Bệnh của chó, mèo

BỆNH VIÊM PHÚC MẠC TRÊN MÈO

Ngày đăng: by Khoa Thú y

 

Bệnh viện phúc mạc truyền nhiễm ở mèo (FIP) do virus Corona ở mèo (FCoV) gây ra là một bệnh truyền nhiễm xảy ra ở loài mèo trên toàn thế giới. Nghiên cứu này nhằm mục đích xác định một số đặc điểm bệnh lý bệnh viêm phúc mạc truyền nhiễm ở mèo (FIP) và thử nghiệm biện pháp điều trị tại Bệnh viện thú y, Học viện Nông nghiệp Việt Nam

Thông qua thăm khám khi mèo đến khám, nhận thấy các trường hợp bị bệnh FIP thể ướt đến khám ở BVTY-VNUA có những triệu chứng lâm sàng sau: 100% mèo bị báng bụng kèm mất nước, suy nhược. Hầu hết chủ nuôi ban đầu khi thấy bụng mèo to lên đã tưởng mèo béo hơn, nhưng thực tế qua siêu âm và khám lâm sàng thấy bụng mèo tích nước, mèo ngày càng gầy đi với biểu hiện rất rõ ràng khi sờ vào khu vực xương sống của con vật. Xương sống nổi rõ, mèo thực tế gầy chứ không hề béo. Beo da gáy mèo để thử độ đàn hồi thì thấy da lâu hồi lại, điều này có thể giải thích do protein và dịch đã bị kéo vào trong xoang phúc mạc, mèo chống chọi lại quá trình viêm toàn thân kéo dài dẫn dến suy nhược và mất nước.

Bụng mèo tích dịch trên siêu âm

Mèo bị báng bụng, tích dịch nhưng vỗ không đau, dịch trong xoang phúc mạc hút ra nhầy dính, trong, màu vàng nhạt. Nên có thể loại trừ nguyên nhân viêm phúc mạc do vi khuẩn.

Hút dịch phúc mạc cho mèo

Báng bụng, suy nhược kèm với 60% mèo đến khám có biểu hiện vàng da, có thể gây nghi ngờ mèo bị bệnh về gan. Tuy nhiên kết quả của phản ứng Rivalta dương tính tiếp theo đã loại trừ nghi vấn mèo bị bệnh gan, hội chứng thận hư hay suy tim phải. Mèo bị FIP có biểu hiện vàng da ở giai đoạn sau phù hợp với nhận định của (Pedersen N. C., 2009).

100% mèo có biểu hiệu ủ rũ, đây cũng là lý do mà chủ nhân mang mèo đi khám. Chỉ có 1 trường hợp ghi nhận bị sốt, chiếm tỉ lệ 20%. Duy nhất một trường hợp đến khám khi mèo đã bỏ ăn, chủ yếu do chủ nuôi mang đến khám khi mèo đã vào giai đoạn cuối. Việc FIP thể ướt dễ gây cảm giác mèo đang béo lên khiến cho nhiều chủ nuôi không nghĩ rằng mèo bị bệnh để đi khám kịp thời, điều này khiến việc điều trị có thể gặp khó khăn.

Không có trường hợp nào có biểu hiện triệu chứng trên mắt hay thần kinh khi đến khám. Điều này có thể là do toàn bộ mèo trong nghiên cứu đều mắc bệnh FIP ở thể ướt. Nghiên cứu cũng không ghi nhận trường hợp bệnh FIP nào bị tràn dịch màng phổi, khó thở khi đến khám, tuy nhiên khi mổ khám một trường hợp không điều trị và tử vong sau 45 ngày, dịch trong xoang ngực đã hình thành.

Kết quả thử nghiệm điều trị với GS-441524

Vì lý do chi phí sử dụng GS-441524 khá cao, nên chỉ có 2/5 mèo mắc bệnh FIP tham gia điều trị. Kết quả, cả 2 trường hợp đều khỏi bệnh cho thấy GS-441524 thực sự có thể cứu được mèo bị bệnh FIP. Phác đồ thử nghiệm trong nghiên cứu có thể tiến hành triển khai trong thực tế.

Trong khi đó cả 3 trường hợp không tham gia điều trị đều tử vong chỉ sau 14-45 ngày. Việc mèo không điều trị tử vong toàn bộ không ngoài dự đoán và phù hợp với các nghiên cứu trước đó vì FIP đã được coi là căn bệnh gây tử vong lên đến 100% trong suốt hơn nửa thế kỉ khi chưa có thuốc điều trị đặc hiệu.

Tiến triển triệu chứng lâm sàng trong thời gian theo dõi

Kết quả điều trị rõ ràng qua từng ngày. Triệu chứng sốt hết trong 1 ngày. Sau 7 ngày điều trị, dịch trong xoang phúc mạc ở nhóm điều trị tự thoát hết mà không cần rút dịch. Mèo thèm ăn, vui vẻ, tăng cường hoạt động từng ngày. Dù lượng dịch trong cơ thể giảm, người mèo nhỏ đi, nhưng cân nặng tăng lên. Mèo khoẻ mạnh hơn, không còn bị mất nước. Triệu chứng vàng da cũng mất dần sau 2 – 3 tuần.

Bụng tích dịch ngày 0

      

Bụng thoát hết dịch ngày 7

Quan sát nước tiểu ở mèo được điều trị FIP, thấy nước tiểu dần biến đổi từ lượng nước tiểu ít, màu vàng đậm trong những ngày đầu trở nên vàng nhạt và nhiều hơn trong giai đoạn sau. Cho thấy tình trạng mất nước đã giảm, dịch bụng được thoát ra theo đường niệu.

Nước tiểu ngày 0

Nước tiểu ngày 3

Nước tiểu ngày 7

Kết quả này cũng giống với thử nghiệm điều trị FIP bằng GS-441524 trên mèo mắc bệnh tự nhiên của (Pedersen N. C. & cs., 2019b).

Như vậy, phác đồ cho đáp ứng tốt với bệnh, triệu chứng thuyên giảm nhanh chóng. Con vật trở về trạng thái gần như bình thường sau 2 tuần điều trị. Trong khi đó, ở nhóm không điều trị GS-441524, dù đã rút hết dịch nhưng bụng nhanh chóng to trở lại chỉ sau 2-3 ngày.

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