1例猫慢性肾衰的诊断与治疗

Diagnosis and treatment of chronic renal failure in a cat

1只7岁本土短毛猫近日表现食欲下降、口腔异味、多饮多尿、呕吐、精神不振等症状,体重降至2.36 kg,采用临床体格检查、化验室检查等方法进行诊断。结果显示:患猫体温37℃,动脉收缩压130 mmHg,心率165 bmp/min,反应力较差,瞳孔白,口腔黏膜溃疡。血常规结果显示,红细胞数目、血细胞比容及血红蛋白浓度偏低,提示患猫贫血。血液生化检查结果显示,肌酐、尿素氮、磷及对称性二甲基精氨酸共4个指标数值均升高,表示肾脏损伤。血气检查结果显示,患猫pH值和碳酸氢根数值降低,二氧化碳分压数值升高,提示患猫发生代谢性酸中毒。尿液检查结果显示,尿比重降低,提示患猫肾脏的尿液浓缩能力降低;尿蛋白肌酐比(UPC)数值升高,提示患猫存在蛋白尿情况。经综合诊断最终确诊该猫患慢性肾衰。从改善饮食和对症治疗两个方面进行治疗,延缓病情,患猫症状得到基本缓解。

A 7-year-old domestic shorthair cat recently presented with symptoms such as decreased appetite,oral odor,polydipsia,polyuria,vomiting,and lethargy,with a weight decline to 2.36 kg.Diagnosis was conducted using clinical physical examinations and laboratory tests.Results revealed the cat had a body temperature of 37℃,blood pressure of 130 mmHg,heart rate of 165 bpm/min,poor responsiveness,pale pupils,and oral mucosal ulcers.Blood routine analysis indicated decreased red blood cell count,hematocrit,and hemoglobin concentration,suggesting anemia.Blood biochemistry results showed elevated levels of creatinine,blood urea nitrogen,phosphorus,and symmetric dimethylarginine,indicating renal damage.Blood gas analysis revealed a decrease in pH and HCO_(3)^(-)values and an increase in pCO_(2) values,indicating metabolic acidosis.Urinalysis showed decreased urine specific gravity,suggesting reduced kidney concentrating ability,and an elevated urine protein-to-creatinine ratio(UPC),indicating proteinuria.A comprehensive diagnosis confirmed chronic renal failure in the cat.Treatment focused on improving diet and symptomatic management,resulting in a slowed progression of the disease and significant relief of the cat's symptoms.