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1.
A retrospective study of bovine peritoneal fluids collected over a two year period was conducted. Of a total of 66 cattle studied, 31 had a nonseptic peritonitis, 11 acute bacterial peritonitis, eight ascites and 16 miscellaneous disorders such as abomasal impaction, enteritis and lymphosarcoma. Peritoneal fluid analysis was a useful aid in the diagnosis of abdominal disorders of cattle, especially as hematological changes were absent in many cases. Due to relatively low nucleated cell counts in bovine peritonitis, all parameters (i.e. nucleated cell count, total protein and differential cell counts) must be evaluated before interpretation. A nucleated cell count of greater than 6000 cells/μL and total protein content of greater than 3 g/dL was consistent with the diagnosis of peritoneal inflammation in 80% of the cases studied. An atlas of cell types common to bovine peritoneal fluid is presented.  相似文献   

2.
Peritoneal fluid from 10 healthy young male Holstein calves was analyzed three times (2 to 3 days, 12 to 15 days and 27 to 30 days) during the first month of life. A new technique for collection of peritoneal fluid from calves positioned in left lateral recumbency was developed. The technique was found to be reliable and without noticeable complications. Mean peritoneal fluid nucleated cell counts, red blood cell counts, and absolute counts for mononuclear cells, lymphocytes and eosinophils did not change significantly (P 相似文献   

3.
Background: Peritoneal fluid analysis in cattle traditionally includes the classic parameters despite the fact that they have only moderate diagnostic accuracy and often fail to identify the pathogenesis or etiological factors. Therefore additional parameters recently have been established to improve diagnostic precision. In a recent study, reference ranges for several of these parameters have been proposed in dairy cows. Hypothesis/Objectives: The aim of this observational study was to assess the diagnostic value of D‐Dimer and other measurements of peritoneal fluid analysis in dairy cows with peritonitis. Animals: The study included 110 Holstein‐Friesian cows grouped into cows with peritonitis (n = 47) and cows without peritonitis (n = 63). Methods: Peritoneal fluid was obtained by abdominocentesis. Total protein, albumin, glucose, cholesterol, fibrinogen, l ‐lactate, D‐Dimer, lactate dehydrogenase (LDH), alkaline phosphatase, creatine phosphokinase, white blood cell, and red blood cell were determined in peritoneal fluid and venous blood. Serum‐ascites albumin gradient (SAAG) and ratios of peritoneal fluid‐venous blood were calculated. Sensitivity (SN) and specificity (SP) were calculated and receiver operating characteristic curve analysis performed. Results: Peritoneal fluid D‐Dimer was most accurate in diagnosing peritonitis in cows (SN and SP>95.0%). Total protein concentration, LDH and LDH ratio, and SAAG had sensitivities between 49.0 and 67.1%, and specificities between 88.4 and 95.5%. A low‐peritoneal fluid glucose concentration was found to be highly indicative of septic peritonitis. Conclusions and Clinical Importance: Measurement of the recently introduced parameters may increase the diagnostic value of peritoneal fluid analysis and provide additional specific information. Therefore these measurements should be included in the routine procedure.  相似文献   

4.
Peritoneal fluid and blood was collected from 8 healthy adult horses. Four 1-ml aliquots of peritoneal fluid from each horse were then contaminated with 0 ml (normal), 0.05 ml (1 drop), 0.10 ml (2 drops), and 0.20 ml (4 drops) of blood from the same horse. Samples were analyzed for RBC count, nucleated blood cell count, total protein concentration, and nucleated cell differential count. Statistical analysis revealed no significant changes in nucleated cell number, nucleated cell differential, or total protein concentration in peritoneal samples contaminated with blood. The RBC count significantly increased with blood contamination. It was concluded that up to 17% blood contamination of peritoneal fluid in clinically normal horses did not significantly alter interpretation of the nucleated cell count or protein concentration.  相似文献   

5.
Effects of Castration on Peritoneal Fluid in the Horse   总被引:1,自引:0,他引:1  
Twenty-four clinically normal horses were castrated by routine methods. Peritoneal fluid was collected prior to castration and at 1, 3, 5, and 7 days postcastration. Peritoneal fluid was collected on days 9 and 11 if nucleated cell (NC) counts were still markedly elevated on day 7. Peritonitis, defined as NC counts greater than 10,000/microliters, was evident in 15 horses following castration. Mean NC counts peaked on day 5 but were less than 10,000/microliters for 74% of the horses by day 7, and 90% of the horses by day 9. One horse had a NC count greater than 60,000/microliters on day 11 when sampling ended. Postcastration peritoneal fluid was obviously blood-tinged in 21 horses. Peak RBC counts occurred on day 3 but markedly decreased by day 5. Elevated peritoneal RBC counts correlated well with elevated NC counts (P less than 0.001). Horses with peritonitis tended to have fever (P less than 0.05). Other clinical signs of peritonitis were not apparent.  相似文献   

6.
The analysis of peritoneal fluid is of value in the differential diagnosis of equine colic but its characteristics have not been evaluated in grass sickness. Peritoneal fluid was collected from 15 normal horses and from 11 cases of medical colic, 11 cases of surgical colic, 20 cases of acute grass sickness and 13 cases of subacute grass sickness. The fluid was analysed for its appearance, total and differential white cell count, specific gravity, total protein concentration and total and intestinal alkaline phosphatase activity. Fluid from cases of medical colic was normal in these respects. Surgical cases were unique in having bloodstained fluid with a high alkaline phosphatase activity. Grass sickness cases had a higher specific gravity and protein content than the cases of medical colic although the appearance of the fluid was similar. Grass sickness cases were distinguishable from cases of surgical colic on the basis of the appearance of the fluid and its lower alkaline phosphatase activity.  相似文献   

7.
OBJECTIVE: To determine whether peritoneal fluid pH, glucose concentration, and lactate dehydrogenase activity can be used to differentiate horses with septic peritonitis from those with nonseptic peritonitis. DESIGN: Prospective study. ANIMALS: 46 horses, including 10 healthy horses, 15 horses with septic peritonitis, and 21 horses with nonseptic peritonitis. PROCEDURE: Peritoneal fluid and blood samples were analyzed for pH, glucose concentration, and lactate dehydrogenase activity. Complete blood cell counts were performed, and peritoneal fluid samples were submitted for bacterial culture. RESULTS: Horses with septic peritonitis had significantly lower peritoneal fluid pH and glucose concentrations than horses with nonseptic peritonitis and healthy horses. Compared with other tests, serum-to-peritoneal fluid glucose concentration differences > 50 mg/dl had the highest diagnostic use for detection of septic peritonitis. Peritoneal fluid pH < 7.3, glucose concentration < 30 mg/dl, and fibrinogen concentration > 200 mg/dl were also highly indicative of septic peritonitis. CLINICAL IMPLICATIONS: Peritoneal fluid pH and glucose concentration can be used to assist in the identification of horses with septic peritonitis. These measurements can provide an early indication of sepsis, especially if cytologic evaluation of peritoneal fluid is unavailable or results are equivocal and peritoneal fluid bacterial culture results are pending.  相似文献   

8.
Peritoneal fluid was analysed from 17 foals, aged 13 to 134 days with a mean age of 68 days. Cytologically, the peritoneal fluid was characterised by a mean total cell count of 0.45 x 10(9)/litre (range 0.06 to 1.42 x 10(9)/litre), rare eosinophils, rare cytophagia and variable percentages of neutrophils and mononuclear cells. These data indicate that peritoneal fluid nucleated cell counts over 1.50 x 10(9)/litre in the foal should be interpreted as elevated. Biochemical evaluation revealed a mean biuret protein level of 12 g/litre, mean refractive index protein level of 16 g/litre and urea nitrogen concentration of 1.96 mmol/litre. There was no correlation between the foals' white blood cell and peritoneal fluid nucleated cell counts. Results of this study indicate that adult horse reference values for evaluation of peritoneal fluid are of questionable validity for foals. Diagnostically, the most important observation was that maximum peritoneal fluid nucleated cell counts in healthy foals were much lower than reported maximal reference values for adult horses (1.5 x 10(9)/litre versus 5.0 x 10(9)/litre or 10.0 x 10(9)/litre).  相似文献   

9.
Peritoneal lavage was performed on ponies to determine the effect on peritoneal surfaces. Lavage solution (20 L) was introduced into each pony's peritoneal cavity through catheters placed in the paralumbar fossa, and the solution was removed by drainage from the ventral portion of the abdomen. Six ponies each were lavaged with sterile saline (0.9% NaCl) solution, sterile saline solution containing 5 X 10(6) U of potassium penicillin and 3 g of neomycin or povidone-iodine diluted to 3% by volume with sterile saline solution, and 3 ponies were lavaged with povidone-iodine diluted to 10% with sterile saline solution. Peritoneal lavage catheters were inserted in 3 control ponies, but lavage fluids were not administered. Peritoneal fluid specimens were collected at 6, 24, 48, and 96 hours after lavage. Nucleated cell counts, RBC counts, total protein determinations, and cytologic analysis were performed. The ponies were euthanatized at 96 hours, and representative sections of the peritoneum were examined. Lavage with saline solution and saline solution with antibiotics induced a mild, transient inflammatory response in the peritoneal fluid, with minimal or no changes observed at necropsy. Solutions containing povidone-iodine induced chemical peritonitis, which was severe in ponies lavaged with 10% povidone-iodine solution. Peritoneal lavage with povidone-iodine solutions as dilute as 3% cannot be accomplished without causing inflammation of peritoneal surfaces.  相似文献   

10.
OBJECTIVE: To describe a technique for abdominocentesis in camelids and report peritoneal fluid biochemical and cytologic findings from healthy llamas and alpacas. DESIGN: Prospective study. Animals-17 adult llamas and 5 adult alpacas. PROCEDURES: Right paracostal abdominocentesis was performed. Peritoneal fluid was collected by gravity flow into tubes containing potassium-EDTA for cell count and cytologic evaluation and lithium heparin for biochemical analysis. Blood samples were collected via jugular venipuncture into heparinized tubes at the same time. Cytologic components were quantified. Fluid pH and concentrations of total carbon dioxide, sodium, potassium, chloride, lactate, and glucose were compared between peritoneal fluid and venous blood. RESULTS: All but 3 camelids had peritoneal fluid cell counts of < 3,000 nucleated cells/microL, with < 2,000 neutrophils/microL and < 1,040 large mononuclear cells/microL. All but 1 had peritoneal fluid protein concentrations of > or = 2.5 g/dL. Peritoneal fluid of camelids generally contained slightly less glucose, lactate, and sodium and roughly equal concentrations of potassium and chloride as venous blood. CONCLUSIONS AND CLINICAL RELEVANCE: Peritoneal fluid was collected safely from healthy camelids. Compared with blood, peritoneal fluid usually had a low cell count and protein concentration, but some individuals had higher values. Electrolyte concentrations resembled those found in blood. High cell counts and protein concentrations found in peritoneal fluid of some healthy camelids may overlap with values found in diseased camelids, complicating interpretation of peritoneal fluid values.  相似文献   

11.
A Thoroughbred gelding in North America was evaluated for Actinobacillus peritonitis on three different occasions over a 4-year period. At each presentation, peritoneal fluid had an elevated nucleated cell count (220,000-550,000 cells/μL) characterised by non-degenerate neutrophils, no visible bacteria, an elevated total protein (4.6-5.5 g/dL) and bacterial culture yielding Actinobacillus spp. Actinobacillus peritonitis appears to be a regional disease occurring in Australia and less commonly in New Zealand and North America. Recurrence, other than incomplete resolution, has not been previously reported. This case highlights the classical presentation, response to therapy and excellent prognosis despite the alarmingly abnormal peritoneal fluid characteristic of Actinobacillus peritonitis and questions the role of parasite migration in the pathogenesis. Finally, this case is remarkable because Actinobacillus peritonitis was recurrent over several years in an otherwise normal horse.  相似文献   

12.
BACKGROUND: To the authors' knowledge, there is no information in the literature about normal peritoneal fluid values in ovine species. OBJECTIVES: The purpose of the study reported here was to establish reference intervals for peritoneal fluid from clinically normal Awassi sheep and to compare the values to those in blood. METHODS: Peritoneal fluid and blood samples were collected into tubes containing EDTA, from 40 clinically healthy, nonpregnant, female Awassi sheep, aged 2 to 7 years. Total nucleated cell count (TNCC) was determined using an electronic cell counter. Total protein, albumin, urea, creatinine, and glucose concentrations and aspartate transaminase activity were analyzed using commercially available kits. RESULTS: TNCC (mean +/- SD) of peritoneal fluid was 1.1 +/- 0.87 X 10(3)/microl, with neutrophils (3.9%), lymphocytes (33.5%), macrophages/monocytes (61.2%), and eosinophils (1.4%). Biochemical results in peritoneal fluid were: total protein, 1.7 +/- 0.74 g/dL; albumin, 1.0 +/- 0.04 g/dL; urea, 12.6 +/- 3.95 mg/dL; creatinine, 0.6 +/- 0.19 mg/dL; glucose, 54.8 +/- 6.11 mg/dL; and aspartate transaminase, 23.5 +/- 8.82 U/L. Eosinophil percentage and creatinine concentration did not differ significantly from blood values. CONCLUSION: Baseline values for cytologic and biochemical parameters in peritoneal fluid of Awassi sheep, with comparison to blood, have been generated. Such data may be applicable to other ovine species and can be used in the clinical investigation of ovine abdominal disorders.  相似文献   

13.
Background: Plasma d -dimer concentration is a useful marker to assess systemic coagulation and fibrinolytic activities in humans, dogs, and horses. Peritoneal fibrinolytic activity increases in horses with colic, especially in horses with endotoxin in the peritoneal fluid.
Hypothesis/Objectives: Peritoneal d -dimer concentration can be used to assess peritoneal fibrinolytic activity in horses with severe gastrointestinal (GI) disorders and altered peritoneal fluid.
Animals: Two hundred and twenty-one colic horses and 15 control horses.
Methods: Prospective observational clinical study. Blood and peritoneal fluid were collected on admission. Horses were grouped according to diagnosis, peritoneal fluid analysis, and outcome. Peritoneal d -dimer concentration was determined, together with peritoneal tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) activities. Plasma d -dimer concentration also was measured.
Results: Peritoneal d -dimer concentration was significantly higher in all colic groups compared with controls, and in horses with enteritis, peritonitis, and ischemic disorders compared with horses with large intestinal obstructions. Peritoneal d -dimer concentration was significantly higher in horses with altered peritoneal fluid (modified transudate and exudate) compared with horses with normal peritoneal fluid analysis. Plasma d -dimer concentration also was significantly higher in the peritonitis group, and in horses with altered peritoneal fluid analysis. Peritoneal and plasma d -dimer concentrations also were significantly higher in nonsurvivors. Peritoneal d -dimer concentration was significantly correlated with decreased peritoneal t-PA activity and increased peritoneal PAI-1 activity.
Conclusions and Clinical Importance: Peritoneal d -dimer concentration is markedly higher in severe GI disorders, and it can be used to assess peritoneal fibrinolytic activity in horses with colic.  相似文献   

14.
REASONS FOR PERFORMING STUDY: The most common cause of death as a direct result of colic is acute circulatory failure secondary to intestinal ischaemia. Early and accurate recognition of ischaemic bowel is essential to decrease complications and increase survival. Blood to peritoneal lactate values have been evaluated as a prognostic indicator, but lactate values characterised by type of lesion have not been reported. HYPOTHESIS: Plasma and peritoneal lactate values are higher in horses with intestinal ischaemia secondary to a strangulating obstruction (ISSO). METHODS: Venous blood and peritoneal fluid were collected sequentially from 20 clinically healthy horses and 189 horses admitted for colic during a one-year period. Blood gas, pH, electrolyte (K+, Na+, Ca++, Cl-), glucose and lactate values were determined for blood and peritoneal fluid samples; other values recorded for peritoneal fluid included gross appearance, total protein and nucleated cell count. Information regarding diagnosis, treatment and outcome was retrieved from the medical records. RESULTS: Peritoneal and plasma levels of lactate were lower in control compared to clinical cases. Horses with ISSO had a higher peritoneal lactate value (8.45 mmol/l) than those with nonstrangulating obstruction (2.09 mmo/l). Factors with the strongest correlations with the presence of ISSO were changes in the gross appearance of the peritoneal fluid and values of peritoneal fluid chloride, pH and log10 lactate. CONCLUSIONS: Analysis of peritoneal fluid gross appearance, pH, lactate and chloride can be used for diagnosis of ISSO. POTENTIAL RELEVANCE: Peritoneal fluid lactate is a better predictor of ISSO than blood lactate and may aid in early detection of catastrophic peritoneal lesions such as intestinal strangulation and rupture.  相似文献   

15.
The purpose of this study was to evaluate the surgical outcomes of 28 dogs with generalized septic peritonitis treated without postoperative abdominal drainage. The overall mortality rate was 46%, with most cases of peritonitis being caused by leakage of the gastrointestinal tract (75%). Etiology of peritonitis, abdominal cytopathology, total white blood cell count, packed cell volume, total protein, and results of serum biochemistries were not statistically different between survivors and nonsurvivors. The mortality rate of 46% is similar to other studies in which the abdomen was left open postoperatively for the management of septic peritonitis, although more advanced medical treatment than that used in earlier studies may have positively affected the outcome. The results of this study show that closure of the abdomen after the source of contamination has been successfully corrected, in combination with thorough intraoperative peritoneal lavage and appropriate postoperative medical management, may be an acceptable alternative method for the management of septic peritonitis.  相似文献   

16.
Thirty cases of peritonitis, in which the diagnosis was based on a peritoneal fluid white blood cell count in excess of 10 x 10(9)/litre, are described. Colic, ileus, pyrexia, weight loss and diarrhoea were common presenting signs. Treatments included intravenous fluids, anti-inflammatory analgesics, broad spectrum antibiotics and anthelmintics. Duration of treatment was determined by the clinical condition of the horse and sequential analyses of the peritoneal fluid and the haemogram. In the majority of cases the primary cause of peritonitis was not accurately determined, but 21 horses (70 per cent) recovered. All the horses with diarrhoea were killed after marked deterioration in their clinical condition despite intensive treatment. No individual laboratory parameter was of value in determining prognosis, although of the eight (27 per cent) horses from which bacteria were identified in the initial peritoneal fluid by Gram stain, four (50 per cent) were subsequently killed.  相似文献   

17.
OBJECTIVE: To determine the predictive values, sensitivity and specificity of abdominal fluid variables associated with the need for surgery in horses with an acute abdominal crisis. DESIGN: Retrospective study. ANIMALS: Two-hundred and thirty-six horses examined for signs of abdominal pain between January 1993 and June 1999. METHODS: Breed, age and gender of the horse and colour, total protein concentration and total nucleated cell count of an abdominal fluid sample were recorded. Colour of the abdominal fluid was classified as normal if it was yellow and transparent. Turbid fluid or fluid that was serosanguinous or other colours was classified as abnormal. Protein concentration < or = 20 g/L and a total nucleated cell count < or = 5 x 10(9) cells/L were considered normal and values above these were considered abnormal. An abdominal fluid sample was classified as abnormal if one or more of the three variables were considered abnormal. Cases were defined as surgical when lesions identified at surgery or necropsy examination would not have resolved with medical treatment alone. Cases were defined as medical in horses that survived without surgical intervention, and those with a lesion found at surgery or necropsy that would have resolved with medical treatment alone. A third category was identified during the study as those diagnosed with Actinobacillus equuli--induced peritonitis. These horses were included in the study but not in the data analysis. DATA ANALYSIS: The association between the sensitivity, specificity and positive and negative predictive value of colour, total protein, and total nucleated cell count in the abdominal fluid and the need for surgery was calculated. RESULTS: There were 100 females and 136 males of mixed breeds, ranging from 3 days to 26 years of age that had an abdominocentesis performed during the specified period. There were 97 horses with a lesion classified as surgical, 91 horses with a lesion classified as medical and 48 horses with a diagnosis of A equuli-induced peritonitis. Colour of the abdominal fluid was recorded in all horses, protein concentration was recorded in 194 horses and total nucleated cell count was recorded in 179 horses. Abnormal abdominal fluid colour had a sensitivity, specificity, positive and negative predictive value of 92%, 74%, 79% and 89% respectively, associated with the need for surgery. Sensitivity, specificity, positive and negative predictive values for a serosanguinous abdominal fluid sample associated with the need for surgery were 48%, 99%, 98% and 64% respectively. Abnormal abdominal fluid protein concentration had a sensitivity, specificity, positive and negative predictive value of 86%, 75%, 77% and 85% respectively, associated with the need for surgery. The sensitivity, specificity, positive and negative predictive value associated with the need for surgery in horses with an abnormal total nucleated cell count in the abdominal fluid were 59%, 75%, 67% and 67%, respectively. An abdominal fluid sample classified as abnormal had a sensitivity, specificity, positive and negative predictive value of 92%, 74%, 79% and 89% respectively, associated with the need for surgery. CONCLUSION: Results of this study suggest that abdominal fluid sample analysis contributes to the decision to proceed to surgery, but is not a diagnostic panacea. Colour and protein concentration of abdominal fluid were the most useful variables in abdominal fluid for differentiating medical and surgical lesions. Colour and protein had a greater value in horses with a disease likely to respond to medical treatment (negative predictive value) than those with a lesion requiring surgery (positive predictive value) except when the fluid was serosanguinous. Abdominal fluid colour and protein are clinically relevant and easily measured in the field, providing immediate information without the need for sophisticated laboratory techniques.  相似文献   

18.
OBJECTIVE: To determine survival rates in dogs and cats with septic peritonitis treated with open peritoneal drainage (OPD) versus primary closure (PC) after laparotomy. STUDY DESIGN: Retrospective analysis of medical records from Colorado State University Veterinary Teaching Hospital from 1993 to 1999. SAMPLE POPULATION: Thirty-six dogs and 6 cats with septic peritonitis documented by cytological examination or microbiological culture of abdominal fluid. METHODS: Medical records of dogs and cats with septic peritonitis treated by OPD or PC were reviewed. Age, weight, species, white blood cell (WBC) count, band neutrophil count, platelet count, serum glucose concentration, heart rate, body temperature, duration of hospitalization, and clinical outcome were recorded for each animal. Differences in treatments administered between the OPD and PC groups as well as the underlying cause of septic peritonitis were determined. RESULTS: There was no significant difference in survival between animals in the OPD versus PC groups (P =.26) with an overall survival rate of 71%. White blood cell count, band neutrophil count, platelet count, serum glucose and total bilirubin concentrations, heart rate, age, and weight were not significantly different between groups (P >.05). A significantly greater number of animals in the OPD group received plasma (P =.009), blood (P =.037), and a jejunostomy tube (P =.02) than animals in the PC group. There was a significant difference in the number of days spent in critical care unit with a mean of 6.0 +/- 4.1 days for the OPD group and 3.5 +/- 2.3 days for the PC group (P =.02). CONCLUSIONS: Open peritoneal drainage for the management of septic peritonitis in dogs and cats is an acceptable alternative to PC.  相似文献   

19.
20.
OBJECTIVE: To establish a reliable diagnostic tool for septic peritonitis in dogs and cats using pH, bicarbonate, lactate, and glucose concentrations in peritoneal fluid and venous blood. STUDY DESIGN: Prospective clinical study. ANIMALS: Eighteen dogs and 12 cats with peritoneal effusion. METHODS: pH, bicarbonate, electrolyte, lactate, and glucose concentrations were measured on 1- to 2-mL samples of venous blood and peritoneal fluid collected at admission. The concentration difference between blood and peritoneal fluid for pH, bicarbonate, glucose, and lactate concentrations were calculated by subtracting the peritoneal fluid concentration from the blood concentration. Peritoneal fluid was submitted for cytologic examination and bacterial culture. Peritonitis was classified as septic or nonseptic based on cytology and bacterial culture results. RESULTS: In dogs, with septic effusion, peritoneal fluid glucose concentration was always lower than the blood glucose concentration. A blood-to-fluid glucose (BFG) difference > 20 mg/dL was 100% sensitive and 100% specific for the diagnosis of septic peritoneal effusion in dogs. In 7 dogs in which it was evaluated, a blood-to-fluid lactate (BFL) difference < -2.0 mmol/L was also 100% sensitive and specific for a diagnosis of septic peritoneal effusion. In cats, the BFG difference was 86% sensitive and 100% specific for a diagnosis of septic peritonitis. In dogs and cats, the BFG difference was more accurate for a diagnosis of septic peritonitis than peritoneal fluid glucose concentration alone. CONCLUSIONS: A concentration difference > 20 mg/dL between blood and peritoneal fluid glucose concentration provides a rapid and reliable means to differentiate a septic peritoneal effusion from a nonseptic peritoneal effusion in dogs and cats. CLINICAL RELEVANCE: The difference between blood and peritoneal fluid glucose concentrations should be used as a more reliable diagnostic indicator of septic peritoneal effusion than peritoneal fluid glucose concentration alone.  相似文献   

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