초록
체중 32kg의 3년령 암컷 독일셰퍼드가 식이역류와 구토로 내원하였다. 신체검사에서 체중감소, 음성변화, 유연 및 후구유약이 관찰되었다. 방사선검사에서 거대식도가 관찰되었다. Neostigmine challenge test는 음성이었으며 acetyle\choline receptor에 대한 항체가는 1.58nmol/L로 양성이었다. 따라서 후천성 중증 근육무력증의 만성형으로 진단하였다. Pyridostigmine bromide 1mg/kg을 1일 2회 투여하여 치료하여 후구의 유약 증상은 현저히 개선되었고, 정상보행을 보였다. 치료과정중 이물성 폐렴이 발생하였고, 항생제 치료를 실시하였으나 관리의 어려움과 경제적 문제로 인한 보호자의 요구로 안락사 시켰다.
A three-year old intact female German shepherd dog weighing 32kg was presented with the history of regurgitation and vomiting. Physical examination revealed a thin body condition, hoarse voice, hypersalivation, and pelvic limb weakness. In radiograph, meagaesophagus was identified. The neostigmine challenge test was positive. The titer of acetylcholine receptor (AChR) antibody was 1.58 nmol/L (reference range, <0.6nmol). Therefore, the dog was diagnosed to be suffering with chronic generalized form of acquired myasthenia gravis and followed by treatment with pyridostigmine bromide, 1mg/kg, q12 hrs. Treatment improved the pelvic limb weakness, however intermittent regurgitation and vomiting persisted. This resulted in aspiration pneumonia f3r which antibiotics were administered However, the dog was euthanized due to poor management and owner's request.
