貓生殖道疾病diseases of the feline reproductive tract

Vuvla,Vestibulum&陰戶，前庭和陰Vuvla,Vestibulum&陰戶，前庭和陰????DevelopmentalabnormalitiesMasculinizationVaginaltumorsVulva,Ves>bulum&Developmental?littlehasbeendescribeddiagnosemoredifficultbecauseofDevelopmental?littlehasbeendescribeddiagnosemoredifficultbecauseoftheanatomyandtheIntersexanimals:ambiguousexternalmalepseudhermaphrodites:malegonadsandfeminizationoftheexternalgenitaliaFailureofinternalgenitalia內(nèi)生殖器的失敗??????FailureinthedevelopmentoftheMüllerianductFailureofthefusionbetweentheMüllerianandtheurogenitalsinus=>cancauseatresiaortheformationofseptainthetubulargenitalorgans,whichmaycausefluidaccumulationwithabdominaldistension導(dǎo)致管道生殖器官內(nèi)的縱隔Vulva,Ves>bulum&DevelopmentalDiagnosis診斷visualinspectionpalpation/ultrasoundDevelopmentalDiagnosis診斷visualinspectionpalpation/ultrasoundoftheestablishmentofthekaryotypedeterminationofthegonadalsexVulva,Ves>bulum&MasculinizationDefinition定義InitiallynormalexternalgenitaliaMasculinizationDefinition定義Initiallynormalexternalgenitaliabecomemasculinized,thequeenmaydevelopanenlargedbarbedclitorisorvaginalDiagnose診斷visualinspectionCause病因atestosterone-producingovarianoverproductionofsexsteroidsbytheadrenalTreatment治療OvariectomytherapyoftheadrenalglandVulva,Ves>bulum&?primaryvaginitisisSymptomes癥狀?vaginalDifferentialdiagnosesforvaginal陰道分泌物的鑒別診斷??fetalremnantswithinthe?primaryvaginitisisSymptomes癥狀?vaginalDifferentialdiagnosesforvaginal陰道分泌物的鑒別診斷??fetalremnantswithintheuterineCause病因?Clamydophilafelis貓衣原Diagnosis診斷?exclusionofotherTreatment治療?antibiotictherapyafterbacterialswapandVulva,Ves>bulum&Vaginaltumours陰道腫??extremelyfibromas,Symptomes癥狀constipationasaresultofdorsalVaginaltumours陰道腫??extremelyfibromas,Symptomes癥狀constipationasaresultofdorsalpressureonthevaginaldischarge??Diagnosis診斷??Ultrasound超Treatment治療?surgicalremovalVulva,Ves>bulum&Uterus子?developmental???????cysticendometrialUterus子?developmental???????cysticendometrialhyperplasiaMetritis子宮炎Pyometra子宮蓄膿Mucometra子宮積液uterineadenomyosisuterinetumoursDevelopmentalCause病因?failureofnormaldevelopmnetoftheMüllerianDevelopmentalCause病因?failureofnormaldevelopmnetoftheMüllerian苗勒管不能正Clinicalmanifestation臨床癥狀???uterusunicornussegmentalaplsiaofauterinehorn子宮角部分發(fā)育usuallybothoviductsandovariesare通常兩側(cè)輸卵管和卵巢同renalagenesisatthesamesideis在同側(cè)，常見(jiàn)?Diagnosis診斷???Palpation觸LaparotomyCysticendometrialhyperplasiaoftheendometrialepitheliumandcysticdilataionof?endometrial子宮Cysticendometrialhyperplasiaoftheendometrialepitheliumandcysticdilataionof?endometrial子宮內(nèi)膜上皮增生和子宮內(nèi)膜腺commoncondition,incidenceincreaseswith常見(jiàn)情況，隨著年齡增長(zhǎng)，發(fā)生???generalillnessincasesof在感染的病例，可見(jiàn)全身癥????repeatedestrouscycles反復(fù)發(fā)treatmentwithpogestogens孕酮的治Diagnosis治療?Ultrasound超Treatment治療o(wú)variohysterectomybecauseoftheriskof鑒于感染的風(fēng)險(xiǎn)，行卵巢子宮切除=accumulationofpuswithinthe=accumulationofpuswithintheuterineClinicalsigns臨床癥狀Vulvaldischarge外陰分泌(68-Lethargy精神沉Vomiting嘔Fever(20發(fā)燒Leucocytosisandneutropheliawithleft白細(xì)胞增多癥和中性粒細(xì)胞減少癥，伴隨核左Anaemia,hyperproteinaemiaand貧血，高蛋白血癥和高球蛋白血Pyometra子宮蓄isolatedbacteriabelongPyometra子宮蓄isolatedbacteriabelongtothenormalvaginal分離的細(xì)菌屬于常在的菌duringestruscervixisopenandbacteriamayenterthe在動(dòng)情期，子宮頸是開放的，細(xì)菌更易于進(jìn)入子mostcommon:Escherichiacoli,Streptococcusspp.，Staphylococcusspp.,Pasteurellaspp.,Klebsiellapp.,Moraxellaspp.最常見(jiàn):大腸桿菌，鏈球菌,葡萄球菌，巴氏桿菌，克雷伯氏菌，莫氏桿mostoftenwithin2monthsafterthelastestrus,thelutealphasebutisalsoreportedwithcysticovaries,inactiveovariesorincatswithinactiveovaries最常發(fā)于最后一次動(dòng)情后2個(gè)月內(nèi),在黃體期,但是囊性卵巢或卵巢非活性期的Predisposingfactors發(fā)病誘因frequentestouscyclesspontaneousovulationsPyometra:surgical子宮蓄膿：手術(shù)治????infusiontherapyPyometra:surgical子宮蓄膿：手術(shù)治????infusiontherapyPyometra:medical子宮蓄膿：內(nèi)科治Requirementsformedicaltreatment內(nèi)科治Pyometra:medical子宮蓄膿：內(nèi)科治Requirementsformedicaltreatment內(nèi)科治療的需求?onlyforcatsingoodbodyrepeatultrasoundformonitoringtheeffectofaccompaniedbyinfusionandantibiotic??Followup隨訪???recurrenceofthediseasemayoccurtreatmentcanbefertilityrateupto生育率高達(dá)Pyometra:medical子宮蓄膿：內(nèi)科治1)AglepristoneprogesteronePyometra:medical子宮蓄膿：內(nèi)科治1)Aglepristoneprogesteronereceptoragonist孕酮受體激10mg/kgSConday1,2,7and1410mg/kg,SC,在第1，2，7和14effectiveforupto2有效期達(dá)2Sideeffects:skinreactions,hairlossattheinjection副作用：皮膚反應(yīng)，注射位置脫2)naturalProstaglandins2α天然前列腺素0.1mg/kgSCevery12-24hfor3-5daysinopencervix治療子宮頸開放的子宮蓄膿0.1mg/kg,SC，每12-24小時(shí)一次，3-5Sideeffects:panting,restlessness,tenesmus,salivation,diarrhoea,mydriasis,emesis,urinationresolvewithin1hourandcatsgetusedto=uterusfilledwithclearandwaterytomucinousnon-=uterusfilledwithclearandwaterytomucinousnon-clinicalsign:goodhelathexceptproblemsaccompaniedtheabdominaldistensionCauses病因increasedsecretoryactivityoftheCauses病因increasedsecretoryactivityoftheendometrialcongenitaloracquiredobstructionofthefemaletubularorgans診斷ultrasonograohy,uterusoftenthinTreatment治療o(wú)variohysterectomyisrecommended,administrationof10mg/kgaglepristonetwice24hapartisdescribed推薦卵巢子宮切除術(shù)，給予10mg/kg阿來(lái)24小時(shí)分開使用2Uterinetumours子宮腫rareandoftenadditionalbuttheUterinetumours子宮腫rareandoftenadditionalbutthemostcommentumoursofthegenitaltractinmostcommonadenocarcinomaothers:adenosarcoma,leiomyosarcoma,fibrosarcoma,carcinosarcoma,lymphosarcoma,fibroma,lipoma,normallyinintactqueens,butalsodescribedintheuterusaftercastrationUterine子宮腫Clinicalsigns臨床癥狀各不相Uterine子宮腫Clinicalsigns臨床癥狀各不相同abdominalenlargement,palpablemass,weightloss,lethargy,haemorrhagicvaginaldischarge,stranguria,constipationand性Diagnosis診斷palpation,ultrasonography,finallypatomorphological觸診，超聲檢查，最終病理形態(tài)學(xué)檢Treatment治療intheabsenceofmetastasis,沒(méi)有轉(zhuǎn)移時(shí)，卵巢子宮切除卵OvarianOvarianOvarianremnant卵OvarianOvarianOvarianremnantOvarianmaturefollicelsareuptoOvarianmaturefollicelsareupto3mmandpresentonlyduring成熟的卵泡達(dá)3mmsmallerfollicelscanbeseenduringotherstagesofthecystic囊性結(jié)構(gòu)follicularcysticdistensionofthereteovariicysticdilationofremnantsfromthecranialmesonephricOvariannormallyasymptomaticuntilproblemsbecauseoftheOvariannormallyasymptomaticuntilproblemsbecauseofthesizemay正常沒(méi)有癥狀，直到體積較大時(shí)才會(huì)有相應(yīng)表follicularcystsmayproduceoestradiolleadingtoprolongedoestrusandinfertility卵泡囊腫會(huì)產(chǎn)生雌二醇，從而導(dǎo)致動(dòng)情期延長(zhǎng)和不Treatment:Ovariohysterectomyincasesofclinical治療：有臨床癥狀的病例行卵巢子宮OvarianuncommonincatsmostOvarianuncommonincatsmostcommonincats>5yearsofage,but最常見(jiàn)于5reportedinmostcommonneoplasia:granulosacelloftenmalignantwith44-60%經(jīng)常是惡性的，44-60%的轉(zhuǎn)clinicalsigns:persistentoestrusandhyperoesogenismwithCEHandalopecia臨床癥狀：持續(xù)動(dòng)情，伴隨CEHothertumours:dysgerminoma,cystadenoma,luteoma,OvarianClinicalsigns臨床癥狀?abnormaloestrusorOvarianClinicalsigns臨床癥狀?abnormaloestrusormasculinebehaviourindysgerminomasandluteomaspossible在無(wú)性細(xì)胞瘤和黃體瘤時(shí)，可能會(huì)出現(xiàn)異常的動(dòng)情期或雄性行apalpableabdominalmass,abdominal觸診腹部腫塊，腹anorexiaand厭食癥??Diagnosis診斷子宮卵巢切除后組織學(xué)檢??Treatment治療o(wú)variohysterectomyifthereareno如果沒(méi)有轉(zhuǎn)移，子宮卵巢Ovarianremnant=remnantsofoftheovariesOvarianremnant=remnantsofoftheovariesleftintheabdomen在手術(shù)時(shí)，卵巢殘留在腹Clinicalsigns臨床癥狀spayedfemalesarecontinuetoshowoestrousbehaviourarangefrom17daysto9yearsisdescribedCauses病因almostalwaysasmallpieceofthenormalovariantissuewasn‘tremoved幾乎總是只有一小片正常卵巢沒(méi)有被切supernumeraryovarieshavebeen超數(shù)卵巢也已Treatment治療surgicalremovaloftheremnants手術(shù)移除殘OvarianremnantStagetoObservationofoestrousPronouncedoestrousbehaviourisindicativeVaginalSerumoestradiolOvarianremnantStagetoObservationofoestrousPronouncedoestrousbehaviourisindicativeVaginalSerumoestradiolCornifiedsmearsare>12pmol/lnotalwaysInductionofovulationwith25μgGnRHor500IUhCGandmeasurementofprogesterone1-3weekslaterMostpreciseifprogesteroneisabovebasalconcentrationInjectionof0.4μg/kgbuserelinandmeasurementofoestradiol2hourslateronlyusedtodifferentiateintactfromspayedcatsMeasurementofAMH,intherangeof0.1-0.8ng/mlonlyonereportbutseemstobeusefull卵巢殘端綜合測(cè)測(cè)試進(jìn)行的時(shí)解發(fā)情卵巢殘端綜合測(cè)測(cè)試進(jìn)行的時(shí)解發(fā)情行為的觀動(dòng)情陰道細(xì)動(dòng)情血清雌二醇濃度的25μgGnRH或500IUhCG來(lái)誘動(dòng)情>12pmol/l不一任何時(shí)只用來(lái)鑒別貓咪是否抗穆勒氏管激素測(cè)定，范0.1-任何Mammarygland乳AgalactiaMastitisMammaryneoplasiaMammarygland乳AgalactiaMastitisMammaryneoplasiaMammaryhypertrophyMammaryAgalactia泌乳抑Causes病因nervousAgalactia泌乳抑Causes病因nervouscatscaesareansectiontoearlyTreatment治療Metoclopramide0.1-0.2mg/kgSCororallyevery6-8hoursuntilmilkproductionsucklingofthekittenssupplementaryfeedingofthekittensaslongasMammaryMastitis乳房Forms形式acutemastitis急性乳房Mastitis乳房Forms形式acutemastitis急性乳房gangrenousmastitis壞疽性乳房chronicmastitis慢性乳房Causes病因mostfrequentascendingbacterialmorerarelyhaematogenous最罕見(jiàn)出血擴(kuò)mainisolatedpathogens:E.coli,staphylococci,分離的主要病原：大腸桿菌，葡萄球菌，鏈球MammaryMastitis乳房Acutemastitis急性乳房炎mammaryglandishot,Mastitis乳房Acutemastitis急性乳房炎mammaryglandishot,painful,swollen,feverlethargydon‘tallowthekittenstodeathofakittenpossible=toxicmilk可能造成幼貓死亡=secrition:normal,brownish,purulentorGangrenousmastitis壞疽性乳房炎followsasevereacuteabscessesandsubsequentnecrosisaffectedglands:darkend,coldand/orcatwithsystemicsignsofMammaryMastitis乳房chronicmastitis慢性乳房炎maybeMastitis乳房chronicmastitis慢性乳房炎maybeanincidentaldfindinginolderaffectedglandsshowminimalinflammatoryaffectedglandsmayappearswollenwithpalpablenoduleslikeinneoplasmssubclinical亞臨床乳房炎shouldbesuspectedwithanincreaseinneonatalshouldbesuspectedifthekittenshowimproperweightMammaryDiagnosis診斷haematology:neutrophilicleucocytosisinacuteDiagnosis診斷haematology:neutrophilicleucocytosisinacutecytology細(xì)胞學(xué)largenumbersofdegeneratedneutrophils(<3000mlwithingestedbacteriaandmacrophagesincasesofacutemastitisthebarrierthatseperatestheplasmafromthemilkhasalreadybeenbrokensoeveryantibiotichelpsinathercasesmilkpH<7.2:trimethoprim/sulfonamide,erythromycin,lincomycinmilkpH>7.4ampicillin,cefalexinmanualemptyingofthemilktoavoidaccumulationtoremovethekittenornotisacontroversialissueincasesofabcessestheshouldbeMammaryGalactostasis乳汁蓄=excessivmilkproductionwithaGalactostasis乳汁蓄=excessivmilkproductionwithalackofmilkletincatsmoreoftenthecranialglandsareaffectedClinicalsigns臨床癥狀swollenglandsinflammedandoedematousinearlyphasethecatissystemicallywellconditionmayresultinasterilorsepticmastitis病情可能會(huì)造成無(wú)菌性Diagnosis診斷clinicmilkcytolgoy:highnumberofnon-degeneratedneutrophils,macrophagesandpolymorphnuclearleucocyteelastaseTreatment治療coldcompressesfor10-15minutesseveraltimesadiureticsorglucocorticoidsfor2-5days利尿劑或皮質(zhì)醇，連用2-5Prolactin-inhibitorafterweaningnoemptyingofthemammarygland=>moremilkMammaryMammary=MammaryfibroadenomatousMammaryMammary=MammaryfibroadenomatousMammaryMammaryHistology組織學(xué)nonneoplasticproliferationMammaryHistology組織學(xué)nonneoplasticproliferationofthemammarystroma,withoutnecrosis,inflammationandlactation,affectedtissuewithprogesteronereceptorsAetiology病因?qū)Witseemstobeinducedbyprogesterone:看似孕酮誘導(dǎo)所致:懷孕，假孕，外源孕酮 butitisalsoreportedwithoutprogesteroneinpreviousspayedanimalsalsointomcats但是也有報(bào)道見(jiàn)于之前已絕育的動(dòng)物和雄MammaryMammaryaffectsoneorMammaryaffectsoneormoremammaryglands影響1mainlyaffectsyoungqueensaftertheir1stoestrus,butitcanaffectallagesandbothsexesriskofsuperficialskininjuriesTreatment治療castrationwithdrawlofprogesteronetreatmentadministrationofprogesteronereceptor10-15mg/kgaglepristoneSConday1,2andantibioticsincasesofulcerationorinfectionNSAIDsagainstinflammationandpaininseverecasesmastectomyregressionmaylastseveralmonthsMammaryMammaryMammaryMammaryMammaryMammary3rdmostfrequentcancerMammary3rdmostfrequentcancerinthe雌性貓第三常見(jiàn)的癌upto80%are高達(dá)80%thereisahighincidenceinSiamesecatsbutnoknowngeneticpredispositionclinicalsignsthatindictateapoorrapidgrowth,infiltrationofnearbytissueorpoordelineation,inflammatorychanges,metastasistoregionallymphnodesortothelungs(,liver,bones),sizeof>0.75cm,involvementofseveralglandsMammaryMammaryDiagnosis診斷completephysicalexamination,PalpationandMammaryDiagnosis診斷completephysicalexamination,Palpationand完整的體檢，觸診-thoracic胸部Xultrasonography:exclusionofdifferentialdiagnosisandcheckofabdominalorgnas超聲檢查:排除鑒別診斷，并檢查腹腔器bloodanalysis:evaluatekidneyandliverfunction,bloodcalcium,whiteandredbloodcells血液分析：評(píng)估肝腎功能，血鈣，紅細(xì)胞和白細(xì)fine-needleaspirationBiopsy活Differentialdiagnosis鑒別診斷mammaryglan