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1.
A 2-year-old female neutered Somali cat was presented with vomiting and acute onset jaundice 1 year after diagnosis of pyruvate kinase (PK) deficiency. Diagnostic investigations revealed a moderate regenerative haemolytic anaemia, severe hyperbilirubinaemia and elevated liver enzymes. Ultrasonography revealed marked distension of the gall bladder and common bile duct (CBD), consistent with extrahepatic biliary obstruction (EHBO). At cholecystotomy, the gall bladder contained purulent material, and two obstructive choleliths were removed from the CBD by choledochotomy. The cat recovered from surgery uneventfully, and serum liver enzymes and bilirubin normalised within 10 days. Postoperative treatment consisted of cephalexin, metronidazole and ursodeoxycholic acid (UDCA). Bacterial culture of the gall bladder contents yielded a pure growth of an Actinomyces species. Cholelith analysis revealed that they consisted of 100% bilirubin. Antibiotic treatment was stopped 4 weeks after surgery but UDCA was continued indefinitely. The cat remains clinically well with no recurrence of cholelithiasis 20 months after initial presentation. This is the first report of successful treatment and long-term follow-up of a cat with EHBO due to bilirubin cholelithiasis in association with PK deficiency-induced chronic haemolysis.  相似文献   

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3.
: A domestic-longhair cat presented due to lethargy, dyspnoea and hypersalivation. Radiographic examination revealed a bilateral pleural effusion, which was diagnosed as pyothorax based on cytological examination. Ultrasonographic examination revealed extensive loculations within the thoracic cavity. Exploratory sternotomy, under general anaesthesia, allowed the removal of approximately 100 ml of purulent fluid and debridement of a partially walled-off abscess and necrotic material from the pleural cavity. Postoperative positive-pressure ventilation was required due to severe respiratory depression. Intensive postoperative care, including intensive continuous monitoring, thoracostomy tube drainage and lavage of the pleural cavity and oesophagostomy tube feeding, was performed. Complete resolution of clinical signs had occurred by 15 days postoperatively. Clinical or radiographic abnormalities were not detected at a follow-up examination one year after surgery.  相似文献   

4.
A 10-year-old cat was presented with a history of inappetence, pyrexia and weight loss. Clinical investigations showed anaemia, hyperbilirubinaemia, septic peritonitis and a double gall bladder with choleliths in an extrahepatic duct. Initial medical stabilisation was performed. At laparotomy, a duplex gall bladder with two separate cystic ducts was identified. The left gall bladder was thickened and had ruptured at the apex. Multiple choleliths were identified in the left cystic duct. The right gall bladder and cystic duct were grossly normal. The ruptured gall bladder was repaired, the gallstones were removed via a choledochotomy of the left cystic duct and a choledochoduodenostomy was created from the dilated left cystic duct. The cat remained depressed and anorexic, and it was euthanased 72 hours postoperatively at the owners' request. This is the first ante-mortem investigation of extrahepatic biliary disease associated with gall bladder duplication in the cat.  相似文献   

5.
A veterinarian dealing with critical and trauma patients must be proficient with techniques for tracheostomy, thoracostomy tube placement for chest drainage, diagnostic peritoneal lavage, and autotransfusion. The utilization of these techniques may be life-saving in the critical patient. A tracheostomy is indicated in any patient with upper airway obstruction that cannot be managed with supplemental oxygen and/or orotracheal intubation. A tracheostomy tube with an inner cannula is preferred. Tracheostomy tubes should be cleaned at 3- to 4-h intervals, and methods should be employed to decrease thick tracheal secretions and to remove them from the trachea. A patient with a tracheostomy tube should be monitored continuously. A thoracostomy tube is indicated in any patient with large and/or continuous accumulation of air, blood, fluid, or chyle in the pleural space. The thoracostomy tube should be at least the same size as the patient's main stem bronchus. The thoracostomy tube is placed aseptically at the seventh intercostal space at the junction of the upper one third and lower two thirds of the lateral chest wall. Fluid or air may be removed from the chest intermittently with a three-way stopcock attached to the thoracostomy tube and a 60-ml syringe. If continuous drainage is needed, a continuous underwater seal and suction system should be used. Diagnostic abdominal paracentesis and peritoneal lavage are useful techniques in the determination of abdominal trauma, hollow viscus rupture, peritonitis, hepatic trauma, and urinary system trauma. When a multiholed catheter and lavage are used, the accuracy of detecting abdominal trauma is 95 per cent. When only needle paracentesis is used, the accuracy drops to 47 per cent. Abdominal lavage fluid can be analyzed for bacteria, whole blood, white blood cells, free bilirubin, creatinine, blood urea nitrogen, amylase, alkaline phosphatase, and alanine aminotransferase. Large volumes of whole blood recovered from abdominal or thoracic paracentesis can be reinfused into the patient if needed, providing it is not contaminated or markedly hemolyzed. The blood should be collected aseptically into blood bottles or bags. If the bleeding is ongoing or the blood only a few hours old, anticoagulants should be used. If the hemorrhage is several hours old, then clotting and defibrination has already occurred and the blood can be collected into "dry" bags or bottles. Before use, abdominal blood should be analyzed for urine, bile or fecal contamination. Blood collected from the thoracic cavity is much less likely to be contaminated. Autotransfused blood is administered through a standard blood administration set.  相似文献   

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7.
Objective— To report a technique for tube cystostomy placement via a minimally invasive inguinal approach and outcome in 9 dogs and 6 cats with urinary tract obstruction or detrusor atony.
Study Design— Case series.
Animals— Dogs (n=9) and cats (6).
Methods— Medical records (January 2004–January 2008) of dogs and cats that had tube cystostomy via an inguinal approach were reviewed. Retrieved data included signalment, diagnosis, surgical technique, and complications. Access to the bladder was through a muscle splitting approach in the inguinal region with the cystostomy tube placed through a skin incision made several centimeters proximal to this incision and secured in the bladder by a purse string suture. Cystopexy during closure of the muscle layers ensured secure closure and minimized the likelihood of uroabdomen if tube dislodgment occurred.
Results— Cystostomy tubes were placed in 5 cats as an emergency procedure for treatment of acute urinary tract obstruction or urethral rupture, and as an elective procedure in 9 dogs and 1 cat. No complications occurred during cystostomy tube placement. Postprocedural complications were minor (peristomal irritation in 2 dogs with latex catheters, catheter laceration, premature removal) and only occurred when tubes were retained for >4 weeks. Urinary tract infection at catheter removal in 6 dogs resolved with antibiotic administration.
Conclusions— An inguinal approach for cystostomy tube placement facilitated rapid catheter placement into the bladder with minimal soft tissue dissection. Cystopexy during abdominal wall closure provided peritoneal protection should premature dislodgement of the cystostomy tube occur.
Clinical Relevance— An inguinal approach should be considered for rapid tube cystostomy particularly in metabolically compromised animals.  相似文献   

8.
Objectives— To describe a technique for, and outcome after, laparoscopic cholecystectomy (LC) for management of uncomplicated gall bladder mucocele (GBM) in dogs. Study Design— Case series. Animals— Dogs (n=6) with uncomplicated GBM. Methods— Dogs with ultrasonographic evidence of GBM but without imaging or laboratory signs of gall bladder rupture, peritonitis, or extra‐hepatic biliary tract rupture that had LC were included. A 4 portal technique was used. A fan retractor was used to retract the gall bladder to allow dissection around the cystic duct with 5 or 10 mm right‐angle dissecting forceps. The cystic duct was ligated using extracorporeally tied ligatures supplemented sometimes with hemostatic clips. A harmonic scalpel was used to dissect the gall bladder from its fossa. The gall bladder was placed into a specimen retrieval bag and after bile aspiration the bag was withdrawn through the 11 mm portal incision. Results— Five dogs had mild intermittent clinical signs including vomiting, inappetence, and lethargy. All dogs had successful LC without conversion to an open approach. All dogs with clinical signs had improvement or resolution of signs postoperatively. No important perioperative complications occurred and all dogs were alive at a median of 8 months postoperatively (range, 3–14 months). Conclusions— LC can be accomplished safely and effectively in dogs with uncomplicated GBM. Clinical Relevance— A minimally invasive approach for cholecystectomy can be used for the treatment of GBM in dogs.  相似文献   

9.
A 13-year-old female spayed domestic shorthair cat presented for investigation of decreased appetite and increased serum liver enzyme concentrations. An abdominal ultrasound revealed multiple sessile hyperechoic structures along the luminal aspect of the gall bladder wall and a mildly enlarged liver with hyperechoic nodules. Cholecystectomy was performed and biopsies were obtained by laparotomy. Histopathologic examination with immunohistochemistry was consistent with a diagnosis of small-cell lymphoma of T cells within the gall bladder, liver and small intestine. Clonality testing confirmed the diagnosis. The cat remains clinically stable 23 months after institution of treatment with prednisolone, chlorambucil and ursodeoxycholic acid. This is the first report of small-cell lymphoma in the gall bladder of a cat.  相似文献   

10.
A Somali cat was presented with recurrent anorexia, lethargy, vomiting and icterus. A macrocytic-hypochromic, regenerative haemolytic anaemia was identified and hereditary pyruvate kinase deficiency was confirmed by means of breed-specific DNA mutation analysis. The case was complicated by the presence of markedly elevated serum liver enzyme activities, hyperbilirubinaemia, coagulopathy and ultrasonographic evidence of gall bladder choleliths and extrahepatic bile duct obstruction. The choleliths consisted of 100 per cent bilirubin, likely because of chronic haemolysis and haeme degradation. In conclusion, haemosiderosis and bilirubin cholelithiasis can be a consequence of chronic haemolysis in pyruvate kinase-deficient cats, as seen in human beings with a variety of chronic haemolytic disorders.  相似文献   

11.
O bjectives : The objective of this study was to evaluate the relationship between the volume of fluid being produced at the time of thoracostomy drain removal and the time to hospital discharge in dogs and cats.
M ethods : Records of 101 dogs and 26 cats with thoracostomy drains were reviewed. Three subgroups were created according to the reason for thoracostomy drain placement: P (postsurgical), A (air) and F (fluid). A generalised linear model with Poisson Errors was performed to test the relationship between the volume of fluid produced at the time of thoracostomy drain removal and the time to discharge. The volume of fluid produced and the time to discharge were compared between species and subgroups.
R esults : No significant relationship was found between the volume of fluid produced at the time of thoracostomy drain removal and the time to discharge in either species or between the time to discharge and the reason for thoracostomy drain placement. Animals with a volume of fluid higher than 2 ml/kg/day at the time of thoracostomy drain removal did not have increased hospitalisation times.
C linical S ignificance : Thoracostomy drain can be removed, without clinical compromise, when the volume of fluid produced exceeds 2 ml/kg/day. However, other clinical parameters must be taken into consideration.  相似文献   

12.
Therapy for pyothorax, or pleural empyema, has not been described for large felids. This case describes the successful treatment of pyothorax in a captive, large felid. A 15-yr-old multiparous, female Amur tiger (Panthera tigris altaica) presented with nonspecific clinical signs caused by an insidious onset of pyothorax. Management of pyothorax cases in companion animals often involves thoracostomy tube placement with recurrent drainage of the pleural cavity, intensive supportive care, and monitoring. In this case, conservative management was elected because hospitalization was not a viable option. Thoracocentesis was performed to drain as much fluid from the chest cavity as possible, yielding more than 1.3 L. Corynebacterium sp. and unidentified anaerobic gram-positive cocci were cultured. Treatment included cefovecin subcutaneously, oral antibiotic therapy with clindamycin and marbofloxacin, meloxicam, and restricted exercise by minimizing access to the main exhibit. Significant improvement was noted clinically and radiographically 6 wk later, and no relapses were noted in the following weeks. An examination 11.5 mo later confirmed resolution.  相似文献   

13.
A malignant neoplastic process originating from gall bladder epithelium was diagnosed in a 14-year-old, spayed female, domestic shorthair cat. The tumor produced widespread pulmonary and lymphatic metastases. The clinical and pathological manifestations are described. Neoplasia arising from the gall bladder epithelium is rarely reported in animals.  相似文献   

14.
The effects of amino acids on growth hormone (GH) release and cytosolic calcium concentration ([Ca2+]i) were investigated in caprine anterior pituitary cells cultured for 3 d in Dulbecco modified Eagle medium. The addition of an amino acid mixture consisting of seven nonessential amino acids (NEAA: l-Asp, Gly, l-Ala, l-Ser, l-Pro, l-Asn, and l-Glu; concentration of each 12.5–200 μmol/l) in the medium significantly raised GH release from the cultured cells in a concentration-dependent manner with the maximum release at 200 μmol/l NEAA. Although an addition of l-Asp (0.1–100 μmol/l) caused a significant rise in GH release in a concentration-dependent manner, neither the individual amino acids contained in NEAA except l-Asp nor others (l-Leu, l-Phe, l-Gln, l-Met, and l-Arg) caused a rise in GH release when added alone to the medium. The rise in GH release induced by NEAA (200 μmol/l) and GH-releasing hormone (GHRH, 10 nmol/l) was significantly reduced by the addition of EGTA (l.8 mmol/l) and nifedipine (1 μmol/l) to the medium, respectively. The addition of NEAA (200 μmol/l) caused a rapid and transient [Ca2+]i increase, followed thereafter by a steady increase. The prior addition of nifedipine (1 μmol/l), which itself significantly reduced the basal [Ca2+]i, completely abolished the response induced by NEAA or GHRH. From these findings, we conclude that: 1) NEAA raises GH release and [Ca2+]i in cultured caprine anterior pituitary cells, and 2) Ca2+ influx from the medium may be responsible for the cellular action of NEAA.  相似文献   

15.
对某种鹅场疑似白血病的朗德鹅进行了病理组织学观察。剖检可见病鹅极度消瘦，肝、肾、脾、胆囊和卵巢等组织器官呈不同程度肿瘤样病理变化。其中肝病变尤为明显，稍肿胀，表面有颗粒状弥漫性结节，切面有斑驳状异变；肾苍白，质硬，正常结构消失，形成肿瘤结节；胆囊变硬，胆囊壁增厚。组织切片观察可见肝细胞大量坏死，结缔组织增生，淋巴细胞浸润，肿瘤细胞增生；肾小管上皮脱落，肾间质与肾小球有不同程度的坏死，血管球结构模糊；脾淋巴细胞显著减少，异嗜性粒细胞增多，有多量肿瘤细胞浸润；胰腺、卵巢、胆囊等则有纤维化、淋巴细胞浸润和凝固性坏死等病理变化。  相似文献   

16.
A 4-month-old intact male domestic shorthair cat was evaluated for urinary outflow obstruction after several weeks of medical management for traumatic urethral rupture. Positive-contrast retrograde urethrography and anterograde cystoscopy performed 4 weeks after the initial urethral injury confirmed a stricture approximately 1cm distal to the bladder trigone at the site of the initial urethral tear. A self-expanding metallic urethral stent (SEMS) was placed under fluoroscopic guidance to relieve the urethral stricture and re-establish luminal patency. After stent placement, the cat was able to void urine normally with minimal urinary incontinence noted. This resolved several months post-stent placement. No known clinical complications persisted other than mild intermittent hematuria.  相似文献   

17.
Objective – To evaluate clinical characteristics and outcomes of cats undergoing surgical intervention in the course of treatment for severe acute pancreatitis. Design – Retrospective observational study from 2003 to 2007 with a median follow‐up period of 2.2 years (range 11 d–5.4 y) postoperatively. Setting – Private referral veterinary center. Animals – Eight cats. Interventions – None. Measurements and Main Results – Quantitative data included preoperative physical and clinicopathologic values. Qualitative parameters included preoperative ultrasonographic interpretation, perioperative and intraoperative feeding tube placement, presence of free abdominal fluid, intraoperative closed suction abdominal drain placement, postoperative complications, microbiological culture, and histopathology. Common presenting clinical signs included lethargy, anorexia, and vomiting. Leukocytosis and hyponatremia were present in 5 of 8 cats. Hypokalemia, increased total bilirubin, and hyperglycemia were present in 6 of 8 cats. Elevated alanine aminotransferase and aspartate transferase were present in all cats. Surgery for extrahepatic biliary obstruction was performed in 6 cats, pancreatic abscess in 3 cats, and pancreatic necrosis in 1 cat. Six of the 8 cats survived. Five of the 6 cats that underwent surgery for extrahepatic biliary obstruction and 1 cat that underwent pancreatic necrosectomy survived. All 5 of the cats with extrahepatic biliary obstruction secondary to pancreatitis survived. The 2 nonsurvivors included a cat with a pancreatic abscess and a cat with severe pancreatitis and extrahepatic biliary obstruction secondary to a mass at the gastroduodenal junction. Postoperative complications included progression of diabetes mellitus, septic peritonitis, local gastrostomy tube stoma inflammation, local gastrostomy tube stoma infection, and mild dermal suture reaction. Conclusion – Cats with severe acute pancreatitis and concomitant extrahepatic biliary obstruction, pancreatic necrosis, or pancreatic abscesses may benefit from surgical intervention. Cats with extrahepatic biliary obstruction secondary to severe acute pancreatitis may have a good prognosis.  相似文献   

18.
Diseases of the abdomen of the cheetah (Acinonyx jubatus) include those affecting the liver, spleen, and urinary tract. The most common diseases of captive-bred cheetah are gastritis, gastric ulceration, glomerulosclerosis, and hepatic veno-occlusive disease, and are the most frequent causes of mortality in these animals. The purpose of this study was to describe the ultrasonographic anatomy of the normal liver, spleen, kidney, and urinary bladder of the anesthetized captive-bred cheetah. Twenty-one cheetahs were examined. Eight of the 21 animals had subclinical evidence of either gastritis or chronic renal disease. The ultrasonographic appearances of the liver, gall bladder, common bile duct, and spleen were evaluated and various measurements made. Statistical analyses of the measurements were performed on all the healthy and subclinically ill animals taking sex, age, mass, and anesthetic protocol into account. There were no significant differences in any parameters between the healthy and subclinically ill animals (P > 0.25) and data were combined for statistical analyses. The mean mass was 41.1kg ( +/- 8.8) and the mean age was 5.0 years (+/- 2.2). The mean thickness of the liver medial to the gall bladder was 67.0 mm (+/- 14.8) and the liver was within the left costal arch in 75% of animals, extended caudal to the right costal arch in 50% of animals for an average of 30 mm, and extended caudal to the sternum in 63% of animals for an average of 32.5 mm. The maximum mean hepatic vein diameter at the entrance to the caudal vena cava was 8.6 +/- 2.8 mm; the mean diameters of the portal vein at the hilus and that of the caudal vena cava as it entered the liver were 7.5 +/- 1.6 and 9.9 +/- 4.1 mm, respectively. The mean diameter of the caudal vena cava was significantly affected by the type of anesthetic used (P < 0.10). The mass of the animals was significant in explaining the variance in maximum portal vein diameters (P < 0.10). The mean maximum velocity of the hepatic vein flow at the entrance to the caudal vena cava was 25.3 +/- 2.8 cm/s (n=4), the hilar portal vein was 11.7 +/- 3.3 cm/s (n=7), and the caudal vena cava was 33.8 +/- 19.8 cm/s (n=5). The mean maximum gall bladder length and width, and the mean common bile duct diameters were 44.6 mm (+/- 10.4), 23.3 mm (+/- 5.0), and 8.1 mm (+/- 2.4), respectively. Age was significant in explaining the variance in gall bladder lengths (P<0.10). Urinary tract ultrasonography was performed only in animals that had normal urea and creatinine levels (n=13). Renal cortico-medullary distinction was present in all kidneys and a cortico-medullary rim sign was seen in 21 of 26 kidneys. Mean kidney length, height, and width was 63.9 +/- 5.7, 38.1 +/- 5.2, and 42.1 +/- 5 mm, respectively. The average resistivity index was 0.58 (n=5). Mean urinary bladder length, height, and width were 57.0, 19.2, and 34.9 mm, respectively.  相似文献   

19.
In fasting dogs between 29 and 53 per cent (median 42 per cent) of newly produced bile was stored in the gall bladder, with the remainder being released directly into the duodenum. Pretreatment with methadone and atropine resulted in the complete closure of the sphincter of Oddi for three hours, and the complete retention of bile in the gall bladder. This effect could be abolished with nalorphine. The minimum dose of methadone to prevent bile from entering the intestines was 0.25 mg/kg, in combination with 0.1 mg/kg atropine. A meal of canned dog food resulted in the release of between 5 and 65 per cent of gall bladder bile (median 31 per cent) into the duodenum. Infusion with cholecystokinin octapeptide emptied the gall bladder more effectively and predictably and a median of 80 per cent (range 62 to 93 per cent) of the bile had been emptied into the duodenum after one hour. It was concluded that the induction of bile storage in the gall bladder with methadone and the subsequent stimulation of its release into the duodenum by the infusion of cholecystokinin produced an endogenous bile acid load that was three to four times larger than that induced by a meal after a period of fasting.  相似文献   

20.
The influence of different copper and zinc contents in rations on blood serum concentrations was tested in a feeding trial at the Institute of Animal Nutrition of the Federal Research Institute for Animal Health (FLI). A total of 60 German Holstein breed cows (38 first lactating and 22 second lactating cows) were tested. All animals received a diet based on maize‐ and grass silage ad libitum. The animals were divided into two groups with 30 cows each. Group A received concentrates supplemented with copper and zinc as recommended, whereas Group B was offered a concentrate with roughly double the amount of copper and zinc. Blood samples were taken several times during the lactation. The concentrations of copper and zinc in the serum were measured and correlations between trace element intake and their serum concentrations were calculated. The mean dry matter intake was significantly higher for cows in the second lactation (19.1 kg/day) than for cows in the first lactation (16.4 kg/day), whereas the DM‐intake was constant in the different feeding groups (17.3 and 17.4 kg/day). The correlation between feed intake in the first and the second lactation was r = 0.76. The copper concentration in the serum was not influenced by the different feedings (11.9 and 12.5 μmol/l), but high variations were found between the cows. The influence of the lactation number was not significant (12.1 and 12.4 μmol/l). In contrast to copper, the zinc concentration in the serum was significantly higher for Group B (14.0 μmol/l) than for Group A (12.2 μmol/l), respectively, for second lactating cows (13.8 μmol/l) in relation to 12.7 μmol/l for first lactating cows. The individual variation was also high as for copper. Neither the correlation between copper intake and copper serum concentration nor the correlation between zinc intake and zinc serum concentration was significant.  相似文献   

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