钩端螺旋体引起犬肾功能衰竭的诊断与治疗

doi:10.16431/j.cnki.1671-7236.2020.11.042

摘要/Abstract

摘要： 为判定肾功能衰竭病原及引起的相关症状，并提供合理的诊治方案，本研究对一例柯基病犬进行表征、血常规、血液生化、血气及病原进行检测。结果显示，与正常参考值相比，病犬前期血常规检测中淋巴细胞比例（W-SCR）、中间细胞比例（W-MID）、中间细胞（MID）及红细胞分布宽度（RDW-CV）升高；粒细胞比例（W-LCR）、红细胞压积（PCV）、红细胞平均体积（MCV）、血红蛋白含量（MCH）、红细胞分布宽度（RDW-SD）明显降低。与正常参考值相比，生化指标中钙离子（Ca²⁺）、血糖（GLU）、尿素氮（BUN）、血磷（PHOS）、胰淀粉酶（AMYL）及肌酐（CRE）明显升高。血气指标中GLU、BUN、钾离子（K⁺）均比参考值高；钠离子（Na⁺）、氯离子（Cl^-）、二氧化碳分压（PCO₂）比参考值降低。犬钩端螺旋体抗原检测板检测结果为阳性。治疗后血常规中白细胞总数（WBC）、淋巴细胞（SCR）比正常参考值明显升高；红细胞总数（RBC）、血红蛋白（HGB）及血小板总数（PLT）则比参考值降低。经Hotelling T²对治疗前后各指标进行多变量分析，结果F=1 905 045.32，P=0.001，差异极显著；单变量检测指标中WBC、W-LCR、SCR、MID、HGB、PCV、MCV、RDW-SD差异极显著（P<0.01），W-MID、RBC、MCH及血小板分布宽度（PDW）差异显著（P<0.05）。治疗后生化检测指标中，与正常参考值相比，多数指标在正常值范围内。治疗后期病犬精神好转，经Hotelling T²与治疗前差异性分析，多变量F=85.21，P=0.081，差异不显著；单变量检验指标GLU、BUN、PHOS、AMYL及CRE差异极显著（P<0.01）。治疗后期血气指标中GLU、BUN、K⁺均比参考值高；Na⁺、Cl^-及PCO₂比参考值低，对治疗前后血气指标进行Hotelling T²差异性分析，多变量检验结果F=7 978.48，P=0.008，差异极显著；单变量检验结果中，GLU和BUN差异极显著（P<0.01）。治疗方案中，采用利尿、抗生素药物，附加补充电解质、能量、维生素及CoA等综合输液治疗，7 d后，病犬精神好转，机体机能基本恢复正常，转归期部分指标的升高属于机体机能恢复健康的一种正常体现。说明治疗方案正确，综合体液疗法是治疗该病引起肾功能衰竭有效的方法。

关键词: 钩端螺旋体; 肾功能衰竭; 柯基犬

Abstract: To determine the pathogen and related symptoms caused by renal failure,and to provide a reasonable diagnosis and treatment plan,a case of disease on Welsh Corgi dog was tested by the method of symptoms,blood routine examination,blood biochemical test,blood gas analysis and identification of pathogen.The results showed that these data of W-SCR,W-MID,MID and RDW-CV rose than normal reference index in blood routine examination before the hospitalization,respectively.Meanwhile,data of W-LCR,PCV,MCV,MCH and RDW-SD had reduced separately.These data of Ca²⁺,GLU,BUN,PHOS,AMYL and CRE were up than normal reference index in blood biochemical test,respectively.These data of GLU,BUN and K⁺ had risen respectively,nevertheless,these data of Na⁺,Cl^- and PCO₂ had lowered separately.The result was positive by the antigen testing with the Leptospira detector plate.After treatment with synthetical therapy,WBC and SCR had risen than normal references index,and data of RBC,HGB and PLT were down respectively.By the Hotelling T² analysis of the difference between before and after the therapy on blood routine index,it was significant difference in the multivariate test (F=1 905 045.32,P=0.001).These data of WBC,W-LCR,SCR,MID,HGB,PCV,MCV and RDW-SD were extremely significant differences in single variable analysis (P<0.01),and other data with significant differences were W-MID,RBC,MCH and PDW(P<0.05).But,in blood biochemical test,most of data were in normal reference values.The mental state of sick dog was recovering gradually normal than before.Multivariate test was no significant difference by the Hotelling T² analysis (F=85.21,P=0.081),but other data of GLU,BUN,PHOS,AMYL and CRE were extremely significantly different in single variable analysis (P<0.01).These data of GLU,BUN and K⁺ were up than after therapy in blood gas analysis,and data of Na⁺,Cl^- and PCO₂ reduced respectively.There were extremely significant differences in the multivariate test (F=7 978.48,P=0.008).These data with extremely significant differences were GLU and BUN in single variable analysis(P<0.01).The sick dog was recovering normal after treatment,and mental state went back to normal after 7 days therapy using the drugs of diuretics,antibiotics,rehydration electrolyte,energy medicine,vitamins and CoA.It should be noted that the part of high index of reexamination was a normal manifestation when the body was recovering to normal functioning.The method of synthetical fluid therapy was provided the correctness to treat the renal failure caused by canine Leptospira.

Key words: Leptospira; renal failure; Welsh Corgi dog

中图分类号:

S858.29⁺2

刘贵芳, 田发益. 钩端螺旋体引起犬肾功能衰竭的诊断与治疗[J]. 中国畜牧兽医, 2020, 47(11): 3774-3782.

LIU Guifang, TIAN Fayi. Diagnosis and Therapy on Renal Failure Caused by Canine Leptospira[J]. China Animal Husbandry and Veterinary Medicine, 2020, 47(11): 3774-3782.

参考文献

[1] SATHIYAMOORTHY A,SELVARAJU G,PALANI-VEL K M,et al.Development of indirect enzyme-linked immunosorbent assay for diagnosis of canine leptospirosis[J].Veterinary World,2017,10(5):530-535.
[2] 齐海霞,张海云,邓小雨,等.犬、猫钩端螺旋体病的流行病学调查[J].中国畜牧兽医,2012,39(11):203-206. QI H X,ZHANG H Y,DENG X Y,et al.Epidemiological survey of leptospirosis on dogs and cats[J].China Animal Husbandry & Veterinary Medicine,2012,39(11):203-206.(in Chinese)
[3] 吴殿君.亚治疗量氟喹诺酮类药物加剧钩端螺旋体感染的分子机制研究[D].大庆:黑龙江八一农垦大学,2017. WU D J.The potential molecular mechanism of subtherapeutic fluoroquinolones exacerbate leptospi-rosis[D].Daqing:Heilongjiang Bayi Agricultural University,2017.(in Chinese)
[4] 肖啸,杨林富,杨继生,等.犬钩端螺旋体病的防制[J].中国畜牧兽医,2008,35(8):102-103. XIAO X,YANG L F,YANG J S,et al.Prevention and cure of canine leptospirosis[J].China Animal Husbandry & Veterinary Medicine,2008,35(8):102-103.(in Chinese)
[5] BOUVET J,LEMAITRE L,CARIOU C,et al.A canine vaccine against Leptospira serovars Icterohaemorrhagiae,Canicola and Grippotyphosa provides cross protection against Leptospira serovar Copenhageni[J].Veterinary Immunology and Immunopathology,2020,219:109985.
[6] WHITE A M,ZAMBRANA T C,ALLEN T,et al.Hotspots of canine leptospirosis in the United States of America[J].Veterinaria Journal,2017,222(4):29-35.
[7] RAMIREZ C V H,CAMACHO S M G,RAMIREZ I O,et al.Prevalence and risk factors associated with serovars of Leptospira in dogs from Culiacan,Sinaloa[J].Veterinaria Mexico,2017,4(2):1-12.
[8] WORLD HEALTH ORGANIZATION.Informal consultation on global burden of leptospirosis:Methods of assessment[Z].Geneva:WHO,2006.
[9] SYKES J E,HARTMANN K,LUNN K F,et al.2010 ACVIM small animal consensus statement on leptospirosis:Diagnosis,epidemiology,treatment,and prevention[J].Journal of Veterinary Internal Medicine,2011,25(1):1-13.
[10] NELSON R W,COUTO C G著.夏兆飞,张海彬,袁占奎主译.小动物内科学[M].第3版.北京:中国农业大学出版社,2012. NELSON R W,COUTO C G (author).XIAO Z F,ZHANG H S,YUAN Z K (translator).Small Animal Internal Medicine[M].3rd Edition.Beijing:China Agricultural University Press,2012.(in Chinese)
[11] 王巍.钩端螺旋体诱发子宫感染有效治疗药物筛选与致病相关基因筛查[D].长春:吉林大学,2015. WANG W.The effective chemicals and pathogenic gene screening in Leptospira interrogans induced uterine infection[D].Changchun:Jilin University,2015.(in Chinese)
[12] 李然.犬慢性肾衰的早期诊断及治疗[D].郑州:河南农业大学,2019. LI R.Early diagnosis and treatment of chronic renal failure in canine[D].Zhengzhou:Henan Agricultural University,2019.(in Chinese)
[13] BRUNNER K T,MEYER K F.Streptomycin in the treatment of Leptospira carriers;Experiments with hamsters and dogs[J].Proceedings of the Society for Experimental Biology and Medicine,1949,70(3):450-452.
[14] CHILDS J E,SCHWARTZ B S,KSIAZEK T G,et al.Risk factors associated with antibodies to leptospires in inner-city residents of Baltimore:A protective role for cats[J].American Journal of Public Health,1992,82(4):597-599.
[15] HUBBERT W T,SHOTTS E B.Leptospirosis in kennel dogs[J].Journal of the American Veterinary Medical Association,1966,148(10):1152-1159.
[16] MENGES R W,GALTON M M,HABERMANN R T.Culture and serologic studies on four dogs inoculated with two leptospiral serotypes, Leptospira Pomona and Leptospira canicola[J]. American Journal of Veterinary Research,1960,21(82):371-376.
[17] DRELICH A,JARGIELLO T,DRELICH G,et al.Renal artery stenosis:Value of contrast-enhanced ultrasonog-raphy[J]. Abdominal Imaging,2004,29(4):518-524.
[18] 肖园,吴海燕,孙艳争,等.犬钩端螺旋体病3例报告[J].中国人兽共患病学报,2017,33(5):469-471. XIAO Y,WU H Y,SUN Y Z,et al.Three cases of canine leptospirosis[J].Chinese Journal of Zoonoses,2017,33(5):469-471.(in Chinese)
[19] 朱来萍,王生奎,陈俊宏,等.犬肾衰竭的诊疗[J].上海畜牧兽医通讯,2019,3:50-51. ZHU L P,WANG S K,CHEN J H,et al.Diagnosis and therapy on renal failure caused of canine[J].Shanghai Animal Husbandry and Veterinary Journal,2019,3:50-51.(in Chinese)
[20] ALBRECHT J,NORENBERG M D.Glutamine:A Trojan horse in ammonia neurotoxicity[J].Hepatology,2006,44(4):788-794.
[21] Kyoto Encyclopedia of Genes and Genomes[EB/OL].https://www.genome.jp/kegg-bin/show_pathway?map00910.
[22] Kyoto Encyclopedia of Genes and Genomes[EB/OL].https://www.genome.jp/kegg-bin/show_pathway?map00330+M00.
[23] BOYD L M,LANGSTON C,THOMOPSON K,et al.Survival in cats with naturally occurring chronic disease[J].Journal of Veterinary Internal Medicine,2008,22(5):1111-1117.
[24] 夏兆飞.兽医临床实验室检验手册[M].北京:中国农业大学出版社,2010. XIA Z F.Laboratory Procedures for Veterinary Technicians[M].Beijing:China Agricultural University Press,2010.(in Chinese)