Öz
Bu çalışmada köpeklerde çift taraflı üreter tıkanmasında klinik ve bazı hematolojik bulguların belirlenmesi ve kanda miktarı artan metabolitlerin vücuttan uzaklaştırılması ve kanın biyokimyasal dengesinin korunmasında peritoneal diyaliz uygulamalarının etkinliğinin araştırılması amaçlandı. Paramedian olarak karın boşluğuna girilip, üreterler klipsler ile geçici olarak tıkandı ve parsiyel omentektomi eşliğinde kalıcı Tenckhoff kateteri yerleştirildi. Operasyon sonrası 3 saat aralıklarla kan üre nitrojen (BUN), kreatinin değerleri kontrol edildi ve BUN değeri 90 mg/dl’yi aştığında diyalize başlandı. Diyaliz için %1.5’luk glikoz içeren ticari solüsyon 6 saat arayla 2 gün süresince toplam 8 seans kullanıldı. Klinik kontroller çalışma süresince; kan sayımı sonuçları operasyon öncesi (0) ve sonrasındaki her 24 saatte ve serum parametreleri 0 ve diyalize başladıktan sonra her seansın öncesi ve sonrasında belirlendi. Depresyon, halsizlik, çevreye karşı ilgisizlik, kusma, dehidrasyon ve mukozalarda solgunluk ortak klinik bulgular olarak belirlendi. BUN değeri 90 mg/dl’nin üzerine 30-39. saatlerde çıktı. Operasyon öncesi ile karşılaştırıldığında diyaliz başlangıcında BUN, kreatinin, K+ ve P-2 değerleri önemli oranda yükselirken, Total protein (TP) ve albumin değerleri düştü, Na+, Ca+2 ve Cl- değerleri değişmedi. Diyalize başlandıktan sonra, her seansın sonunda saptanan BUN, kreatinin ve K+ değerlerinin seans öncesine göre önemli oranda düştüğü, ancak 0 değerine göre hala yüksek olduğu belirlendi. Diyaliz seansları, TP, albumin ve P-2 değerlerinde de düşmeye neden oldu. Son seans sonrasında BUN, kreatinin ve P-2 değerinin operasyon öncesi değere göre yüksek, TP, albumin ve Cldeğerinin ise düşük olduğu belirlendi. Sonuç olarak, bilateral tam üreteral obstrüksiyon oluşturulan köpeklerde 6 saat ara ile yapılan her diyaliz seansının vücuttaki zararlı metabolitlerin uzaklaştırılmasında etkili olduğu ancak sağlıklı hayvanlardaki düzeylere kadar düşüremediği ve uygulamalar sırasında hipoalbuminemi ile karşılaşılabileceği, kalıcı Tenckhoff kateterin köpeklerde parsiyel omentektomi eşliğinde güvenle kullanılabileceği kanısına varıldı
Anahtar Kelimeler
Kaynakça
- Arık N (2001): Periton diyalizi. 244-250. Arık, N.(Ed.), Nefroloji. Deniz Matbaacılık İstanbul.
- Bovée KC (1984): Urinary obstruction disease, 385-395. In: K.C. Bovée (Ed.), Canine Nephrology, Harwal Publishing Company, Pensylvania.
- Cowgill LD (1995): Application of peritoneal dialysis an hemodialysis in the management of renal failure. 573-596 In: C Osborne, A Finco (Eds) Canine and Feline Nephrology and Urology, D. R. Waverly Company, Philadelphia.
- Cowgill LD, Langston CE (1996): Role of hemodialysis in the management of dogs and cats with renal failure. Vet Clin North Am (Small Anim Pract), 26, 1347-1377.
- Crisp MS, Chew DJ, Dibartola SP, Birchard SJ (1989): Peritoneal dialysis in dogs and cats: 27 cases (1976- 1987). JAVMA, 195, 1262-1266.
- Dzyban LA, Labato MA, Ross LA (2000): CVT update: peritoneal dialysis. 859-860 In JD Bonagura, R Kersey (Eds), Kırk’s Current Veterinary Theraphy XIII Small Animal Practice. 13th Ed. W.B. Saunder Company, Phila- delphia.
- Elliot J (1996): Emergency treatment of acute renal failure. 185-194 In: J. Bainbridge (Ed), BSAVA Manual of Canine and Feline Nephrology and Urology. 1th Ed. Fusion Design, Fordingbridge.
- Grauer GF, Lane IF (1995): Acute renal failure.1720- 1733. In: SJ Ettinger, CE Feldman (Eds), Textbook of Veterinary Internal Medicine, 4th Ed. W.B. Saunders Company Philadelphia.
- Gregory CR, Lirtzman RA, Kochin EJ, et al. (1996): A Mucosal apposition technique for ureteroneocystostomy after renal transplantasyonin cats. Vet Surg, 25, 13-17.
- Hurroy RH, Ellet EW, O’Hara PJ (1966): Bilateral hydronephrosis resulting from a transitional epithelial carcinoma in a dog. JAVMA, 149, 412-417.
- Katirtzoglou A, Oreopoulos, DG, Husdan H, et al. (1980): Reappraisal of protein losses in patients under- going continuos ablulatory peritoneal dialysis. Nephron, 26, 230-233.
- Labato MA (2000): Peritoneal dialysis in emergency and critical care medicine. Clin Tech Small Anim Pract, 15, 126-135.
- Labato MA (2001): Strategies for management of aute renal failure, Vet Clin North Am (Small Anim Pract), 31, 1256-1286.
- Lai KN, Lai KB, Lam CW, Chan TM, Li FK, Leung JC (2000): Changes of cytokine profiles during peritonitis in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis, 35, 644-652.
- Lane IF, Carter LJ, Lappin MR (1992): Peritoneal dialysis: an update on methods and usefulness; 865-875 In: LE Mills (Ed), Current Veterinary Theraphy XI Small Animal Practice. W.B. Saunders Company, Philadelphia.
- Lees GE (1995): Fundamentals of the practice of veterinary nephrology and urology. 49-67 In: CA Osborne, DR Finco (Eds), Canine and Feline Nephrology and Urology. Waverly Company, Philadelphia.
- Leib MS, Allen TA, Konde LJ, Jokinen MP (1988): Bilateral hydronephrosis attributale to bilateral ureteral fibrosis in a cat. JAVMA, 192, 795-797.
- O’Reilly PH (2003): Upper tract obstruction.
- Erişim:[http://www.elsevier-international.com/e- books/pdf/314.pdf.]
- Erişim Tarihi: 04.04.2003.
- Parker HR (1980): Current status of peritoneal dialysis. 1106-1111 In: RW Kırk (Ed) Current Veterinary Theraphy VII Small Animal Practice. W.B. Saunders Company, Philadelphia.
- Rubin J, Quintus J, Bover JD (1983): A model of long term peritoneal dialysis in the dog. Nephron; 35: 259-263.
- Shaw DH, Ihle SL (1997): Urinary tract disease and fluid and electrolyte disorders. 323-381 In: DH Shaw, SL Ihle (Eds), Small Animal Internal Medicine. Wolters Kluwer Company. Philadelphia.
- Stone EA, Kyles AE (2000): Diagnosis and Management of Ureteral Obstruction. 868-870 In: JD Bonagura, R Kersey (Eds), Kırk’s Current Veterinary Theraphy XIII Small Animal Practice. 13th Ed. W.B. Saunders Company, Philadelphia.
- Şeker Y, Kurtdede A, Alkan Z, Sarıca A, Karademir N, Bumin A (1997): Köpeklerde deneysel hidronefrozis. An- kara Üniv Vet Fak Derg, 42, 533-541.
- Thornhill JA, Hartman J, Boon GD, Riviere JE, Jacobs D, Ash SR (1984): Support of an anephric dog for 54 days with ambulatory peritoneal dialysis and a new designed peritoneal catheter. Am J Vet Res, 45, 1156-1161.
- Turgut K (2000): Sıvı-elektrolit ve asit-baz dengesi bozuk- lukları. 367-415. Alındı: K. Turgut (Ed.), Veteriner Klinik Laboratuar Teşhis. Genişletilmiş 2. Baskı. Bahçıvanlar Ba- sım Sanayi. Konya.
- Turgut K, Diker Ş, Özlem MB, Aslanbey D (1987): Peritoneal dialysis of two dogs with experimentally induced uremia. Ankara Üniv Vet.Fak.Derg, 34, 467-478.
- Vaden SL, Levine J, Breitschwerdt EB (1997): A retrospective case-control study of acute renal failure in 99 dogs. J Vet Intern Med, 11, 58.
- Wild J (2003): Peritoneal dialysis.
- Erişim: [http://www.harcourt-international.com/e-books/ pdf/374.pdf. ]
- Erişim Tarihi: 31.03.2003.
- Geliş tarihi: 07.10.2003 / Kabul tarihi : 03.11.2003
Öz
This study was designed to determine clinical and some hematological changes associated with bilateral uretheral obstruction and effect of peritoneal dialysis in discard of increased metabolites in blood and in maintanence of biochemical balance of blood in dogs. The abdominal cavity was opened through paramedian incision and clips were placed on the ureters and omentum was dissected partially in order to place permanent Tenckhoff catheter. The blood ure nitrogen and creatinin levels were determined at 3 hours interval post surgery and peritoneal dialysis was commenced when BUN level exceeded 90 mg/dl. For dialysis, a commercial dialysis solution containing 1,5% glucose was used every 6 hours for 2 days a total of 8 sessions. Clinical examination of the animals were carried out throughout the study, hematological parametes were determined before the operation and every 24 hours post operation and biochemical parameters were determined before operation and, before and after each dialysis sessions. Common clinical findings were depression, nausea, vomiting, dehydration and pale mucous membranes. BUN level was determined above 90 mg/dl at 30.-39. hours of obstruction. The concentration of BUN, creatinin, K+ and P-2 were significantly higher at the beginning of the dialysis when compared with values obtained before obstruction. BUN, creatinin and K+ levels of the dogs after each dialysis applications were lower than those determined before dialysis but still significantly higher than those obtained before obstruction. TP, albumin and P-2 concentrations decreased after dialysis. BUN creatinin and P-2 levels determined after the last sessions of dialysis were still higher than the values obtained before the operation while TP, albumin and Cl- levels were low. In conclusion, dialysis applications at 6 hour intervals were effective to remove vaste products, but did not decrease to the levels of healthy animals and dialysis sessions may result in hypoalbuminemia. Therefore, permanent Tenckhoff catheter can be used safely in dogs after partial omentectomy
Anahtar Kelimeler
Kaynakça
- Arık N (2001): Periton diyalizi. 244-250. Arık, N.(Ed.), Nefroloji. Deniz Matbaacılık İstanbul.
- Bovée KC (1984): Urinary obstruction disease, 385-395. In: K.C. Bovée (Ed.), Canine Nephrology, Harwal Publishing Company, Pensylvania.
- Cowgill LD (1995): Application of peritoneal dialysis an hemodialysis in the management of renal failure. 573-596 In: C Osborne, A Finco (Eds) Canine and Feline Nephrology and Urology, D. R. Waverly Company, Philadelphia.
- Cowgill LD, Langston CE (1996): Role of hemodialysis in the management of dogs and cats with renal failure. Vet Clin North Am (Small Anim Pract), 26, 1347-1377.
- Crisp MS, Chew DJ, Dibartola SP, Birchard SJ (1989): Peritoneal dialysis in dogs and cats: 27 cases (1976- 1987). JAVMA, 195, 1262-1266.
- Dzyban LA, Labato MA, Ross LA (2000): CVT update: peritoneal dialysis. 859-860 In JD Bonagura, R Kersey (Eds), Kırk’s Current Veterinary Theraphy XIII Small Animal Practice. 13th Ed. W.B. Saunder Company, Phila- delphia.
- Elliot J (1996): Emergency treatment of acute renal failure. 185-194 In: J. Bainbridge (Ed), BSAVA Manual of Canine and Feline Nephrology and Urology. 1th Ed. Fusion Design, Fordingbridge.
- Grauer GF, Lane IF (1995): Acute renal failure.1720- 1733. In: SJ Ettinger, CE Feldman (Eds), Textbook of Veterinary Internal Medicine, 4th Ed. W.B. Saunders Company Philadelphia.
- Gregory CR, Lirtzman RA, Kochin EJ, et al. (1996): A Mucosal apposition technique for ureteroneocystostomy after renal transplantasyonin cats. Vet Surg, 25, 13-17.
- Hurroy RH, Ellet EW, O’Hara PJ (1966): Bilateral hydronephrosis resulting from a transitional epithelial carcinoma in a dog. JAVMA, 149, 412-417.
- Katirtzoglou A, Oreopoulos, DG, Husdan H, et al. (1980): Reappraisal of protein losses in patients under- going continuos ablulatory peritoneal dialysis. Nephron, 26, 230-233.
- Labato MA (2000): Peritoneal dialysis in emergency and critical care medicine. Clin Tech Small Anim Pract, 15, 126-135.
- Labato MA (2001): Strategies for management of aute renal failure, Vet Clin North Am (Small Anim Pract), 31, 1256-1286.
- Lai KN, Lai KB, Lam CW, Chan TM, Li FK, Leung JC (2000): Changes of cytokine profiles during peritonitis in patients on continuous ambulatory peritoneal dialysis. Am J Kidney Dis, 35, 644-652.
- Lane IF, Carter LJ, Lappin MR (1992): Peritoneal dialysis: an update on methods and usefulness; 865-875 In: LE Mills (Ed), Current Veterinary Theraphy XI Small Animal Practice. W.B. Saunders Company, Philadelphia.
- Lees GE (1995): Fundamentals of the practice of veterinary nephrology and urology. 49-67 In: CA Osborne, DR Finco (Eds), Canine and Feline Nephrology and Urology. Waverly Company, Philadelphia.
- Leib MS, Allen TA, Konde LJ, Jokinen MP (1988): Bilateral hydronephrosis attributale to bilateral ureteral fibrosis in a cat. JAVMA, 192, 795-797.
- O’Reilly PH (2003): Upper tract obstruction.
- Erişim:[http://www.elsevier-international.com/e- books/pdf/314.pdf.]
- Erişim Tarihi: 04.04.2003.
- Parker HR (1980): Current status of peritoneal dialysis. 1106-1111 In: RW Kırk (Ed) Current Veterinary Theraphy VII Small Animal Practice. W.B. Saunders Company, Philadelphia.
- Rubin J, Quintus J, Bover JD (1983): A model of long term peritoneal dialysis in the dog. Nephron; 35: 259-263.
- Shaw DH, Ihle SL (1997): Urinary tract disease and fluid and electrolyte disorders. 323-381 In: DH Shaw, SL Ihle (Eds), Small Animal Internal Medicine. Wolters Kluwer Company. Philadelphia.
- Stone EA, Kyles AE (2000): Diagnosis and Management of Ureteral Obstruction. 868-870 In: JD Bonagura, R Kersey (Eds), Kırk’s Current Veterinary Theraphy XIII Small Animal Practice. 13th Ed. W.B. Saunders Company, Philadelphia.
- Şeker Y, Kurtdede A, Alkan Z, Sarıca A, Karademir N, Bumin A (1997): Köpeklerde deneysel hidronefrozis. An- kara Üniv Vet Fak Derg, 42, 533-541.
- Thornhill JA, Hartman J, Boon GD, Riviere JE, Jacobs D, Ash SR (1984): Support of an anephric dog for 54 days with ambulatory peritoneal dialysis and a new designed peritoneal catheter. Am J Vet Res, 45, 1156-1161.
- Turgut K (2000): Sıvı-elektrolit ve asit-baz dengesi bozuk- lukları. 367-415. Alındı: K. Turgut (Ed.), Veteriner Klinik Laboratuar Teşhis. Genişletilmiş 2. Baskı. Bahçıvanlar Ba- sım Sanayi. Konya.
- Turgut K, Diker Ş, Özlem MB, Aslanbey D (1987): Peritoneal dialysis of two dogs with experimentally induced uremia. Ankara Üniv Vet.Fak.Derg, 34, 467-478.
- Vaden SL, Levine J, Breitschwerdt EB (1997): A retrospective case-control study of acute renal failure in 99 dogs. J Vet Intern Med, 11, 58.
- Wild J (2003): Peritoneal dialysis.
- Erişim: [http://www.harcourt-international.com/e-books/ pdf/374.pdf. ]
- Erişim Tarihi: 31.03.2003.
- Geliş tarihi: 07.10.2003 / Kabul tarihi : 03.11.2003
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Eylül 2004 |
| Yayımlandığı Sayı | Yıl 2004Cilt: 51 Sayı: 3 |