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== Overview == 小狗嘎小多 2024 年 6 月 5 日晚吃了一个南瓜鸡肉的罐头,夜里不安、呕吐,把吃的晚饭全吐出来了,带她出去,刚出小区门就不走了,要回家。。。 第二天上午还是萎靡,但能走。中午时仍然未见好转,呆在最爱的淋浴房喘,赶紧带着去医院。 心超一查右心衰 + 心包积液,胸腔还有积液 腹超一查也有少量积液。。。 <br> == 心超判读 == ECG: echocardiogram,超声心动图 <br> == 心包穿刺 == 心包积液快速增多容易引起心脏填塞(症状包括:不安、'''站立呼吸'''、手脚冰凉、'''血压低大部分时候测不到''',其他辅助判断包括:牙龈发紫,按压白变红时间大于2秒,呼吸次数>60次/分) 心脏填塞很危险,就是心脏功能严重受限,血液循环受阻严重,各功能细胞长时间无法从血液里获取到氧,容易造成多脏器衰竭。。。 有效且快速的缓解手段,就是在超声引导下,行心包穿刺术,把积液先抽出来,不要压迫心脏 心包穿刺过多,可能会引起缩窄性心包炎 (Constrictive Pericarditis) <br> == 血管肉瘤 (HSA) 原因 == 阿霉素 (Doxorubicin, 商品名:多柔比星) 脂质体 多柔比星 (Liposomes Doxorubicin) https://www.bilibili.com/video/av455160916/ [Clinical features and prognosis of retroperitoneal hemangiosarcoma in dogs with surgical resection with or without adjuvant doxorubicin] * 1991: [[VAC 化疗(长春新碱、多柔比星和环磷酰胺)对血管肉瘤狗的疗效和毒性]] [https://pubmed.ncbi.nlm.nih.gov/1920253/ Efficacy and toxicity of VAC chemotherapy (vincristine, doxorubicin, and cyclophosphamide) in dogs with hemangiosarcoma] * 1993: [[多柔比星和环磷酰胺治疗犬血管肉瘤]] [https://pubmed.ncbi.nlm.nih.gov/8114034/ Chemotherapy of canine hemangiosarcoma with doxorubicin and cyclophosphamide] * 1996: [[狗狗血管肉瘤的手术与多柔比星治疗]] [https://pubmed.ncbi.nlm.nih.gov/8947871/ Surgery and doxorubicin in dogs with hemangiosarcoma] * 2000: [[犬血管肉瘤的治疗:2000 年及以后]]兽医内科杂志 [https://pubmed.ncbi.nlm.nih.gov/11012108/ Treatment of canine hemangiosarcoma: 2000 and beyond. Journal of Veterinary Internal Medicine 2000] * 2010: [[狗的胸腔镜次全心包切除术和右心房肿块切除术]] [https://pubmed.ncbi.nlm.nih.gov/20807133/ Thoracoscopic subtotal pericardiectomy and right atrial mass resection in a dog] * 2013: [[狗狗原发性心脏血管肉瘤的流行病学、临床和病理特征:51例的回顾]]。兽医学杂志 [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942993/ Epidemiological, clinical and pathological features of primary cardiac hemangiosarcoma in dogs: a review of 51 cases.] * 2014: [http://wiki.jackslab.org/2014.Doxorubicin.HSA 阿霉素化疗治疗狗的推定性心脏血管肉瘤] [https://pubmed.ncbi.nlm.nih.gov/25524594 Doxorubicin chemotherapy for presumptive cardiac hemangiosarcoma in dogs] * 2014: [[基于多柔比星的化疗对右心房肿块和心包积液狗的回顾性评估]][https://pubmed.ncbi.nlm.nih.gov/24697499/ A retrospective evaluation of doxorubicin-based chemotherapy for dogs with right atrial masses and pericardial effusion] * 2017: [http://wiki.jackslab.org/2017.HSA.doxorubicin.AC.vs.ADTIC 多柔比星-环磷酰胺与多柔比星-达卡巴嗪辅助治疗犬血管肉瘤的比较] [https://pubmed.ncbi.nlm.nih.gov/25623994/ Comparison of doxorubicin-cyclophosphamide with doxorubicin-dacarbazine for HSA] * 2018: [[犬内脏血管肉瘤单独手术治疗或手术加多柔比星治疗:37例(2005-2014年)]] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091137/ Canine visceral hemangiosarcoma treated with surgery alone or surgery and doxorubicin: 37 cases (2005–2014)] * 2024: [[犬内脏血管肉瘤中的肿瘤相关巨噬细胞]] [https://pubmed.ncbi.nlm.nih.gov/37341055/ Tumor-associated macrophages in canine visceral hemangiosarcoma] * 2011: [[胞壁酰二肽及其衍生物:免疫疾病和癌症治疗中的肽佐剂]] [https://pubmed.ncbi.nlm.nih.gov/22180736/ Muramyl dipeptide and its derivatives: peptide adjuvant in immunological disorders and cancer therapy] * 1995: [[脂质体包封的胞壁酰三肽磷脂酰乙醇胺辅助免疫治疗狗脾血管肉瘤:一项随机多机构临床试验]] [https://pubmed.ncbi.nlm.nih.gov/9815908/ Liposome-encapsulated muramyl tripeptide phosphatidylethanolamine adjuvant immunotherapy for splenic hemangiosarcoma in the dog: A randomized multi-institutional clinical trial] * 1989: [[静脉注射脂质体包封的胞壁酰三肽治疗狗骨肉瘤]] [https://pubmed.ncbi.nlm.nih.gov/2733037/ Therapy for osteosarcoma in dogs with intravenous injection of liposome-encapsulated muramyl tripeptide] * 1981: [[通过静脉注射含有胞壁酰二肽的脂质体根除自发性转移和激活肺泡巨噬细胞]] [https://pubmed.ncbi.nlm.nih.gov/6940181/ Eradication of spontaneous metastases and activation of alveolar macrophages by intravenous injection of liposomes containing muramyl dipeptide] * [https://todaysveterinarypractice.com/nutrition/nutritional-management-of-veterinary-patients-with-neoplasia/ Nutritional Management of Patients with Neoplasia] [[小动物肿瘤患者的营养管理]] [https://pubmed.ncbi.nlm.nih.gov/27669112/ Use of Yunnan Baiyao and epsilon aminocaproic acid in dogs with right atrial masses and pericardial effusion] 云南白药和 ε-氨基己酸在右心房肿块和心包积液狗中的应用 2017 <br> == TODO == * 2024: [https://pubmed.ncbi.nlm.nih.gov/38434164/ Obstructive cardiac myxosarcoma of the right ventricular outflow tract with pulmonary embolism and concurrent right atrial hemangiosarcoma in a dog] [[狗狗右心室流出道阻塞性心肌粘液肉瘤伴肺栓塞和并发右心房血管肉瘤]] * 2021: [https://pubmed.ncbi.nlm.nih.gov/34296746/ Comparison of the oncogenomic landscape of canine and feline hemangiosarcoma shows novel parallels with human angiosarcoma]犬和猫血管肉瘤的肿瘤基因组图的比较显示出与人类血管肉瘤的新相似之处 * 2020: [https://pubmed.ncbi.nlm.nih.gov/32182572/ Real-time three-dimensional echocardiographic study of a cardiac hemangiosarcoma in a dog] 狗心脏血管肉瘤的实时三维超声心动图研究 * 2017: [https://pubmed.ncbi.nlm.nih.gov/26420436/ A descriptive review of cardiac tumours in dogs and cats] 狗狗和猫心脏肿瘤的描述性回顾 * 2015: [https://pubmed.ncbi.nlm.nih.gov/25307069/ Use of multidetector computed tomography in the assessment of dogs with pericardial effusion] 使用多排计算机断层扫描评估患有心包积液的狗 * 2009: [https://pubmed.ncbi.nlm.nih.gov/20001781/ Echocardiographic and clinicopathologic characterization of pericardial effusion in dogs: 107 cases (1985-2006)] 狗心包积液的超声心动图和临床病理学特征:107 例 (1985-2006) <br> == 抗凝血鼠药原因 == 抗凝血鼠药急性/慢性中毒引起心包积液的概率很低,平均 11 年左右文献报道一次:分别是 1999年、2011年、2022年 心超如果没有发现明显的肿物,可以查一下血凝指标排除一下 * [https://pubmed.ncbi.nlm.nih.gov/10476710/ 1999: Pericardial effusion and cardiac tamponade secondary to brodifacoum toxicosis in a dog][https://avmajournals.avma.org/view/journals/javma/215/5/javma.1999.215.05.647.xml?tab_body=pdf PDF][[1999.PE]] * [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022455/pdf/cvj_02_165.pdf 2011: Successful therapy of coumatetralyl rodenticide induced pericardial effusion with pericardiocentesis in a dog][http://wiki.jackslab.org/2011.PE 心包穿刺术成功治疗香豆四烯基杀鼠剂诱导的狗狗心包腔积液病] * [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9789774/pdf/OpenVetJ-12-728.pdf 2022: Acute severe pericarditis secondary to rodenticide intoxication in a dog][http://wiki.jackslab.org/2022.PE 继发于狗杀鼠剂中毒的急性重度心包炎] <br> == 甲状腺减退原因 == 甲状腺功能减退引起心包积液的概率也很低,怀疑的话可以查一下甲状腺功能 <br> == 感染原因 == 去农大动物医院(圆明园路附件)了解到心包炎根本无法通过标志物判断,只能切一片做病理,还不是 100% 能判断。。。 <br> == Reference == * Manual of Canine and Feline Cardiology 5th Edtion (犬猫心脏病学手册第5版) * [https://mp.weixin.qq.com/s/h3xwl-L1KHPMNT-2hMFWMQ 临床一线 | 一例犬心包积液的病例报告] 宠福鑫动物医院 * [https://mp.weixin.qq.com/s/cBTU_JUKpZ_7imLQ0CxdAA 10岁田园犬的心包积液诊断治疗] 中农董军实验室 * [https://mp.weixin.qq.com/s/fAzK87abDphSn3I9_ZFTtg 犬凝血障碍病例分享——鼠药中毒] 林静动物医院 * [https://www.baywatch.cn/yixuelunwen/yixuelunwen/xinlishuaijielun/2020/1023/156200.html 一例犬心力衰竭的诊断和治疗] 浙江大学附属动物医院 * [https://www.echopen.com/en/cas-usages 掌上心超 echOpen] <br>
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