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?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常見情況，隨著年齡增長，發(fā)生???generalillnessincasesof在感染的病例，可見全身癥????repeatedestrouscycles反復發(fā)treatmentwithpogestogens孕酮的治Diagnosis治療?Ultrasound超Treatment治療ovariohysterectomybecauseoftheriskof鑒于感染的風險，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白細胞增多癥和中性粒細胞減少癥，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分離的細菌屬于常在的菌duringestruscervixisopenandbacteriamayenterthe在動情期，子宮頸是開放的，細菌更易于進入子mostcommon:Escherichiacoli,Streptococcusspp.，Staphylococcusspp.,Pasteurellaspp.,Klebsiellapp.,Moraxellaspp.最常見: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)于最后一次動情后2個月內(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：手術治????infusiontherapyPyometra:surgical子宮蓄膿：手術治????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2Sideeffects:skinreactions,hairlossattheinjection副作用：皮膚反應，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ovariohysterectomyisrecommended,administrationof10mg/kgaglepristonetwice24hapartisdescribed推薦卵巢子宮切除術，給予10mg/kg阿來24小時分開使用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)學檢Treatment治療intheabsenceofmetastasis,沒有轉(zhuǎn)移時，卵巢子宮切除卵OvarianOvarianOvarianremnant卵OvarianOvarianOvarianremnantOvarianmaturefollicelsareuptoOvarianmaturefollicelsareupto3mmandpresentonlyduring成熟的卵泡達3mmsmallerfollicelscanbeseenduringotherstagesofthecystic囊性結(jié)構follicularcysticdistensionofthereteovariicysticdilationofremnantsfromthecranialmesonephricOvariannormallyasymptomaticuntilproblemsbecauseoftheOvariannormallyasymptomaticuntilproblemsbecauseofthesizemay正常沒有癥狀，直到體積較大時才會有相應表follicularcystsmayproduceoestradiolleadingtoprolongedoestrusandinfertility卵泡囊腫會產(chǎn)生雌二醇，從而導致動情期延長和不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)動情，伴隨CEHothertumours:dysgerminoma,cystadenoma,luteoma,OvarianClinicalsigns臨床癥狀?abnormaloestrusorOvarianClinicalsigns臨床癥狀?abnormaloestrusormasculinebehaviourindysgerminomasandluteomaspossible在無性細胞瘤和黃體瘤時，可能會出現(xiàn)異常的動情期或雄性行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檢??Treatment治療ovariohysterectomyifthereareno如果沒有轉(zhuǎn)移，子宮卵巢Ovarianremnant=remnantsofoftheovariesOvarianremnant=remnantsofoftheovariesleftintheabdomen在手術時，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有被切supernumeraryovarieshavebeen超數(shù)卵巢也已Treatment治療surgicalremovaloftheremnants手術移除殘OvarianremnantStagetoObservationofoestrousPronouncedoestrousbehaviourisindicativeVaginalSerumoestradiolOvarianremnantStagetoObservationofoestrousPronouncedoestrousbehaviourisindicativeVaginalSerumoestradiolCornifiedsmearsare>12pmol/lnotalwaysInductionofovulationwith25μgGnRHor500IUhCGandmeasurementofprogesterone1-3weekslaterMostpreciseifprogesteroneisabovebasalconcentrationInjectionof0.4μg/kgbuserelinandmeasurementofoestradiol2hourslateronlyusedtodifferentiateintactfromspayedcatsMeasurementofAMH,intherangeof0.1-0.8ng/mlonlyonereportbutseemstobeusefull卵巢殘端綜合測測試進行的時解發(fā)情卵巢殘端綜合測測試進行的時解發(fā)情行為的觀動情陰道細動情血清雌二醇濃度的25μgGnRH或500IUhCG來誘動情>12pmol/l不一任何時只用來鑒別貓咪是否抗穆勒氏管激素測定，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最罕見出血擴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細胞學largenumbersofdegeneratedneutrophils(<3000mlwithingestedbacteriaandmacrophagesincasesofacutemastitisthebarrierthatseperatestheplasmafromthemilkhasalreadybeenbrokensoeveryantibiotichelpsinathercasesmilkpH<7.2:trimethoprim/sulfonamide,erythromycin,lincomycinmilkpH>7.4ampicillin,cefalexinmanualemptyingofthemilktoavoidaccumulationtoremovethekittenornotisacontroversialissueincasesofabcessestheshouldbeMammaryGalactostasis乳汁蓄=excessivmilkproductionwithaGalactostasis乳汁蓄=excessivmilkproductionwithalackofmilkletincatsmoreoftenthecranialglandsareaffectedClinicalsigns臨床癥狀swollenglandsinflammedandoedematousinearlyphasethecatissystemicallywellconditionmayresultinasterilorsepticmastitis病情可能會造成無菌性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nonneoplasticproliferationMammaryHistology組織學nonneoplasticproliferationofthemammarystroma,withoutnecrosis,inflammationandlactation,affectedtissuewithprogesteronereceptorsAetiology病因?qū)Witseemstobeinducedbyprogesterone:看似孕酮誘導所致:懷孕，假孕，外源孕酮 butitisalsoreportedwithoutprogesteroneinpreviousspayedanimalsalsointomcats但是也有報道見于之前已絕育的動物和雄MammaryMammaryaffectsoneorMammaryaffectsoneormoremammaryglands影響1mainlyaffectsyoungqueensaftertheir1stoestrus,butitcanaffectallagesandbothsexesriskofsuperficialskininjuriesTreatment治療castrationwithdrawlofprogesteronetreatmentadministrationofprogesteronereceptor10-15mg/kgaglepristoneSConday1,2andantibioticsincasesofulcerationorinfectionNSAIDsagainstinflammationandpaininseverecasesmastectomyregressionmaylastseveralmonthsMammaryMammaryMammaryMammaryMammaryMammary3rdmostfrequentcancerMammary3rdmostfrequentcancerinthe雌性貓第三常見的癌upto80%are高達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：評估肝腎功能，血鈣，紅細胞和白細fine-needleaspirationBiopsy活Differentialdiagnosis鑒別診斷mammaryglan