11 ȭ īĴϿ(Cocker spaniel) ̰ ߰ο ģ Ŵ Ͽ. 1 ϴٰ ߰Ͽ, ̶ ϰ ѺҴµ, ĥ ĿǾ.
Ǻΰ Ǽ Ǻο Ͽ Ͽ. Ŀ α .
װ˻翡 (WBC 35,800 cells/ul) (HCT 34.3%), ȿ ġ (lipase 167U/L, amylase 1359U/L), ˺ι(Albumin 1.8 g/dl) ȮεǾ. 1.020̾, ħ Ͽ. ϸϾƴ 25umol/L ̾. 缺Ǻο ȣ Ͽµ(IDEXX ˻), cT4 1.1ug/dl (ġ 1.6~5ug/dl) ణ Ǿ. ̴ euthyroid sick syndrome ǴܵǾ thyroid profile(Antech) Ƿ ʾҴ. 缱 η ̴ ʾҴ.
Ͽ 4 ð óġ ǽϿ. Cephradine(30mg/kg, IV),tramadol(2mg/kg, IV), enrofloxacin(5mg/kg, IM) óġϿ, propofol(6mg/kg, IV) Ͽ. Isoflurane 븦 Ͽ Ͽ. װ ϰ Ǻκ ǽϿ. ȸ óġ , óġϿ.
˻縦 ǷϿ.
װ˻翡 ˺ι(albumin 1.5g/dl) (HCT 29.7%) , (WBC 36,300cells/ul) ӵǾ ȯڰ Ծ Կ 2° Ŀ ϰ ֻ 汸 ȯϿ. Cephalexin 500mg, enrofloxacin 50mg, tramadol 50mg, rantiidne 35mg, ketoconazole 100mg, prednisolone 5mg Ϸ 2ȸ 汸óϿ. װ Ͽ dressingϸ鼭 ش븦 ־µ, Ϸ 1ȸ ǽϿ. װ ؼ ͼ Կ 5° װ ϰ ״. 5 ϸ Ͽ Ͽ .
ŵ ũⰡ ʹ Ŀ formalin ϴµ 2 ̻ ð ҿǾ. ˻ ᱹ ϰ 3 Ŀ Ȯ ־. soft tissue sarcoma(grade III) ܵǾ. Ұ . ̺ȭ 缼 Ǵ Ǽ ȴ. Ϲ ̿ soft tissue sarcoma Īϸ ̴ 缱, ܻ, ̹ ִ. Soft tissue sarcoma grade 缼 ȭ, п, grade, , еǸ grade Ŀ ִ. (50%̸), ȭ ټ п(10 400 þ߿ 57) grade ȴ. Grade Soft tissue sarcoma ߰ ̰ ϴٰ ˷ ִ.
ȯ ˻ ܸ ǽõ ħ ʿ ȴ. 缼 ȭ ȣ ʾ H&E Ȯ ľϱ , ľ, Ư¡ fibrosarcoma ɼ غ ִ. Ȯ ؼ 鿪, Ư ߰ ˻簡 ʿϴ.
Ȯ ߰ ˻簡 ʿ, ǽ ߴ. Ǽ ǴܵǾ ġḦ ȣںв Ͽ, ġḦ źϼ̴.
̴ ȯ̾. ϰ 45° Ǵ grade II Ͽ. ̹ ġ 24ð Ŀ ɾٴϱ Ͽ. MRԿ Ͽ ȣ ġḸ ϼ̴. ι缱 ̴ ʾҴ. 48ð óġ óϿ ״. ȣںв 1 ڰ ް.
ȣڴ ̸ ʾҴ. ̵ ٸ ȯڵó ± ϰ ־µ, 6 ħ Ͽ. 3 ħ ߰Ͽ, 庴 ܹް óҴٰ Ѵ. ķ ħ Ͽ. 庴 Ȯ ˻縦 ؼ Ͽ.
ι缱 Ŀκ Ŀٶ Ǿ. 8 ߰ ߰, ߾ٴ ذ ־. Ʈ ڼ ϱ ܵǾٴ ߰ Ͽ. ! ̵ ̱! CTԿϰ ü ұ? ʹ ū, ġḸ ұ? ƴϸ İ ҷϿ ϱ óϰ Ѻڰ ұ? . CTԿ Ϸ ؾ ϰ. 庴 δ Ǿ İ˻ , , װ˻ ǽϿ. 庴 ISACHC class II ǴܵǾ 뿡 ٰ ǴܵǾ.
ȣںв ġؾ ߴ Ͽ. ȣڵ ؾ ϱⰡ ƴٰ ϼ̴. ð Ѵ. ݰ Ȳ ð 帱 . ũⰡ ũ ϼž Ѵٰ 帮 óϿ. Ramipril 0.125mg/kg/day, furosemide 2mg/kg, bid, PO.
ȣںв ̷ٰ ᱹ 3ְ 귶. ħ ٰ ϼ̴. ι缱 ũⰡ Ͽ йϿ ħ ǴܵǾ. ٵ Ƽ ȣںв ġ ǽڰ Ͽ. ̹ ȣڰ ġḦ ³Ͽ.
ұ? cisplatin Ǵ carboplat in ߿ ұ? ƴϸ doxorubicin? carboplatin doxorubicin ϴ ? Ǵ metronomic chemotherapy ұ? cisplatin alkylating ַ õȴ. cisplatin ź ϴ 찡 Ƿ ֱٿ ʰ, carboplatin ַ Ѵ. ʿ ȿ ߴ. Doxorubicin , ȿ 찡 .
mitoxantrone ؼ ȿ Ҵ 찡 ־ mitoxantrone Ͽ. ϱ ؼ piroxicam(0.3mg/kg, sid, PO) ϱ Ͽ. Mitoxantrone doxorubicin 迭 ̴. ۿ а , , Ż, ι ִ. ġ ǥ1 Ѵ.
Mitoxantrone 20mg(1vial) 5ml ȥϿ Ѵ. Mitoxantrone 뷮 5mg/m2 Ͽ. 19kg üǥ ȯϸ 0.719 ϸ ȴ. , 3.6mg ȴ. Mitoxantrone 4mg/ml̹Ƿ 3.6mg 0.9ml̴. 0.9ml 50ml Ŀ Ͽ 1ð ļ ø ̿Ͽ Ѵ. mitoxantrone ٸ ǹǷ ʵ ؾ Ѵ. mitoxantrone ϱ 5~10ml Ŀ bolus Ͽ Ȯ Ѵ. ϴ ȿ ȯڰ ̸ ɼ Ȱ ְų, ϱ Ѵ.
ۿ ϱ ؼ 1 Կϱ Ͽ. óġ ʿؼ 0.9% Ŀ vitamin B C ÷Ͽ ӵ Ͽ. 庴 ֱ ־ Žð ȣ ϰ, furosemide(2mg/kg, bid IV) Բ , ÷ ֵ Ͽ. ȯڴ 1 ϴ ȿ ȣ ʾҴ.
ÿ ǥ 2 3 Ͽ óϿ, ӻ ٸ 3 Ŀ ϱ Ͽ. 3̹Ƿ ʵ ȣ Ͽ. 3ָ Ͽ װ˻ ι缱˻縦 ǽϰ, (WBC < 3,000cells/ul) ٸ ġḦ ǽϰ, 1 óġ ۿ뿡 ״. ÿ óϿ. 3 ġ(2013.9.8.)ñ ι缱 ũ ȭ . ʾ, ħ Ǿ. 4 ġ(2013.9.29.) ι缱 е ҿ ũ Ұ ϰ Ǿ, Ǿ. 4 ġñ ӻ(ħ) ũ ȭ ʾƼ ȣڸ Ͽ ߰ ġḦ ұ ϴ .
ȣںв ġḦ ϰڴٰ ϼ̴. 3 ָٴ ϱ ٰ Ͽ5
(2013.10.27.) ʹ 4ָ ϱ Ͽ. 5 ġ ι缱 Ǿ, ũ е ϱ VD 谡 DZ Ͽ. 6 ġ(2013.11.24.) ũⰡ ϰ Ȯ ־. 5 ġ(2013.10.27.)ϱ ħ ϱ Ͽ. 5 ġᶧ ߿ 2 Ͽ. 8 ġ(2014.1.19.) ũ е ϰ ȮϿ. 8 ġ(2014.1.19.) Ǵٽ . ũⰡ Ͽ ? CTԿ ٸ ̰ ٸ ̰ ? ȣںв ̴. ġḸ ̰ Ƿ ġḦ ϼ̴. 8 ġ(2014.1.19.) Ǿ ġḦ ϱ Ͽ.
ġ ϴ ȿ ʾҴ. 1 2 ġñ ȮεǾ, 3 ġ ñʹ ġ ־. ʱ Ǿ. CRP(C-reactive protein: Ÿ ǥ) Բ Ͽٸ ٵ ȯڿ ߴ. ǰ Ȯε ʾҴ. Ǿµ . BUN creatinine ϴ 찡 ־. ȯ̹Ƿ ȣںв źȭٴ ܹ ַ ̶ ߾ ̾ . ó ̴ ϰ Ƿ ణ Ż BUN creatinine Ѵٰ ߾. 7 ġ(2013.12.22.) ȣںв ܹ ̰, ä źȭ ø Ͽ. 8 ġ BUN creatinine . ̿ Ǵ Ͽ. Ŀ BUN creatinine Ͽ ̿ Ȯ ʿϴ.
Mitoxantrone ϱ ɱ ջ Ȯϱ ؼ cTnI Ͽ. 6 ġ(2013.11.24.) cTnI 0.13 ng/ml ϰ Ͽٰ 7 ġ(2013.12.22.) Ͽ.
Doxorubicin 6 ϰ ؾ ϴµ, mitoxantrone 6 ̻ ص ɱ ջ . Lactate Ǿ. ΰ ϸ鼭 ȯڰ 庴 ־ mitoxantrone Ͽ. ȯڿ ϴٰ Ǵߴ. ˻縦 ǽ ʾұ ( ) ̵ , . ߴ Ȳ̾. ̵ ̶ ռ ϴ ߴ. pi roxicam Բ ϱ Ͽ. Oqilvie GK mitoxantrone Ͽ پ ġϿ(1991). 126 29 (23%) PR (partial remission)Ǵ CR (complete remission. ũⰡ 50% ̻ ) Ͽ. , Ǽ翡 mitoxantrone Ͽ ũ⸦ ִٰ ǴϿ. Moore AS lymphoma ġῡ mitoxantrone ȿ ǥ Ͽ(1994). 41% PR Ǵ CR Ͽ. ۿ ̾.
ȯڴ ϰ 8 ̵Ǿ Ͽ. ̵ ũⰡ ſ ũǷ ġḦ ־, ġ(mitoxantrone 5mg/m2 IV q3-4w; piroxicam 0.3mg/kg sid PO) ũⰡ Ͽ ȯ Ǿ ȣڵ ſ Ͽ.
ġῡ ۿ뵵 ʾҴ. ʸ ؼ Ǵ ȯڿ mitoxantrone piroxicam ġϴ ȣڿ ̴.