猫生殖道疾病diseases of the feline reproductive tract

Vuvla,Vestibulum&阴户，前庭和阴Vuvla,Vestibulum&阴户，前庭和阴••••DevelopmentalabnormalitiesMasculinizationVaginaltumorsVulva,Ves>bulum&Developmental•littlehasbeendescribeddiagnosemoredifficultbecauseofDevelopmental•littlehasbeendescribeddiagnosemoredifficultbecauseoftheanatomyandtheIntersexanimals:ambiguousexternalmalepseudhermaphrodites:malegonadsandfeminizationoftheexternalgenitaliaFailureofinternalgenitalia内生殖器的失败••••••FailureinthedevelopmentoftheMüllerianductFailureofthefusionbetweentheMüllerianandtheurogenitalsinus=>cancauseatresiaortheformationofseptainthetubulargenitalorgans,whichmaycausefluidaccumulationwithabdominaldistension导致管道生殖器官内的纵隔Vulva,Ves>bulum&DevelopmentalDiagnosis诊断visualinspectionpalpation/ultrasoundDevelopmentalDiagnosis诊断visualinspectionpalpation/ultrasoundoftheestablishmentofthekaryotypedeterminationofthegonadalsexVulva,Ves>bulum&MasculinizationDefinition定义InitiallynormalexternalgenitaliaMasculinizationDefinition定义Initiallynormalexternalgenitaliabecomemasculinized,thequeenmaydevelopanenlargedbarbedclitorisorvaginalDiagnose诊断visualinspectionCause病因atestosterone-producingovarianoverproductionofsexsteroidsbytheadrenalTreatment治疗OvariectomytherapyoftheadrenalglandVulva,Ves>bulum&•primaryvaginitisisSymptomes症状•vaginalDifferentialdiagnosesforvaginal阴道分泌物的鉴别诊断••fetalremnantswithinthe•primaryvaginitisisSymptomes症状•vaginalDifferentialdiagnosesforvaginal阴道分泌物的鉴别诊断••fetalremnantswithintheuterineCause病因•Clamydophilafelis猫衣原Diagnosis诊断•exclusionofotherTreatment治疗•antibiotictherapyafterbacterialswapandVulva,Ves>bulum&Vaginaltumours阴道肿••extremelyfibromas,Symptomes症状constipationasaresultofdorsalVaginaltumours阴道肿••extremelyfibromas,Symptomes症状constipationasaresultofdorsalpressureonthevaginaldischarge••Diagnosis诊断••Ultrasound超Treatment治疗•surgicalremovalVulva,Ves>bulum&Uterus子•developmental•••••••cysticendometrialUterus子•developmental•••••••cysticendometrialhyperplasiaMetritis子宫炎Pyometra子宫蓄脓Mucometra子宫积液uterineadenomyosisuterinetumoursDevelopmentalCause病因•failureofnormaldevelopmnetoftheMüllerianDevelopmentalCause病因•failureofnormaldevelopmnetoftheMüllerian苗勒管不能正Clinicalmanifestation临床症状•••uterusunicornussegmentalaplsiaofauterinehorn子宫角部分发育usuallybothoviductsandovariesare通常两侧输卵管和卵巢同renalagenesisatthesamesideis在同侧，常见•Diagnosis诊断•••Palpation触LaparotomyCysticendometrialhyperplasiaoftheendometrialepitheliumandcysticdilataionof•endometrial子宫Cysticendometrialhyperplasiaoftheendometrialepitheliumandcysticdilataionof•endometrial子宫内膜上皮增生和子宫内膜腺commoncondition,incidenceincreaseswith常见情况，随着年龄增长，发生•••generalillnessincasesof在感染的病例，可见全身症••••repeatedestrouscycles反复发treatmentwithpogestogens孕酮的治Diagnosis治疗•Ultrasound超Treatment治疗ovariohysterectomybecauseoftheriskof鉴于感染的风险，行卵巢子宫切除=accumulationofpuswithinthe=accumulationofpuswithintheuterineClinicalsigns临床症状Vulvaldischarge外阴分泌(68-Lethargy精神沉Vomiting呕Fever(20发烧Leucocytosisandneutropheliawithleft白细胞增多症和中性粒细胞减少症，伴随核左Anaemia,hyperproteinaemiaand贫血，高蛋白血症和高球蛋白血Pyometra子宫蓄isolatedbacteriabelongPyometra子宫蓄isolatedbacteriabelongtothenormalvaginal分离的细菌属于常在的菌duringestruscervixisopenandbacteriamayenterthe在动情期，子宫颈是开放的，细菌更易于进入子mostcommon:Escherichiacoli,Streptococcusspp.，Staphylococcusspp.,Pasteurellaspp.,Klebsiellapp.,Moraxellaspp.最常见:大肠杆菌，链球菌,葡萄球菌，巴氏杆菌，克雷伯氏菌，莫氏杆mostoftenwithin2monthsafterthelastestrus,thelutealphasebutisalsoreportedwithcysticovaries,inactiveovariesorincatswithinactiveovaries最常发于最后一次动情后2个月内,在黄体期,但是囊性卵巢或卵巢非活性期的Predisposingfactors发病诱因frequentestouscyclesspontaneousovulationsPyometra:surgical子宫蓄脓：手术治••••infusiontherapyPyometra:surgical子宫蓄脓：手术治••••infusiontherapyPyometra:medical子宫蓄脓：内科治Requirementsformedicaltreatment内科治Pyometra:medical子宫蓄脓：内科治Requirementsformedicaltreatment内科治疗的需求•onlyforcatsingoodbodyrepeatultrasoundformonitoringtheeffectofaccompaniedbyinfusionandantibiotic••Followup随访•••recurrenceofthediseasemayoccurtreatmentcanbefertilityrateupto生育率高达Pyometra:medical子宫蓄脓：内科治1)AglepristoneprogesteronePyometra:medical子宫蓄脓：内科治1)Aglepristoneprogesteronereceptoragonist孕酮受体激10mg/kgSConday1,2,7and1410mg/kg,SC,在第1，2，7和14effectiveforupto2有效期达2Sideeffects:skinreactions,hairlossattheinjection副作用：皮肤反应，注射位置脱2)naturalProstaglandins2α天然前列腺素0.1mg/kgSCevery12-24hfor3-5daysinopencervix治疗子宫颈开放的子宫蓄脓0.1mg/kg,SC，每12-24小时一次，3-5Sideeffects:panting,restlessness,tenesmus,salivation,diarrhoea,mydriasis,emesis,urinationresolvewithin1hourandcatsgetusedto=uterusfilledwithclearandwaterytomucinousnon-=uterusfilledwithclearandwaterytomucinousnon-clinicalsign:goodhelathexceptproblemsaccompaniedtheabdominaldistensionCauses病因increasedsecretoryactivityoftheCauses病因increasedsecretoryactivityoftheendometrialcongenitaloracquiredobstructionofthefemaletubularorgans诊断ultrasonograohy,uterusoftenthinTreatment治疗ovariohysterectomyisrecommended,administrationof10mg/kgaglepristonetwice24hapartisdescribed推荐卵巢子宫切除术，给予10mg/kg阿来24小时分开使用2Uterinetumours子宫肿rareandoftenadditionalbuttheUterinetumours子宫肿rareandoftenadditionalbutthemostcommentumoursofthegenitaltractinmostcommonadenocarcinomaothers:adenosarcoma,leiomyosarcoma,fibrosarcoma,carcinosarcoma,lymphosarcoma,fibroma,lipoma,normallyinintactqueens,butalsodescribedintheuterusaftercastrationUterine子宫肿Clinicalsigns临床症状各不相Uterine子宫肿Clinicalsigns临床症状各不相同abdominalenlargement,palpablemass,weightloss,lethargy,haemorrhagicvaginaldischarge,stranguria,constipationand性Diagnosis诊断palpation,ultrasonography,finallypatomorphological触诊，超声检查，最终病理形态学检Treatment治疗intheabsenceofmetastasis,没有转移时，卵巢子宫切除卵OvarianOvarianOvarianremnant卵OvarianOvarianOvarianremnantOvarianmaturefollicelsareuptoOvarianmaturefollicelsareupto3mmandpresentonlyduring成熟的卵泡达3mmsmallerfollicelscanbeseenduringotherstagesofthecystic囊性结构follicularcysticdistensionofthereteovariicysticdilationofremnantsfromthecranialmesonephricOvariannormallyasymptomaticuntilproblemsbecauseoftheOvariannormallyasymptomaticuntilproblemsbecauseofthesizemay正常没有症状，直到体积较大时才会有相应表follicularcystsmayproduceoestradiolleadingtoprolongedoestrusandinfertility卵泡囊肿会产生雌二醇，从而导致动情期延长和不Treatment:Ovariohysterectomyincasesofclinical治疗：有临床症状的病例行卵巢子宫OvarianuncommonincatsmostOvarianuncommonincatsmostcommonincats>5yearsofage,but最常见于5reportedinmostcommonneoplasia:granulosacelloftenmalignantwith44-60%经常是恶性的，44-60%的转clinicalsigns:persistentoestrusandhyperoesogenismwithCEHandalopecia临床症状：持续动情，伴随CEHothertumours:dysgerminoma,cystadenoma,luteoma,OvarianClinicalsigns临床症状•abnormaloestrusorOvarianClinicalsigns临床症状•abnormaloestrusormasculinebehaviourindysgerminomasandluteomaspossible在无性细胞瘤和黄体瘤时，可能会出现异常的动情期或雄性行apalpableabdominalmass,abdominal触诊腹部肿块，腹anorexiaand厌食症••Diagnosis诊断子宫卵巢切除后组织学检••Treatment治疗ovariohysterectomyifthereareno如果没有转移，子宫卵巢Ovarianremnant=remnantsofoftheovariesOvarianremnant=remnantsofoftheovariesleftintheabdomen在手术时，卵巢残留在腹Clinicalsigns临床症状spayedfemalesarecontinuetoshowoestrousbehaviourarangefrom17daysto9yearsisdescribedCauses病因almostalwaysasmallpieceofthenormalovariantissuewasn‘tremoved几乎总是只有一小片正常卵巢没有被切supernumeraryovarieshavebeen超数卵巢也已Treatment治疗surgicalremovaloftheremnants手术移除残OvarianremnantStagetoObservationofoestrousPronouncedoestrousbehaviourisindicativeVaginalSerumoestradiolOvarianremnantStagetoObservationofoestrousPronouncedoestrousbehaviourisindicativeVaginalSerumoestradiolCornifiedsmearsare>12pmol/lnotalwaysInductionofovulationwith25µgGnRHor500IUhCGandmeasurementofprogesterone1-3weekslaterMostpreciseifprogesteroneisabovebasalconcentrationInjectionof0.4µg/kgbuserelinandmeasurementofoestradiol2hourslateronlyusedtodifferentiateintactfromspayedcatsMeasurementofAMH,intherangeof0.1-0.8ng/mlonlyonereportbutseemstobeusefull卵巢残端综合测测试进行的时解发情卵巢残端综合测测试进行的时解发情行为的观动情阴道细动情血清雌二醇浓度的25µgGnRH或500IUhCG来诱动情>12pmol/l不一任何时只用来鉴别猫咪是否抗穆勒氏管激素测定，范0.1-任何Mammarygland乳AgalactiaMastitisMammaryneoplasiaMammarygland乳AgalactiaMastitisMammaryneoplasiaMammaryhypertrophyMammaryAgalactia泌乳抑Causes病因nervousAgalactia泌乳抑Causes病因nervouscatscaesareansectiontoearlyTreatment治疗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坏疽性乳房chronicmastitis慢性乳房Causes病因mostfrequentascendingbacterialmorerarelyhaematogenous最罕见出血扩mainisolatedpathogens:E.coli,staphylococci,分离的主要病原：大肠杆菌，葡萄球菌，链球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可能造成幼猫死亡=secrition:normal,brownish,purulentorGangrenousmastitis坏疽性乳房炎followsasevereacuteabscessesandsubsequentnecrosisaffectedglands:darkend,coldand/orcatwithsystemicsignsofMammaryMastitis乳房chronicmastitis慢性乳房炎maybeMastitis乳房chronicmastitis慢性乳房炎maybeanincidentaldfindinginolderaffectedglandsshowminimalinflammatoryaffectedglandsmayappearswollenwithpalpablenoduleslikeinneoplasmssubclinical亚临床乳房炎shouldbesuspectedwithanincreaseinneonatalshouldbesuspectedifthekittenshowimproperweightMammaryDiagnosis诊断haematology:neutrophilicleucocytosisinacuteDiagnosis诊断haematology:neutrophilicleucocytosisinacutecytology细胞学largenumbersofdegeneratedneutrophils(<3000mlwithingestedbacteriaandmacrophagesincasesofacutemastitisthebarrierthatseperatestheplasmafromthemilkhasalreadybeenbrokensoeveryantibiotichelpsinathercasesmilkpH<7.2:trimethoprim/sulfonamide,erythromycin,lincomycinmilkpH>7.4ampicillin,cefalexinmanualemptyingofthemilktoavoidaccumulationtoremovethekittenornotisacontroversialissueincasesofabcessestheshouldbeMammaryGalactostasis乳汁蓄=excessivmilkproductionwithaGalactostasis乳汁蓄=excessivmilkproductionwithalackofmilkletincatsmoreoftenthecranialglandsareaffectedClinicalsigns临床症状swollenglandsinflammedandoedematousinearlyphasethecatissystemicallywellconditionmayresultinasterilorsepticmastitis病情可能会造成无菌性Diagnosis诊断clinicmilkcytolgoy:highnumberofnon-degeneratedneutrophils,macrophagesandpolymorphnuclearleucocyteelastaseTreatment治疗coldcompressesfor10-15minutesseveraltimesadiureticsorglucocorticoidsfor2-5days利尿剂或皮质醇，连用2-5Prolactin-inhibitorafterweaningnoemptyingofthemammarygland=>moremilkMammaryMammary=MammaryfibroadenomatousMammaryMammary=MammaryfibroadenomatousMammaryMammaryHistology组织学nonneoplasticproliferationMammaryHistology组织学nonneoplasticproliferationofthemammarystroma,withoutnecrosis,inflammationandlactation,affectedtissuewithprogesteronereceptorsAetiology病因学itseemstobeinducedbyprogesterone:看似孕酮诱导所致:怀孕，假孕，外源孕酮 butitisalsoreportedwithoutprogesteroneinpreviousspayedanimalsalsointomcats但是也有报道见于之前已绝育的动物和雄MammaryMammaryaffectsoneorMammaryaffectsoneormoremammaryglands影响1mainlyaffectsyoungqueensaftertheir1stoestrus,butitcanaffectallagesandbothsexesriskofsuperficialskininjuriesTreatment治疗castrationwithdrawlofprogesteronetreatmentadministrationofprogesteronereceptor10-15mg/kgaglepristoneSConday1,2andantibioticsincasesofulcerationorinfectionNSAIDsagainstinflammationandpaininseverecasesmastectomyregressionmaylastseveralmonthsMammaryMammaryMammaryMammaryMammaryMammary3rdmostfrequentcancerMammary3rdmostfrequentcancerinthe雌性猫第三常见的癌upto80%are高达80%thereisahighincidenceinSiamesecatsbutnoknowngeneticpredispositionclinicalsignsthatindictateapoorrapidgrowth,infiltrationofnearbytissueorpoordelineation,inflammatorychanges,metastasistoregionallymphnodesortothelungs(,liver,bones),sizeof>0.75cm,involvementofseveralglandsMammaryMammaryDiagnosis诊断completephysicalexamination,PalpationandMammaryDiagnosis诊断completephysicalexamination,Palpationand完整的体检，触诊-thoracic胸部Xultrasonography:exclusionofdifferentialdiagnosisandcheckofabdominalorgnas超声检查:排除鉴别诊断，并检查腹腔器bloodanalysis:evaluatekidneyandliverfunction,bloodcalcium,whiteandredbloodcells血液分析：评估肝肾功能，血钙，红细胞和白细fine-needleaspirationBiopsy活Differentialdiagnosis鉴别诊断mammaryglan