PDF(Pubmed)
Abstract：
A dog with bilateral renal dioctophymosis presented with stage 5 acute kidney injury, weight loss, vomiting, apathy, and hematuria. Laboratory tests showed creatinine of 17.2 mg/dL and Dioctophyme renale eggs in the urine. It underwent a 30-min session of hyperbaric oxygen preconditioning at a pressure of 2 ATA. Subsequently, bilateral nephroscopy was performed, without warm ischemia, using Amplatz-type renal dilators. Five parasites were removed, three females from the right kidney, one female from the left kidney, and one male from the abdominal cavity. After surgery, the patient continued doing daily hyperbaric oxygen therapy (HBOT) sessions and clinical therapy. Postoperative care consisted of analgesics, antimicrobials, antioxidants, gastric protector and fluid therapy. Ultrasound monitoring showed a reduction in the area of renal dilation and the hematological and biochemical tests showed rapid recovery from acute kidney injury. There was no bacterial growth in the urine sample collected directly from the kidneys. The patient had an excellent clinical progression and was discharged from hospital 7 days postoperatively, with creatinine values of 2.9 mg/dL. This is the first report of the use of nephroscopy in the treatment of dioctophymosis and indicates excellent chances of cure even in severe cases of bilateral parasitosis. HBOT was shown to be an ally in the clinical therapy of patients with D. renale by helping with stabilization and postoperative recovery.
摘要：
一只犬的双肾肾功能不全，表现为5期急性肾损伤，减肥,呕吐,冷漠,还有血尿.实验室检查显示肌酐为17.2mg/dL，尿液中有Dioctophymerenale卵。在2ATA的压力下进行了30分钟的高压氧预处理。随后，进行了双侧肾镜检查，没有热缺血，使用Amplatz型肾脏扩张器。五个寄生虫被移除,三个女性来自右肾，一名女性来自左肾，还有一个来自腹腔的男性.手术后,患者继续每日进行高压氧治疗(HBOT)和临床治疗.术后护理包括镇痛药，抗菌药物,抗氧化剂,胃保护器和液体治疗。超声监测显示肾脏扩张面积减少，血液学和生化检查显示急性肾损伤迅速恢复。直接从肾脏收集的尿液样品中没有细菌生长。患者临床进展良好，术后7天出院，肌酐值为2.9mg/dL。这是首次报道使用肾镜检查治疗糖尿病，即使在双侧寄生虫病的严重病例中，也有很好的治愈机会。通过帮助稳定和术后恢复，HBOT被证明是D.renale患者临床治疗的盟友。
