Sielman E S, Sweeney R W, Whitlock R H, Reams R Y
Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348, USA.
J Am Vet Med Assoc. 1997 Jan 15;210(2):240-3.
To evaluate clinical findings in cows with recumbency associated with hypokalemia.
Retrospective case series.
10 adult dairy cows with weakness or recumbency and hypokalemia.
Signalment, history, physical examination findings, results of diagnostic tests, and response to treatment were extracted from the medical record of each cow.
8 cows were recumbent on admission and 2 were profoundly weak. All cows had been given isoflupredone acetate as treatment for ketosis prior to admission. All were hypokalemic (serum potassium concentration, 1.4 to 2.3 mEq/L) with no other apparent cause for recumbency. Despite treatment with potassium, plasma potassium concentrations within the reference range were achieved in only 6 of the 9 cows treated. Two cows responded to treatment. Three cows died, 3 were euthanatized, 2 improved clinically and were discharged, 1 was discharged while still recumbent, and 1 was sent to slaughter prior to treatment. Histologic examination of muscle tissue from 2 cows revealed myonecrosis and vacuolation consistent with hypokalemic myopathy.
Hypokalemia should be considered in the differential diagnosis for cows that are weak or recumbent, particularly after treatment for ketosis with isoflupredone acetate. Aggressive treatment with potassium salts administered orally is indicated.
评估与低钾血症相关的卧地奶牛的临床症状。
回顾性病例系列。
10头出现虚弱或卧地且伴有低钾血症的成年奶牛。
从每头奶牛的病历中提取信号、病史、体格检查结果、诊断性检查结果及治疗反应。
8头奶牛入院时卧地，2头极度虚弱。所有奶牛在入院前均接受过醋酸异氟泼尼龙治疗酮病。所有奶牛均为低钾血症（血清钾浓度为1.4至2.3 mEq/L），且无其他明显的卧地原因。尽管进行了补钾治疗，但在接受治疗的9头奶牛中，只有6头奶牛的血浆钾浓度达到参考范围。2头奶牛对治疗有反应。3头奶牛死亡，3头被安乐死，2头临床症状改善并出院，1头出院时仍卧地，1头在治疗前被送去屠宰。对2头奶牛的肌肉组织进行组织学检查，发现有与低钾性肌病一致的肌坏死和空泡形成。
对于虚弱或卧地的奶牛，尤其是在用醋酸异氟泼尼龙治疗酮病后，鉴别诊断时应考虑低钾血症。建议积极口服补钾盐治疗。
