一例老年猫口鼻瘘的诊治

Clinical diagnosis and treatment of an old cat with oral and nasal fistula

宠物医院接诊一例13岁患猫,用灭菌生理盐水冲洗左侧上颌犬齿拔牙部深在的腔洞,可从鼻孔和内眼角处流出,并且有大量干酪样物从左侧鼻孔冲出,诊断为猫口鼻瘘。进行了血细胞、血液生化、血气离子分析和药敏试验,连续1周全身药物治疗加局部清创处理。结果表明:白细胞数为29.2×109/L,明显高于参考值,有严重感染;血糖含量为20.93 mmol/L,显著高于参考值,提示该病例猫的伤口不利于愈合。细菌培养、菌种鉴定为大肠埃希菌。药敏试验显示对大多数青霉素类、头孢菌素类以及喹诺酮类等抗生素药物耐药,对碳青霉烯类药物等敏感。对患猫进行清创处理,选用美罗培南按24 mg/kg剂量静脉注射,输液治疗3 d后精神状态好转,5 d后可自主进食,7 d后停止输液,每日冲洗瘘道至24 d痊愈。

In this paper,a 13-year-old cat was treated in a pet hospital.The deep cavity in the extraction part of the left maxillary canine teeth was washed with sterilized saline,which could flow out from the nostril and the inner corner of the eye.A large number of cheese-like substances rushed out from the left nostril.The diagnosis of the cat’s mouth-nostril fistula was made.Blood cell,blood biochemistry,blood gas ion analysis and drug sensitivity test were carried out,and systemic drug treatment and local debridement were carried out for a week.The results showed that the leucocyte count was 29.2×109/L,which was significantly higher than the reference value,and the blood sugar was 20.93 mmol/L,which was significantly higher than the reference value,suggesting that the wound of the cat in this case was not conducive to healing.Bacterial culture and strains were identified as Escherichia coli.Drug susceptibility tests showed that it was resistant to most antibiotics such as penicillins,cephalosporins and quinolones,and sensitive to carbapenems.The cat was debrided and meropenem was injected intravenously at a dose of 24 mg/kg.After 3 days of infusion treatment,the cat’s mental state improved.After 5 days,the cat could eat independently.After 7 days,the infusion was stopped and the fistula was washed every day until the 24 th day.