪变性和急性胰腺炎;3)并发急性胰腺炎预后较差;4)肝脂肪变性和急性胰腺炎营养策略相反。