Farrar E T, Washabau R J, Saunders H M
Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia 19104-6010, USA.
J Am Vet Med Assoc. 1996 Jan 15;208(2):243-7.
To determine typical clinical signs and clinicopathologic findings in dogs with hepatic abscesses, to assess outcome of treatment, and to evaluate the role that abdominal ultrasonography has in the diagnosis of hepatic abscesses in dogs and in monitoring response to treatment.
Retrospective case series.
14 dogs with hepatic abscesses.
Anorexia and lethargy were the most common historical complaints, followed by vomiting and diarrhea. Physical abnormalities included fever, dehydration, signs of abdominal pain, hepatomegaly, and mucosal bleeding. Hematologic abnormalities included leukocytosis with neutrophilia, mild to moderate thrombocytopenia, and mild anemia. Serum biochemical abnormalities included high alkaline phosphatase and alanine aminotransferase activities and high bilirubin concentration; hypoalbuminemia and prolonged coagulation values were also reported. Abdominal radiography revealed hepatomegaly, poor abdominal detail, a hepatic mass, or splenomegaly in 9 dogs. Thoracic radiography revealed alveolar consolidation or mixed bronchial/interstitial pulmonary patterns in 6 dogs. Hypoechoic, heteroechoic, or hyperechoic masses were identified in all dogs in which ultrasonography was performed. Escherichia coli, Clostridium sp, Klebsiella pneumoniae, Enterococcus sp, Staphylococcus epidermidis, and S intermedius were the most common bacteria isolated from hepatic abscesses. Concurrent infections were identified in the biliary tract, spleen, blood, endocardium, lung, prostate gland, peritoneum, lymph nodes, salivary gland, or brain of several dogs. Seven dogs died or were euthanatized before definitive treatment could be initiated. One dog was successfully treated with antibiotics and was alive 12 months after medical treatment. Six dogs were treated surgically (ie, full or partial liver lobectomy, drainage, abdominal lavage) and medically (ie, antibiotic administration). Five of these dogs survived and were alive 12 months after surgery. Ultrasonography was used to monitor response to treatment in several dogs.
Hepatic abscesses are rare in dogs, but the clinical signs and clinicopathologic findings are similar to other inflammatory hepatic disease. Ultrasonography revealed abnormalities in all animals in which imaging studies were performed, and was successfully used to monitor response to treatment in several dogs. Medical and surgical treatments were used successfully to treat hepatic abscesses in dogs.
确定患有肝脓肿的犬的典型临床症状和临床病理特征，评估治疗效果，并评价腹部超声检查在犬肝脓肿诊断及监测治疗反应中的作用。
回顾性病例系列研究。
14只患有肝脓肿的犬。
厌食和嗜睡是最常见的病史主诉，其次是呕吐和腹泻。体格检查异常包括发热、脱水、腹痛体征、肝肿大和黏膜出血。血液学异常包括白细胞增多伴中性粒细胞增多、轻度至中度血小板减少和轻度贫血。血清生化异常包括碱性磷酸酶和丙氨酸转氨酶活性升高以及胆红素浓度升高；还报告有低白蛋白血症和凝血值延长。腹部X线摄影显示9只犬存在肝肿大、腹部细节显示不清、肝脏肿块或脾肿大。胸部X线摄影显示6只犬存在肺泡实变或混合性支气管/间质性肺部影像。在所有接受超声检查的犬中均发现了低回声、等回声或高回声肿块。大肠杆菌、梭菌属、肺炎克雷伯菌、肠球菌属、表皮葡萄球菌和中间葡萄球菌是从肝脓肿中分离出的最常见细菌。在几只犬的胆道、脾脏、血液、心内膜、肺、前列腺、腹膜、淋巴结、唾液腺或脑部发现了并发感染。7只犬在开始确定性治疗前死亡或被安乐死。1只犬经抗生素治疗成功，药物治疗后存活12个月。6只犬接受了手术治疗（即全肝或部分肝叶切除术、引流、腹腔灌洗）和药物治疗（即给予抗生素）。其中5只犬存活，术后12个月仍存活。超声检查用于监测几只犬的治疗反应。
肝脓肿在犬中较为罕见，但临床症状和临床病理特征与其他炎症性肝病相似。超声检查在所有接受影像学检查的动物中均显示出异常，并成功用于监测几只犬的治疗反应。药物和手术治疗成功地治疗了犬肝脓肿。
