版權(quán)說(shuō)明:本文檔由用戶提供并上傳,收益歸屬內(nèi)容提供方,若內(nèi)容存在侵權(quán),請(qǐng)進(jìn)行舉報(bào)或認(rèn)領(lǐng)
文檔簡(jiǎn)介
Felinelowerurinarytract RoswithaDorschDipl.ECVIM-CAMedizinischeKleintierklinik,LMUIntroductionFLUTD介diseasesofthefelinelowerurinary hematuria,stranguria,periuriarecurrentepisodesobstructive,non-proportionalmorbidity1– (Lundetal.,1999;Lekcharuensuketal.,EtiologyFLUTD病idiopathiccystitis自發(fā) 炎(55%touroliths (13%tobacterialurinarytract 細(xì) (1%toMiscellaneousanatomicalabnormalitiesbehaviour行為(ca. smsoftheurinary 腫瘤(ca.(Krugeretal.,1991;Buffingtonetal.,1997;Gerberetal.,2005;Eggertsdottiretal.,2007)EtiologyFLUTD(obstructiveform)FLUTD病因(阻塞型)
UrethralamorphousmaterialwithembeddederythrocytesUrethralUrethralUrethral youngadultcats dryformuladiet obesity indoorlifestyle moreoftenseenduringwintermonthsPatientsMTKMunich2000-632catswithFLUTD id,Allinin♂♀2炎♂♀2♂♀134♂尿♀2♂♀9PatientsMTK2000-Agedistributionof632affected id,PatientsMTK20002007BodyWeight體重Mean=5.2kgSD=+/-1,6Mitwert=Mitwert=5,Std.-Std.-Abw.=1,613N=212
GewGewicht
10,
12,BMBMin id,PatientsMTKseasonaldistribution季節(jié)分布252015105MMittelwert=6,37Std.-Abw.=3,634N=210,0
2,0
4,0 6,0 8,0Monat_Erstvor lun
10,0
12,0 id,DSH?Moritz“,3J,History病史hasn′tbeenabletourinatefor2daysvocalizeswhenvisitingthelittervomited ?Moritz“,3yrs,mkphysicalexam臨床檢查DepressedT36,3°C,paleMM,CRFT3sec,HR122/min,skinturgor,7%largeandtensedurinarybladder,painfulonComplicationsassociatedwithurethralobstructionobstructionsformorethan24to48postrenalazotemia,metabolicanorexia,vomiting,厭食 serumchemistryandblood ysisis metabolicacidosisHyperkalemiaCBCRBC紅細(xì)胞WBC白細(xì)胞etsSegm.SerumChemistryMoritz“生Parameter項(xiàng) Valu Reference Glucose血糖 尿素氮CreatininTP總蛋白Albumine白蛋白ALTU/lAP堿性磷酸酶U/lBilirubin Bloodgasandelectrolytes血SodiumK+鉀Ca++ChloridHCO3-pCO2urinaryurinaryi.v.fluidfori.v.fluidforemergencylabUrethral Fluidtherapy輸nopotassium(e.g.NaCl)lowpotassiumi.v.fluids(e.g.LactatedRingerWhichfluidistheNormosol-R?vs.NaCl0,9withinthefirst12hoursNormosol-R?和NaCl0.9%在最初12小時(shí)bothfluidssafeandeffective2nosignificantdifferenceindecreaseofK+betweenacid-basedisorderswerecorrectedfasterwithbufferedelectrolytesolution(Normosol-R?)(Normosol-R?DROBATZundCOLE,JVetEmergCritCare.physiologyofpotassium mostimportant importantforrestingcellmembranepotentialcellvolumecellgrowthEffectsofLeafundCotran:RenalPathophysiology,ConsequencesofHyperkalemiaECGbradycardia,largeand?tented“TprolongedPRintervalwideQRScomplexessinoatrialventricularSodiumbicarbonateECIC):碳酸氫鈉(細(xì)胞外→細(xì)胞內(nèi))1-2mmol/kgover30mini.v.Glucoseor0,25–0,5U/kgregularinsulin+2gglucose/UInsulinini.v.fluids(EC→IC)葡萄糖或0,250,5U/kg常規(guī)胰島素2g葡萄糖/U胰島素加入靜脈液中(胞外→胞內(nèi))Calciumgluconate:0,5-1,5ml/kg10%solutionslowlyover10min(ECGmonitoring!)葡萄糖酸鈣:100,51,5ml/kg,EffectsofLeafundCotran:RenalPathophysiology,TherapyUrethralurinarycatheter插導(dǎo)尿管 pressivecystozentesis Indwellingurinarycatheterandclosedindicatedifpatientisobstructionwasdifficulttomacroscopicallyabnormaldysfunctionofdetrusor TherapyUrethralmonitorurineoutputTherapyUrethral監(jiān)視尿排出量(阻塞后利尿GuidelinesforindwellingurinaryClosedsystemis必須用密閉系統(tǒng)Removeassoonaspossible(<3IfpossiblenoNoUrinecultureafterremovalofTherapyUrethral gesia監(jiān) Chemistry?Moritz“生daydaynormalBUNCreatininePotassiumIsitpossibletoavoidtransurethralstablecatswithurethral nosevereazotemia,acidosisor沒有嚴(yán)重的氮質(zhì)血癥, nourolithsidentifiedonCOOPERetal.,JAVMAIsitpossibletoavoidtransurethralinitiallycystocentesistoemptythe acepromazin(0,25mg/cator0,05mg/kg)buprenorphine丁丙啡諾(15μg/kgrepeatedcystocentesisifnecessarySQfluidscalmdarkenedenvironment11/15successfully 4/15developeduroabdomenorhemoabdomenCOOPERetal.,JAVMA ynecessarydiagnostictestsare….completeurinalysisdiagnosticimaging(ultrasoundand/orfreshurinesamples24hstorage→crystalsin92%ofafewcrystalsarenormalurinepHincreaseswithexcitementand ysis?Moritz“尿 Protein蛋 Blood USG Epithelialcells上皮細(xì) Erythrocytes紅細(xì) Idiopathiccystitis nodiagnosticmarkerexclusionofotherdiseases ysisurineculture尿檢,abdominalradiographs腹部Xabdominalultrasound腹部Bretrogr.urethro-and Exclusionofotherdiseases排 Exclusionofotherdiseases排DSH?Stupsi“,11y,DSH?Tigerle“,14yrs,recurrentepisodesofstranguriaandretrogr.retrogr.retrogr.retrogr.IdiopathicIdiopathicCystitis自炎definitivediagnosis–確診 T.C.McCarthy,VeterinaryEndoscopyfortheSmallAnimalElsevierSaunders, 鏡 IdiopathicCystitis 炎病Environmental
IdiopathicCystitis 炎病IrritatingsubstancesEpithelialdefects epithelialdefectssmalleramountofGAGs↑permeabiltyofbladder上皮細(xì)胞通透性
↑fractionofresponsivenociceptivefibersinsubmucosal粘膜下層 反應(yīng)性纖維的比率LavelleJPetal.,AmJPhys,2000;PressSMetal.,JUrol,IdiopathicCystitis 炎病IdiopathicCystitis 炎病CNS:↑synthesisof中樞神經(jīng):去甲腎上腺素的合成↓inhibitoryeffectofα2-Agonisteninbrainandα2激動(dòng)劑在腦和脊柱中的抑制作用changesofthepituitaryadrenalRecheandBuffington,1998Buffingtonetal.,2002Westroppetal.,2003RiskfactorsforidiopathicRiskfactorsforidiopathic highernumberofcatsinthehouseholduseofalitterboxlowwaterintakelowactivitylevelhigherbodyconditionscorebeingnervousandfearfulmorehidingbehaviourhousemoveDefauwetal.,Idiopathiccystitis: epigeneticmodulationofgeneexpression(BuffingtonUrineproteinsinUrineproteinsin FibronectinEvaluationofproteinpatterninEvaluationofproteinpatternincatswithFICandhealthy MALDI-TOF/TOF(tandemmass(串聯(lián)質(zhì)譜法Westernblots:(candidatespecificprimaryTrefoilfactor2IntensityIntensity0
Lembergeretal.,WesternBlotWesternBlothealthycontrolsversus
p<Trefoilfactor炎ImmunohistochemistryImmunohistochemistryTFF2免炎Histologie(x10,HE組ImmunhistochemieImmunhistochemietrefoilfactor2 12kDaproteinwithgrowthfactoractivity evolutionallyhighlyconservedbetweenItohetal.,1996;CampbellandJabbesearlyupregulatedaftermucosalWongetal.,accelerateshealingofmucosallesionsandenhancesmucosalrestitutionPoulsonetal.,2005;Hoffmannimpactonimmune-responseKurt-Jonesetal.,Trefoilfactorcauseorconsequence?導(dǎo)致或結(jié)果deficiencyofTrefoilfactor AJVRincreasedurinaryfibronectinimportantforcellgrowthandcelladhesioncontrolsversusFIC對(duì)照VS貓自發(fā) signalsignalintensity
Lembergeretal.,
p<
results-Westernblot結(jié)果p>signalsignalintensity
Lembergeretal.,
BacterialDNABacterialDNAintheurineofcatswith患有貓自發(fā) 炎的貓中細(xì)菌的50cultureResultsResultsofsequencingofclonedPCR 10/11cloneswith83–93%silmilaritytoIdiopathicCystitis 炎治Environmental
Idiopathic Therapeuticoptions治getics(acute止疼(急性期MEMO(multimodalenvironmentalmodification)increasedwaterpsychopharmaca,anticholinergicGAGs?葡萄糖胺聚糖geticsforacuteside0,2-0,4mg/kgsedation,ataxia,q6to121,25–2,5q72hurineretention,resp.Meloxicamforacute50catswithidiopathicFLUTD cebo-controlledclinicalMeloxicamfor5days美洛昔康用5(0.1mg/kgday1,0,05mg/kgday2–(第一天0.1mg/kg第2-5天clinicalparametersrepeatedurinalysesdiariesZELLNER,MeloxicamMeloxicamforacutepdurationofcatheterisation????returntonormalgeneraldemeanor??returntonormalfoodintake恢復(fù)正常進(jìn)食時(shí)間(天??stranguria??↑frequencyofurination??IdiopathicCystitis 炎解痙increasedurethralclosurepressurein12femalecatswithFIC →spasmsareimportantpartofthe→therapywithPhenoxybenazaminWUetal.,multimodalenvironmentalMinimalrequirementsforindoorcats,In:?Basicneeds“ofthe.室內(nèi)貓所需的基本條件, MultimodalEnvironmentalModificationoptimalavailabilityoflitterquiet cesviewingandrestingscratchingpoststoys抓板,clinicalimprovement,20%Buffingtonetal.,JFelineMedSurg,studygetic-512,5mg/catq12–24getic-0,25-0,5q24-2,5-5mg/cat貓q12h每12Anti-0,5-1q24h每24 40 moistfoodmoistfooddryfoodLinear(dryfood)302520151050 IdiopathicCystitis: Nosignif
溫馨提示
- 1. 本站所有資源如無(wú)特殊說(shuō)明,都需要本地電腦安裝OFFICE2007和PDF閱讀器。圖紙軟件為CAD,CAXA,PROE,UG,SolidWorks等.壓縮文件請(qǐng)下載最新的WinRAR軟件解壓。
- 2. 本站的文檔不包含任何第三方提供的附件圖紙等,如果需要附件,請(qǐng)聯(lián)系上傳者。文件的所有權(quán)益歸上傳用戶所有。
- 3. 本站RAR壓縮包中若帶圖紙,網(wǎng)頁(yè)內(nèi)容里面會(huì)有圖紙預(yù)覽,若沒有圖紙預(yù)覽就沒有圖紙。
- 4. 未經(jīng)權(quán)益所有人同意不得將文件中的內(nèi)容挪作商業(yè)或盈利用途。
- 5. 人人文庫(kù)網(wǎng)僅提供信息存儲(chǔ)空間,僅對(duì)用戶上傳內(nèi)容的表現(xiàn)方式做保護(hù)處理,對(duì)用戶上傳分享的文檔內(nèi)容本身不做任何修改或編輯,并不能對(duì)任何下載內(nèi)容負(fù)責(zé)。
- 6. 下載文件中如有侵權(quán)或不適當(dāng)內(nèi)容,請(qǐng)與我們聯(lián)系,我們立即糾正。
- 7. 本站不保證下載資源的準(zhǔn)確性、安全性和完整性, 同時(shí)也不承擔(dān)用戶因使用這些下載資源對(duì)自己和他人造成任何形式的傷害或損失。
最新文檔
- 宜賓2025年四川省宜賓市中級(jí)人民法院招聘3人筆試歷年參考題庫(kù)附帶答案詳解
- 四川四川省醫(yī)學(xué)科學(xué)院·四川省人民醫(yī)院心血管超聲及心功能科醫(yī)師招聘筆試歷年參考題庫(kù)附帶答案詳解
- 南充四川南充市住房公積金管理中心和南充市財(cái)政綜合服務(wù)中心引進(jìn)3人筆試歷年參考題庫(kù)附帶答案詳解
- 內(nèi)蒙古2025年內(nèi)蒙古工業(yè)大學(xué)招聘21人筆試歷年參考題庫(kù)附帶答案詳解
- 中山2025年廣東中山市阜沙鎮(zhèn)人民政府招聘第二批合同制工作人員6人筆試歷年參考題庫(kù)附帶答案詳解
- 職業(yè)中毒事件的信息發(fā)布與公眾溝通策略
- 生產(chǎn)設(shè)備的安全培訓(xùn)課件
- 企業(yè)安全生產(chǎn)費(fèi)用提取使用制度
- 耐藥腫瘤的風(fēng)險(xiǎn)分層與治療策略調(diào)整-1
- 紅色喜慶剪紙藝術(shù)風(fēng)春節(jié)傳統(tǒng)文化學(xué)習(xí)培訓(xùn)課件
- 實(shí)施指南(2025)《HG-T 6214-2023 鄰氨基苯酚》
- 安全生產(chǎn)相關(guān)工作主要業(yè)績(jī)及研究成果
- 2025廣西百色能源投資發(fā)展集團(tuán)有限公司招聘7人(第一批)筆試歷年參考題庫(kù)附帶答案詳解
- 地下礦山職工安全培訓(xùn)課件
- 供熱安全培訓(xùn)課件
- 供水管網(wǎng)搶修課件
- 培訓(xùn)意識(shí)形態(tài)課件
- 運(yùn)輸公司安全領(lǐng)導(dǎo)小組會(huì)議記錄內(nèi)容
- 7.2動(dòng)物的特征及類群①課件-滬教版生物七年級(jí)下冊(cè)
- 2025年麒麟運(yùn)維考試題庫(kù)
- 綿陽(yáng)北控水務(wù)污泥減量化及資源化中心項(xiàng)目環(huán)評(píng)報(bào)告
評(píng)論
0/150
提交評(píng)論