45 40 : Blood transfusion(100ml) PCV(%) Days Prednisolone Mesalazine Chlorambucil Cyclospo

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1 短報要約 colonic vascular ectasia : CVE estrogen-progesteron EP EP, 症例. kg PCV. CBC PCV.. MCV. fl MCHC. g/dl. / l, / l X 臨床経過と治療 ml ml PCV mg/kg SID A B FAX chikazaw@vmas.kitasato-u.ac.jp 767

2 45 40 : Blood transfusion(100ml) PCV(%) Days Prednisolone Mesalazine Chlorambucil Cyclosporine EP therapy Benazepril PCV ml/ VH B mg/kg BID mg/kg BID mg/kg BID mg/kg SID C PCV... mg/dl mg/dl. g/ml g/ml mg/kg CBC RBC / l... WBC / l.. Hb g/dl.. PCV... MCV fl... MCHC g/dl... Corrected Rericulocyte. PLT / l. TP g/dl... ALB g/dl... Glu mg/dl AST U/l ALT U/l ALP U/l T Bil mg/dl.. BUN mg/dl... Cre mg/dl... ip mg/dl... Ca mg/dl... Na meq/l... K meq/l... Cl meq/l... CRP mg/dl.. 768

3 A B C D M S A B C D Bar m MS SID mg/kg BIDmg/m mg/kg SID D T Estrogen Progesteron EP EP. mg/kg SID mg/kg SC 769

4 EP EP CBC PCV. MCV. fl MCHC. g/dl gastric antral vascular ectasia : GAVE CVE CVE 考察 CVE colonic vascular ectasia : CVE CVE CVE Rogers CVE vascular endothelial growth factor : VEGF CVE VEGF CVE, CVE CVE CVE CVE CVE CVE EP CVE EP CVE EP CVE EP EP 770

5 GAVE EP CVE EP VEGF CVE CVE EP EP 引用文献 Willard MDSmall Animal Internal Medicine Nelson RW Couto CG Craven M, Mansfield CS, Simpson KW : Granulomatous colitis of boxer dogs, Vet Clin N Am-Small,, () Boley SJ, Brandt LJ : Vascular ectasia of the colon, Digest Dis Sci,, S S () Rogers KS, Butler LM, Edwards JF, Brassard J, Boothe H, Cargile J : Rectal hemorrhage associated with vascular ectasia in a young dog, J Am Vet Med Assoc,, () Charlesworth TM, Dunning M, Scase TJ, Anderson DM : Colonic vascular ectasia (angiodysplasia) in a juvenile dog, J Small Anim Pract,, () Daugherty MA, Leib MS, Lanz OI, Duncan RB : Diagnosis and surgical management of vascular ectasia in a dog, J Am Vet Med Assoc,, () Fan TM, Simpson KW, Polack E, Dykes N, Harvey J : Intestinal haemorrhage associated with colonic vascular ectasia (angiodysplasia) in a dog, J Small Anim Pract,, () Goldman CK, Parnell NK, Holland CH : Hormone therapy for treatment of chronic vascular ectasia in dogs, J Vet Intern Med,, () Sami SS, Al-Araji SA, Ragunath K : Review article: gastrointestinal angiodysplasia pathogenesis, diagnosis and management, Aliment Phamacol,, () Burak KW, Lee SS, Beck PL : Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) syndrome, Gut,, () Leib MS, baechtel MS, Monroe WE : Complications associated with flexible colonoscopic procedures in dogs, J Vet Intern Med,, () Tran AT, Villeneuve JP, Bilodeau M, Willems B, Marleau D, Fenyves D, Parent R, Pomiler-Layrargues G : Treatment of chronic bleeding from gastric antral vascular ectasia (GAVE) with estrogen-progesterone in cirrhotic patients: An open pilot study, Am J Gastroenterol,, () 771

6 Canine Case of Suspected Colonic Vascular Ectasia with Severe Repeated Colonic Bleeding Seishiro CHIKAZAWA ), Hitoshi HATAI ) and Terunobu GOTO ) ) School of Veterinary Medicine, Kitasato University, Higashi, Towada, , Japan ) Goto Animal Hospital, Shimonaga, Hachinohe, , Japan SUMMARY A seven-year-old intact female miniature dachshund was referred with progressive anemia and hematochezia. During a colonoscopy, dilated mucosal vessels and bleeding lesions were identified in the colon. The dog did not appear to respond to antibiotic and immunosuppressive therapy, and required repeated blood transfusions. Since the colonic mucosal specimens displayed slight vessel dilation on histopathological examination, we strongly suspected colonic vascular ectasia. We therefore experimentally used estrogen-progesterone (EP) therapy (ethinyl estradiol and norethindrone) and benazepril. With the therapy, the symptoms improved, and long-term care was achieved at home without further blood transfusions. Key words : colonic vascular ectasia, EP therapy, lower gastrointestinal hemorrhage. Correspondence to : Seishiro CHIKAZAWA (Department of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University) Higashi, Towada, , Japan TEL FAX chikazaw@vmas.kitasato-u.ac.jp J. Jpn. Vet. Med. Assoc.,, () 772

indd

indd 60 4 2010 197 症例報告 1 1 1 2 2 2 2 3 4 1 2 3 4 2010 7 27 2010 9 24 Case of a Young Adult Male Complicated with Ischemic Colitis EMI OGATA 1, TAKERU WAKATSUKI 1, HIROAKI SAKAMOTO 1, NATSUMI SAKAMOTO 2, OSAMU