首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 46 毫秒
1.
Of 100 critically ill dogs and cats, 49 (39 dogs, 10 cats) had bacteremia. Gram-negative bacilli were the most common isolates from the bloodstream of dogs with bacteremia (46%), and gram-positive cocci and anaerobic bacteria were isolated from 36% and 31% of positive cultures, respectively; 15% of positive cultures were polymicrobial. In cats, gram-negative bacilli (especially Salmonella enteritidis) and anaerobic bacteria were the most common isolates, and 30% of positive cultures were polymicrobial. Gram-positive cocci were not isolated from the blood-stream of cats. Odds ratios, adjusted for the combined effects of disease status (severe vs nonsevere), results of bacterial culture of blood result (positive vs negative), and species (dog vs cat) were calculated for mortality in animals in the study. In animals with bacteremia, severe disease increased the risk of death 11.6-fold, compared with the risk in animals with nonsevere disease. Bacteremia increased mortality 10-fold in animals with severe disease, compared with mortality in animals with severe disease without bacteremia. Animals with severe disease and bacteremia were 15.6 times more likely to die than were those with nonsevere disease and negative culture results. In animals with nonsevere disease, culture results (positive vs negative) were not related significantly to mortality. Disease status (severe vs nonsevere) in animals without bacteremia also was not significantly related to mortality. There was no significant difference in overall mortality in dogs, compared with that in cats.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

2.
Blood culture of the canine patient   总被引:2,自引:0,他引:2  
Blood for bacteriologic culture was obtained from 581 sick dogs. Of these, 134 (23%) were considered to have bacteremia. The conditions most frequently associated with bacteremia were malignant neoplasms and infections of the skeletal, cardiovascular, and urogenital systems. The most frequently isolated bacteria were members of the family Enterobacteriaceae and coagulase-positive staphylococci, in sum accounting for more than 50% of the 150 isolates. Most of the dogs with bacteremia had high proportions of immature neutrophils, segmented neutrophils, and monocytes in blood. Dogs with bacteremia and osteomyelitis due to staphylococci had normal hemograms. Blood from dogs with bacteremia due to gram-negative bacteria was more likely to have a high proportion of immature and segmented neutrophil leukocytes than was blood from dogs with bacteremia due to a gram-positive species. Toxic neutrophils were observed more often in blood obtained from patients with bacteremia due to gram-negative bacteria. The development of fever correlated with the bacteremic state regardless of the species of bacteria in the blood.  相似文献   

3.
The value of ultrasonography was evaluated in 85 dogs and 17 cats presented with a clinically suspected portosystemic shunt (PSS). A PSS was confirmed in 50 dogs and nine cats (single congenital extrahepatic in 42, single congenital intrahepatic in 11, and multiple acquired in six). Six dogs and one cat had hepatic microvascular dysplasia, and 29 dogs and seven cats had a normal portal system. Ultrasonography was 92% sensitive, 98% specific, and had positive and negative predictive values of 98% and 89%, respectively, in identifying PSS, with an overall accuracy of 95%. When a PSS was identified with ultrasonography, extrahepatic, intrahepatic, and multiple acquired PSS could be correctly differentiated in 53/54 patients (98%). The combination of a small liver, large kidneys, and uroliths had positive and negative predictive values of 100% and 51% for the presence of a congenital PSS in dogs. The portal vein/aorta (PV/Ao) and portal vein/caudal vena cava (PV/ CVC) ratios were smaller in animals with extrahepatic PSSs compared with animals with microvascular dysplasia, intrahepatic PSSs and those without portal venous anomalies (P<0.001). All dogs and cats with a PV/Ao ratio of < or = 0.65 had an extrahepatic PSS or idiopathic noncirrhotic portal hypertension. Dogs and cats with PV/Ao and PV/CVC ratios of > or = 0.8 and > or = 0.75, respectively, did not have an extrahepatic PSS. Reduced or reversed portal flow was seen in four of four patients with multiple acquired PSSs secondary to portal hypertension. The presence of turbulence in the caudal vena cava of dogs had positive and negative predictive values of 91% and 84%, respectively, for the presence of any PSS terminating into that vein.  相似文献   

4.
Bacterial translocation is characterized by the passage of intestinally derived bacteria across the intestinal mucosa to local or regional tissues. This phenomenon is believed to be important in the pathogenesis of gram-negative bacteremia and septicemia; however, the pathway or route of translocation remains unclear. To define the route of translocation better, mesenteric lymph nodes from 50 apparently healthy dogs undergoing elective ovariohysterectomies were cultured aerobically and anaerobically. The aims of this study were to determine the prevalence of bacterial translocation and to quantify and identify types of organisms found in mesenteric lymph nodes. Peripheral blood and portal blood samples were similarly cultured to rule out hematogenous organisms as a source of lymph node contamination. Bacteria were isolated from mesenteric lymph nodes of 26 dogs (52%). The number of bacteria varied from 50 to > 105 organ-isms/g of tissue. Bacteria isolated included Staphylococcus intermedius (n = 3), coagulase-negative Staphylococcus (n = 2), nonhemolytic Streptococcus (n = 4), Bacillus species (n = 5), Escherichia coli (n = 6), Salmonella species (n = 3), Pseudomonas species (n = 2), Enterococcus species (n = 2), Clostridium sordelli (n = 1), Micrococcus species (n = 1), Lactobacillus species (n = 1), and Propionibacterium acnes (n = 1). One of 50 peripheral blood samples yielded an unidentified gram-positive coccus and a coagulase-negative Staphylococcus. No bacteria were isolated from portal blood samples of any dog. Further studies of this type on sick dogs are warranted before clinical recommendations can be made to culture mesenteric lymph nodes routinely.  相似文献   

5.
Objective — This study evaluates the association between dental procedures and bacteremia in dogs, including a comparison of bacteria isolated from plaque and blood, severity of the bacteremia versus the severity of dental disease, and the longevity of bacteremia.
Study Design — Bacteria cultured from the blood over time were compared with those isolated from the plaque and crevicular fluid and in relation to severity of dental disease.
Animals or Sample Population — Twenty adult greyhounds.
Methods — Blood samples were collected for culture before induction of general anesthesia, immediately after intubation, 20 minutes after initiation of the dental procedure, and at 10-minute intervals until 10 minutes after the dental procedure was completed. Samples of plaque were taken for microbiological culture.
Results — Sixty to ninety percent of the bacterial genera isolated from the plaque were present in the blood. Dogs classified according to severity of dental disease showed no difference in the total number of different species or number of different Gram-negative, Gram-positive, or anaerobic bacteria isolated from plaque or blood (P <.05). Bacteremia was present in all of the dogs studied, within 40 minutes from the initiation of the dental procedure, regardless of the severity of oral disease.
Conclusions — Gram-negative, Gram-positive, and anaerobic bacteria are present in blood during dental procedures; the bacteremia can persist beyond the dental procedure, and is not associated with the severity of dental disease.
Clinical Relevance — The nature and extent of bacteremia occuring during routine dental procedures is important in understanding a potential risk to dogs.  相似文献   

6.
In a 1-year survey (1975 to 1976) of anaerobic bacteria recovered from diseased animals, anaerobes were as follows: Clostridium spp, 50%; gram-positive nonspore-forming anaerobic bacilli, 19%; gram-negative anaerobic bacilli, 19%; Actinomyces spp, 10%; and anaerobic cocci, 1%. Anaerobes were in approximately 61% of the specimens that were culturally positive for any bacteria. Approximately 25% of the specimens did not yield any bacteria (sterile specimens). The method for isolating and identifying anaerobes was based upon the use of reducible solid mediums and was specially designed for veterinary diagnostic laboratories. Emphasis was placed on the selection, collection, and transportation of specimens.  相似文献   

7.
Diagnosis of bacterial septicemia was confirmed by results of bacteriologic culture of antemortem blood samples and/or necropsy specimens obtained from 47 foals up to 8 days old. Gram-negative bacteria were isolated from all 47 foals, and mixed infections with more than one organism were involved in 26 (55%). Escherichia coli, Actinobacillus spp, and Klebsiella pneumoniae were the most frequent isolates, infecting 55, 34, and 23% of foals, respectively. Gram-positive bacteria and anaerobic bacteria were isolated only from foals with mixed infections with gram-negative organisms. Clostridium perfringens was the only anaerobe isolated. In 38 (81%) of 47 foals with confirmed septicemia, blood samples were culture-positive. Thirty-two septicemic foals subsequently died, allowing a comparison to be made between the species of bacteria isolated by culture of blood with those recovered by culture of internal organs at necropsy. Blood failed to yield any gram-negative organisms in 12 (37.5%) of 32 foals from which a gram-negative pathogen was isolated at necropsy. Forty-three percent of the gram-negative bacteria, including 59% of the E coli, and 10% of the gram-positive bacteria found in septicemic foals at necropsy were not detected earlier by results of bacteriologic culture of blood.  相似文献   

8.
Bacteremia in dogs was found to be more prevalent than suspected and Staphylococcus aureus, Escherichia coli, and beta-hemolytic streptococci were the most commonly isolated microbes. Administration of glucocorticoids was the most common predisposing cause of infections. Subacute and chronic bacteremia often followed integumentary infections such as abscesses, cellulitis, and infected wounds and was usually the result of gram-positive microbes. Peracute and acute bacteremia was associated with internal infections and was usually the result of E coli. Many dogs with bacteremia had unusual or multisystemic signs similar to those observed with immune-mediated diseases. Hypotension, tachycardia, and weakness were features of gram-negative bacteremia, whereas gram-positive bacteremia had more chronic signs and tended to develop into diskospondylitis. The adequacy of treatment, type of bacteremia, source of infection, and delay before treatment influenced the course of illness. Cephalosporins and gentamicin were most effective against all types of bacteremia.  相似文献   

9.
The objectives of this study were to evaluate in vivo tolerance, and antimicrobial and clinical activities of a topical otic preparation containing EDTA tromethamine (Tris) and chlorhexidine digluconate 0.15% solution (Otodine®) in dogs with chronic bacterial otitis externa. Eleven dogs were included. The affected ears were filled with the solution once daily during a 2-week period. Dogs were evaluated on days 0, 14 and 28. Three clinical parameters (exudate, erythema, pain) and three cytologic parameters ( Malassezia , cocci, rods) were scored (0–4 scale) by otoscopic and cytological examinations of otic exudate. Bacterial cultures were performed at each time point. If there were bacteria on cytological examination on day 14, the dogs were treated with the original product, with the addition of enrofloxacin (5%) applied 10 min after the original product, for a further 2 weeks. All 11 cases yielded isolates of resistant gram-negative bacteria; gram-positive bacteria were also isolated from six of 11 dogs. On day 14, six of 11 dogs were negative on culture examination; on day 28, 10 of 11 were negative and only one case had a positive culture. On day 14, clinical and microbial scores (cytology) were reduced by 54.6 and 71.1%, respectively, and by 85.7 and 94% on day 28. All cases reported good tolerance of the treatment. The results show that this ear solution was helpful in the management of chronic bacterial otitis externa in dogs and was well tolerated. There seems to be a synergistic effect of the combination of Tris-EDTA/chlorhexidine digluconate 0.15% solution, and an antimicrobial agent (enrofloxacin) against resistant gram-positive and gram-negative bacteria.
Funding: Self-funded.  相似文献   

10.
At an abattoir, lesion specimens from 140 condemned sheep livers were collected for bacteriologic culture and for pathologic examination. Grossly, 23 lesions were abscesses; from 9 of which, Fusobacterium necrophorum biovar A (3 in pure culture and 6 in mixed culture) was isolated and from 14 of which, biovar B (6 in pure culture and 8 in mixed culture) was isolated. Escherichia coli was the predominant facultative anaerobic bacterium and Clostridium perfringens was the predominant obligate anaerobic bacterium isolated from the 14 lesions with mixed bacterial infection. Histologically, these lesions had a core of coagulation necrosis, encircled by a zone of necrotic phagocytic cells and bacteria with cellular characteristics of F necrophorum biovars A or B, and a connective tissue capsule. Of the 117 lesions without F necrophorum, 49 were culture-positive (for other organisms) and 69 were culture-negative. These 117 lesions were fibrous and were smaller than the 23 abscesses. A variety of gram-positive and gram-negative facultative anaerobic and obligate anaerobic bacteria was isolated from the culture-positive lesions, but always in low numbers. Eleven culture-negative and 18 culture-positive lesions were examined and had histologic characteristics of parasite-induced granulomas, with numerous eosinophils and epithelioid giant cells. Results of the study indicated that the histologic appearance of ovine hepatic lesions with F necrophorum was similar to bovine liver abscesses caused by F necrophorum, but unlike bovine liver abscesses, F necrophorum biovar B was isolated more frequently than was biovar A and often in pure culture. Most of the lesions in the condemned livers were parasite-induced granulomas.  相似文献   

11.
OBJECTIVE: To determine the prevalence of bacterial colonization of IV catheters among young dogs suspected to have parvoviral enteritis, to identify the organisms responsible for catheter colonization, and to determine the antimicrobial susceptibility of organisms that were obtained. DESIGN: Case series. ANIMALS: 100 dogs. PROCEDURE: Catheters were aseptically removed when fluid therapy was discontinued, the catheter was replaced, or the dog died. The distal tip of the catheter was cut off, split open, and vortexed with sterile saline (0.9% NaCl) solution. The saline solution was plated on culture plates, which were then incubated and examined for bacterial growth every 24 hours for 72 hours. All bacteria cultured were identified, and antimicrobial susceptibility was determined. RESULTS: Bacteria were isolated from 22 catheters. Most bacteria that were isolated were of gastrointestinal tract or environmental origin (Serratia odorifera, S. liquefaciens, S. marcescens, Acinobacter anitratus, Citrobacter freundii, Klebsiella pneumoniae, K. oxytoca, Escherichia coli, Enterobacter spp). Only 2 gram-positive organisms were isolated (Staphylococcus intermedius and Streptococcus spp). High percentages of organisms were resistant to penicillin, lincomycin, cloxacillin, erythromycin, and cephalexin. Percentages of organisms resistant to amikacin, enrofloxacin, chloramphenicol, potentiated sulfonamides, and amoxicillin-clavulanic acid were low. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that IV catheters may be colonized with bacteria in 22% of young dogs suspected to have parvovirus infection.  相似文献   

12.
OBJECTIVE: To evaluate the efficacy of cellophane banding of single congenital extrahepatic portosystemic shunts in dogs using transcolonic portal scintigraphy. To investigate the portal circulation of those dogs with elevated postoperative shunt fractions to determine the cause of the persistent shunting. Further, to evaluate whether presenting signs, clinical pathology findings and liver histopathology are predictive of outcome. DESIGN: Prospective study of 16 dogs presenting with single congenital extrahepatic portosystemic shunts. PROCEDURE: Dogs with single extrahepatic portosystemic shunts attenuated by cellophane banding underwent portal scintigraphy and bile acids tolerance testing pre- and post-operatively. Dogs identified with elevated shunt fractions at 10 weeks post-operatively underwent mesenteric portovenography. Qualitative hepatic histopathology from all dogs was reviewed by a veterinary pathologist and assigned a semi-quantitative score to identify any abnormalities that may predict surgical outcome. RESULTS: At 10 weeks post cellophane banding, 10 of 16 cases (63%) had normal shunt fractions, whilst six dogs (37%) had increased shunt fractions and seven dogs (44%) had increased serum bile acids. Of these dogs, mesenteric portovenography revealed incomplete closure of the shunt in three dogs (18.6%) and multiple acquired shunts in three dogs (18.6%). Liver histopathology findings were similar for all dogs, regardless of outcome. CONCLUSIONS: Cellophane banding is an efficacious method for complete gradual occlusion of single extrahepatic shunts when the shunt vessel is attenuated to < or = 3 mm. Transcolonic portal scintigraphy is a reliable method for assessment of shunt attenuation and, unlike serum bile acids, is not influenced by other causes of liver dysfunction.  相似文献   

13.
OBJECTIVES: To evaluate outcome in dogs with left divisional intrahepatic portosystemic shunts (PSS) treated by partial ligation (PL) or ameroid ring constrictor (ARC) placement on the left hepatic vein. DESIGN: Retrospective study. ANIMALS: Dogs (n=28) with left divisional intrahepatic PSS. METHODS: Retrieved data from medical records of dogs with left divisional intrahepatic PSS that had PL (n=17) or ARC (n=11) were signalment, history, clinical signs, preoperative blood work, portal pressure measurements, ARC size, complications and postoperative technetium scintigraphy. Outcome assessed by owner interview 6 months-10 years after surgery was classified as excellent, good or poor. Differences were tested by exact chi2 test. RESULTS: Major complications occurred in 3 dogs: coagulopathy (1 PL dog died), ascites (1 PL dog survived) and seizures (1 ARC dog died). Eight PL dogs had technetium portal scintigraphy; 1 dog was negative and 7 dogs positive for persistent shunting. Seven ARC dogs had scintigraphy; 4 dogs were negative and 3 positive for persistent shunting. In PL dogs, long-term clinical outcome was excellent (92%) or good (8%) whereas, in ARC dogs it was excellent (20%), good (50%) or poor (30%). This outcome difference between treatment groups was significant (P=.0012). CONCLUSION: Dogs treated by PL had significantly better long-term outcome compared with ARC treated dogs. CLINICAL RELEVANCE: Based on these data, ARC placement on the left hepatic vein in dogs with left-divisional intrahepatic PSS cannot be recommended.  相似文献   

14.
A survey for anaerobic bacteria was conducted in 314 clinical specimens from dogs and cats. A total of 187 anaerobic isolates in pure and mixed culture were isolated from 111 of the specimens that contained anaerobic bacteria. Common isolated included Actinomyces (9.1%), Clostridium perfringens (19.3%), other Clostridium spp (11.2%), Peptostreptococcus anaerobius (7.5%), Bacteroides melaninogenicus (13.4%), other Bacteroides spp (17.6%), and Fusobacterium necrophorum (5.3%). Anaerobic bacteria were involved in serious lesions that often were life threatening to the animals. Antibiotic susceptibility data indicated that the lincomycin family, the penicillin family, chloramphenicol, and cephaloridine are preferred drugs for treatment of anaerobic infections. Data from the survey were used in formulation of a table to aid practitioners in clinical diagnosis of disease caused by anaerobes. Clostridium perfringens was isolated in large numbers from five of six dogs with a clinical diagnosis of canine hemorrhagic gastroenteritis and from one cat with hemorrhagic diarrhea. Experimental infections were induced in rats, using caine feces as inoculum. Induced lesions contained aerobic and anaerobic bacteria similar to those bacteria isolated in the clinical survey, indicating that feces may serve as a major source of these bacteria in clinical infections of the dog.  相似文献   

15.
OBJECTIVE: To determine the organisms most commonly isolated from pleural fluid from dogs and cats with pyothorax. DESIGN: Retrospective study. ANIMALS: 51 dogs and 47 cats. PROCEDURE: Results of bacteriologic culture of pleural fluid samples obtained by means of thoracentesis were obtained from medical records. To obtain information on in vitro antimicrobial susceptibility of organisms commonly isolated from dogs and cats, records of all dogs and cats examined during 1998 were reviewed, and information was obtained on identity and in vitro antimicrobial susceptibility of aerobic organisms isolated from samples other than urine or urinary tract samples. RESULTS: Median ages of dogs and cats were 4 years. Bacteria were isolated from pleural fluid samples from 47 of 51 (92%) dogs and 45 of 47 (96%) cats. Obligate anaerobic bacteria were isolated from 28 dogs and 40 cats. A mixture of obligate anaerobic and facultative bacteria was isolated from 17 dogs and 20 cats. Samples from cats most often yielded a member of the nonenteric group (most commonly members of the genus Pasteurella), whereas those from dogs more often yielded a member of the family Enterobacteriaceae (most commonly E coli). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that antimicrobial agents chosen for the initial treatment of dogs and cats with pyothorax should be active against a mixture of obligate anaerobic and facultative bacteria.  相似文献   

16.
OBJECTIVE: To assess microorganisms isolated from blood specimens obtained from critically ill neonatal foals and to evaluate their antimicrobial susceptibility patterns. DESIGN: Retrospective study. ANIMALS: 543 neonatal foals. PROCEDURE: Medical records of foals that were < 1 month old and were admitted to a referral neonatal intensive care unit were reviewed for results of bacteriologic culture of blood and antimicrobial susceptibility patterns. RESULTS: At least 1 microorganism was isolated from 155 of 543 (28.5%) foals. Escherichia coli was the most commonly isolated bacterium. A single gram-positive organism was detected in 49 foals. Although 90% of the E coli isolates were susceptible to amikacin, some gram-negative and gram-positive organisms had resistance against multiple antimicrobials. CONCLUSIONS AND CLINICAL RELEVANCE: Gram-negative bacteria remain the most common isolates from blood of neonatal foals; however, gram-positive organisms were also found, and with greater prevalence than reported elsewhere. Susceptibility patterns may vary, and resistance to multiple antimicrobials may develop. This is especially true for organisms such as Enterobacter spp and Enterococcus spp. Prudent empirical treatment for neonatal sepsis should include broad-spectrum antimicrobials.  相似文献   

17.
The clinical attributes of 40 dairy cows which had mastitis but no growth of bacteria from the milk were analyzed and compared to the attributes in 102 cows with only gram-positive and 61 cows with only gram-negative bacteria cultured from the milk. Cows with no bacteria cultured from the milk did not differ significantly from cows with gram-positive bacteria cultured, but 9 of 12 attributes were significantly different between cows with no bacteria cultured and cows with gram-negative bacteria cultured. Discriminant analysis was used to classify cows as members of the gram-positive or gram-negative culture groups. The discriminant equation was then applied to the cows with no bacteria cultured, and 78% of cows with no bacteria cultured were classified as members of the gram-positive group. Most mastitis in cows with no bacteria grown from the milk was probably due to gram-positive bacteria. If antibiotic therapy is used in cows with persistent mastitis and a negative culture in the belief that the culture is a false negative, treatment with antibiotics effective only against gram-negative organisms would not be appropriate.  相似文献   

18.
The accuracy of a scheme for predicting the gram-staining reaction of organisms causing bovine mastitis in cows with systemic signs of disease (anorexia) was evaluated over 1 year. Criteria for making the predictions included: season of year, stage of lactation, appearance of milk, detection and duration of teat injuries, and milk odor. It was possible to determine the cause by microbiologic culture of specimens from 136 of the 147 cows of the study. Of 78 infections caused by gram-negative (mostly coliform) organisms, 62 (79%) were predicted accurately to be caused by gram-negative organisms. Of 57 infections caused by gram-positive organisms, 45 (79%) were predicted correctly to be caused by gram-positive organisms. Correctly predicted as gram-positive organisms causing infection were: Actinomyces pyogenes in 20 of 21 (95%) cows; Staphylococcus sp in 14 of 22 (64%) cows; Streptococcus sp in 10 of 13 (77%) cows and Bacillus sp in 1 cow. Overall accuracy, in those instances when bacteria were isolated (136 cows), was 78%.  相似文献   

19.
Transvenous retrograde portography for identification and characterization of portosystemic shunts in dogs A method for transvenous retrograde portography (TRP) in dogs suspected to have a portosystemic shunt (PSS) and results in 20 dogs are described. For TRP, dogs were anesthetized and positioned in left lateral recumbency A dual-lumen balloon-tipped catheter was inserted into the right jugular vein and advanced into the azygos vein. The balloon was inflated to occlude the azygos vein, and contrast material was injected during fluoroscopic evaluation. The catheter was then positioned in the caudal vena cava just cranial to the diaphragm. The balloon was again inflated to occlude the vena cava, and contrast material was again injected. Once a shunt was identified, selective catheterization was attempted with a guide wire and angled catheter. A PSS was identified in 18 of the 20 dogs. In 10 of the 18, the shunt vessel could be selectively catheterized, allowing measurement of portal pressures while the shunt was occluded with the balloon. In 1 dog, results of TRP were normal, but subsequent exploratory celiotomy revealed a single extrahepatic PSS, which was surgically attenuated. The other dog in which results of TRP were normal did not have a macroscopic PSS. In dogs suspected to have a PSS, TRP may be a useful adjunctive diagnostic test that is less invasive than operative mesenteric vein portography and allows measurement of portal pressures before and after temporary shunt occlusion.  相似文献   

20.
OBJECTIVE: To evaluate the use of a portocaval venograft without an ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS). STUDY DESIGN: Prospective clinical study. ANIMALS: Seven dogs with intrahepatic PSS. METHODS: Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure > or =8 mm Hg or signs of portal hypertension, a single extrahepatic portocaval shunt was created using a jugular vein. Clinical outcome and complications were recorded. RESULTS: The mean (+/-SD) portal pressure increased from 5.9+/-1.6 to 17.9+/-4.1 mm Hg with PSS occlusion. There were no intraoperative complications and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in all dogs. The final portal pressure was 9.6+/-1.9 mm Hg. Complications developed during postoperative hospitalization in 5 dogs and included incisional discharge (4 dogs), ascites (3), ventricular premature contractions (2), and melena, bloody diarrhea, neurologic signs, coagulopathy, and aspiration pneumonia (each in 1 dog). Six dogs died or were euthanatized with clinical signs related to depression, inappetance, abdominal pain, vomiting, melena, and abdominal distention, with a median survival of 82 days (range, 20-990 days). One dog was clinically normal at 33 months after surgery. CONCLUSIONS: Clinical signs observed in 6 dogs after surgery were consistent with portal hypertension. Use of a portocaval venograft without an ameroid constrictor may reduce the likelihood of hepatic vascular development, thereby increasing the risk of life-threatening portal hypertension should the venograft suddenly occlude. CLINICAL RELEVANCE: Use of a portocaval venograft without an ameroid constrictor to control portal hypertension after ligation of an intrahepatic PSS cannot be recommended.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号