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minibabyqq 2006-12-20 20:02

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[size=12px][color=magenta][size=5][b]Scleritis 和 Episcleritis[/b][/size]
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sclera 和episclera 的主要激動條件是免疫斡旋的混亂為充血和變厚地球的纖維狀外面長袍描繪。這些情況也許難與結膜炎或青光眼臨床區別。scleritis 的散開形式最共同地看在斗雞家Spaniel, 也許posteriorly 延伸以脈絡膜介入和(罕見的) 次要視網膜退化。在conjunctival 和scleral 血管engorgement 之間可能由柔和地移動區分內眼膜與一個棉花被打翻的拖把在典型麻醉的應用以後。
Scleritis 和episcleritis 也許難與結膜炎或青光眼臨床區別。區分這的鑰匙從青光眼是缺乏角膜腫鼓和正常pupillary 輕的反應。因為青光眼是共同和毀滅的對視覺, 如果在對診斷的疑義, 確認由眼內壓力的準確測量被獲得。
[img=328,252]http://www.veterinaryvision.com/pictures/scleritis_2_diffuse.jpg[/img]

[img=232,252]http://www.veterinaryvision.com/pictures/scleritis_6_regional.jpg[/img]
通常, scleritis 地方發生以可以程度入角膜激動細胞和粒化組織的一個proliferative 反應。切片檢查法是診斷的以血漿細胞和淋巴細胞的密集的儲積。

這個情況的一個地方化的形式最共同地發生在大牧羊犬養殖和提出如同明顯被上升的, 節狀損害在異色邊緣(通常世俗地) 。這些大量迅速地擴大帶領關注一個造形術過程。部份切除也許執行以診斷的histopathologic 確認。
[img=272,252]http://www.veterinaryvision.com/pictures/scleritis_1_nodular.jpg[/img]

scleritis 的嚴厲形式也許進步以後部段介入(次要chorioretinal 退化), scleral 變薄, ulcerative 角膜炎和角膜營養失調。
[img=217,252]http://www.veterinaryvision.com/pictures/scleritis_3_post.jpg[/img]
[img=288,243]http://www.veterinaryvision.com/pictures/scleritis_4_necrotic.jpg[/img]
[img=218,247]http://www.veterinaryvision.com/pictures/scleritis_5_atrophy.jpg[/img]
[img=240,247]http://www.veterinaryvision.com/pictures/scleritis_7_keratitis.jpg[/img]
[b]治療[/b] 介入抗發炎療程(類皮質激素、cyclosporine, azathioprine) 典型地, subconjunctivally 和偶爾地系統地被給。多數案件反應很好4-8 毫克triamcinolone 的唯一subconjunctival 射入以持續的典型1% prednisolone 懸浮一兩次每日。典型療程慢慢地被減少在頻率2-3 月雖然許多案件要求終身(一次每日每隔一天) 療法。

[align=center][img=413,265]http://www.veterinaryvision.com/pictures/eyedrawing.gif[/img][/align]Primary inflammatory conditions of the sclera and episclera are immune-mediated disorders characterized by hyperemia and thickening of the fibrous outer tunic of the globe. These conditions may be difficult to distinguish clinically from conjunctivitis or glaucoma. The diffuse form of scleritis is seen most commonly in the Cocker Spaniel and may extend posteriorly with choroidal involvement and (rare) secondary retinal degeneration. The distinction between conjunctival and scleral vascular engorgement can be made by gently moving the conjunctiva with a cotton-tipped swab after application of topical anesthesia.
Scleritis and episcleritis may be difficult to distinguish clinically from conjunctivitis or glaucoma. Keys to differentiating this from glaucoma are the absence of corneal edema and normal pupillary light response. As glaucoma is both more common and more devastating to vision, if in doubt about the diagnosis, confirmation by accurate measurement of intraocular pressure should be obtained.
[img=328,252]http://www.veterinaryvision.com/pictures/scleritis_2_diffuse.jpg[/img]

[img=232,252]http://www.veterinaryvision.com/pictures/scleritis_6_regional.jpg[/img]
More commonly, scleritis occurs regionally with a proliferative response of inflammatory cells and granulation tissue which may extent into the cornea. A biopsy is diagnostic with dense accumulation of plasma cells and lymphocytes.

A more localized form of this condition occurs most commonly in the Collie breeds and presents as a markedly raised, nodular lesion at the limbus (usually temporally). These masses rapidly enlarge leading to concern about a neo-plastic process. Partial excision may be performed with histopathologic confirmation of the diagnosis.
[img=272,252]http://www.veterinaryvision.com/pictures/scleritis_1_nodular.jpg[/img]

Severe forms of scleritis may progress with posterior segment involvement (secondary chorioretinal degeneration), scleral thinning, ulcerative keratitis and corneal dystrophy.
[img=217,252]http://www.veterinaryvision.com/pictures/scleritis_3_post.jpg[/img]
[img=288,243]http://www.veterinaryvision.com/pictures/scleritis_4_necrotic.jpg[/img]
[img=218,247]http://www.veterinaryvision.com/pictures/scleritis_5_atrophy.jpg[/img]
[img=240,247]http://www.veterinaryvision.com/pictures/scleritis_7_keratitis.jpg[/img]
[b]Treatment[/b] involves anti-inflammatory medications (corticosteroids, cyclosporine, azathioprine) given topically, subconjunctivally and occasionally systemically. Most cases respond well to a single subconjunctival injection of 4-8 mg triamcinolone with continued topical 1% prednisolone suspension once or twice daily. The topical medication is reduced in frequency slowly over 2-3 months although many cases require life-time (once daily to every other day) therapy.

[align=center][img=413,265]http://www.veterinaryvision.com/pictures/eyedrawing.gif[/img][/align][/size]
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minibabyqq 2006-12-20 20:03

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[size=12px][size=5][color=magenta][b]角膜潰瘍  Persistent Corneal Ulcers[/b][/color][/size] [table=98%][tr][td=2,1]當提出與不改善在5-7 天之內的明顯簡單的(non-infected) 角膜潰瘍, 使複雜化的因素必須被考慮, 有:
[/td][/tr][tr][td=2,1][size=+2][size=+2]機械起因 [img=381,252]http://www.veterinaryvision.com/pictures/entropion.jpg[/img]
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[b]Entropion[/b] 是慢性角膜潰瘍的頻繁主要起因在幼小狗。這是一個被繼承的情況在許多養殖, 有:
[list][*]食物食物[*]SharPei[*]公牛Mastiff[*]Mastiff[*]金黃獵犬[*]拉布拉多獵犬[*]美國和英國斗雞家spaniels[*]許多其它炫耀的養殖。[/list][b]角膜或conjunctival 外國身體 [/b]-- 這些也許極端小和在某些情況下要求切開燈biomicroscopy 為證明。
[img=180,217]http://www.veterinaryvision.com/pictures/eyelash.gif[/img][b]出軌睫毛[/b] -- 很少做 [i]distichia[/i] (額外鞭子起源於meibomian 封墊開頭於眼皮邊際) 起因潰瘍雖然他們也許導致撕毀。相反, [i]EC[/i]t[i]opic 纖毛[/i] 推出通過眼皮內眼膜是在直接聯繫與角膜和經常導致潰瘍和痛苦。兩個通常發生在更加幼小的動物。

[b]Lagophthalmos[/b] (疏忽完全地眨眼睛) -- 這經常被看見在養殖與突出的眼睛(Pekingese 、Pug, 波士頓狗) 但也許並且發生如同後遺症對角膜結疤的導致的被減少的角膜感覺。
[i][size=+1][/i][i][size=+1]注: 很少摩擦在眼睛單獨負責任對被延遲的癒合。[/i]
[size=+2][i][size=+1][/i][size=+2]淚花影片反常性 缺乏在含水生產是最共同和是可發現的由Schirmer 淚花測試; 價值少於15 mm/min 是疑神疑鬼, 少於10 mm/min 在成人狗重大的。另外, 缺乏在黏液或油脂層數也許並且導致被延遲的角膜癒合, 特別在中央角膜在眼皮裂痕之內。 [i]因為典型atropine 可能減少淚花作用, 它的用途contraindicated 在表面角膜潰瘍[/i]。
[size=+2][size=+2]角膜營養失調 雖然許多角膜潰瘍由精神創傷造成, 他們也許並且是角膜退化幾綜合症狀的結果。多數這些更加頻繁地發生在更舊的狗並且一些有被繼承的素質。這些情況歸入二個主要類別: [i]反常儲蓄在角膜之內[/i], 和 [i]瑕疵細胞黏附力[/i]。
[img=220,252]http://www.veterinaryvision.com/pictures/ca_degen.jpg[/img]反常儲蓄在角膜之內通常包含鈣和油脂(膽固醇的) 組合。這些也許單邊地或雙邊發生和區域經常自發雖然他們也許同 [i]甲狀腺機能不足聯繫在一起[/i]。他們出現作為通常自已限制的唯一或多顆粒狀角膜opacities 並且不干涉視覺。當最初地觀察, 保守的管理以觀察唯一被推薦1-2 個月。如果有進步的證據在那時間期間, 典型結為螯合物的解答(2% EDTA) 可能嚮困境鈣被應用和因而, 減慢不透明的進步。在罕見的案件, 通常在狗經過12 年年紀, 受影響的眼睛也許突然變得痛苦與潰瘍發生由於"外國身體" 類型對反常材料的反應在角膜。一旦潰瘍被觀察, 手術(表面keratectomy) 被表明去除儲蓄。這些潰瘍經常是非痛苦的, 也許進步對穿孔。

[img=273,270]http://www.veterinaryvision.com/pictures/ree.jpg[/img]瑕疵細胞黏附力是自發表面潰瘍的相對地同道會在中年對更舊的狗。這個情況看來是主要反常性在角膜stromal 細胞外矩陣這樣, 皮膜不遵守部下的stroma 。這些損害被描述了在拳擊手狗(與命名"拳擊手潰瘍") 並且最初有一次典型臨床出現: 表面潰瘍以毗鄰皮膜的邊緣的海拔。痛苦是一不一致發現-- 多數動物展覽斷斷續續的blepharospasm 以清楚的視覺放電。治療被指揮在刺激keratocytes 導致新矩陣"水泥。" 最初地, 角膜是debrided, 取消獨立的皮膜。角膜膠原盾也許是應用的。這些盾由被脫水的膠原製成和非常看起來像軟的隱形眼鏡; 一旦應用, 他們遵守角膜和溶化大約四天。患者被再檢查在一個星期-- 大約60-70% 案件解決了在這時間。殘餘的案件經常未展示改善。在這些情況下, 一表面keratectomy 執行在一般麻醉之下。使用一個經營的顯微鏡, 所有非依附皮膜和表面25% 角膜stroma 外科地被去除。表面keratectomy 結果在幾乎所有案件的決議在10 天之內。

[align=center][img=413,265]http://www.veterinaryvision.com/pictures/eyedrawing.gif[/img][/align][/td][/tr][/table][table=98%][tr][td=2,1]When presented with an apparently simple (non-infected) corneal ulcer which fails to improve within 5-7 days, complicating factors must be considered, including:
[/td][/tr][tr][td=2,1][size=+2]Mechanical Causes [img=381,252]http://www.veterinaryvision.com/pictures/entropion.jpg[/img]
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[b]Entropion[/b] is a frequent primary cause of chronic corneal ulceration in young dogs. This is an inherited condition in many breeds, including:
[list][*]Chow Chow[*]SharPei[*]Bull Mastiff[*]Mastiff[*]Golden Retriever[*]Labrador Retriever[*]American and English Cocker spaniels[*]Many other sporting breeds.[/list][b]Corneal or conjunctival foreign body [/b]-- in some cases these may be extremely small and require slit lamp biomicroscopy for identification.
[img=180,217]http://www.veterinaryvision.com/pictures/eyelash.gif[/img][b]Aberrant eyelashes[/b] -- rarely do [i]distichia[/i] (extra lashes originating from the meibomian gland openings in the eyelid margin) cause ulceration although they may cause tearing. In contrast, [i]ec[/i]t[i]opic cilia[/i] protruding through the eyelid conjunctiva are in more direct contact with the cornea and often cause ulceration and pain. Both occur more commonly in younger animals.

[b]Lagophthalmos[/b] (failure to blink completely) -- this is seen most often in breeds with prominent eyes (Pekingese, Pug, Boston terrier) but may also occur as a sequela to corneal scarring causing reduced corneal sensation.
[i][size=+1]Note: rarely is rubbing at the eye alone responsible for delayed healing.[/i]
[size=+2]Tear Film Abnormalities Deficiency in aqueous production is the most common and is detectable by the Schirmer tear test; values less than 15 mm/min are suspicious, less than 10 mm/min in an adult dog is significant. In addition, deficiencies in the mucous or lipid layers may also cause delayed corneal healing, particularly in the central cornea within the palpebral fissure. [i]Since topical atropine can reduce tear function, its use is contraindicated in superficial corneal ulcers[/i].
[size=+2]Corneal Dystrophy Although many corneal ulcers are caused by trauma, they may also be the result of several syndromes of corneal degeneration. Most of these occur more frequently in older dogs and some have an inherited predisposition. These conditions fall into two major categories: [i]abnormal deposits within the cornea[/i], and [i]defective cell adhesion[/i].
[img=220,252]http://www.veterinaryvision.com/pictures/ca_degen.jpg[/img]Abnormal deposits within the cornea usually contain a combination of calcium and lipids (cholesterol). These may occur unilaterally or bilaterally and area often spontaneous although they may be associated with [i]hypothyroidism[/i]. They appear as single or multiple granular corneal opacities which are usually self-limiting and do not interfere with vision. When initially observed, conservative management with observation only is recommended for 1-2 months. If there is evidence of progression during that time, topical chelating solutions (2% EDTA) can be applied to bind calcium and thus, slow the progression of the opacity. In rare cases, usually in dogs over 12 years old, affected eyes may become suddenly painful with ulceration occurring as a result of a "foreign body" type of response to the abnormal material in the cornea. Once ulceration is observed, surgery (superficial keratectomy) is indicated to remove the deposit. These ulcers are often non-painful and may progress to perforation.

[img=273,270]http://www.veterinaryvision.com/pictures/ree.jpg[/img]Defective cell adhesion is a relatively common cause of spontaneous superficial ulcers in middle-aged to older dogs. This condition appears to be a primary abnormality in the corneal stromal extracellular matrix such that the epithelium fails to adhere to the underlying stroma. These lesions were originally described in the Boxer dog (with the name "Boxer ulcer") and have a characteristic clinical appearance: a superficial ulcer with elevation of the edges of the adjacent epithelium. Pain is an inconsistent finding -- Most animals exhibit intermittent blepharospasm with a clear ocular discharge. Treatment is directed at stimulating the keratocytes to produce new matrix "cement." Initially, the cornea is debrided, removing the unattached epithelium. A corneal collagen shield may be applied. These shields are made of desiccated collagen and look very much like soft contact lenses; once applied, they adhere to the cornea and dissolve over approximately four days. The patient is re-examined in one week -- approximately 60-70% of cases have resolved in this time. The remaining cases often have demonstrated no improvement. In these cases, a superficial keratectomy is performed under general anesthesia. Using an operating microscope, all non-adherent epithelium and the superficial 25% of the corneal stroma are surgically removed. Superficial keratectomy results in resolution of nearly all cases within 10 days.

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minibabyqq 2006-12-28 00:23

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[size=12px][color=magenta][b][size=5]多個骨髓瘤-- 視覺顯示  Multiple Myeloma --The Ocular Manifestations[/size][/b]

[/color]多個骨髓瘤是一種系統疾病介入血漿細胞的造形術擴散。骨髓是最共同的主要站點, 但其它器官譬如胃腸道、肝臟, 和脾臟頻繁地也被介入。血漿細胞的分泌本質可能導致許多paraneoplastic 情況: hypercalcemia 、hyperviscosity 綜合症狀, 和腎衰竭是最共同。
Hyperglobulinemia 是hyperviscosity 綜合症狀的起因。大小、形狀、集中, 和程度免疫球蛋白的蛋白質蛋白質互作用影響清液黏度。由於他們的大小, IgM 和IgA, 比IgG 可能導致hyperviscosity 。
hyperviscosity 綜合症狀的顯示變化, 有: 靈菌混亂、神經學標誌(昏迷、消沉, 老年癡呆), 充血的心力衰竭, 和腎衰竭。視覺損傷也許並且是一種最初的提出的症狀。
hyperviscosity 視覺損害與它的血管顯示有關: 膨脹的視網膜船、視網膜出血並且/或者獨立小分隊, 和視覺圓盤膨脹。任何這些也許導致pupillary 擴張和部份或完全視覺損傷。
病理生理學retinopathy 介入貧血症、出血性的素質、高血壓、組織低氧症, 和血管stasis 。貧血症也許是骨髓鎮壓或容量擴展的結果被高球蛋白含量導致在血管空間。免疫球蛋白的高濃度也許導致thrombocytopenia 或小片官能不良造成出血性的素質。反常性在凝結的小瀑布和纖維蛋白凝塊形成也看了與多個骨髓瘤。
多個骨髓瘤和hyperviscosity 綜合症狀是對治療是敏感的情況。如果hyperviscosity 不是嚴厲的, 口頭化療是療法中流砥柱經常給18 個月或更多的生存時間以優秀生活水平。二種藥物最共同地被運用是melphalan 和強體松, 雖然vincristine, cytoxan, 和doxorubicin (Adriamycin) 被使用在加工困難的案件。如果hyperviscosity 是存在, plasmapharesis 是選擇的直接治療。這個療法的形式迅速地減少血液黏度和允許較不迅速地行動的化療運作。進取的診斷和治療經常必需成功地對待動物以hyperviscosity 綜合症狀。但是, 一旦hyperviscosity 是在控制之下, 患者可能然後被處理以定期化療。
深刻盲目性在一隻狗或貓與視網膜損害一致與任何或所有反常性被描述上面應該提示查尋系統疾病包括多個骨髓瘤。不同於許多造形術情況, 多個骨髓瘤的治療一般有價值付得起和重大在減少耐心病態。
[size=+2][size=+2]視覺標誌聯繫了多個骨髓瘤 [list][*]視覺impairment/pupillary 擴張[*]視網膜獨立小分隊[*]視網膜出血[*]Papilledema/optic 神經炎[/list][size=+2]系統情況聯繫了多個骨髓瘤 [list][*]系統toxemia/septicemia[*]病毒[*]黴菌[*]立克次休屬微生物[*]Lyme 疾病[*]系統高血壓[*]其它傳播的瘤形成[*]Lymphosarcoma[/list]Multiple myeloma is a systemic disease involving neoplastic proliferation of plasma cells. The bone marrow is the most common primary site, but other organs such as the gastrointestinal tract, liver, and spleen are also frequently involved. The secretory nature of the plasma cells can lead to many paraneoplastic conditions: hypercalcemia, hyperviscosity syndrome, and renal failure are the most common.
Hyperglobulinemia is the cause of the hyperviscosity syndrome. The size, shape, concentration, and degree of protein-protein interactions of the immunoglobulins affect the serum viscosity. Because of their size, IgM and IgA, are much more likely than IgG to cause the hyperviscosity.
The manifestations of hyperviscosity syndrome are varied, including: bleeding disorders, neurologic signs (coma, depression, dementia), congestive heart failure, and renal failure. Vision impairment may also be an initial presenting symptom.
Ocular lesions of hyperviscosity are related to its vascular manifestations: dilating retinal vessels, retinal hemorrhage and/or detachment, and optic disc swelling. Any of these may result in pupillary dilation and partial or complete vision impairment.
The pathophysiology of the retinopathy involves anemia, hemorrhagic diathesis, hypertension, tissue hypoxia, and vascular stasis. Anemia may be the result of bone marrow suppression or volume expansion induced by the high globulin concentration in the vascular space. The high concentrations of immunoglobulins may cause thrombocytopenia or platelet dysfunction resulting in hemorrhagic diathesis. Abnormalities in the clotting cascade and fibrin clot formation have also been seen with multiple myeloma.
Multiple myeloma and hyperviscosity syndrome are conditions which are responsive to treatment. If hyperviscosity is not severe, oral chemotherapy is the mainstay of therapy often giving survival times of 18 months or more with excellent quality of life. The two drugs most commonly utilized are melphalan and prednisone, although vincristine, cytoxan, and doxorubicin (Adriamycin) are used in refractory cases. If hyperviscosity is present, plasmapharesis is the immediate treatment of choice. This form of therapy rapidly reduces blood viscosity and allows the less rapidly acting chemotherapy to work. Aggressive diagnostics and treatment are often required to successfully treat animals with hyperviscosity syndrome. However, once the hyperviscosity is under control, the patient can then be managed with routine chemotherapy.
Acute blindness in a dog or cat with retinal lesions consistent with any or all of the abnormalities described above should prompt the search for systemic diseases including multiple myeloma. Unlike many neoplastic conditions, the treatment of multiple myeloma is generally affordable and of significant value in reducing patient morbidity.
[size=+2]Ocular Signs Associated with Multiple Myeloma
[list][*]Vision impairment/pupillary dilation[*]Retinal detachment[*]Retinal hemorrhages[*]Papilledema/optic neuritis[/list][size=+2]Systemic Conditions Associated with Multiple Myeloma
[list][*]Systemic toxemia/septicemia[*]viral[*]fungal[*]rickettsia[*]Lyme disease[*]Systemic hypertension[*]Other disseminated neoplasia[*]Lymphosarcoma[/list][/size]

minibabyqq 2006-12-28 00:24

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[size=12px][color=magenta][size=5][b]心臟病[/b][/size]
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期限PDA 想像手扶的微型電腦的圖像為多數人民但在獸醫心臟病學方面, PDA 立場為情況給予專利ductus arteriosus, 最共同的先天心臟瑕疵在狗。
[b]如此什麼是Ductus Arteriosus 和為什麼這是專利的shouldn.t?[/b]
大家曾經有一ductus arteriosus 但這是久時光前, 後面在one.s 胎兒天。作為一個顯現出的胎兒, 你取決於one.s 臍帶循環供應氧氣。終究, 不僅是肺沒被發展但沒有空氣呼吸在mom.s 子宮體裡面。但我們仍然有心臟並且它仍然抽血液在胎兒階段。問題是, 我們真正地需要血液繞過non-functional 肺並且那是ductus arteriosus 進來的地方。ductus arteriosus 是一種小渠道連接一天將運載血液對肺) 的肺動脈(並且已經運載血液對身體剩餘) 的主動脈(。由於肺是顯現出, 充分流體, 和一般不準備做什麼, 血管生長那裡有高抵抗。換句話說, 它會採取很多力量從心臟流通血液那裡。因為有一種低抵抗渠道大開, 血液牽制那裡, 繞過肺, 和流通通過胎兒身體的剩餘。 [table=335][tr][td][table=335][tr][td][/td][/tr][tr][td][img=335,302]http://www.vin.com/ImageDBPub/VP05000/IMG02195.GIF[/img][/td][/tr][tr][td][i][b][size=1][color=#0c0c75]在正常胚胎[/color][/size][/b][/i][/td][/tr][/table][/td][/tr][/table][table=335][tr][td][table=335][tr][td][b][size=1][color=#0c0c75][/color][/size][/b][/td][/tr][tr][td][b][size=1][color=#0c0c75][img=335,302]http://www.vin.com/ImageDBPub/VP05000/IMG02196.GIF[/img][/color][/size][/b][/td][/tr][tr][td][b][size=1][color=#0c0c75][i]專利ductus arteriosis[/i] [/color][/size][/b][/td][/tr][/table][/td][/tr][/table]出生時, 一切改變。我們採取我們的第一呼吸。我們的肺開始運轉當他們意味: 交換氣體。積土以空氣和循環抵抗下落。它然後變得容易對血液流經到肺而不是ductus 。ductus 關閉第一3 在天內的生活和在天7 到10 以前生活安全地關閉。
血液現在流動它應該的方式: 從心臟的右邊對肺拾起氧氣然後回到心臟的左邊對身體交付氧氣。
或至少那是什麼應該發生。有時ductus 不關閉。這保留開放或patent. 。當ductus 逗留打開, 血液從主動脈將想要流動, 不是到身體而且到低抵抗ductus 開頭和入肺動脈。這稱左邊對正確的分流器和創造問題的分類。
[b]為什麼聽任正確轉軌是壞[/b]
身體有它的氧氣要求和要求由心臟為服務。問題是那很多血液(多少取決於ductus 的大小) 轉軌回到肺循環。為了適應body.s 氧氣需要, 心臟必須抽更加血液到蓋子什麼流通在分流器並且什麼身體需要。這是很多額外工作為心臟並且失敗可能收效, 導致咳嗽, 弱點, 和困難呼吸。實際上, 超過25% 小狗有某一程度心力衰竭在他們的專利ductus 被發現時候。
治療為PDA 介入外科栓ductus 以縫合或卷片斷。
[b][i]如果這可能是成功的, 所有心臟問題是反演性的。

如果心力衰竭是存在, 它將需要被控制以醫學在手術是可能的之前。[/i][/b]

如果容量超載對lung.s 循環被允許去在不確定地(和患者未死於心力衰竭在puppyhood 期間), 抵抗增加在肺並且分流器也許減少甚至扭轉在右邊對左分流器。增加的抵抗在肺循環叫做肺高血壓。左分流器的權利不再是某事可能是固定的並且患者將是非常病的從心臟病由年齡2 到3 。
[b]PDA 診斷[/b]
一句典型私語能聽見在患者與專利ductus arteriosus 。私語被描述像聽起來洗衣機和經常叫continuous 。或machinery. 私語。謹慎心臟thumps. 無法被做; 連續只飛快移動私語聽見。私語最好聽見與聽診器被安置在患者左arm 坑。如果情況進步在右邊對左轉軌, 私語不會聽見。
懷疑一個增加的索引為狗養殖存在以已知的素質對PDA 。這些養殖包括德國牧羊人狗、微型長捲毛狗、毛獅狗、斗雞家Spaniel, Pomeranian, 大牧羊犬, 和Shetland Sheepdog 。
工作證實ductus 的出現將包括胸口射線照相排除可變的組合從心力衰竭, 和尋找主動脈的典型擴大和額外血液容量包含心臟的左邊。Echocardiography 緊抓住診斷作為所有分庭大小被測量並且專利ductus 能實際上被看見。
[b]治療: 外科結紮術[/b]
這是修理傳統方法。胸口被張開並且縫合片斷被使用栓專利ductus 。專家通常被要求執行這個做法但複雜化率5% 是少於, 用少於2% 要求第二個做法由於ductus 的re-opening 。
[b]治療: 卷Embolization[/b]
如果患者相當小, 第二個選擇存在: 經皮transarterial 卷embolization 。這裡, 卷由鋼製成和Dacron 被安置在ductus 從外在動脈在腿或喉頭。卷導致小凝塊對形式和根本上塞住ductus 的狹窄的結尾。2.4% 死亡率同這個做法聯繫在一起。它呼籲照原樣較不蔓延性。
[b][i]沒有治療受影響的小狗的2/3 將死在到達的年齡之前一年。
[/i][/b]

[b][i]The term PDA conjures up images of handheld mini-computers for most people but in veterinary cardiology, PDA stands for the condition patent ductus arteriosus, the most common congenital heart defects in dogs.
[b]So what is a Ductus Arteriosus and why shouldn㦙 it be Patent?[/b]
Everybody had a ductus arteriosus once but it was a long time ago, back in one𠏋 fetal days. As a developing fetus, one depends on one𠏋 umbilical circulation to supply oxygen. After all, not only are the lungs not developed yet but there is no air to breathe inside mom𠏋 uterus. But we still have a heart and it still pumps blood even in the fetal stage. The problem is that we really need the blood to bypass the non-functional lung and that is where the ductus arteriosus comes in. The ductus arteriosus is a small channel connecting the pulmonary artery (which will one day carry blood to the lungs) and the aorta (which already carries blood to the rest of the body). Because the lung is developing, full of fluid, and generally not ready to do anything, blood vessels growing there have high resistance. In other words, it would take a lot of force from the heart to circulate blood there. Since there is a low resistance channel wide open, blood diverts there, by-passing the lungs, and circulating through the rest of the fetal body. [table=335][tr][td][table=335][tr][td][/td][/tr][tr][td][img=335,302]http://www.vin.com/ImageDBPub/VP05000/IMG02195.GIF[/img][/td][/tr][tr][td][i]In the normal embryo[/i][/td][/tr][/table][/td][/tr][/table][table=335][tr][td][table=335][tr][td][/td][/tr][tr][td][img=335,302]http://www.vin.com/ImageDBPub/VP05000/IMG02196.GIF[/img][/td][/tr][tr][td][i]Patent ductus arteriosis[/i] [/td][/tr][/table][/td][/tr][/table]At birth, everything changes. We take our first breath. Our lungs begin to work as they were meant to: to exchange gases. The fill with air and the circulatory resistance drops. It then becomes easier for the blood to flow to the lung rather than through the ductus. The ductus closes within the first 3 days of life and is securely closed by day 7 to 10 of life.
Blood now flows the way it is supposed to: from the right side of the heart to the lung to pick up oxygen then back to the left side of the heart to the body to deliver the oxygen.
Or at least that is what is supposed to happen. Sometimes the ductus does not close. It remains open or 𢖯atent.?When the ductus stays open, blood from the aorta will want to flow, not to the body but to the low resistance ductus opening and into the pulmonary artery. This is called a left to right shunt and creates an assortment of problems.
[b]Why Left to Right Shunting is Bad[/b]
The body has its oxygen requirement and demands to be serviced by the heart. The problem is that a great deal of blood (how much depends on the size of the ductus) is shunting back to the pulmonary circulation. In order to meet the body𠏋 oxygen demand, the heart is going to have to pump all the more blood to cover what circulates in the shunt as well as what the body needs. This is a lot of extra work for the heart and failure can result, leading to coughing, weakness, and difficulty breathing. In fact, more than 25% of pups have some degree of heart failure at the time their patent ductus is discovered.
Treatment for PDA involves surgical tying off of the ductus with a piece of suture or coil.
[b][i]If this can be accomplished, all the heart problems are reversible.

If heart failure is present, it will need to be controlled with medicine before surgery is possible.[/i][/b]


If the volume overload to the lung𠏋 circulation is allowed to go on indefinitely (and the patient has not died from heart failure during puppyhood), resistance increases in the lung and the shunt may diminish or even reverse to a right to left shunt. Increased resistance in the lung circulation is called pulmonary hypertension. A right to left shunt is no longer something that can be fixed and the patient will be very sick from heart disease by age 2 to 3.
[b]Diagnosis of PDA[/b]
A characteristic murmur can be heard in patients with a patent ductus arteriosus. The murmur is described as sounding like a washing machine and is often called a 𡤧ontinuous?or 𢘫achinery?murmur. Discreet heart 懀humps?cannot be made out; only the continuous whooshing of the murmur is heard. The murmur is best heard with the stethoscope positioned in the patients left 弌rm pit.?If the condition progresses to right to left shunting, no murmur will be heard.
An increased index of suspicion exists for breeds of dogs with a known predisposition to PDA. These breeds include German Shepherd Dog, Miniature Poodle, Keeshond, Cocker Spaniel, Pomeranian, Collie, and Shetland Sheepdog.
The work-up to confirm the presence of the ductus will include chest radiographs to rule out fluid build up from heart failure, and to look for characteristic enlargement of the aorta and the left side of the heart where the extra blood volume is contained. Echocardiography clinches the diagnosis as all the chamber sizes are measured and the patent ductus can actually be seen.
[b]Treatment: Surgical Ligation[/b]
This is the traditional method of repair. The chest is opened and a piece of suture is used to tie off the patent ductus. Generally a specialist is required to perform this procedure but complication rate is less than 5%, with less than 2% requiring a second procedure due to re-opening of the ductus.
[b]Treatment: Coil Embolization[/b]
If the patient is fairly small, a second option exists: percutaneous transarterial coil embolization. Here, coils made of steel and Dacron are placed in the ductus from an external artery in the leg or throat. The coil essentially causes small clots to form and plug the narrow end of the ductus. A 2.4% mortality rate is associated with this procedure. It is appealing as it is less invasive.
[b][i]Without treatment 2/3 of affected puppies will die before reaching age one year.
[/i][/b][/i][/b][/size]

minibabyqq 2006-12-28 00:25

[table][tr][td]轉貼自4682

[size=12px][size=5][color=magenta][b]二尖瓣不足: 心力衰竭的起因Mitral Valve Insufficiency: A Cause of Heart Failure[/b][/color][/size]


心臟是頻繁地無法狗和驚奇的器官, 它發生在所有年齡狗。在年輕人, 這典型地是先天反常性的 結果 在心臟或血管的形成, 圍攏它。在更舊的動物, 這通常是一邊或分庭被減弱或工作的由於修改過的循環樣式的案件。
心臟作為泵浦

心臟實際上是□什麼更多比一個機械泵浦。它接受血液在一邊和力量它通過肺, 它的另外一半然後抽液體通過整個身體。心臟不改變或不修改血液在任何情況下。它沒有腺 組織 和藏匿因此□什麼入血液亦不它提取任何東西。這大概是最簡單和最容易地被瞭解的器官在整個身體。

作為快的回顧, 血液從身體返回和輸入心臟的正確的上部分庭, 稱正確的 心房。這時, 血液是降低在氧氣但高的在二氧化碳裡。它然後抽從心房通過正確的房室的閥門入 右心室。從這更大的分庭, 它然後被強迫入肺領域通過肺動脈。這是唯一的動脈在運載非被氧化的血液的身體。二氧化碳是身體新陳代謝副產物和附有紅血球。在肺, 二氧化碳用氧氣替換。reoxygenated 血液那麼行動通過肺靜脈回到心臟和進入左心房。這分庭沉重抽血液通過二尖瓣入左心室, 是最大的, 心臟的肌肉的分庭。當其它分庭只移動血液一個短的距離, 左心室有強迫血液的責任在整個身體過程中通過主動脈。這完成系統, 允許血液流通在身體過程中和然後返回到心臟。

心臟病比較在人和狗

在人, 心臟病通常介入提供血液給心肌的動脈。他們在某些情況下硬化, 丟失他們的彈性和能力反應血壓區別當他們分佈血液對心肌。在其它案件, 可能適當節食或遺傳學, 動脈也許成為阻礙與加強內部在動脈牆壁上的匾。這導致心臟的肌肉接受較不比充分相當數量血液。挨餓為氧氣, 結果通常是心臟病發作。在狗, 動脈硬化症(硬化動脈), 匾形成, 和心臟病發作是全部非常罕見。但是, 心臟病是非常, 非常共同。

似犬心力衰竭簡單地意味, 肌肉' 給。' 這由一分庭通常造成或心臟的邊必需做更多比它完全能做。它也許是, 過份力量必需抽血液通過區域, 並且隨時間, 肌肉失敗。並且, 在某些情況下, 比特殊分庭必須抽跟上心臟其它區域是更多血液的容量可能適應自己移動, 再導致肌肉失敗。不同於心臟病發作在人, 心臟病失敗在狗是發生經過幾個月或幾年的一個緩慢的陰險過程。在這些情況下, 一旦症狀是著名, 他們將惡化在時間期間直到動物被安置在治療, 模子, 或' 被投入睡覺。'

二尖瓣不足

心力衰竭在更舊的狗通常歸結於有心臟的二尖瓣的問題, 和最共同地發生在更小的養殖, 譬如長捲毛狗、Yorkies 、Pugs 、Pomeranians 、Lhasas, 等。作為狗年齡, 二尖瓣在左心房和左心室之間起動無法。心臟瓣膜被設計防止流動。血液可能容易地抽通過閥門, 但一旦更加向前的分庭被填裝, 閥門關閉防止血液流動落後入心房。這些閥門很大地增加心臟的效率當泵浦, 因為血液必須只抽一次繼續它行動今後從一分庭向其它分庭。血液不溢出, 會要求另外的努力移動它今後。在二尖瓣混亂情況下(指僧帽形的不足), 閥門變老和收縮和因此不完全地關閉區域在心臟的左邊在二分庭之間。左心室是非常強的, 並且以僧帽形的不足, 它容易地強迫血液的部份落後入左心房以各心跳。血液壓力在通常作用的心臟之內是最高的在左心室, 照原樣必需移動血液在整個身體過程中。當血流落後入心房, 它舉起血壓在那分庭和進一步回到肺領域。有另外的複雜化, 增加壓力在心臟的右邊當它試圖正確地抽血液今後入肺為oxygenation 。與這被舉起的壓力面對在肺領域之內, 心臟的右邊必須艱苦運作在搬入血液區域。

症狀: 僧帽形的不足的結果是被舉起的血壓在肺領域和心臟之內的右邊。症狀由這個情況造成是非常可預測的。當高血壓(更加高級比正常血壓) 發生在肺之內, 流體實際上留下血管和洩漏入組織。醫學術語使用描述' 流體在肺的是' 肺腫鼓。' 這導致受影響的個體咳嗽為清除肺流體, 正您會做以胸口寒冷。典型地發生在鍛煉, 興奮以後的咳嗽, 或當動物首先起來了在睡覺以後是第一臨床症狀被注意以僧帽形的不足。在許多情況下, 這被控制以 導致動物小便更和從他的肺因此取消剩餘流體的利尿藥。

當情況進步, 心臟的右邊開始無法由於它增加的工作和舉起了壓力。起初肌肉加強, 因此增加它的牆壁的大量和厚度。在時間期間, 然而, 甚而這些' 運動' 肌肉無法跟上持續增長的壓力並且他們開始失敗。在混亂的這個後者階段期間, 動物將是微弱的並且更加容易地疲倦, 可能平衡微弱。

治療: 療程被使用加強並且協調肌肉的收縮和他們將幫助(和可能消滅) 臨床標誌。這些療程包括 digoxin 和 血管緊縮素轉換酵素(一點) 抗化劑 譬如 enalapril。利尿藥(水藥片) 譬如 Lasix 可能幫助取消可能積累在肺的剩餘流體。飲食降下在鈉裡也許協助減少可變的積累。有限的鍛煉也許是有利的, 然而, 與您的獸醫協商在開始您的狗之前在鍛煉節目。不管治療, 解剖變動繼續內部發生因此療程只將減速疾病的進步。以療法, 情況通常惡化在時間期間, 並且在許多情況下, 最後導致動物的死亡。

預防: 有可能做防止二尖瓣不足的少量事。診斷疾病及早在它的路線是非常有用的在減慢進步。通知所有心力衰竭的標誌的您的獸醫在您的狗。保持您的狗健康和在他理想的重量可能減輕症狀嚴肅如果僧帽形的不足發生。心臟的閥門可能由傳染傷害; 這傳染可能起因於嚴厲牙齒問題, 允許細菌從嘴進入血液。好口頭健康然後, 還重要。


The heart is an organ which frequently fails in the dog and surprisingly, it happens to dogs of all ages. In the young, this is typically the result of congenital abnormalities in the formation of the heart or blood vessels, which surround it. In older animals, it is usually a case in which one side or chamber is weakened or over worked due to altered circulatory patterns.
The heart as a pump

The heart is actually nothing more than a mechanical pump. It accepts blood on one side and forces it through the lungs, then its other half pumps the liquid on through the entire body. The heart does not change or alter the blood in any way. It has no glandular tissue and therefore secretes nothing into the blood nor does it extract anything. It is probably the simplest and most easily understood organ in the entire body


As a quick review, blood returns from the body and enters the right upper chamber of the heart, called the right atrium. At this point, the blood is low in oxygen but high in carbon dioxide. It is then pumped from the atrium through the right atrioventricular valve into the right ventricle. From this larger chamber, it is then forced on into the lung field through the pulmonary artery. This is the only artery in the body that carries non-oxygenated blood. Carbon dioxide is a by-product of body metabolism and is attached to the red blood cells. In the lungs, carbon dioxide is replaced with oxygen. The reoxygenated blood then moves through the pulmonary vein back into the heart and enters the left atrium. This chamber pumps the blood through the mitral valve into the left ventricle, which is the largest, most heavily muscled chamber of the heart. While other chambers only move the blood a short distance, the left ventricle has the responsibility of forcing blood throughout the entire body through the aorta. This completes the system, which allows blood to circulate throughout the body and then return to the heart.

Comparison of heart disease in people and dogs

In people, heart disease usually involves the arteries that supply blood to the heart muscle. In some cases they harden, losing their elasticity and the ability to respond to blood pressure differences as they distribute blood to the cardiac muscle. In other cases, possibly due to diet or genetics, the arteries may become obstructed with a plaque that builds up internally on the artery walls. This causes the muscles of the heart to receive less than adequate amounts of blood. Starved for oxygen, the result is usually a heart attack. In dogs, arteriosclerosis (the hardening of the arteries), plaque formation, and heart attacks are all very rare. However, heart disease is very, very common.

Canine heart failure simply means that the muscles 'give out.' This is usually caused by one chamber or side of the heart being required to do more than it is physically able to do. It may be that excessive force is required to pump the blood through an area, and over time, the muscles fail. Also, in some cases, the volume of blood that must be pumped to keep up with other areas of the heart is more than the particular chamber can adapt itself to move, again leading to muscle failure. Unlike a heart attack in humans, cardiac failure in the dog is a slow insidious process that occurs over months or years. In these cases, once symptoms are noted, they will worsen over time until the animal is placed on treatment, dies, or is 'put to sleep.'

Mitral valve insufficiency

Heart failure in older dogs is usually due to problems with the mitral valve of the heart, and occurs most commonly in smaller breeds, such as Poodles, Yorkies, Pugs, Pomeranians, Lhasas, etc. As the dog ages, the mitral valve between the left atrium and left ventricle starts to fail. A heart valve is designed to prevent back flow. Blood can be easily pumped through the valve, but once the more forward chamber is filled, the valve closes to prevent blood from flowing backwards into the atrium. These valves greatly increase the efficiency of the heart as a pump, since the blood only has to be pumped once to keep it moving forward from one chamber to another chamber. No blood is spilling back, which would require additional effort to move it forward. In the case of a mitral valve disorder (referred to as mitral insufficiency), the valve ages and shrinks and thereby fails to completely close off the area on the left side of the heart between the two chambers. The left ventricle is very strong, and with mitral insufficiency, it easily forces a portion of the blood backward into the left atrium with each heartbeat. The pressure of blood within a normally functioning heart is highest in the left ventricle, as it is required to move the blood throughout the entire body. When blood flows backwards into the atrium, it elevates the blood pressure in that chamber and even further back into the lung field. There are additional complications, which increase pressures in the right side of the heart as it attempts to correctly pump blood forward into the lungs for oxygenation. Confronted with this elevated pressure within the lung field, the right side of the heart must work harder in moving the blood into the area.

Symptoms: The result of mitral insufficiency is elevated blood pressure within both the lung field and right side of the heart. The symptoms caused by this condition are very predictable. When hypertension (higher than normal blood pressure) occurs within the lungs, fluid actually leaves the blood vessels and leaks into the tissues. The medical term used to describe 'fluid in the lungs' is 'pulmonary edema.' This causes the affected individual to cough in an attempt to clear the lungs of the fluid, just as you would do with a chest cold. The cough that typically occurs after exercise, excitement, or when the animal has first gotten up after sleeping is the first clinical symptom noted with mitral insufficiency. In most cases, this is controlled with diuretics that cause the animal to urinate more and thereby remove excess fluids from his lungs.

As the condition progresses, the right side of the heart starts to fail because of its increased work and elevated pressures. At first the muscles strengthen, thereby incre>><<athletic' muscles cannot keep up with the ever-increasing pressures and they start to fail. During this latter stage of the disorder, the animal will be weaker and tire more easily, maybe even faint.

Treatment: Medications are used to strengthen and coordinate the muscles' contractions and they will help (and possibly eliminate) the clinical signs. These medications include digoxin and angiotensin-converting-enzyme (ACE) inhibitor such as enalapril. Diuretics (water pills) such as Lasix can help remove the excess fluid that can accumulate in the lungs. Diets lower in sodium may assist in decreasing the fluid build-up. Limited exercise may be beneficial, however, consult with your veterinarian before starting your dog on an exercise program. Regardless of treatment, anatomical changes continue to occur internally so the medications will only slow down the progression of the disease. Even with therapy, the condition usually worsens over time, and in many cases, finally results in the death of the animal.

Prevention: There are few things that can be done to prevent mitral valve insufficiency. Diagnosing the disease earlier in its course is very helpful in slowing the progression. Notify your veterinarian of any signs of heart failure in your dog. Keeping your dog healthy and at his ideal weight can lessen the severity of symptoms if mitral insufficiency does occur. Valves of the heart can be injured by infection; this infection can result from severe dental problems, which allow bacteria from the mouth to enter the bloodstream. Good oral health then, is also important.[/size]
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[size=12px][size=5][color=magenta][b]健康& 獸醫關心為更舊的狗Health & Veterinary Care for Older Dogs[/b][/color][/size]


規則專業獸醫關心對您的更舊的狗健康是根本的。不是因為您的狗是小狗有規則核對和接種很重要。預防獸醫關心可能增加幾年和質量來您的更舊的狗生活。自認, 您的狗, 和您的獸醫和雇用職員主要目標是保持您的狗愉快, 健康的一個隊, 並且在與您的一個愛戀的關係為越久越好。

由於許多我們的寵物長期居住, 並且我們認為及早在疾病過程中我們能做診斷和開始治療, 更好結果。許多獸醫診所和醫院開發了特別預防關心節目為更舊的動物。這些經常叫做' 老年醫學的盤區, ' ' 老年醫學的健康節目, ' ' 老年醫學的屏幕, ' 或' 資深關心節目。' 這些可能包括各種各樣的診斷測試的組合包括驗血、urinalyis 、糞便檢查、射線照相(X-射線), 和EKGs 。問您的獸醫哪個測試是適當的為您的狗。獸醫也許推薦為一條更舊的狗的各種各樣的測試、檢查、規程, 和服務下述。

健康開始在構想

您的狗的健康由他的父母健康部份地今天確定在他被設想的天。接種、營養、牙齒關心、wormings 、heartworm 預防, 和您的狗有通過他的生活有直接對他當前的健康有影響的其它寄生生物控制。我們能更加健康地保留狗當他是年輕, 更加可能的他將是健康的雖然他增長更老。

重量管理, 飲食和營養建議

到您的獸醫的每次參觀應該包括您的狗的重量的測量。重量獲取和未經說明的減重也許是第一疾病症狀, 並且記住, 肥胖病是最共同(和最可防止的) 疾病的當中一個在更舊的狗。多數藥物, wormers 藥量, 並且heartworm 預防措施根據重量, 因此有當前的重量重要。如果您的狗的重量變動, 咨詢您的獸醫關於改變任何療程或補充藥量您的狗採取。如果您關注變化在您的狗的重量或胃口上, 是肯定的告訴您的獸醫。

您的獸醫或獸醫職員應該能推薦哪食物和補充您的狗應該接受根據他的重量、健康狀態, 和養殖。更舊的狗消化系統不起反應很好對突然的變動。如果一個變化在飲食上被推薦, 慢慢地做變動在一個星期或更多中, 逐漸加新食物來老。

病史

您的獸醫過去常確定的扼要工具的當中一個如果疾病過程發生□在您的狗, 是準確病史。監測您的更舊的寵物和記錄疾病症狀將有價值在及早做一個適當的診斷疾病其間。問題譬如' 當做了這種症狀或標誌首先出現?', ' 是它得到更好或更壞?', 並且' 是標誌或症狀總當前, 或是它斷斷續續?', 是問題只您能回答。如果您不是肯定的是否某一行為或觀察是表示的疾病, 要求您的獸醫。

體檢

更舊的狗應該接受規則體檢。多頻繁這些檢查應該發生取決於您的狗的健康狀態, 但他們應該至少年年是。為大約更舊狗, 二或更多檢查每年可以被推薦。請務必告訴您的獸醫關於您觀察了的所有情況並且要評估。如果您不瞭解什麼您的獸醫做□在檢查期間, 要求。

口頭和牙齒檢查

一次體檢應該包括嘴、牙、膠、舌頭, 和喉頭的考試。取決於狗的個性, 這可能非常容易做, 或它可能是實際上不可能的沒有鎮靜。得到小狗被使用對安排他的嘴張當他是年輕, 巨大地將幫助如同他增長更老。

直腸檢查

直腸檢查是一次體檢的一重要部份為狗。您的獸醫將審查內在骨盆區域, 內部 淋巴結, 冒號的襯裡, 和在公狗, 攝護腺。泌尿系統的部份可能並且被評估此時。

眼科檢查

當狗變老, 定期眼科(眼睛) 檢查被推薦。更舊的狗是在發展大瀑布、青光眼 ,和 '乾燥眼睛更多風險, ' 一個條件那裡是不足的淚花生產。眼科檢查, 包括tonometry (壓力的測量在眼睛), 將幫助辨認這些問題, 也許預防永久損壞對於眼睛。

頭髮和外套關心

在體檢期間, 您的獸醫將評估您的狗皮膚和外套的健康。特別香波, 另外修飾, 補充, 或某些診斷測試也許被推薦。

體外寄生蟲(寄生生物控制在身體的外部)

體檢應該包括皮膚和耳朵的考試為所有外在寄生生物的標誌譬如 蚤、壁虱、虱子, 或小蜘蛛。您的獸醫能推薦產品保護您的狗免受這些寄生生物或對待您的狗如果寄生生物被發現。

endoparasites (parsites 控制在身體的裡面)

糞便檢查 應該定期地是奔跑辨認 也許是 存在的所有小腸寄生生物。檢查毛皮在肛門區域附近也許幫助確定如果您的狗有腸類圓蟲。您的獸醫能推薦哪wormers 您的狗應該接受。

Heartworm 預防

heartworm 測試 頻率 取決於您的狗接受的類型預防措施, 是否您的狗錯過了預防物的任何藥量, heartworm 疾病頻率在您的地理區域, 並且是否您的狗顯示任何heartworm 疾病的標誌。請求您的獸醫您可以有關於類型heartworm 預防措施使用的任何問題, 管理藥量, 和頻率。

接種

由於一條 更舊的狗的 免疫系統不能起作用並且當他是年輕, 它非常重要保持您的狗最新在他的 接種。與您的獸醫協商關於哪疫苗您的狗應該接受, 並且多頻繁。

尿分析

許多獸醫將推薦 尿分析 執行在更舊的狗。尿分析是真正地一系列的測試, 提供財富資訊。樣品一般容易獲得, 並且測試可能進行在您的獸醫的辦公室在短的時間。如果您注意了任一個變化在顏色、氣味, 或相當數量您的狗的尿上, 您注意他有困難小便, 或他有' 事故, ' 它非常重要尿分析執行。

血液計數

有可能執行在血液的許多測試。評估血液的多孔的部份的幾個共同性測試包括在 完全血液計數。在某些情況下, 您的獸醫也許推薦, 只一兩這些測試執行。

化學盤區

測試的數量評估各種各樣的化學製品、酵素、蛋白質、激素、廢品, 和 電解質 在血液是在上百。通常, 將評估 6-12 這些組分的化學盤區將執行。這個化學盤區是一個可貴的工具在辨認 糖尿病mellitus、 肝臟病、腎臟疾病, 和幾種荷爾蒙疾病。測試的數量在盤區和多頻繁他們執行將取決於您的更舊的狗的年齡和健康狀態。

EKG

心電圖(EKG) 可能相當容易地執行在狗。有新儀器可利用, 可能僅僅被拿著在動物的邊獲得EKG - 沒有導線帶領從機器需要附有(難受地) 您的狗。再, 是否您的獸醫推薦EKG 為您的狗將取決於體檢的結果(是心臟私語當前?), 您的狗年齡和養殖, 和任何的心臟病的標誌您的狗也許體驗。

甲狀腺測試

甲狀腺測試也許由您的獸醫並且推薦, 再根據體檢的結果, 您的狗養殖, 和所有甲狀腺激素缺乏或剩餘的標誌。需要採取甲狀腺療程的狗將需要有他們的甲狀腺激素水平被檢查在正則區間。

射線照相

特別是如果您的狗顯示標誌或有心臟、肺、腎臟、肝臟, 或食道疾病的歷史, 射線照相(X-射線) 也許被推薦。因為狗增長更舊, 它經常是有用有胸口和腹部的射線照相被採取當狗是健康的。如果狗開發疾病症狀, 這些' 正常' 射線照相有價值在提供評估射線照相被採取在疾病過程以後開始了的基礎線。在許多情況下, 有或有癌症的狗將有射線照相被採取, 特別是胸口, 尋找任何疾病的傳播。

Preanesthetic 掩護

一個更舊的動物一般是在更加巨大的風險為有有害反應對麻醉劑。肝腎功能的評估, 血液組分, 和電解質被推薦為被麻醉的更舊的狗。知道問題好比發現存在予先是在大約問題之外當您的狗是在外科手術中間。如果反常性被發現在前麻醉劑屏幕, 做法要求麻醉也許被延期, 類型和相當數量麻醉劑被使用也許被修改, 或執行做法方法也許被改變。

選擇為診斷測試和治療

是較不蔓延性, 短的在期間, 或也許執行以地方麻醉的更新的規程變得越來越可利用在獸醫方面。這些包括laser 手術、內窺鏡檢察、 超聲波, 和electrosurgery 。這些可能是優秀選擇為衛生問題也許阻止他們從更加傳統的規程的更舊的狗。

血壓監視

近來, 測量動物血壓是一繁瑣做法, 和無法獲得的在許多獸醫醫院。新儀器和技術使血壓測量較不笨重, 並且更多獸醫將有這個診斷和監視做法可利用。

痛苦控制

痛苦控制的問題在動物中演講更多由獸醫和在獸醫文學。新療程變得可利用, 可能幫助更舊的狗是更加舒適的。這些療程並且有價值在也許有終端和痛苦的疾病動物的治療。

寵愛損失、無痛苦的死亡, 和哀情管理

無痛苦的死亡繼續是一個選擇為不要他們終端不適的寵物遭受, 或也許發現獸醫費用為他們的寵物持續的治療是禁止的許多寵物所有者。它經常是有用與您的獸醫談論無痛苦的死亡的過程很好在它的發生前。哪個家庭成員將是存在在做法期間, 何時何地它將發生, 選擇為處理寵物的遺骸的, 怎麼家庭成員也許想要說再見或為他們的寵物提供紀念品, 並且怎麼和與誰他們將花費時間在無痛苦的死亡是應該被談論的首要的問題之後。

基於家的招待所關心變得可利用通過一些獸醫醫院和志願組織。概念在寵物招待所之後將為一隻終端不適的寵物在家提供舒適的關心。這樣的關心也許是有用的當寵物的家庭成員需要更多時刻對他們的寵物臨近死亡調整。招待所可能是特別有用的在提供兒童時間瞭解, 家庭寵物垂危, 或給時刻為一個geograhically 遙遠的家庭成員回家說再見和提供相互支持對其它家庭成員。

您的獸醫也許能提供您以提及對哀情建議服務, 寵愛損失支持組, 或協助家庭用其它方式, 譬如幫助他們解釋對年輕家庭成員什麼發生□。 寵愛損失熱線, 書幫助 人民追悼他們的寵物損失, 並且其它資源有還時間幫助家庭成員通過哀情過程。

總結

更舊的寵物需要規則獸醫關心防止疾病並且/或者診斷它及早在它的路線。許多獸醫有特別節目監測狗在他們的最新歲月生活。好通信在所有者、狗, 和獸醫之間可能保持狗健康和做他的資深歲月是美妙的歲月。在您的狗的生活的結尾, 您的獸醫能幫助您在做出決定, 提供支持, 瞭解和分享您的哀情, 和慶祝, 與您, 您的寵物生活。


Regular professional veterinary care is essential to the health of your older dog. Not since your dog was a puppy have regular checkups and vaccinations been so important. Preventive veterinary care can add years and quality to the life of your older dog. Consider yourself, your dog, and your veterinarian and staff a team whose main goal is to keep your dog happy, healthy, and in a loving relationship with you for as long as possible.

Because many of our pets are living longer, and we recognize that the earlier in a disease process we can make a diagnosis and start a treatment, the better the outcome. Many veterinary clinics and hospitals have developed special preventive care programs for older animals. These are often called 'geriatric panels,' 'geriatric wellness programs,' 'geriatric screens,' or 'senior care programs.' These can include combinations of various diagnostic tests including blood tests, urinalyis, fecal exams, radiographs (x-rays), and EKGs. Ask your veterinarian which tests are appropriate for your dog. The various tests, exams, procedures, and services a veterinarian may recommend for an older dog are described below.

Wellness starts at conception

Your dog's health today is partially determined by the health of his father and mother on the day he was conceived. The vaccinations, nutrition, dental care, wormings, heartworm prevention, and other parasite control your dog has had through his life have a direct bearing on his current health. The healthier we can keep a dog when he is young, the more likely he will be healthy as he grows older.

Weight management, diet and nutrition counseling

Every visit to your veterinarian should include a measurement of your dog's weight. Weight gain and unexplained weight loss may be the first signs of disease, and remember, obesity is one of the most common (and preventable) diseases in older dogs. The dose of most drugs, wormers, and heartworm preventives are based on weight, so having a current weight is important. If your dog's weight changes, consult your veterinarian about changing the dose of any medications or supplements your dog is taking. If you are concerned about changes in your dog's weight or appetite, be sure to let your veterinarian know.

Your veterinarian or veterinary staff should be able to recommend which foods and supplements your dog should receive based upon his weight, health status, and breed. The digestive systems of older dogs do not react well to sudden changes. If a change in diet is recommended, make the change slowly over the course of a week or more, gradually adding the new food to the old.

Medical history

One of the main tools your veterinarian uses to determine if a disease process is occurring in your dog, is an accurate medical history. Monitoring your older pet and keeping records of signs of disease will be valuable in making a proper diagnosis early in the course of a disease. Questions such as 'When did this symptom or sign first appear?', 'Is it getting better or worse?', and 'Is the sign or symptom always present, or is it intermittent?', are questions only you will be able to answer. If you are not sure whether a certain behavior or observation is indicative of a disease, ask your veterinarian.

Physical exam

Older dogs should receive regular physical exams. How often these exams should occur depends upon the health status of your dog, but they should be at least annually. For some older dogs, two or more exams per year may be recommended. Be sure to tell your veterinarian about any conditions you have observed and want evaluated. If you do not understand what your veterinarian is doing during an exam, ask.

Oral and dental exam

A physical exam should include an examination of the mouth, teeth, gums, tongue, and throat. Depending upon the personality of the dog, this can be very easy to do, or it can be virtually impossible without sedation. Getting a puppy used to having his mouth opened while he is young, will help tremendously as he grows older.

Rectal exam

A rectal exam is an important part of a physical exam for a dog. Your veterinarian will examine the inner pelvic area, internal lymph nodes, the lining of the colon, and in the male dog, the prostate. Portions of the urinary system can also be evaluated at this time.

Ophthalmic exams

As dogs age, routine ophthalmic (eye) exams are recommended. Older dogs are at more risk of developing cataracts, glaucoma, and 'dry eye,' a condition in which there is insufficient tear production. Ophthalmic exams, including tonometry (measurement of the pressure in the eye), will help identify these problems and may prevent permanent damage to the eye.

Hair and coat care

During the physical exam, your veterinarian will evaluate the health of the skin and coat of your dog. Special shampoos, additional grooming, supplements, or certain diagnostic tests may be recommended.

Control of ectoparasites (parasites on the outside of the body)

The physical exam should include an examination of the skin and ears for any signs of external parasites such as fleas, ticks, lice, or mites. Your veterinarian will be able to recommend products to protect your dog from these parasites or treat your dog if parasites are found.

Control of endoparasites (parsites on the inside of the body)

A fecal exam should be run routinely to identify any intestinal parasites that may be present. Checking the fur around the anal area may help determine if your dog has tapeworms. Your veterinarian will be able to recommend which wormers your dog should receive.

Heartworm prevention

The frequency of heartworm tests depends on the type of preventive your dog is receiving, whether your dog has missed any doses of the preventative, the frequency of heartworm disease in your geographical area, and whether your dog is showing any signs of heartworm disease. Ask your veterinarian any questions you may have regarding the type of heartworm preventive to use, the dose, and frequency of administration.

Vaccinations

Because the immune system of an older dog may not be functioning as well as when he was young, it is very important to keep your dog up-to-date on his vaccinations. Consult with your veterinarian regarding which vaccines your dog should receive, and how often.

Urinalysis

Many veterinarians will recommend a urinalysis be performed on older dogs. A urinalysis is really a series of tests, which provide a wealth of information. The sample is generally easy to obtain, and the test can be run in your veterinarian's office in a short amount of time. If you have noticed any change in the color, odor, or amount of your dog's urine, you have noticed him having difficulty urinating, or he has had 'accidents,' it is very important that a urinalysis be performed.

Blood count

There are many tests which can be performed on blood. Several common tests which evaluate the cellular portion of the blood are included in a complete blood count. In some cases, your veterinarian may recommend that only one or two of these tests be performed.

Chemistry panel

The number of tests evaluating the various chemicals, enzymes, proteins, hormones, waste products, and electrolytes in blood is in the hundreds. Generally, a chemistry panel which will evaluate 6-12 of these components will be performed. This chemistry panel is a valuable tool in identifying diabetes mellitus, liver disease, kidney disease, and several hormonal diseases. The number of tests in the panel and how often they are performed will depend upon the age and health status of your older dog.

EKG

An electrocardiogram (EKG) can be performed quite easily on dogs. There are new instruments available, which can merely be held at the animal's side to obtain an EKG - with no wires leading from the machine needing to be attached (uncomfortably) to your dog. Again, whether your veterinarian recommends an EKG for your dog will depend upon results of the physical exam (were heart murmurs present?), the age and breed of your dog, and any signs of heart disease your dog may be experiencing.

Thyroid testing

Thyroid testing may also be recommended by your veterinarian, again based upon the results of the physical exam, the breed of your dog, and any signs of thyroid hormone deficiency or excess. Dogs who need to take thyroid medication will need to have their thyroid hormone levels checked at regular intervals.

Radiographs

Especially if your dog is showing signs or has a history of heart, lung, kidney, liver, or gastrointestinal disease, radiographs (x-rays) may be recommended. As a dog grows older, it is often helpful to have a radiograph of the chest and abdomen taken while the dog is healthy. If the dog develops signs of disease, these 'normal' radiographs are valuable in providing a baseline by which to evaluate the radiographs taken after a disease process has started. In most cases, a dog who has or has had cancer will have radiographs taken, especially of the chest, to look for any spread of the disease.

Preanesthetic screening

An older animal is generally at greater risk for having adverse reactions to anesthetics. An evaluation of liver and kidney function, blood components, and electrolytes are recommended for older dogs who are going to be anesthetized. Knowing a problem exists beforehand is much better than finding out about the problem when your dog is in the middle of a surgical procedure. If abnormalities are found on the pre-anesthetic screen, the procedure requiring anesthesia may be postponed, the types and amounts of anesthetics used may be altered, or the method of performing the procedure may be changed.

Options for diagnostic tests and treatments

Newer procedures which are less invasive, shorter in duration, or may be performed with local anesthesia are becoming increasingly available in veterinary medicine. These include laser surgery, endoscopy, ultrasound, and electrosurgery. These can be excellent alternatives for older dogs whose health problems may preclude them from the more traditional procedures.

Blood pressure monitoring

Until recently, measuring the blood pressure of animals was a tedious procedure, and unavailable in many veterinary hospitals. New instruments and techniques have made blood pressure measurement less cumbersome, and more veterinarians will have this diagnostic and monitoring procedure available.

Pain control

The issue of pain control in animals is being addressed more by veterinarians and in the veterinary literature. New medications have become available, which can help older dogs be much more comfortable. These medications are also valuable in the treatment of animals who may have a terminal and painful disease.

Pet loss, euthanasia, and grief management

Euthanasia continues to be an option for many pet owners who do not want their terminally-ill pet to suffer, or who may find the veterinary costs for continued treatment of their pet to be prohibitive. It is often helpful to discuss the process of euthanasia with your veterinarian well in advance of its occurrence. Which family members will be present during the procedure, when and where it will take place, options for handling the pet's remains, how the family members may want to say good-bye or provide a memorial for their pet, and how and with whom they will spend time immediately after the euthanasia are all important issues which should be discussed.[/size]
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minibabyqq 2006-12-28 00:26

轉貼自4682

[size=12px][size=5][color=magenta][b]腎臟疾病: 治療  Kidney Disease: Treatment[/b][/color][/size]


腎臟疾病的治療(並且指在醫療術語腎臟病) 在狗和貓將變化取決於有些起因和如果疾病是 深刻 或 慢性的。

急性腎衰竭的治療(ARF)

在深刻腎臟疾病案件, 動物通常有突然發生的嚴厲標誌。這些也許包括消沉, 嘔吐, 胃口熱病、損失, 和變化在相當數量排尿上。好病史和測試將需要進行發現起因。起因也許是可治療的譬如傳染由細螺旋體病 造成; 大批出沒與寄生生物譬如 巨型腎臟蠕蟲; 或對毒素的暴露譬如 復活節百合 或 不凍液。血液和尿樣理想地被採取在治療因此治療開始不影響測試結果之前。

可變的療法: 腎臟疾病的最初的治療, 介入典型地重新水化患者大約2-10 個小時和維護正常水合作用以後那。這典型地做與 靜脈注射 (iv) 流體在獸醫診所因此適當的數額可能被測量並且寵物可能被監測為適當的可變的產品(排尿) 。許多次, IV 可變的管理是足夠開始或增加尿產品。如果尿產品仍然不是正常的, 療程譬如 furosemide 或 甘露醇 也許是必要設法得到腎臟生產尿。 電解質 譬如鈉、鉀, 和其它電解質被監測和被維護在正常範圍通過IV 流體和, 有時, 療程的管理。

營養: 當寵物成為重新水化與流體, 他開始感到較不令人噁心和典型地變得更加願意吃。如果寵物願意吃得或如果管哺養進行, 高質量低數量蛋白質應該被哺養。這限制要求在腎臟當提供身體以需要的營養。在嚴厲案件, 腸外 營養也許被給通過IV 線。

如果動物嘔吐由於腎臟病, 治療也許包括給頻繁小飯食和療程譬如 腸潰藥 或chlorpromazine 。噁心也許一整天來和去因此小飯食日間被提供也許增加整體攝食。

其它治療: 同時可變的療法開始, 治療為根本原因通常開始譬如 抗生素 為嘔吐的細菌傳染或歸納為某些毒素。

腎臟 透析 可能完成在一些獸醫診所、特別是提及診所或獸醫學校。也許受益於透析的寵物包括那些不反應正常療法, 那些有一種毒害腎臟的(毒性對腎臟) 毒物在他們, 那些不生產尿, 或那些要求緊急手術譬如為尿道修理由於精神創傷。

腎臟移植為狗 和貓是選擇可利用在幾家獸醫醫院此時。

以早期和進取的治療, 急性腎衰竭也許是反演性的。

慢性腎衰竭的治療(CRF)

慢性腎衰竭為不可逆的損害描繪在腎臟之內。在許多情況下, 腎臟作用的改善不應該被期望一旦身體補償了儘量。如果腎衰竭是(的prerenal 由疾病造成除減少血流對腎臟) 的實際腎臟故障之外或postrenal (由壓力積累造成在泌尿系統從阻礙, 例如) 組分, 它也許是部份地反演性的以治療。腎臟作用在慢性案件傾向於是相對地穩定的幾星期對幾個月露出未預見到的變動。作用進步地惡化在幾星期對幾個月對幾年。被減少的腎臟作用的臨床和生物化學的後果可能由根據症狀和支援療法減到最小。

許多次, CRF 的最早期的標誌由所有者錯過。這些包括一溫和減輕在乾渴和排尿的增量(煩渴和polyuria) 並且需要小便在夜(nocturia 期間) 。其它共同性早期的臨床研究結果包括易變的減重、惡劣的頭髮外套、慵倦, 和有選擇性的胃口。當情況進步, 更多標誌出現。

如果CRF 的起因可能被辨認, 它應該被對待如果可能。許多次, 情況被發現在更舊的寵物和歸結於年齡。

可變的療法: 可變的需要是偉大的在CRF 患者因為患者無法集中尿因此更多水通過在身體外面以尿的形式。在早期, 患者也許能維護可變的平衡由繼續吃和增加相當數量水被消耗。液面需要被維護防止 失水。當疾病進步, 另外的流體以 皮膚下 (平方) 流體的形式也許是必要的。所有者能在家典型地給這些流體在被顯示以後怎麼在獸醫診所。鉀的加法對流體或對飲食也許是必要維護這電解質的適當的水平在身體。低鉀水平起因推斷了肌肉弱點和心臟節奏干擾。在某些情況下, 靜脈注射(iv) 流體也許並且需要被給。

寵物應該總有對新鮮, 乾淨的水的自由存取。扣壓的水在晚上不會減少寵物的需要隔夜小便和也許導致一次深刻危機。相當數量水和食物被消耗每天應該被監測因此所有者知道是否寵物是吃和喝正常數額。如果不是, 另外的流體(IV 或平方) 將是必要維護水合作用。

體重應該被檢查每個星期確定足夠的卡路里被消耗維護重量並且失水不是問題。

飲食: 獸醫也許推薦對更低, 但高質量的飲食變動, 蛋白質飲食, 也許減少重音在害病的腎臟。經常, 罐裝食物被推薦。變動也許需要慢慢地完成保留寵物吃。蛋白質制約無法過份或寵物也許開發蛋白質營養不良由於蛋白質損失通過腎臟或 不被發現在健康寵物的胃腸道。飲食應該由檢查寵物的重量, 檢查貧血症 ,和檢查監測hypoalbuminemia 。如果這些是存在, 在蛋白質含量的增量也許是必要的。總遵守飲食指示被給您由您的獸醫。

寵物應該被鼓勵吃一相當數量食物維護重量和提供適當的營養。增加胃口, 它也許幫助哺養幾小飯食每天, 提高飲食的palatability 與添加劑譬如酸奶乾酪, 酸奶, 或砍菜, 或增加刺激胃口的療程。溫暖食物也許並且增加palatability 。和燒傷也許收效不要哺養熱的食物。胃口也許日間來和去, 因此設法哺養在不同時候日間。食物導致的噁心也許某時發生天和不在其它的時候。療程控制噁心也許並且增加胃口。

電解質、維生素, 和脂肪酸: 電解質水平需要被維護在正常範圍。磷進水閘也許需要被減少對幫助 清液 水平保留正常。磷酸鹽黏合劑也許被使用當飲食改變並且可變的療法不保留磷級在正常範圍。鈣補充也許是必要的並且維生素D 療法。鹽進水閘需要是充分的幫助維護水合作用和給食物味道但那它不太高惡化高血壓。減少食物的鹽含量在幾個星期允許腎臟補嘗變動。鉀水平應該被監測並且補充被給如果需要。

水溶維生素(B 和C) 應該被補充, 特別是在粗劣吃期間的時期。維生素A 和D 的補充在極小值每日要求之外不被推薦的歸結於維生素A 積累和變化在維生素D 上他們的新陳代謝在腎臟患者。

Ω3 脂肪酸補充也許是好處對一些動物以慢性腎衰竭。

其它治療: 任何療程對待其它條件譬如膀胱傳染或心臟病需要仔細地被給和寵物被監測為副作用。劑量也許需要被減少作為腎臟也許是主要器官從身體消滅療程。

寵物應該被監測為貧血症和治療被創始如果需要。 Erythropoietin 也許被給作為射入幫助身體導致紅血球。尿毒症的治療將幫助加長紅血球的壽命。在更加嚴厲的案件, 輸血可能被給。

血壓應該被監測幫助預防進一步損壞對於腎臟, 能導致在疾病進步的增量並且對視網膜的 損傷, 可能導致盲目性。療程也許是必要維護正常血壓。

腎臟移植是可利用的為狗和貓在幾家獸醫醫院。

與治療, 寵物與CRF 也許居住幾個月對幾年。它全部將依賴於怎樣身體反應出現的治療和其它健康關心。


The treatment of kidney disease (also referred to in medical terminology as renal disease) in dogs and cats will vary somewhat depending upon the cause and if the disease is acute or chronic.

Treatment of acute renal failure (ARF)

In cases of acute kidney disease, the animal usually has severe signs that occurred suddenly. These may include depression, vomiting, fever, loss of appetite, and changes in the amount of urination. A good medical history and testing will need to be performed to find the cause. The cause may be treatable such as infection caused by leptospirosis; an infestation with a parasite such as the giant kidney worm; or exposure to toxins such as the Easter lily or antifreeze. Blood and urine samples are ideally taken before the start of treatment so the treatment does not affect the test results.

Fluid therapy: Initial treatment of kidney disease, involves rehydrating the patient typically over about 2-10 hours and maintaining normal hydration after that. This is typically done with intravenous (IV) fluids in the veterinary clinic so the appropriate amounts can be given and the pet can be monitored for appropriate fluid output (urination). Many times, the IV fluid administration is enough to start or increase urine output. If urine output is still not normal, medication such as furosemide or mannitol may be necessary to try to get the kidneys to produce urine. Electrolytes such as sodium, potassium, and other electrolytes are monitored and maintained in the normal range through the administration of the IV fluids and, sometimes, medications.

Nutrition: As the pet becomes rehydrated with the fluids, he typically starts feeling less nauseous and becomes more willing to eat. If the pet eats willingly or if tube feeding is performed, a high quality lower quantity protein should be fed. This limits the demands on the kidneys while providing the body with needed nutrition. In severe cases, parenteral nutrition may be given via an IV line.

If the animal is vomiting because of the renal disease, treatment may include giving frequent small meals and medication such as cimetidine or chlorpromazine. The nausea may come and go through the day so small meals offered throughout the day may increase the overall food intake.

Other treatments: At the same time fluid therapy is started, treatment for the underlying cause is usually begun such as antibiotics for a bacterial infection or induction of vomiting for certain toxins.

Kidney dialysis can be done at some veterinary clinics, especially referral clinics or veterinary schools. Pets that may benefit from dialysis include those that fail to respond to normal therapies, those that have a nephrotoxic (toxic to the kidney) poison in them, those that are not producing urine, or those that require emergency surgery such as for repair of the urinary tract due to trauma.

Kidney transplants for dogs and cats are an option available at a few veterinary hospitals at this time.

With early and aggressive treatment, acute renal failure may be reversible.

Treatment of chronic renal failure (CRF)

Chronic renal failure is characterized by irreversible lesions within the kidney. In most cases, improvement of the renal function should not be expected once the body has compensated as much as possible. If the renal failure is prerenal (caused by a disease other than actual kidney malfunction that decreases the blood flow to the kidney) or postrenal (caused by a build-up of pressure in the urinary system from an obstruction, for example) components, it may be partially reversible with treatment. Renal function in chronic cases tends to be relatively stable for weeks to months baring unforeseen changes. Function does progressively deteriorate over weeks to months to years. The clinical and biochemical consequences of reduced renal function can be minimized by symptomatic and supportive therapy.

Many times, the earliest signs of CRF are missed by owners. These include a mild to moderate increase in thirst and urination (polydipsia and polyuria) and a need to urinate during the night (nocturia). Other common early clinical findings include variable weight loss, poor hair coat, lethargy, and selective appetite. As the condition progresses, more signs appear.

If the cause of the CRF can be identified, it should be treated if possible. Many times, the condition is found in older pets and is due to age.

Fluid therapy: The fluid need is greater in the CRF patient because the patient is unable to concentrate the urine so more water is passed out of the body in the form of urine. In earlier stages, patients may be able to maintain fluid balance by continuing to eat and increasing the amount of water consumed. The fluid level needs to be maintained to prevent dehydration. As the disease progresses, additional fluid in the form of subcutaneous (SQ) fluid may be necessary. Owners can typically give these fluids at home after being shown how at the veterinary clinic. The addition of potassium to the fluids or to the diet may be necessary to maintain proper levels of this electrolyte in the body. Low potassium levels cause generalized muscle weakness and heart rhythm disturbances. In some cases, intravenous (IV) fluids may also need to be given.

The pet should always have free access to fresh, clean water. Withholding water at night will not decrease the pet's need to urinate overnight and may cause an acute crisis. The amount of water and food consumed each day should be monitored so the owner knows whether the pet is eating and drinking normal amounts. If not, additional fluids (IV or SQ) will be necessary to maintain hydration.

The body weight should be checked every week to make sure enough calories are being consumed to maintain weight and that dehydration is not a problem.

Diet: The veterinarian may recommend a diet change to a lower, but high quality, protein diet, which may decrease the stress on the diseased kidneys. Often, canned food is recommended. The change may need to be done slowly to keep the pet eating. The protein restriction cannot be excessive or the pet may develop protein malnutrition due to loss of protein via the kidney or the gastrointestinal tract that is not found in healthy pets. The diet should be monitored by checking the pet's weight, checking for anemia, and checking for hypoalbuminemia. If these are present, an increase in protein content may be necessary. Always follow the dietary instructions given to you by your veterinarian.

Pets should be encouraged to eat an amount of food to maintain weight and provide the appropriate nutrition. To increase the appetite, it may help to feed several small meals a day, to enhance the palatability of the diet with additives such as cottage cheese, yogurt, or chopped up vegetables, or to add a medication that stimulates appetite. Warming the food may also increase the palatability. Do not feed hot food as burns may result. The appetite may come and go during the day, so try feeding at various times during the day. Food-induced nausea may happen at certain times of the day and not at other times. Medication to control nausea may increase the appetite also.

Electrolytes, vitamins, and fatty acids: Electrolyte levels need to be maintained in the normal range. The phosphorus intake may need to be decreased to help serum levels remain normal. Phosphate binders may be used when diet changes and fluid therapy do not keep the phosphorus level in the normal range. Calcium supplementation may be necessary as well as vitamin D therapy. Salt intake needs to be adequate to help maintain hydration and to give the food flavor but not too high that it worsens hypertension. Decrease the salt content of the food over several weeks to allow the kidneys to compensate for the change. Potassium levels should be monitored and a supplement given if necessary.

Water soluble vitamins (B and C) should be supplemented, especially during times of poor eating. Supplementation of vitamin A and D beyond the minimum daily requirement is not recommended due to a build-up of vitamin A and the changes in their metabolism of vitamin D in renal patients.

Omega-3 fatty acid supplementation may be of benefit to some animals with chronic renal failure.

Other treatments: Any medications to treat other conditions such as bladder infections or heart disease need to be given carefully and the pet monitored for side effects. The dosage may need to be decreased as the kidneys may be the main organ to eliminate the medication from the body.

The pet should be monitored for anemia and treatment initiated if necessary. Erythropoietin may be given as injections to help the body produce more red blood cells. Treatment of uremia will help lengthen the life span of the red blood cells. In more severe cases, blood transfusions can be given.

Blood pressure should be monitored to help prevent further damage to the kidneys, which could cause an increase in progression of the disease as well as damage to the retinas, which can result in blindness. Medication may be necessary to maintain normal blood pressure.

Kidney transplants are available for dogs and cats at several veterinary hospitals.

With treatment, pets with CRF may live months to years. It will all depend on how the body responds to the treatment and other health concerns that arise.[/size]

minibabyqq 2006-12-28 00:27

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[size=12px][size=5][color=magenta][b]完全血液計數(CBC)  Complete Blood Count (CBC)[/b][/color][/size]





是否這是人、狗、貓、甚至鳥或白鼬, 當病殘, 他們的醫生典型地畫血樣和執行一些測試幫助確定診斷。這些測試一般是二型的當中一個。第一型是完全血液計數(CBC), 確定數量和類型血細胞當前。科學與這個血液的多孔的部份有關叫做 血液學。第二類型測試是 測量各種各樣的電解質 、酵素, 或化合物的 數量 在樣品的液體部份的血液化學盤區。有時這些測試產生關於案件的一點資訊, 但更加典型, 他們是最快速和最佳的診斷器械可利用對醫生。
血液組分

血液被彌補一個液體部份加上所有各種各樣的血細胞。它起作用運輸 營養素 和氧氣對細胞; 廢物和二氧化碳對器官負責任對他們的撤除或故障; 並且並且保衛身體反對細菌、 病毒, 和其它有機體。

血液的液體部份指血漿, 如果血液未被允許凝結, 並且 清液, 如果它是。這個液體部份, 沒有細胞, 一般是秸桿或light-yellow 顏色。血液的液體部份被使用在化學測試。

每滴血液逐字地包含成千上萬血細胞。雖然樣品被畫為CBC 也許似乎小, 它包含這是這些細胞的總數一個優秀和準確寫照被發現在血液的這樣細胞的巨大的數字。CBC 與數量和類型紅血球、 白細胞,和小片 有關。

紅血球

首先, 讓我們看紅血球(RBC 的) 。這些是負責對運載氧氣對身體的組織的微小的 耕馬。RBC 的包含分子血紅蛋白。被採取入我們的身體的氧氣附有血紅蛋白作為RBC 的通行證通過肺。RBC 的交付氧氣對所有其它細胞在身體和然後需要二氧化碳回到肺。

RBC 的被形成在骨髓。骨髓經常生產新RBC 的, 從RBC 的壽命是只大約120 天。身體可能迅速反應維護RBC 的數字當前在血管。身體簡單地測量他們的數字由評估氧氣的數量被提供給它的組織。如果沒有足夠的氧氣是可利用的, 那麼身體看見作為對更多運作的RBC 的需要。

如果更多RBC 的迅速必要, 那麼更加發育未全的細胞(叫做reticulocytes) 被釋放入循環從骨髓。但是, 如果有充分細胞當前, 它減速新的發行。

血流比容計: 在CBC, 我們確定RBC 的數字用幾個不同的方式。最快和最容易稱血流比容計, 並且指 被包裝的細胞容量 (PCV) 。血樣被安置在一個微小的玻璃管和轉動在離心機。這設備轉動管圓和圓在幾一千轉每分鐘。細胞比血漿重的和變緊密在管的一個末端。在管轉動之後, 它被審查並且PCV 被確定作為多孔的部份的百分比相對總額血液在管(即, 剩下的人是血漿) 。法線為狗是40-59 並且貓是29-50 。

如果PCV 是降低, 有比我們會期望少量紅細胞在身體。這個情況指貧血症。在貧血症嚴厲案件, 動物會有蒼白膜在它的嘴和大概似乎微弱和疲乏, 因為它的身體會得到較少氧氣比必要。貧血症被分類進一步像或再生或nonregenerative 。在前, 即使紅血球的數量比法線低, 身體反應由釋放新reticulocytes 入循環。在nonregenerative 貧血症, 沒有或非常少量發育未全的RBC 的在樣品和身體繼續丟失紅血球, 但新的不導致。nonregenerative 貧血症是非常, 非常嚴肅的, 迅速將變得威脅生命的。

當PCV 是大於55, 它被認為舉起。這被看見在被脫水的動物當他們的血液成為集中。它被注意在其它條件, 譬如震動、反應(空氣是' 稀釋劑, ' 因此有較少氧氣, 因此更多RBC 的被投入入循環), 疾病肺, 等一些案件對高處的。記住, 任何減少相當數量氧氣到達身體組織將導致紅血球的更高的數字被發現在CBC 。

紅血球計數: 我們能並且測量RBC 的實際數字在血液的一個指定的數量。這叫' 紅色計數, ' 和比血流比容計是難執行。紅血球計數不被測量作為任何東西的百分比, 而是寧可細胞的實際數量被發現在一微升(. l) 。投入事入對那些的透視我們不relish 公制, 一公升比一夸脫是正義的一少許大, 並且一微升是百萬分之一分之一一公升。各個實驗室有他們自己的套' 正常' 範圍為RBC 計數, 但平均是5.6-8.7 x 106 RBC 的每微升為狗, 和6.1-11.9 x 106/ . l 為貓。

血紅蛋白: 我們能評估RBC 的一個最後的方式是由定量相當數量血紅蛋白禮物。在一些貧血症, RBC 的實際數字不也許是真正的低落, 但是如果細胞比正常數量包含較少血紅蛋白, 貧血症的標誌能是相當嚴厲的。正常血紅蛋白水平為狗是14-20 grams/deciliter, 和9-15.6 g/dl 為貓。

白細胞

另一主要類型血細胞是白細胞(WBC 的), 並且指白血球。有比有WBC 的許多RBC 的。為每粒白血球當前在樣品有通常將是600 到700 RBC 的。白細胞的主要角色是保衛身體反對侵略的有機體譬如細菌、病毒, 和真菌。有不同的類型白血球, 並且白色血液計數(WBC) 是一共計所有各種各樣的種類。正常範圍為WBC 計數在狗會是在6,000 和17,000 之間每微升, 和在貓, 4,900-20,000/. l 。WBC 的數字被舉起當身體與嚴厲傳染戰鬥或由新陳代謝的毒素典型地強調(是在深刻腎臟 失敗 與廢品加強在它的身體的患者通常會有被舉起的WBC) 。另外, 何時極端激動的(如果我們激發或過度嚇唬動物當畫血樣) 白細胞將被釋放入血液和水平將上升。WBC 計數比法線低, 如果動物被減弱了從延長, 致衰弱的疾病和在一些病毒傳染。

WBC 的被劃分成二個小組根據怎樣他們起反應對被使用更好觀察他們在顯微鏡下的汙點。有(的granulocytes 他們是WBC 的與吸收汙點) 的粒子並且agranulocytes (那些不吸收汙點) 。granulocytes 包括嗜中性、eosinophils, 和basophils, 當agranulocytes 是淋巴細胞和monocytes 。

嗜中性: 嗜中性並且被形成在骨髓。成熟細胞' 被分割的細胞的有一個多有裂片的中堅力量和指(有時叫做' segs 的), 當發育未全部分有一個唯一有裂片的中堅力量和指' 帶。' 帶比segs 年輕- 當從骨髓嗜中性首先發布是帶, 並且在消費時間以後在流通的血液他們成熟入segs 。這些細胞起作用由實際上吞噬疾病導致細菌和其它小顆粒。在細菌傳染面前, 他們的數字在周邊血液增加, 骨髓釋放更多年輕細胞入循環, 並且帶的百分比增加關於被分割的部分。正常範圍為成熟嗜中性是在3,000 之間對12,000/. l 。法線為帶是大約100 到300 每微升。

當總嗜中性數字被增加, 這通常是細菌傳染或某種極端重音的形式的標誌。如果帶的數量巨大增加關於segs 的數量, 它認為是更加嚴厲的反應, 因為身體釋放越□越發育未全的細胞入循環保護自己反對傳染。在多數病毒傳染, 嗜中性的總數減少。

Eosinophils: Eosinophils 通常被看見在少的數字比嗜中性。他們並且被生產在骨髓並且他們的正常範圍是大約100 到1200 每微升。他們並且有能力吃光或吞噬外國微粒入他們的身體。他們的數量增加在流通的血液當動物遭受傳染與寄生生物, 或有過敏。在導致極端或長時期的重音對狗或貓的情況, 嗜伊紅嗜伊紅體的數字減少。

Basophils: granulocytes 的為時是basophil 。這些是所有WBC 的最少共同性。在許多樣品, 無是存在。他們的作用是未知的, 但他們並且被生產與骨髓。

淋巴細胞: agranulocytes, 最豐富是淋巴細胞。有通常500-4,800 這些在一微升狗的血液, 和1,500-7,000/. l 在貓的。他們從淋巴腺組織被形成和被發布譬如 淋巴結、 脾臟, 等。他們無法吃或吞噬有機體, 但履行他們的保衛身體的作用用其它方式。淋巴細胞可能被劃分成二主要型由他們的作用- B 細胞和 T 細胞, 而是這些無法是卓越的從彼此通過看他們在顯微鏡下。B 細胞生產抗體, 是蛋白質分子附有和因此毀壞侵略的有機體或其它雜質和微粒。T 細胞激活和幫助其它細胞毀壞病毒和其它雜質。當淋巴細胞數字減少它指淋巴球減少症, 和頻繁地被注意在傳染最初的階段(一個共同的例子會是 parvovirus) 或跟隨對類皮質激素的 用途 像強體松。有達到被減少的淋巴細胞數字的其它情況, 但他們是相當不凡的。在淋巴細胞的數量的增量不發生作為一致地如可能已預期, 而是被注意在長時期的病症。這的例子會是細菌或病毒傳染進來在長期或在某些 自動免疫的 疾病。增加的淋巴細胞的同道會是白血病, 是血細胞生產癌症通常是致命的。

Monocytes: Monocytes 顯現出和被存放在脾臟和骨髓。通常, 有只100 到1800 年這些每各微升狗的血液, 和0-850/. l 在貓。他們並且有能力吃或吞噬雜質, 譬如感染有機體。另外, 他們藏匿幫助在乾淨被激起的和被激怒的組織的各種各樣的蛋白質分子。他們的數字不很大地變化除非有一個癌白血病情況影響他們的細胞線。

小片

我們學習當解釋CBC, 是小片的最後的組分。他們發揮一個重要作用在凝塊的形成。認可他們的重要性, 認為有大裁減和怎麼它會是可能流血對死亡, 如果法線凝結沒有發生。在事實, 我們一直流血。小船經常微小地打破在我們的身體之內, 但我們不注意它, 因為凝塊形成在幾秒鐘內並且相當數量血液丟失是無意義的。小片和蛋白質叫做纖維蛋白原負責對所有損壞的血管修理。既使有從未裁減在我們的身體的外部, 沒有小片和纖維蛋白原共同努力, 我們會流血對死亡內部在幾天之內事情。如果小片數字被減少, 它也許意味, 身體或者用盡很大數量的可利用的細胞在凝塊形成, 或他們的數字也許是降低並且動物是在巨大風險, 如果靈菌在將來開始。

細胞形態學

執行CBC 報告不僅不同的細胞類型的數量的一個一流的質量實驗室, 而且供應他們的大小和形狀的描述。我們提到這作為細胞形態學。是非常具體的為某些疾病的反常性經常看。例子會是在是的情況以許多白血病的影響血細胞的某些癌症, 不同的形式。

許多次, CBC 的結果當與一次好體檢結合和歷史, 使診斷容易。一條母狗早先是在熱2 個到3 個月, 她的水消耗量被舉起, 並且她似乎微弱在後方處所。獸醫是認為她也許有嚴厲子宮混亂叫做pyometra 。CBC 回來以總被舉起的WBC 計數45,000 並且診斷實際上被證實。

當CBC 的結果供給我們, 我們更好被裝備確定動物的整體健康。它將幫助我們確定如果傳染是存在和區分如果它是病毒, 細菌, 或寄生的。CBC 可能診斷或幫助證實其它混亂譬如過敏、自動免疫的疾病、貧血症, 白血病, 和許多其他。

正常血液學價值為狗和貓*

單位 似犬 似貓
血流比容計(PCV)
%
40-59
29-50

血紅蛋白
g/dl
14-20
9-15.6

紅血球計數
x106/.l
5.6-8.7
6.1-11.9

白細胞計數
/.l
6,000-17,000
4,900-20,000

嗜中性
/.l
3,000-12,000
2,500-12,500

淋巴細胞
/.l
530-4,800
1,500-7,000

Monocytes
/.l
100-1800
0-850

Eosinophils
/.l
0-1,900
0-1,500

Basophils
/.l
<100
<100

小片
/.l
145-440
190-800


* 正常價值也許不同從實驗室到實驗室。


Whether it is a human, dog, cat, or even bird or ferret, when sick, their doctors typically draw a blood sample and perform some tests to help determine a diagnosis. These tests are generally one of two types. The first type is the complete blood count (CBC), which determines the number and types of blood cells present. The science concerned with this cellular portion of the blood is called hematology. The second type of test is a blood chemistry panel that measures the quantities of various electrolytes, enzymes, or chemical compounds in the liquid portion of the sample. Sometimes these tests yield little information about the case, but more typically, they are the fastest and best diagnostic tool available to the doctor.
Components of Blood

Blood is made up of a liquid portion plus all the various blood cells. It functions to transport nutrients and oxygen to the cells; wastes and carbon dioxide to the organs responsible for their removal or breakdown; and also to defend the body against bacteria, viruses, and other organisms.

The liquid portion of blood is referred to as plasma, if the blood was not allowed to clot, and serum, if it was. This liquid portion, without the cells, is generally a straw or light yellow color. The liquid portion of the blood is used in the chemistry tests.

Every drop of blood literally contains millions of blood cells. Although the sample drawn for a CBC may seem small, it contains such huge numbers of cells that it is an excellent and accurate portrayal of the total numbers of these cells found in the bloodstream. The CBC is concerned with the quantities and types of red blood cells, white blood cells, and platelets.

Red Blood Cells

First, let us look at the red blood cells (RBC’s). These are the tiny workhorses that are responsible for carrying oxygen to the body’s tissue. RBC’s contain the molecule hemoglobin. Oxygen that is taken into our bodies attaches to the hemoglobin as the RBC’s pass through the lungs. The RBC's then deliver the oxygen to all the other cells in the body and take the carbon dioxide back to the lungs.

RBC's are formed in the bone marrow. The bone marrow constantly produces new RBC's, since the life span of an RBC is only about 120 days. The body can respond quickly to maintain the number of RBC's present in the blood vessels. The body measures their numbers simply by evaluating the quantity of oxygen being supplied to its tissues. If not enough oxygen is available, then the body sees that as a need for more working RBC’s.

If more RBC's are needed quickly, then more immature cells (called reticulocytes) are released into the circulation from the bone marrow. However, if there are adequate cells present, it slows down the release of new ones.

Hematocrit: In the CBC, we determine the number of RBC’s in several different ways. The quickest and easiest is called the hematocrit, also referred to as the packed cell volume (PCV). A blood sample is placed in a tiny glass tube and spun in a centrifuge. This device spins the tube round and round at several thousand revolutions per minute. The cells are heavier than the plasma and are compacted at one end of the tube. After the tube is spun, it is examined and the PCV is determined as the percentage of the cellular portion relative to the total amount of blood in the tube (i.e., remainder being the plasma). The normal for dogs is 40-59 and cats is 29-50.

If the PCV is low, there are fewer red cells in the body than we would expect. This condition is referred to as anemia. In severe cases of anemia, the animal would probably have pale membranes in its mouth and seem weak and tired, since its body would be getting less oxygen than needed. Anemias are further classified as either regenerative or nonregenerative. In the former, even though the number of red blood cells is lower than normal, the body is responding by releasing new reticulocytes into the circulation. In the nonregenerative anemia, there are no or very few immature RBC’s in the sample and the body continues to lose red blood cells, but no new ones are produced. A nonregenerative anemia is very, very serious and will quickly become life-threatening.

When the PCV is greater than 55, it is said to be elevated. This is seen in dehydrated animals as their blood is becoming more concentrated. It is noted in other conditions, such as some cases of shock, response to high altitudes (the air is 'thinner,' therefore there is less oxygen, so more RBC’s are put into circulation), diseases of the lungs, etc. Remember, anything that decreases the amount of oxygen reaching the tissues of the body will cause higher numbers of red blood cells to be found in the CBC.

Red Blood Cell Count: We can also measure the actual number of RBC's in a given quantity of blood. This is called the 'red count,' and is more difficult to perform than a hematocrit. The red blood cell count is not measured as a percentage of anything, but rather the actual number of cells found in a microliter (µ l). To put things into perspective for those of us who do not relish the metric system, a liter is just a little larger than a quart, and a microliter is one millionth of a liter. Each laboratory has their own set of 'normal' ranges for a RBC count, but the average is 5.6-8.7 x 106 RBC's per microliter for dogs, and 6.1-11.9 x 106/µ l for cats.

Hemoglobin: A final way we can evaluate the RBC's is by quantifying the amount of hemoglobin present. In some anemias, the actual number of RBC's may not be real low, but if the cells contain less than the normal amount of hemoglobin, the signs of anemia could be quite severe. The normal hemoglobin level for a dog is 14-20 grams/deciliter, and 9-15.6 g/dl for cats.

White Blood Cells

The other major type of blood cells are the white blood cells (WBC’s), which are also referred to as leukocytes. There are many more RBC’s than there are WBC’s. For every leukocyte present in a sample there will normally be 600 to 700 RBC’s. The major role of the white blood cells is to defend the body against invading organisms such as bacteria, viruses, and fungi. There are different types of leukocytes, and a white blood count (WBC) is a total of all the various kinds. The normal range for a WBC count in the dog would be between 6,000 and 17,000 per microliter, and in the cat, 4,900-20,000/µ l. The number of WBC's is typically elevated when the body is fighting a severe infection or stressed by metabolic toxins (a patient that was in acute kidney failure with waste products building up in its body would normally have an elevated WBC). In addition, when extremely excited (if we overly excite or frighten the animal when drawing the blood sample) white blood cells will be released into the blood and the levels will rise. The WBC count will be lower than normal, if an animal has been weakened from a prolonged, debilitating disease and in some viral infections.

WBC’s are divided into two groups depending on how they react to the stains that are used to better observe them under a microscope. There are granulocytes (they are WBC's with granules that absorb the stain) and the agranulocytes (those that do not absorb the stain). The granulocytes include the neutrophils, eosinophils, and the basophils, while the agranulocytes are the lymphocytes and monocytes.

Neutrophils: Neutrophils are also formed in the bone marrow. Mature cells have a multi-lobed nucleus and are referred to as 'segmented cells' (sometimes called 'segs'), while the immature ones have a single-lobed nucleus and are referred to as 'bands.' The bands are younger than the segs - when first released from the marrow neutrophils are bands, and after spending time in the circulating blood they mature into segs. These cells function by actually engulfing disease-causing bacteria and other small particles. In the presence of a bacterial infection, their number in the peripheral blood increases, the bone marrow releases more of the young cells into the circulation, and the percentage of bands increases in relation to the segmented ones. The normal range for mature neutrophils is between 3,000 to 12,000/µ l. The normal for the bands is approximately 100 to 300 per microliter.

When total neutrophil numbers are increased, it is usually a sign of a bacterial infection or some form of extreme stress. If the number of bands increases dramatically in relation to the number of segs, it is thought to be a more severe reaction, since the body is releasing more and more immature cells into the circulation to defend itself against the infection. In most viral infections, the total number of neutrophils decreases.

Eosinophils: Eosinophils are normally seen in fewer numbers than neutrophils. They are also produced in the bone marrow and their normal range is about 100 to 1200 per microliter. They also have the ability to eat up or engulf foreign particles into their bodies. Their quantities increase in the circulating blood when the animal is suffering from an infection with parasites, or has allergies. In conditions that cause extreme or prolonged stress to the dog or cat, eosinophil numbers decrease.

Basophils: The last of the granulocytes is the basophil. These are the least common of all the WBC’s. In many samples, none are present. Their function is unknown, but they are also produced with the bone marrow.

Lymphocytes: Of the agranulocytes, the most abundant is the lymphocyte. There are normally 500-4,800 of these in a microliter of dog's blood, and 1,500-7,000/µ l in a cat's. They are formed and released from lymphoid tissue such as lymph nodes, spleen, etc. They are unable to eat or engulf organisms, but fulfill their function of defending the body in other ways. The lymphocytes can be divided into two major types by their functions - B cells and T cells, but these cannot be distinguished from each other through looking at them under a microscope. The B cells produce antibodies, which are protein molecules that attach to and thereby destroy invading organisms or other foreign materials and particles. The T cells activate and help other cells destroy viruses and other foreign material. When lymphocytes numbers decrease it is referred to as a lymphopenia, and is frequently noted in the initial stages of infections (a common example would be parvovirus) or following the use of corticosteroids like prednisone. There are other situations that bring about reduced lymphocyte numbers, but they are fairly uncommon. An increase in the number of lymphocytes does not happen as consistently as might be expected, but is noted in prolonged illnesses. Examples of this would be when bacterial or viral infections have gone on for a long time or in certain autoimmune diseases. A common cause of increased lymphocytes is leukemia, which is a cancer of blood cell production that is usually fatal.[/size]
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[size=12px][b][size=5][color=magenta]腎臟疾病: 起因、標誌, 和診斷Kidney Disease: Causes, Signs, and Diagnosis[/color][/size][/b]



腎臟疾病(並且指在醫療術語腎臟病) 是一共同發現在貓和狗, 特別是那些到達他們的資深歲月。在 深刻 疾病, 譬如毒力, 標誌突然發生和可能是非常嚴厲的。在 慢性 腎臟疾病, 起始也許是非常慢的並且標誌相當未指明, 即, 動物"不做□很好。" 是否疾病是深刻或慢性的典型地與起因有關。

什麼是腎臟病的起因?

有許多腎臟病的起因, 並且他們也許有:

年齡
病毒, 黴菌, 或細菌傳染
寄生生物
巨蟹星座
Amyloidosis (由有些類型的反常儲蓄造成蛋白質在腎臟)
炎症
自動免疫的 疾病
精神創傷
毒性反應對毒物或療程
先天和被繼承的混亂
這不是一張完全名單而是展示什麼獸醫設法排除或作為標誌的起因。

什麼是腎臟疾病的標誌?

寵物以腎臟疾病能顯示各種各樣的物理標誌。一些標誌是未指明的, 也許被看見在其它混亂譬如肝臟或胰臟疾病, 或尿道混亂不介入腎臟。標誌也許有:


增加的水消耗量(煩渴)
增加的排尿容量(polyuria)
被減少的排尿(尿少)
缺乏排尿(anuria)
使尿無效在夜(nocturia 期間)
血液在尿(血尿)
被減少的胃口(厭食)
嘔吐
減重
慵倦
腹瀉
彎成拱狀在姿勢或勉強行動
惡劣或不整潔的頭髮外套
在體格檢查期間, 獸醫也許並且發現流動的標誌:

蒼白黏膜(即, 膠) 從在紅血球生產的減退造成 貧血症

擴大的並且/或者痛苦的腎臟或小, 不規則的腎臟

潰瘍 在嘴, 最共同地在面頰的舌頭、膠, 或裡面

口臭(口臭) 由於毒性物質加強在血液

失水

肢體的膨脹由於流體(皮膚下腫鼓的) 儲積

擴大的腹部由於流體(腹水的) 儲積

高血壓

變化在 視網膜上 由於高血壓

變柔和骨頭(橡膠下頜) 在幼小狗以遺傳性腎臟疾病(纖維狀骨營養不良)

什麼測試完成確定診斷?

各種各樣的驗血可能執行確定如果腎臟疾病是存在, 多麼嚴厲它也許是, 並且什麼可以導致它。另外, 尿分析和想像技術也許並且幫助確定起因和嚴肅。

化學盤區

不同的類型測試執行幫助診斷疾病過程。多個測試可能執行在一個血樣。經常包括在化學 盤區 跑尋找腎臟疾病的測試有:

血尿素氮(清液硝酸□): 小圓麵包是對血尿素氮的簡稱。動物消耗在他們的飲食的蛋白質是大分子。因為他們由身體劃分和使用, 副產物是一種nitrogen-containing 尿素化合物。這是沒有用途的對身體和由腎臟排泄。如果腎臟正確地不運作和不過濾這些浪費產品, 他們加強在血液。一個十二小時快速(沒有攝食) 是理想的在接受這考試之前因為水平也許輕微地上升在吃蛋白質以後。

肌氨酸酐: 肌氨酸酐並且被使用測量腎臟的濾清率。腎臟是排泄這種物質的唯一的器官, 並且如果它加強更加高級比正常水平, 這是腎臟的被減少的或被削弱的作用的標誌。

Azotemia 是醫學術語為在小圓麵包或肌氨酸酐的增量。尿毒症被定義作為azotemia 加上腎衰竭的臨床標誌譬如貧血症, polyuria 煩渴, 嘔吐, 或減重。Azotemia 被劃分進一步成prerenal, 腎臟, 或postrenal 起因。Prerenal azotemia 歸結於減少血流對腎臟的起因不同於實際腎臟故障。這些包括失水、 Addison 的疾病, 或心臟病。腎臟azotemia 發生由於對腎臟的損傷, 和可能包括慢性或深刻腎臟disease/failure 那結果在超過75% nephrons 中不起作用。Postrenal azotemia 發生當有壓力積累在泌尿系統。起因也許包括尿道的封鎖由於 似貓的更低的尿道疾病 (FLUTD) 或膀胱石頭, 防止尿從身體被去除。

磷: 正常鈣和磷水平在血液由三激素的互作用 維護 在三種身體器官。磷水平增加在腎臟疾病因為較少排泄入尿由腎臟。在貓, 磷水平也許並且增加由於 hyperthyroid 疾病。

尿分析

多個測試執行在 尿樣。他們是特別重要在確定如果腎臟疾病是存在。

尿比重: 這個測試是測量怎樣集中尿是。以腎臟疾病, 尿通常不被集中, 並且許多水丟失。正常比重通常是在1.025 之上, 當動物以腎臟疾病也許是在1.008 - 1.015 範圍。低比重應該再實驗確定它是一反覆性發現。其它疾病可能導致低比重, 因此這個測試本質上, 不是充足做診斷腎臟疾病。

蛋白質: 在一些類型腎臟疾病, 很多蛋白質丟失在尿。

沉積: 尿可能 被分離 因此更大的微粒也許被分離和被審查在顯微鏡下。紅血球出現或白細胞在尿沉積幫助點對疾病情況的起因。塑像(脫落的細胞) 從腎臟也許通過在尿。這些表明一個疾病過程在腎臟。

ERD 屏幕測試: 驗血, 稱 ERD, 測試對於某一蛋白質的出現在尿叫做 白蛋白。如果水平是在法線之上, 這是腎功能不全的一個非常早期徵兆, 也許是存在在其它腎臟疾病的標誌出現之前。辨認早期腎臟病考慮到早期治療開始設法減慢疾病過程。

完全血液計數

完全血液計數 (CBC) 是有用檢查傳染的貧血症和徵兆。貧血症在腎衰竭是共同和起因於在erythropoietin 的生產的減退由害病的腎臟。 Erythropoietin 是告訴身體導致紅細胞的激素。紅血球並且有更短的壽命在尿毒症的患者。

想像技術

造影: X-射線 被採取確定腎臟的大小和形狀。小腎臟是共同在慢性腎臟疾病當大腎臟也許表明深刻問題或癌症。

排泄的泌尿系攝影術譬如一靜脈內pyelography (IVP) 是專業類型X-射線。染料(正面對比媒介) 被注射入寵物的靜脈和被監測通過X-射線照原樣由腎臟過濾掉。這被使用為尿道的解剖評估和確定腎臟的大小、形狀, 和地點。它並且給對腎臟作用的一個粗暴評估。

Ultrasonography: Ultrasonography 尋找變化在腎臟的密度上。 切片檢查法 被採取在ultrasonography 期間也許幫助確定腎臟疾病的起因在某些情況下。

總結
由使用病史、標誌、體格檢查和各種各樣的類型診斷器械, 獸醫更好能正確地診斷腎臟混亂。由執行各種各樣的測試, 名單可能有希望地變窄對一個疾病過程。然後治療計劃和 預測 可能被提供。
   



Kidney disease (also referred to in medical terminology as renal disease) is a common finding in cats and dogs, especially those who are reaching their senior years. In acute disease, such as a toxicity, the signs occur suddenly and can be very severe. In chronic kidney disease, the onset may be very slow and the signs fairly nonspecific, i.e., the animal is "just not doing well." Whether the disease is acute or chronic is typically related to the cause.

What are the causes of renal disease?

There are many causes of renal disease, and they may include:

Age
Viral, fungal, or bacterial infections
Parasites
Cancer
Amyloidosis (caused by abnormal deposits of a certain type of protein in the kidney)
Inflammation
Autoimmune diseases
Trauma
Toxic reaction to poisons or medications
Congenital and inherited disorders
This is not a complete list but demonstrates what the veterinarian is trying to rule in or out as cause of the signs.

What are the signs of kidney disease?

Pets with kidney disease can show a variety of physical signs. Some of the signs are nonspecific and may be seen in other disorders such as liver or pancreatic diseases, or urinary tract disorders not involving the kidneys. Signs may include:


Increased water consumption (polydipsia)
Increased urination volume (polyuria)
Decreased urination (oliguria)
Lack of urination (anuria)
Voiding urine during the night (nocturia)
Blood in urine (hematuria)
Decreased appetite (anorexia)
Vomiting
Weight loss
Lethargy
Diarrhea
Hunched over posture or reluctance to move
Poor or unkempt hair coat
During the physical examination, the veterinarian may also find the flowing signs:

Pale mucous membranes (e.g., gums) from a decrease in red blood cell production resulting in anemia

Enlarged and/or painful kidneys or small, irregular kidneys

Ulcers in the mouth, most commonly on the tongue, gum, or inside of the cheek

Bad breath (halitosis) due to toxic substances building up in the blood stream

Dehydration

Swelling of the limbs due to accumulation of fluid (subcutaneous edema)

Enlarged abdomen due to accumulation of fluid (ascites)

High blood pressure

Changes in the retina due to high blood pressure

Softening of the bones (rubber jaw) in young dogs with hereditary kidney disease (fibrous osteodystrophy)

What tests are done to determine a diagnosis?

Various blood tests can be performed to determine if kidney disease is present, how severe it may be, and what may be causing it. In addition, a urinalysis and imaging techniques may also help to determine the cause and severity.

Chemistry panel

Different types of tests are performed to help diagnose the disease process. Multiple tests can be performed on one blood sample. Tests that are often included in a chemistry panel being run to look for kidney disease include:

Blood urea nitrogen (Serum urea nitrogen): BUN is the abbreviation for blood urea nitrogen. The proteins that animals consume in their diet are large molecules. As they are broken down and used by the body, the by-product is a nitrogen-containing urea compound. This is of no use to the body and is excreted by the kidneys. If the kidneys are not working correctly and filtering these waste-products, they build up in the blood. >><<.

Creatinine: Creatinine is also used to measure the filtration rate of the kidneys. The kidneys are the only organs that excrete this substance, and if it builds up to higher than normal levels, it is a sign of decreased or impaired function of the kidneys.

Azotemia is the medical term for an increase in the BUN or creatinine. Uremia is defined as azotemia plus clinical signs of renal failure such as anemia, polyuria-polydipsia, vomiting, or weight loss. Azotemia is divided further into prerenal, renal, or postrenal causes. Prerenal azotemia is due to causes other than actual kidney malfunction that decrease the blood flow to the kidney. These include dehydration, Addison's disease, or heart disease. Renal azotemia occurs due to damage to the kidney itself, and can include chronic or acute renal disease/failure that results in more than 75% of the nephrons not functioning. Postrenal azotemia occurs when there is a build-up of pressure in the urinary system. Causes may include blockage of the urethra due to feline lower urinary tract disease (FLUTD) or bladder stones, which prevent urine from being removed from the body.

Phosphorus: Normal calcium and phosphorus levels in the blood are maintained by an interaction of three hormones on three body organs. The phosphorus level increases in kidney disease because less is excreted into the urine by the kidney. In cats, the phosphorus level may also increase due to hyperthyroid disease.

Urinalysis

Multiple tests are performed on a urine sample. Several of them are especially important in determining if kidney disease is present.

Urine specific gravity: This test is a measurement of how concentrated the urine is. With kidney disease, the urine is not concentrated normally, and too much water is lost. A normal specific gravity is usually above 1.025, while animals with kidney disease may be in the 1.008 - 1.015 range. A low specific gravity should be retested to make sure it is a repeatable finding. Other diseases can cause a low specific gravity, so this test in itself, is not sufficient to make a diagnosis of kidney disease.

Protein: In some types of kidney disease, large amounts of protein are lost in the urine.

Sediment: The urine can be centrifuged so the larger particles may be separated out and examined under the microscope. The presence of red blood cells or white blood cells in the urine sediment help point to the cause of the disease condition. Casts (sloughed cells) from the kidneys may pass out in the urine. These indicate a disease process in the kidney itself.

ERD Screen Test: A blood test, called the ERD, tests for the presence of a certain protein in the urine called albumin. If the level is above normal, it is a very early indication of renal insufficiency and may be present before other signs of kidney disease appear. Identifying early renal disease allows for early treatment to begin to try to slow the disease process.

Complete Blood Count

A complete blood count (CBC) is useful to check for anemia and indications of infection. Anemia in renal failure is common and results from a decrease in the production of a erythropoietin by the diseased kidney. Erythropoietin is a hormone that tells the body to produce more red cells. The red blood cells also have a shorter life span in uremic patients.

Imaging techniques

Radiography: X-rays are taken to determine the size and shape of the kidneys. Small kidneys are more common in chronic kidney disease while large kidneys may indicate an acute problem or cancer.

Excretory urography such as an intravenous pyelography (IVP) is a specialized type of x-ray. A dye (positive contrast media) is injected into the pet's vein and monitored via x-rays as it is filtered out by the kidneys. This is used for anatomic evaluation of the urinary tract and to determine the size, shape, and location of the kidneys. It gives a crude assessment of renal function also.

Ultrasonography: Ultrasonography looks for changes in the density of the kidney. A biopsy taken during ultrasonography may help determine the cause of kidney disease in some cases.

Summary
By using the medical history, signs, physical examination and various other types of diagnostic tools, the veterinarian is better able to correctly diagnose a kidney disorder. By performing various tests, the list can be narrowed hopefully to one disease process. Then a treatment plan and prognosis can be provided.[/size]
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minibabyqq 2006-12-28 00:29

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[size=12px][size=5][color=magenta][b]真菌感染[/b][/color][/size]



Coccidioidomycosis 是真菌感染, 經常叫做"是共同在西南美國的谷熱病," 。真菌, Coccidioides immitis, 能導致溫和對嚴厲 呼吸 疾病在狗、貓, 和人。疾病的溫和的形式是更加共同, 可能容易地被對待; 疾病的更加嚴厲的形式可能是生活威脅。

它在哪裡是被發現?

Coccidioides 居住在土壤和有獨特的套情況必需為它的生存和再生產。它興旺在區域以含沙鹼性土壤、非常高溫度、低降雨量, 和低海拔。這些情況被發現在幾個區域在世界上。在北美洲, 包括西南美國的Sonoran 生活區域, 中美洲的墨西哥, 和部分是這真菌被發現的主要區域。在美國, coccidioidomycosis 是最流行在南加利福尼亞、亞利桑那, 和西南得克薩斯。但是, 案件發生□在西南過程中。

寵物怎麼得到傳染?

傳染主路在寵物和人是由真菌的吸入。只有10 真菌需要微小的片斷被吸入創造傳染。在真菌被吸入之後, 多數傳染將發生在1 個到3 個星期之內。研究表明那活在地方性區域將成為傳染, 然而, 多數傳染不導致症狀或不只導致溫和的疾病症狀的多數人民。動物或人的小百分比將開發將要求治療的更加嚴厲的症狀。有一個被壓制的 免疫系統的動物 是可能開發疾病的更加嚴厲的形式。

什麼是症狀在狗?

最共同的症狀在狗是上部呼吸咳嗽和肺炎像症狀。許多狗並且將有胃口熱病、損失, 和減重。在嚴厲案件, 傳染可能傳播(傳播) 對其它身體部位。狗以傳播的形式經常將有瘸, 脹大的淋巴結, 和排泄 皮膚損害另外的症狀。排泄的皮膚損害經常是存在在被傳染的骨頭站點。疾病可能經常變得 慢性 並且未經治療的狗以傳播的形式經常將死於疾病。

coccidioidomycosis 怎麼被診斷?

診斷根據歷史、症狀、X-射線肺, 證明有機體, 和血液測試的組合。X-射線經常將顯示一個有些典型樣式在肺。如果排泄的損害是存在, 一個小樣品可能被採取從區域和被審查在顯微鏡下為發現真菌。驗血辨認流通的 抗體 對 Coccidioides 經常被使用作為一個根據推定的測試如果診斷無法被做通過 切片檢查法 或樣品由排泄的損害。

它怎麼被對待?

治療包括口頭殺真菌劑的代理的長期 管理 。最共同的殺真菌劑的代理為狗和貓是ketoconazole 。治療的長度是易變的但也許是只要一年在有更加嚴厲的傳播的骨頭損害的狗。比ketoconazole 被使用和經常也許有少的副作用的其它口頭殺真菌劑的藥物是 itraconazole。這種藥物比ketoconazole 昂貴的但一些好結果達到了。治療在溫和的案件通常是成功的, 並且許多呼吸案件獨自大概會解決沒有治療。以進取的長期治療, 一些更加嚴厲的傳播的盒可能仍然被治療但預測是被守衛。

它怎麼可能被防止?

預防包括區域退避已知有 Coccidioides 在土壤。疫苗不是現在可以得到的。避免對免疫抑制的藥物的用途和對待 免疫抑制的 疾病可能並且幫助減少患這種疾病風險。



Coccidioidomycosis is a fungal infection, often called "Valley Fever," which is more common in the Southwestern United States. The fungus, Coccidioides immitis, can cause mild to severe respiratory disease in dogs, cats, and people. The mild form of disease is more common and can be easily treated; the more severe form of the disease can be life threatening.

Where is it found?

Coccidioides lives in the soil and has a unique set of conditions required for its survival and reproduction. It thrives in areas with sandy alkaline soils, very high temperatures, low rainfall, and low elevation. These conditions are found in several areas in the world. In North America, the Sonoran life-zone that includes Southwestern United States, Mexico, and parts of Central America are the primary areas where this fungus is found. In the U.S., coccidioidomycosis is most prevalent in southern California, Arizona, and southwestern Texas. However, cases have occurred throughout the Southwest.

How do pets get the infection?

The main route of infection in pets and people is by inhalation of the fungus. As few as 10 of the tiny pieces of fungus need to be inhaled to create an infection. After the fungus is inhaled, most infections will occur within 1 to 3 weeks. Studies indicate that most people that live in endemic areas will become infected, however, most infections do not cause symptoms or only cause mild signs of disease. A small percentage of animals or people will develop more severe symptoms that will require treatment. Animals that have a suppressed immune system are much more likely to develop the more severe form of the disease.

What are the symptoms in dogs?

The most common symptom in dogs is an upper respiratory cough and pneumonia-like symptoms. Many dogs will also have a fever, loss of appetite, and weight loss. In severe cases, the infection can disseminate (spread) to other parts of the body. Dogs with the disseminated form will often have additional symptoms of lameness, swollen lymph nodes, and draining skin lesions. The draining skin lesions are often present over the sites of infected bones. The disease can often become chronic and untreated dogs with the disseminated form will often die from the disease.

How is coccidioidomycosis diagnosed?

Diagnosis is based on a combination of history, symptoms, x-rays of the lungs, identification of the organism, and blood testing. X-rays will often show a somewhat characteristic pattern in the lungs. If a draining lesion is present, a small sample can be taken from the area and examined under a microscope in an attempt to find the fungus. Blood testing to identify circulating antibodies to Coccidioides is often used as a presumptive test if a diagnosis can not be made through biopsy or a sample from a draining lesion.

How is it treated?

Treatment consists of long-term administration of oral antifungal agents. The most common antifungal agent for dogs and cats is ketoconazole. The length of treatment is variable but may be as long as a year in dogs that have the more severe disseminated bone lesions. Another oral antifungal drug that is often used and may have fewer side effects than ketoconazole is itraconazole. This drug is more expensive than ketoconazole but some good results have been achieved. Treatment in mild cases is usually successful, and many respiratory cases would probably resolve on their own without treatment. With aggressive long-term treatment, some of the more severe disseminated cases can still be cured but the prognosis is much more guarded.

How can it be prevented?

Prevention consists of avoidance of areas known to have Coccidioides in the soil. No vaccine is currently available. Avoiding the use of immunosuppressive drugs and treating immunosuppressive diseases can also help reduce the risk of contracting this disease.
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minibabyqq 2006-12-28 00:30

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[size=12px][size=5][color=magenta][b]化學測試  Chemistry Panels & Tests[/b][/color][/size]

獸醫化學盤區(並且被命名' 生物化學的外形') 包括測試為多個化工組成部分在一個樣品之內。這些化學製品的數量可能顯露許多事關於身體的各種各樣的器官。多數獸醫化學盤區檢查血液 電解質 和肝臟、腎臟, 和胰腺的疾病。
整體血液是血細胞和液體的組合。 完全血液計數(CBC) 應付細胞部份和定量這種不同的紅色和白細胞、 小片, 和 血紅蛋白。化學盤區應付樣品的液體部份在細胞被去除了之後。獲得液體, 血樣被允許凝結在管之內並且管然後轉動在離心機。這強迫凝塊對管的底部並且液體保留在上面。流體離開在凝塊被去除了指'清液之後。' 這是部份被使用為化學盤區。

許多獸醫能執行一些小化學盤區' 在意味在獸醫設施之內的房子裡, ' 。為更大的盤區, 測試由一個地方實驗室經常執行, 頻繁地在一家人的醫院之內。那裡, 清液的少量從原始的收藏被引入一個唯一大機器。微小的樣品從那清液被測試因為各種化工組分。各個測試的結果被編寫和被印在一個唯一形式。使它容易對獸醫和醫師, 形式列出患者的結果與期望的正常價值一起為那種類。

類型盤區

因為實驗室設備有能力進行許多不同的測試, 那裡可能是許多另外化學鑲板(即, 肝臟盤區、電解質盤區、老年醫學的盤區, 前外科盤區) 被引起的取決於哪個個別測試被請求和包括。

一個典型的獸醫化學盤區將測量以下:

血液葡萄糖

小圓麵包

肌氨酸酐



總蛋白含量

白蛋白

球蛋白

總膽紅素

鹼性磷酸鹽

ALT (SGPT)

膽固醇




十三個不同測試, 那如果奔跑單獨, 會花費上百美元。但當執行作為盤區, 測試可能完成以更加合理的價格。不僅是有大挽救在費用, 但盤區經常做大範圍的診斷混亂, 更加容易。

好闡明, 所有獸醫是了不起的診斷員。真相是, 許多時期每年獸醫可能' 把保釋出來' 或由化學盤區保存。在這些事例, 盤區帶領我們我們甚而未考慮在可能的混亂我們的精神名單的診斷。有時, 獸醫能傾聽歷史和審查狗和立刻知道什麼是錯誤的。在其它案件, 獸醫能嚴密審查寵物每二個小時三天和沒有線索至於根本問題。在這個後者情況, 化學盤區有價值毫無疑問的。有時, 結果是一點點或沒有幫助在做診斷過程中, 但那是非常, 非常罕見。

具體測試的描述

血液葡萄糖: 當身體採取在 碳水化合物裡, 它轉換他們成糖朊, 被存放在肝臟。作為單獨需要能量, 糖朊被轉換成葡萄糖, 進入血液和被運輸在身體過程中。血液葡萄糖, 是因此, 動物的營養水平的措施, 但它經常被使用監測新陳代謝和生理。正常範圍為血糖是(是毫克葡萄糖為整體血液各deciliter) 的60 到120 mg/dl 。如果結果比60 低, 動物說飲用低血糖和指hypoglycemic 。如果研究結果是大於130, 狗被認為遭受高血糖症。

低血糖症是一個頻繁問題在幼小小狗、特別是玩具和更小的養殖。這些動物也許似乎微弱, 不協調, 和甚而有奪取。一些成人狗並且有有低血糖症的問題, 特別是在增加的或長時期的活動的期間。這是非常共同在一些狩獵養殖。低血糖被看見在是病的動物中並且長期並且debilitated 和以癌症的某些形式。

輕微地被舉起的血糖結果經常被發現當動物被注重或非常激動當血樣被採取。我們頻繁地看了結果大於160 從興奮單獨, 特別是在貓。但是, 當水平是180 mg/dl, 它發信號問題。這時, 腎臟的門限被超出。(當血液由腎臟過濾, 腎臟應該防止葡萄糖損失在尿。但是, 一旦這個高水平被到達, 腎臟的能力保留葡萄糖被超過和' 糖' 溢出入尿。) 這的同道會是 糖尿病mellitus。這種疾病的全名是糖尿病mellitus, 意味' 甜尿。' 在這個情況, 身體不生產足夠的 胰島素, 是需要的使葡萄糖輸入身體的細胞。以不充分的胰島素生產, 葡萄糖保留在血液。我們看了血糖讀書在糖尿病患者和900 一樣高!

小圓麵包: ' 小圓麵包' 代表血尿素氮。動物消耗在他們的飲食的蛋白質是大分子。因為他們由身體劃分和運用, 這新陳代謝副產物是nitrogen-containing 尿素化合物。這些是沒有用途的對身體和由腎臟排泄。如果腎臟正確地不運作和不過濾這些化合物從血液, 他們加強過份地高水平。當這發生在人身上, 他們被認為' 尿毒症, ' 和大概將被安置在 透析 機器。

當小圓麵包結果是高的, 這是唯一蛋白質氮氣廢物從身體不被去除的徵兆。當腎臟疾病是學習小圓麵包水平的主要原因, 那裡可能是其它起因為它的海拔。我們也看重大小圓麵包海拔當患者被脫水, 因為有正義的沒有足夠的流體在身體使腎臟正確地起作用。另外, 如果任何導致被減少的血流對腎臟, 他們無法充分地過濾血液並且小圓麵包將舉起。這的例子會是心臟病以被減少的循環。如果有阻礙以便尿無法離開身體, 它將加強在膀胱防止腎臟生產更多。這並且會舉起小圓麵包。

更低比正常小圓麵包水平頻繁地被注意在肝臟病。這種器官是蛋白質故障的當中一個主要站點。如果這次故障不發生, 含氮廢物將被發現在更低比正常水平。

肌氨酸酐: 肌氨酸酐並且被使用測量腎臟的濾清率。唯一腎臟排泄這種物質, 和如果它加強更加高級比正常水平, 它是這些器官的被減少的或被削弱的作用的標誌。

鈣: 鈣是被發現在一致的水平在血液之內的礦物。當狗是懷孕或護理小狗, 鈣水平可能成為嚴重壓下在疾病叫做驚厥。另外, 某些療程, 腫瘤, 等, 能影響鈣水平。它重要查出鈣的一個反常血液水平在它之前迅速導致嚴肅的心臟和肌肉混亂。

總蛋白含量: 總蛋白含量水平是二血液蛋白質分子、白蛋白和球蛋白的一次聯合的測量。白蛋白由肝臟通常生產。我們經常看白蛋白水平降低當動物接受不充分或質量差營養, 或 他們的 商店被用完和不被替換了的隨後而來的慢性傳染病。

期限' 球蛋白的包括由身體的免疫系統 生產作為 身體的防禦一部分反對細菌和病毒 的免疫球蛋白。在某些疾病, 譬如似貓的感染腹膜炎, 被舉起的球蛋白可能發生。

一個被舉起的蛋白質水平通常是失水的標誌。

膽紅素: 膽紅素是血紅蛋白故障的副產物。血紅蛋白是負責對運載氧氣對組織的分子在 紅血球之內。當血細胞死或被毀壞, 血紅蛋白由肝臟發布和迅速劃分和排泄作為膽紅素。所以, 膽紅素水平比法線也許高級當紅血球的過份數字劃分, 或如果肝臟無法害病和清除膽紅素從血液。如果有阻礙在肝臟或 膽管之內以便膽紅素無法被釋放入肚腑, 血液水平並且將舉起。

鹼性磷酸鹽: 清液鹼性磷酸鹽(經常省略的' 樹汁') 屬於化合物組叫做 酵素。這些是起作用協助各種各樣的化學反應的蛋白質分子。雖然鹼性磷酸鹽的正常水平變化用動物的不同的種類, 鹼性磷酸鹽在狗被看見在更高的水平以癌症和一些肌肉和肝臟病的某些形式。

SGPT: 清液Glutamic 丙酮酸胺基移轉(SGPT) 並且叫做' 胺基代丙酸氨基transferase ' (ALT) 。這是酵素重要在肝功能。海拔通常意味, 肝臟細胞劃分由於種種原因。肝臟也許是癌的, 有傳染在它裡面, 被充塞或狼吞虎嚥以許多血液(和在心力衰竭), 無法或被用完和 它過濾從血液的肝病, 被阻礙以便廢品和毒素無法從身體被去除通過膽管, 等。基本上, 任何有害地影響肝臟或它的能力正確地起作用將舉起SGPT 。

膽固醇: 膽固醇沒有和一樣它做在人的醫學的內涵。心臟的船的硬化和阻礙不是一個共同的問題在似犬和似貓的醫學。相反, 膽固醇偏差是一般其它疾病的次要標誌。動物與不充分地作用的甲狀腺經常舉起了膽固醇。餓的動物或那些以養料的粗劣的水平也許有更低比期待的膽固醇。

鈉和鉀: 鈉和鉀水平一起被解釋。他們的水平可能嚴重影響在腎上腺封墊的 疾病, 心臟, 腎臟, 或由各種各樣的療程, 等。相反地, 變化在他們的水平上可能導致非常嚴肅的次要問題譬如防止心臟、神經, 和腎臟正確地起作用。

結論

與完全 血液計數比較(CBC) 那神色在多孔的組分在血液, 化學盤區頻繁地提供更多資訊與具體診斷有關。測試列出了上述提供肝臟、腎臟、腎上腺封墊、免疫系統, 等的健康的直接評估。並且, 除幫助之外我們有用做一個診斷, 化學盤區是正在確定預測, (疾病的結果的展望) 。在某些情況下, 然而, 診斷只來自經過一段時間觀看各種各樣的參量變動。

但是, 和與CBC, 化學盤區是正義的患者的身體的圖片在一片刻及時。讀書也許是非常不同的在24 小時, 甚至一個小時。獸醫必須總考慮到一切影響患者和反過來, 怎麼那也許影響測試結果。


A veterinary chemistry panel (also termed 'biochemical profile') includes tests for multiple chemical constituents within one sample. The quantities of these chemicals can reveal many things about the various organs of the body. Most veterinary chemistry panels check blood electrolyte and for diseases of the liver, kidneys, and pancreas.
Whole blood is a combination of blood cells and liquid. The Complete Blood Count (CBC) deals with the cell portion and quantifies the different kinds of red and white blood cells, platelets, and hemoglobin. The chemistry panel deals with the liquid portion of the sample after the cells have been removed. To obtain the liquid, the blood sample is allowed to clot within the tube and then the tube is spun in a centrifuge. This forces the clot to the bottom of the tube and the liquid remains at the top. The fluid left after the clot has been removed is referred to as 'serum.' This is the portion used for a chemistry panel.

Many veterinarians can perform some small chemistry panels 'in house,' which means within the veterinary facility. For larger panels, the tests are often performed by a local laboratory, frequently within a human hospital. There, a small quantity of the serum from the original collection is drawn into a single large machine. Tiny samples from that serum are tested for various chemical components. The results of each test are compiled and printed out on a single form. To make it easier for veterinarians and physicians, the form lists the patient's results along with the expected normal values for that species.

Types of panels

Since the laboratory equipment has the ability to run numerous different tests, there can be many different chemistry panels (e.g., liver panels, electrolyte panels, geriatric panels, pre-surgical panels) produced depending upon which individual tests are requested and included.

A typical veterinary chemistry panel will measure the following:

Blood Glucose

BUN

Creatinine

Calcium

Total Protein

Albumin

Globulin

Total Bilirubin

Alkaline Phosphatase

ALT (SGPT)

Cholesterol

Sodium

Potassium
Thirteen different tests, that if run individually, would cost hundreds of dollars. But when performed as a panel, the tests can be done at a more reasonable price. Not only is there a large saving in cost, but the panel often makes diagnosis of a wide range of disorders much, much easier.

It would be nice to state that all veterinarians are great diagnosticians. The truth is that numerous times every year veterinarians can be 'bailed out' or saved by a chemistry panel. In these instances, the panel leads us to a diagnosis that we had not even considered in our mental list of possible disorders. Sometimes, a veterinarian can just listen to the history and examine the dogs and know immediately what is wrong. In other cases, the veterinarian can examine the pet closely every two hours for three days and not have a clue as to the underlying problem. In this latter situation, the chemistry panel is of unquestionable value. Sometimes, the results are of little or no help in the process of making a diagnosis, but that is very, very rare.

Descriptions of specific tests

Blood Glucose: When the body takes in carbohydrates, it converts them to glycogen, which is stored in the liver. As the individual needs energy, the glycogen is converted to glucose, which enters the bloodstream and is transported throughout the body. Blood glucose, is therefore, a measure of the animal’s nutritional level, but it is more often used to monitor metabolism and physiology. The normal range for blood sugar is 60 to 120 mg/dl (that is milligrams of glucose for each deciliter of whole blood). If the results are lower than 60, the animal is said to have low blood sugar and is referred to as hypoglycemic. If the findings are much greater than 130, the dog is said to be suffering from hyperglycemia.

Hypoglycemia is a frequent problem in young puppies, especially the toy and smaller breeds. These animals may seem weak, uncoordinated, and even have seizures. Some adult dogs also have problems with hypoglycemia, especially during periods of increased or prolonged activity. This is very common in some of the hunting breeds. Low blood sugar is also seen in animals that have been sick and debilitated for a long time and in certain forms of cancer.

Slightly elevated blood sugar results are often found when the animal is stressed or very excited when the blood sample is taken. We have frequently seen results greater than 160 from excitement alone, especially in cats. However, when the level is over 180 mg/dl, it signals problems. At this point, the threshold of the kidneys is exceeded. (While the blood is being filtered by the kidneys, the kidneys are supposed to prevent the loss of glucose in the urine. However, once this high level is reached, the ability of the kidneys to retain glucose is surpassed and 'sugar' spills over into the urine.) The most common cause of this is diabetes mellitus. The full name of this disease is diabetes mellitus, which means 'sweet urine.' In this condition, the body does not produce enough insulin, which is needed for glucose to enter the cells of the body. With inadequate insulin production, the glucose remains in the blood. We have seen blood sugar readings in diabetics as high as 900!

BUN: 'BUN' stands for Blood Urea Nitrogen. The proteins that animals consume in their diet are large molecules. As they are broken down and utilized by the body, the by-product of this metabolism is nitrogen-containing urea compounds. These are of no use to the body and are excreted by the kidneys. If the kidney is not working correctly and filtering these compounds from the blood, they build up to excessively high levels. When this happens to a human, they are said to be 'uremic,' and will probably be placed on a dialysis machine.

When the BUN result is high, it is only an indication that the nitrogen wastes of protein are not being removed from the body. While kidney disease is the primary reason for studying the BUN level, there can be other causes for its elevation. We also see significant BUN elevations when the patient is dehydrated, since there is just not enough fluid in the body for the kidneys to function correctly. Additionally, if anything causes decreased blood flow to the kidneys, they cannot adequately filter the blood and the BUN will elevate. An example of this would be heart disease with decreased circulation. If there is an obstruction so that the urine cannot get out of the body, it will build up in the bladder preventing the kidneys from producing more. This would also elevate the BUN.

Lower than normal BUN levels are frequently noted in liver disease. This organ is one of the primary sites of protein breakdown. If this breakdown does not occur, the nitrogenous wastes will be found at lower than normal levels.

Creatinine: Creatinine is also used to measure the filtration rate of the kidneys. Only the kidneys excrete this substance, and if it builds up to higher than normal levels, it is a sign of decreased or impaired function of these organs.

Calcium: Calcium is a mineral that is found in consistent levels within the bloodstream. While a dog is pregnant or nursing puppies, the calcium level can become seriously depressed in a disease called eclampsia. Additionally, certain medications, tumors, etc., can affect calcium levels. It is important to detect an abnormal blood level of calcium quickly before it leads to serious heart and muscle disorders.

Total Protein: The total protein level is a combined measurement of two blood protein molecules, albumin and globulin. Albumin is normally produced by the liver. We often see albumin levels depressed when the animal is receiving inadequate or poor quality nutrition, or following chronic infectious diseases in which their stores have been used up and not yet replaced.

The term 'globulins' includes immunoglobulins which are produced by the body's immune system as part of the body’s defense against bacteria and viruses. In certain diseases, such as Feline Infectious Peritonitis, elevated globulins can occur.

An elevated protein level is usually a sign of dehydration.

Bilirubin: Bilirubin is by-product of the breakdown of hemoglobin. Hemoglobin is the molecule within red blood cells that is responsible for carrying oxygen to the tissues. When the blood cells die or are destroyed, hemoglobin is released and quickly broken down and excreted by the liver as bilirubin. Therefore, bilirubin levels may be higher than normal when excessive numbers of red blood cells are breaking down, or if the liver is diseased and unable to clear the bilirubin from the blood. If there is an obstruction within the liver or bile duct so that the bilirubin cannot be released into the intestine, blood levels will also elevate.

Alkaline Phosphatase: Serum alkaline phosphatase (often abbreviated 'SAP') belongs to a class of compounds called enzymes. These are protein molecules that function to assist various chemical reactions. Although the normal level of alkaline phosphatase varies in different species of animals, alkaline phosphatase in a dog is seen at higher levels in certain forms of cancer and some muscle and liver diseases.

SGPT: Serum Glutamic Pyruvic Transaminase (SGPT) is also called 'alanine amino transferase' (ALT). It is an enzyme important in liver function. An elevation usually means that the liver cells are breaking down for some reason. The liver may be cancerous, have an infection within it, be congested or engorged with too much blood (as in heart failure), failing or worn out as in cirrhosis, obstructed so that the waste products and toxins it filters from the blood cannot be removed from the body via the bile duct, etc. Basically, anything that adversely affects the liver or its ability to function correctly will elevate the SGPT.

Cholesterol: Cholesterol does not have the same connotation as it does in human medicine. Hardening and obstruction of the vessels of the heart is not a common problem in canine and feline medicine. Rather, cholesterol deviations are generally secondary signs of other diseases. Animals with inadequately functioning thyroid glands often have elevated cholesterol. Starving animals or those with poor levels of nourishment may have lower than expected cholesterol.

Sodium and Potassium: Sodium and potassium levels are interpreted together. Their levels can be seriously affected in diseases of the adrenal glands, heart, kidneys, or by various medications, etc. Conversely, changes in their levels can lead to very serious secondary problems. such as preventing the heart, nerves, and kidneys from functioning correctly.

Conclusion

Compared to the Complete Blood Count (CBC) that looks at the cellular components in the blood, the chemistry panel frequently offers more information related to specific diagnoses. The tests listed above provide direct evaluations of the health of the liver, kidneys, adrenal glands, immune system, etc. Also, in addition to helping us make a diagnosis, the chemistry panel is just as helpful in determining a prognosis, (a forecast of the outcome of the disease). In some cases, however, a diagnosis only comes from watching the various parameters change over a period of time.

Still, as with the CBC, the chemistry panel is just a picture of the patient’s body at one moment in time. The readings may be very different in 24 hours, or even one hour. The veterinarian must always take into consideration everything that is affecting the patient and in turn, how that may affect the test results.[/size]
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minibabyqq 2006-12-28 00:30

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[size=12px][size=5][color=magenta][b]癲癇症  Epilepsy & Seizures[/b][/color][/size]


什麼是癲癇症?
癲癇症一般開始在狗6 個月到5 年紀, 通常在2-3 年。
癲癇症是復發的奪取混亂。奪取通常被描述作為神經元的不協調的生火在腦子之內的部份稱 大腦。機制為什麼這些神經元通常不起作用不被瞭解, 而是相似如果不相同與起因在人。大概某些物質叫做 神經傳送體 不是在適當的化工平衡, 因此神經不表現正常被協調的時尚。有癲癇症一名病人將陳列神經元的不協調的生火週期性回合在腦子之內。這些情節叫做奪取和偶爾地指抽風或"適合。"

奪取的起因

當我們首先出席與有奪取的患者, 我們最初地試圖發現起因。奪取可能由許多情況造成:

先天不足
血液是太高的葡萄糖水平(即; 糖尿病mellitus) 或太低(低血糖症)
低氧氣水平在能由貧血症、心臟 問題, 或困難造成以呼吸的血液
腎臟混亂
肝臟混亂
傳染譬如 似犬慍怒
腫瘤
毒素, 像不凍液、主角, 或巧克力
熱病和 極高熱
腦損傷起因於精神創傷或粗劣的血流對腦子
某些療程
低鈣在護理年輕人的女性(驚厥)
主要或先天癲癇症
類型奪取

部份奪取影響唯一一小部份或身體的一邊。這些由腦子損害經常造成。

廣義奪取影響整體, 可能被劃分成二型、盛大mal 和petit mal 。盛大mal 奪取是最共同。患者體驗盛大mal 奪取跌倒她的邊和通常有無法控制的肌肉活動譬如踢她的腿好像游泳或用漿劃。分泌唾液大方並且患者經常小便和不隨意地排糞。患者對您, 她的周圍, 或她自己的行動是未察覺的。Petit mal 奪取不導致抽風, 但是動物失去知覺。它也許看起來像動物崩潰了。

奪取的最壞的形式是一個患者陳列一個或更多盛大mal 情節沒有恢復從開始。這名患者也許幾個小時實際上是在奪取。這被命名狀態Epilepticus 和簡單地通常指狀態。奪取獨自不是生活威脅除非他們進步入狀態, 在治療立刻被尋找情況下。

什麼是階段在奪取?

如果您嚴密觀察得, 您能經常認可三個階段對奪取。

前奪取階段: 前奪取階段共同地稱氣氛。您的寵物也許看上去不安定, 踱步, 尋找喜愛, salivate, 抱怨, 或掩藏。這些標誌發生正義分鐘在實際奪取開始之前。

衝擊: 奪取叫做衝擊。您的寵物也許看上去激動, 嘔吐, salivate, 運行在圈子, 崩潰, 和有不協調的肌肉活動。這個階段一般持續少於5 分鐘。

崗位Ictal 階段: 在奪取以後, 補救(崗位ictal) 期間開始。您的寵物也許似乎迷失方向, 不協調, 和偶爾地瞎(臨時) 。這也許持續幾分鐘對幾天。

很少做患者變得狠毒在奪取期間。實際上, 多數患者將感覺奪取進展和實際上將尋找所有者為舒適。在實際奪取期間, 患者對他的周圍是未察覺的因此它做一點好使所有者設法安慰seizuring 的患者。這是最佳是那裡為舒適當寵物恢復。

什麼觸發奪取?

實際觸發奪取是未知的, 但多數患者趨向對奪取在激發性的期間。經常, 所有者將闡明, 耐心奪取當演奏球或當孩子從學校在家回來了。我們有seizured 天在參觀我們的獸醫醫院以後, 不管參觀的原因的一名患者。一些患者知道對奪取當睡覺。與作夢請不要混淆這, 它是共同為患者對吠聲或震動的地方當睡覺。一名作的患者可能被喚醒, 但一名seizuring 的患者不能。

癲癇症怎麼被診斷?

首先, 詳細的歷史是需要的。物理和神經學檢查由您的獸醫執行, 實驗室試驗盤區跑, 並且X-射線(射線照相) 有時被需要。如果奪取的起因無法被辨認, 情況被診斷作為先天或主要癲癇症。沒有測試診斷癲癇症就其本身而言, 我們的測試簡單地排除其它奪取的起因。

什麼樣的資訊所有者可以提供幫助獸醫做診斷?

它是有用的如果您, 所有者, 能給您的獸醫答復以下問題:

您的寵物看什麼如當他有奪取?
什麼是各奪取的期間並且多頻繁他們發生?
有只出現在您的寵物的一邊是的標誌(一旁邊壞是比其他) 嗎?
您的寵物有高燒嗎?
您的寵物暴露於任何毒素嗎?
您的寵物體驗了任何精神創傷最近或幾年前嗎?
您的寵物是當前在接種嗎?
您的寵物最近上了或與其它狗嗎?
您的寵物有任何病症的其它標誌嗎?
您的寵物近幾個星期來運行寬鬆嗎?
什麼和當您的寵物吃?
您的寵物有任何行為變動嗎?
奪取發生在樣式與鍛煉, 吃, 睡覺, 或某些活動有關嗎?
您的寵物顯示不同的標誌以前或在奪取以後嗎?
一些動物是有傾向對癲癇症嗎?

癲癇症一般開始在動物中6 個月到5 年紀, 通常在2-3 年。

癲癇症發生總計養殖, 包括混雜的養殖。癲癇症可能是一個基因特徵。它可能甚而familial 癲癇的混亂可能傳通過世代在一個家庭心頭的地方。小獵犬、德國牧羊人、愛爾蘭安裝員、長捲毛狗、聖徒Bernards, Springers 、Malamutes 和愛斯基摩、斗雞家、大牧羊犬、Dachshunds, 和金黃和拉布拉多獵犬是有一個更高的傾向開發癲癇症的一些養殖。它建議, 狗以癲癇症不應該被使用為養殖, 因為這個傾向可能 被繼承。

癲癇症怎麼被對待?

治療為癲癇症通常不開始直到奪取是嚴厲的或多奪取發生□並且樣式被觀察。它非常重要知道奪取的樣式在您的寵物因此您的獸醫能確定如果治療幫助。

治療從未是治病的。目標是減少奪取的頻率、嚴肅, 和期間。

療程□去□常對待癲癇症口頭被給得。各個動物不同地起反應對療程。您的獸醫也許需要設法不同的型或組合發現什麼將是不錯為您的寵物。許多寵物將變得困當他們首先開始療程, 但這很快消減在幾個星期以後。

藥物最常用控制癲癇症是苯巴比妥。Dilantin 和Primidone 是其它藥物被使用在獸醫方面。所有是與苯巴比妥相關的藥物。這些療程必須被給每天。這些療程被分類作為鎮靜劑在宗旨將沉著腦子的神經元情況下, 但不是對患者變得明顯地沉著或"遲鈍的點。" 在正常患者接受這些藥物, 您能很少查出, 狗是在任一個療程。這些是同樣療程被使用在人以癲癇症並且治療的目標是相同。其它療程, 譬如鉀溴化物(KBr), clorazepate 、phenytoin 和clonazepam 、dimethylglycine, 和felbamate 也許被使用單獨或與苯巴比妥的組合, 如果苯巴比妥單獨不是有效的。一旦療程開始了它重要不突然下馬或' 跳' 療程藥量。嚴厲奪取能收效。

如果耐心經驗延長了奪取指狀態, 可注射的藥物譬如valium 是被執行的 靜脈注射 為迅速作用。

Phenobarbitol 和相關的治癲癇藥物可能有副作用在 肝臟, 特別是如果高劑量必需。我們通常建議肝功能測試在我們調整劑量向上之前。雖然這是好實踐, 它是非常罕見看肝臟損傷在高水平。

它是共同為療程的一個劑量水平運作時期, 那麼有在長度或頻率的奪取增量。在這些情況下, 藥物劑量也許被調整。如果治療的患者去幾個月沒有奪取, 那麼我們也許嘗試一種更低的劑量, 也許仍然控制奪取。我們也許增加這裡, 我們讓所有我們的客戶保留奪取的日曆或日誌, 記錄他們持續的日期和時間。這使它容易對我們確定如果調整是必要的。明顯地, 所有者也許錯過一些情節, 因為他們無法觀看他們的狗每分鐘, 但是日曆是有利的。

我應該做什麼如果我的寵物有奪取?

保留鎮靜。

不要投入您的手在您的寵物的嘴。這不會幫助您的寵物並且您可以被咬住。(相反與普遍的信仰, 狗不會吞下他的舌頭。)

防止傷害對您的寵物, 取消附近的鋒利或堅硬對象(即; 桌和椅子) 。

嚴密觀察您的寵物。告訴您的獸醫如果奪取持續超過20 分鐘, 或如果您的寵物有一奪取權利在另以後。嚴厲和長的奪取是醫療應急, 可能是致命的。

唯一, 溫和的奪取不是緊急狀態和很少不表明對長期治療的需要。但在方便的時候, 您應該叫您的獸醫和報告什麼發生了。請務必記錄任一奪取的日期、時期, 和期間。



What is epilepsy?
Epilepsy generally starts in dogs 6 months to 5 years of age, usually at 2-3 years.
Epilepsy is a disorder of recurring seizures. Seizures are described as an uncoordinated firing of the neurons usually within a portion of the brain called the cerebrum. The mechanisms of why these neurons do not function normally is not understood, but is similar if not identical to the causes in humans. Probably certain substances called neurotransmitters are not in the proper chemical balance, so the nerves do not behave in the normal coordinated fashion. A patient with epilepsy will exhibit periodic bouts of uncoordinated firing of the neurons within the brain. These episodes are called seizures and occasionally referred to as convulsions or "fits."

Causes of seizures

When we are first presented with a patient that has had a seizure, we initially attempt to find the cause. Seizures can be caused by many conditions:

Congenital defects
Blood glucose levels that are too high (e.g.; diabetes mellitus) or too low (hypoglycemia)
Low oxygen levels in the blood that could be caused by anemia, heart problems, or difficulties with breathing
Kidney disorders
Liver disorders
Infections such as canine distemper
Tumors
Toxins, like antifreeze, lead, or chocolate
Fevers and hyperthermia
Brain damage resulting from trauma or poor blood flow to the brain
Certain medications
Low calcium in females that are nursing young (eclampsia)
Primary or idiopathic epilepsy
Types of seizures

Partial seizures affect only a small part or one side of the body. These are often caused by a brain lesion.

Generalized seizures affect the whole body and can be divided into two types, grand mal and petit mal. Grand mal seizures are the most common. A patient experiencing a grand mal seizure usually falls on her side and has uncontrollable muscle activity such as kicking her legs as if swimming or paddling. Salivation is profuse and often the patient involuntarily urinates and defecates. The patient is unaware of you, her surroundings, or her own actions. Petit mal seizures do not result in convulsions, but the animal loses consciousness. It may look like the animal just collapsed.

The worst form of seizure is one in which the patient exhibits one or more grand mal episodes without recovering from the first. This patient may actually be in a seizure for hours. This is termed Status Epilepticus and is usually referred to simply as Status. Seizures by themselves are not life threatening unless they progress into Status, in which case medical attention should be sought immediately.

What are the phases in a seizure?

If you observe closely, you can often recognize three phases to a seizure.

Pre-Seizure Phase: The pre-seizure phase is commonly called the aura. Your pet may appear restless, pace, seek affection, salivate, whine, or hide. These signs occur just minutes before the actual seizure begins.

Ictus: The seizure itself is called ictus. Your pet may appear excited, vomit, salivate, run in circles, collapse, and have uncoordinated muscle activity. This stage generally lasts less than 5 minutes.

Post-Ictal Phase: After the seizure, the recovery (post-ictal) period begins. Your pet may seem disoriented, uncoordinated, and occasionally blind (temporary). This may last several minutes to days.

Rarely does a patient become vicious during a seizure. In fact, most patients will actually feel the seizure coming on and seek out the owner for comfort. During the actual seizure, a patient is unaware of his surroundings so it does little good for the owner to try to comfort the seizuring patient. It is best to be there for comfort when the pet recovers.

What triggers a seizure?

The actual triggering of a seizure is unknown, but most patients tend to seizure during periods of excitability. Often, the owner will state that the patient seizures while playing ball or when the children returned home from school. We had one patient who seizured the day after visiting our veterinary hospital, no matter what the reason for the visit. Some patients have been known to seizure while sleeping. Please do not confuse this with dreaming, where it is common for the patient to bark or shake while sleeping. A dreaming patient can be awakened, but a seizuring patient cannot.

How is epilepsy diagnosed?

First, a detailed history is needed. A physical and neurologic exam are performed by your veterinarian, a panel of laboratory tests are run, and sometimes x-rays (radiographs) are taken. If a cause of the seizure can not be identified, the condition is diagnosed as idiopathic or primary epilepsy. There is no test to diagnose epilepsy per se, our tests simply rule out other causes of seizures.

What type of information can the owner provide to help the veterinarian make the diagnosis?

It is helpful if you, the owner, can give your veterinarian answers to the following questions:

What does your pet look like when he is having seizures?
What is the duration of each seizure and how often do they occur?
Are there signs that only appear on one side of your pet (is one side worse than the other)?
Has your pet had a high fever?
Has your pet been exposed to any toxins?
Has your pet experienced any trauma recently or years ago?
Is your pet current on vaccinations?
Has your pet been recently boarded or with other dogs?
Has your pet had any other signs of illness?
Has your pet been running loose in the last several weeks?
What and when does your pet eat?
Has your pet had any behavior changes?
Do the seizures occur in a pattern related to exercise, eating, sleeping, or certain activities?
Does your pet show different signs right before or right after the seizures?
Are some animals more prone to epilepsy?

Epilepsy generally starts in animals 6 months to 5 years of age, usually at 2-3 years.

Epilepsy occurs in all breeds, including mixed breeds. Epilepsy can be a genetic trait. It can even be familial where the epileptic disorder can pass down through generations within one family. Beagles, German Shepherds, Irish Setters, Poodles, Saint Bernards, Springers, Malamutes and Huskies, Cockers, Collies, Dachshunds, and Golden and Labrador Retrievers are some of the breeds which have a higher tendency to develop epilepsy. It is recommended that dogs with epilepsy should not be used for breeding, since this tendency can be inherited.

How is epilepsy treated?

Treatment for epilepsy is usually not begun until a seizure is severe or multiple seizures have occurred and a pattern is observed. It is very important to know the pattern of seizures in your pet so your veterinarian can determine if the treatment is helping.

TREATMENT IS NEVER CURATIVE.The goal is to decrease the frequency, severity, and duration of the seizures.

Medications used to treat epilepsy are given orally. Each animal reacts differently to the medications. Your veterinarian may need to try different types or combinations to find what will be right for your pet. Many pets will become sleepy when they first start medication, but this soon wears off after several weeks.

The drug most commonly used to control epilepsy is Phenobarbital. Dilantin and Primidone are other drugs used in veterinary medicine. All are phenobarbital-related drugs. These medications must be given every day. These medications are classified as sedatives in which case the objective is to sedate the neurons of the brain, but not to the point where the patient becomes obviously sedated or "dopey." In the normal patient receiving these drugs, you can seldom detect that the dog is on any medication. These are the same medications used in humans with epilepsy and the goal of treatment is the same. Other medications, such as potassium bromide (KBr), clorazepate, phenytoin and clonazepam, dimethylglycine, and felbamate may be used alone or in combination with phenobarbital, if phenobarbital alone is not effective. Once medication has started it is IMPORTANT to NOT suddenly discontinue or 'skip' a dose of medication. Severe seizures could result.

If a patient experiences prolonged seizures referred to as Status, injectable drugs such as valium are administered intravenous for rapid effect.

Phenobarbitol and related anti-epileptic drugs can have side effects on the liver, especially if high dosages are required. We usually suggest liver function tests before we adjust dosages upward. Although this is a good practice, it is very rare to see liver damage even at high levels.

It is common for one dosage level of medication to work for a period of time, then have the seizures increase in length or frequency. In these cases, the drug dosages may be adjusted. If the treated patient goes months with no seizures, then we may try a lower dosage, which may still control the seizures. We might add here that we have all of our clients keep a calendar or log of the seizures, recording the date and length of time they lasted. This makes it easier for us to determine if adjustments are necessary. Obviously, the owner may miss some episodes, since they can not watch their dog every minute, but the calendar is beneficial.

What should I do if my pet has a seizure?

Remain calm.

Do not put your hand in your pet's mouth. This will not help your pet and you may be bitten. (Contrary to popular belief, a dog will not swallow his tongue.)

To prevent injury to your pet, remove nearby sharp or hard objects (e.g.; tables and chairs).

Observe your pet closely. Call your veterinarian if the seizure lasts more than 20 minutes, or if your pet has one seizure right after another. Severe and long seizures are a medical emergency and can be fatal.

A single, mild seizure is not an emergency and rarely indicates the need for long-term treatment. But at a convenient time, you should call your veterinarian and report what occurred. Be sure to record the date, time, and duration of any seizure.[/size]
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[size=12px][size=5][color=magenta][b]抗氧劑作為防腐劑在狗食裡Antioxidants As Preservatives in Dog Food[/b][/color][/size]


抗氧劑 是幫助保留油脂和脂溶成份的物質(包括維生素A 和E) 從成為 氧化。油脂一次被氧化, 它開始品嘗餿和丟失它的營養價值。狗食和貓食, 經常包含油脂的重大水平, 是特別易受氧化作用。罐裝食物被保護因為他們不漏氣, 但乾食物需要有抗氧劑增加保存他們。如果抗氧劑被使用, 美國飼料控制官員(AAFCO) 指南的協會要求, 抗氧劑的共同的名字必須出現在標籤, 與在事實的參考一起它被使用作為防腐劑。

有自然和人為抗氧劑, 和他們所有工作保存食物從氧化作用。最共同的人為抗氧劑被使用在寵物食品產業是ethoxyquin 、被丁基化的hydroxytoluene (BHT), 和被丁基化的hydroxyanisole (丁基¥基苯甲醚) 。常用的自然抗氧劑包括維生素E (維生素E), 抗壞血酸(維生素C), 檸檬酸, 和迷迭香。

人為抗氧劑

人為防腐劑保留成份穩定更長和確定地給更長的保存性比自然抗氧劑。但是, 消費者有對人為防腐劑安全的關心在寵物食品裡。最有爭議這些是ethoxyquin, 被批准了用於動物飼養30 年。它當前被允許在狗食在150 份的水平每百萬(ppm), 或0.015% 。

大約10 年前, 糧食與藥物管理局(糧食與藥物管理局) 開始接受報告從認為的狗所有者ethoxyquin 與醫療課題的發展有關在他們的狗, 包括過敏反應、癩、器官失敗、癌症, 和行為問題。有是在80 年代晚期, 一些公司做高性能食物開始增加額外ethoxyquin 作為一個低廉方式延長這些高肥胖產品保存性的猜想。但是, 有並且那些主張使用ethoxyquin 那時的多數寵物食品製造者, 實際上使用更低的數額比那由法律允許。沒有科學證據, 它是難確定是否問題被報告真實地與對ethoxyquin 的用途有關, 並且在什麼水平。

1997 年, 糧食與藥物管理局回顧了一項研究由Monsanto, ethoxyquin 一位主要製造者自願完成。結果從這項研究表示, ethoxyquin 水平在當前的數額之上允許在狗食裡沒有導致再生反常性。唯一的不利影響被注意是輕微增量在某些肝臟酵素的血液水平 和增量在一種正常發生的紅血球代謝產物的水平。這些增量發生了在分泌乳汁母狗的肝臟, 一般吃更多比其它狗。這些肝臟變動認為是溫和的, 也許解決狗回到吃較少食物; 但是, 完全健康意義不會為人所知沒有進一步調查。

糧食與藥物管理局感覺那允許ethoxyquin 被使用在150 ppm 也許不提供安全充分邊際在分泌乳汁的女性和可能小狗。在1997 年7月, 糧食與藥物管理局送了信到ethoxyquin 製造者和到寵物食品產業, 請求, 最大金額ethoxyquin 被使用在寵物食品裡自願降低從150 ppm (0.015%) 對75 ppm (0.0075%) 。看起來, 所有寵物食品製造者依從了。有研究由寵物食品學院, 代表寵物食品製造商在美國的組織執行。這項研究被設計確定是否更低的數量ethoxyquin (30 或60 ppm) 為狗食會提供充分抗氧化保護。

BHT 和丁基¥基苯甲醚是維生素E 綜合性類似物, 和一起經常被使用。丁基¥基苯甲醚是相對地穩定的在高溫。這兩抗氧劑通常被認可作為保險櫃(GRAS) 由糧食與藥物管理局當使用在具體水平, 並且他們是最共同的防腐劑在人的食物裡。那裡, 然而, 繼續爭論至於這些物質安全, 。兩個被懷疑是 致癌物質; 但是, 在2 動物研究, BHT 和丁基¥基苯甲醚被顯示實際上保護免受癌症如果他們增加來食物在動物暴露於致癌物質之前。更多研究是需要的確定這些防腐劑的真實的作用。

自然抗氧劑

一些消費者更喜歡寵物食品與唯一自然防腐劑。維生素E 、維生素C 、檸檬酸, 和迷迭香是在最常用的自然抗氧劑之中。混雜的維生素E 是維生素E 的一個共源極在寵物食品裡。維生素C 由成份提供譬如蔓越桔、藍莓、蘋果, 和其它果子。檸檬酸並且被發現在許多這些, 特別是柑桔。羅斯瑪麗是一種萃取物從植物 Rosmarinus officinalis, 有抗氧化物產的常青灌木。

如果您選擇用狗食包含自然防腐劑, 記住, 他們無法延長保存性只要人為防腐劑能。考慮買食物在少量, 確信, 它被用完在它丟失它的生氣勃勃或營養價值之前。尋找食物與' 最好如果在' 日期以前使用蓋印了在他們。存放這些食物在一個乾燥地點, 從過熱或濕氣。如果可能, 安置袋子在其它乾淨裡面, 烘乾容器一旦它被打開了。

做出明智的決定當選擇您的狗食, 成為一個消息靈通的消費者。學會所有您能關於各種各樣的成份在寵物食品裡, 並且為什麼他們被使用。無法支持以科學證據, 或似乎去反對您的常識的當心要求。手錶對於新資訊和報告關於營養從博學的來源。是被通知關於寵物食品您能幫助保護您的動物健康的其它方式, 以便您能一起享受許多愉快的歲月。
   



   
  Antioxidants >><<dized. Once a fat is oxidized, it starts to taste rancid and loses much of its nutritional value. Dog and cat foods, which often contain significant levels of fat, are especially susceptible to oxidation. Canned foods are protected because they are airtight, but dry foods need to have antioxidants added to preserve them. If an antioxidant is used, the Association of American Feed Control Officials (AAFCO) guidelines require that the common name of the antioxidant must appear on the label, along with a reference to the fact that it is being used as a preservative.

There are both natural and artificial antioxidants, and they all work to preserve food from oxidation. The most common artificial antioxidants used in the pet food industry are ethoxyquin, butylated hydroxytoluene (BHT), and butylated hydroxyanisole (BHA). Commonly used natural antioxidants include tocopherols (vitamin E), ascorbic acid (vitamin C), citric acid, and rosemary.

Artificial antioxidants

Artificial preservatives definitely keep ingredients stable longer and give a longer shelf life than natural antioxidants. However, consumers have had concerns over the safety of artificial preservatives in pet food. The most controversial of these has been ethoxyquin, which has been approved for use in animal feeds for over 30 years. It is currently allowed in dog foods at levels of up to 150 parts per million (ppm), or 0.015%.

About 10 years ago, the Food and Drug Administration (FDA) began receiving reports from dog owners who felt that ethoxyquin was related to the development of medical problems in their dogs, including allergic reactions, skin disease, organ failure, cancer, and behavior problems. There has been speculation that in the late 1980's, some companies that were making high performance foods began adding extra ethoxyquin as an inexpensive way to extend the shelf life of these higher-fat products. However, there are also those who maintain that most pet food manufacturers who were using ethoxyquin at that time, were actually using much lower amounts than that allowed by law. Without scientific evidence, it has been difficult to determine whether or not the problems reported were truly related to the use of ethoxyquin, and at what levels.

In 1997, the FDA reviewed a study done voluntarily by Monsanto, a major manufacturer of ethoxyquin. The results from this study showed that ethoxyquin levels above the current amounts allowed in dog foods produced no reproductive abnormalities. The only adverse effects noted were mild increases in the blood levels of certain liver enzymes and an increase in the levels of a normally-occurring red blood cell metabolite. These increases occurred in the livers of lactating bitches, who generally eat more than other dogs. These liver changes are considered to be mild and may resolve when the dogs return to eating less food; however, the complete health significance will not be known without further investigation.

The FDA felt that allowing ethoxyquin to be used at 150 ppm might not provide an adequate margin of safety in lactating females and possibly puppies. In July 1997, the FDA sent letters to the manufacturers of ethoxyquin and to the pet food industry, requesting that the maximum amount of ethoxyquin used in pet foods be voluntarily lowered from 150 ppm (0.015%) to 75 ppm (0.0075%). It appears that all pet food manufacturers have complied. There is a study being performed by the Pet Food Institute, an organization that represents pet food manufacturers in the United States. This study is designed to determine whether even lower amounts of ethoxyquin (30 or 60 ppm) would provide adequate antioxidant protection for dog food.

BHT and BHA are synthetic analogues of vitamin E, and are often used together. BHA is relatively stable at high temperatures. Both of these antioxidants are Generally Recognized as Safe (GRAS) by the FDA when used at specific levels, and they are the most common preservatives in human food. There is, however, continuing controversy as to the safety of these substances, as well. Both have been suspected of being carcinogens; however, in 2 animal studies, BHT and BHA have been shown to actually protect against cancer if they are added to food before an animal is exposed to a carcinogen. More research is needed to determine the true effect of these preservatives.

Natural antioxidants

Some consumers prefer pet foods with only natural preservatives. Vitamin E, vitamin C, citric acid, and rosemary are among the most commonly used natural antioxidants. Mixed tocopherols are a common source of vitamin E in pet foods. Vitamin C is provided by ingredients such as cranberries, blueberries, apples, and some other fruits. Citric acid is also found in many of these, especially citrus fruits. Rosemary is an extract from the plant Rosmarinus officinalis, an evergreen shrub which has anti-oxidant properties.

If you choose to use a dog food containing natural preservatives, keep in mind that they cannot extend shelf life as long as the artificial preservatives can. Consider buying the food in smaller amounts, to make sure that it is used up before it loses its freshness or nutritional value. Look for foods with a 'best if used by' date stamped on them. Store these foods in a dry location, away from excessive heat or humidity. If possible, place the bag inside another clean, dry container once it has been opened.

To make wise decisions when selecting your dog's food, become an informed consumer. Learn all you can about the various ingredients in pet food, and why they are used. Beware of claims that can not be backed up with scientific evidence, or that seem to go against your common sense. Watch for new information and reports on nutrition from knowledgeable sources. Being informed about pet food is another way you can help to protect your animal's health, so that you can enjoy many happy years together.[/size]
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minibabyqq 2006-12-28 00:32

轉貼自4682

[size=12px][color=magenta][size=5][b]Myasthenia gravis   [/b][/size]
[/color]

Myasthenia gravis


什麼您需要知道瞭解這種疾病

Myasthenia gravis 是中斷方式神經聯絡與肌肉的疾病。為了瞭解這種疾病, 您必須有一些理解對怎樣事運作在正常情況。

神經元是細胞。  
它有一個頭稱細胞身體在一個末端, 一條長的子線稱軸突, 和一個腳片斷與小分支的手指叫做腳過程。myasthenia gravis 介入的神經元有他們的細胞身體(他們的頭) 在脊髓和他們的腳過程(他們的腳) 在我們使用移動我們的身體的義務肌肉(我們的  骨骼肌。) 脊髓送信移動某一肌肉。神經元收到這則消息和運載它對那塊肌肉。

神經是一個小組軸突。  
我們叫神經的白色纖維狀結構實際上是小組軸突一起被包。

神經傳送體是化學製品。  
為了消息轉移在神經元之間, 化學製品從第一神經元的腳過程被發布和由接受神經元的頭的分支的當中一個佔去了(或由肌肉。) 在化工消息成功地轉移了之後, 酵素毀壞神經傳送體分子為了防止持續的刺激。我們牽涉到在myasthenia gravis 的神經傳送體稱Acetylcholine 並且酵素哪些貶低它稱Acetylcholinesterase 。

Neuromuscular 連接點。
這是神經元和肌肉連接的區域。有三類型肌肉: 心肌, 使(或不隨意的) 肌肉(移動食物通過您的肚腑的種類, 或壓縮您的學生, 例如), 和條紋的(或義務) 肌肉(您過去常走, 鍵入, 唱歌的種類光滑, 和控制面部表示) 。這是neuromuscular 連接點在被觸擊在Myasthenia gravis 的條紋的肌肉。

並且現在... MYASTHENIA GRAVIS

先天Myasthenia Gravis
在這個情況, 患者是出生沒有正常neuromuscular 連接點對條紋的肌肉。沒有有效的治療。Myasthenia gravis 被描述了作為一種隱性基因疾病在傑克・Russell 狗、Springer Spaniel, 和光滑的狐狸狗。微型dachshund 得到實際上解決以年齡的一個先天形式。

被獲取的Myasthenia Gravis
這是所謂的自動免疫的疾病, 意味, 免疫系統毀壞neuromuscular 連接點好像他們外國侵略者。什麼肌肉是受影響的取決於哪個連接點被毀壞了。療法圍繞在停止這免疫反應和延長什麼acetylcholine 活動是存在。這做以免疫抑制的代理和療程的組合禁止acetylcholinesterase 。

臨床標誌/症狀

症狀包括肌肉弱點影響面部表示的眼睛、肌肉, 喉頭/食道(在狗), 和肢體。這翻譯成早期的鍛煉疲勞(在大約60% 患者中), megaesophagus, 聲音變動, 或困難吞下。

有迅速地是進步和迅速致死的一個深刻形式。這個形式同thymoma, 胸腺封墊的腫瘤聯繫在一起(位於胸口) 。

由於myasthenia gravis 是很共同, 任一條狗與一般肌肉弱點、困難吞下, 或 megaesophagus 應該被測試為myasthenia gravis 。

測試

在更舊的時期, 測試是複雜的。肌肉切片檢查了。對迅速行動的靜脈內藥物的反應被審查了在什麼結塊了tensilon 測試。  現今, 簡單的(雖則不低廉) 驗血可能完成檢查抗體反對acetylcholine 感受器官。這驗血□假是陰性在只2% 案件中。這些同樣抗體血液水平可能被使用監測治療進展。當抗體滴下到少於0.6 nmol/L, 臨床標誌一般決心。

一旦狗或貓被發現有myasthenia gravis, 它重要考慮, 免疫斡旋的情況一起經常去。那裡也許是其它問題進行中。

胸口射線照相集合應該被採取對檢查對於thymoma 。

治療

Myasthenia gravis 經常進入寬恕沒有治療。在53 條狗的一項研究中, 89% 進入寬恕每平均6.4 月(和在18 個月內) 在診斷以後。在這項研究中, 沒有進入寬恕所有患的癌症在3 年他們的myasthenia 診斷之內的狗。

Megaesophagus
在 megaesophagus , 連接喉頭和胃和運輸食物) 的食道(管變得鬆弛和無用。有這個情況病人regurgitate 他們的食物因為他們無法有效地搬入食物他們的胃。他們丟失重量因為他們無法保留食物。他們並且是高度事先安排好的對吐氣的(吸入的) 食物和唾液和開發特別是難處理的肺炎結果。

它重要, 這個情況迅速被認可以便防止致衰弱的減重和肺炎。

去除胸腺封墊?
胸腺封墊, 位於胸口一般枯萎在childhood/puppyhood/kittenhood 以後。它被介入在免疫系統的成熟性。在人, 腫瘤和胸腺的過份成長頻繁地伴隨myasthenia gravis 的發展。Thymectomy (胸腺封墊的撤除) 是治療的一很好被接受的部份為myasthenia gravis 在人但是未經證明的幫助在狗和貓的治療。

膽鹼酯抑制劑
Pyridostigmine (名牌Mestinon 。) 是通常療程被使用延長acetylcholine 的行動。由撤消的acetylcholinesterase, 被免疫系統未毀壞的感受器官可能長期束縛acetylcholine 。它口頭典型地被給2 到3 次日報和同某一噁心聯繫在一起。這可能應付由稀釋療程或由給療程在一個充分的胃。對方作用可能是剩餘撕毀眼睛, 和流口水。

免疫鎮壓
類皮質激素, 譬如強體松, 和相似的藥物可能壓制毀壞neuromuscular 連接點抗體的生產。總之這些療程被避免除非膽鹼酯抑制劑療法不產生可接受的結果。其它更強的免疫抑壓藥物(譬如azathioprine) 只被使用如果有原因類皮質激素無法半新歸結於糖尿病mellitus, 高血壓, 一致傳染等或如果myasthenia 是特別嚴厲的。
接種應該被延期, 因為接種被顯示惡化活躍myasthenia gravis 。

早期的診斷是重要對成功的療法。

Myasthenia gravis


What You Need to Know to Understand this Disease

Myasthenia gravis is a disease that interrupts the way nerves communicate with muscles. In order to understand this disease, you must have some understanding of how things work in the normal situation.

A Neuron Is a Cell.  
It has a head called a cell body at one end, a long strand called an axon , and a foot piece with small branching fingers called foot processes. The neurons that myasthenia gravis involves have their cell bodies (their heads) in the spinal cord and their foot processes (their feet) in the voluntary muscles that we use to move our bodies (our  skeletal muscles.) The spinal cord sends a message to move a certain muscle. The neuron receives this message and carries it to that muscle.

A Nerve Is a Group of Axons.  
The white fibrous structures we call nerves are actually groups of axons bundled together.

Neurotransmitters Are Chemicals.  
In order for a message to be transferred between neurons, a chemical is released from the foot processes of the first neuron >><<) After the chemical message has been successfully transferred, an enzyme destroys the neurotransmitter molecule in order to prevent on-going stimulation. The neurotransmitter we are concerned with in myasthenia gravis is called Acetylcholine and the enzyme which degrades it is called Acetylcholinesterase.

The Neuromuscular Junction.
This is the area where neuron and muscle interface. There are three types of muscle: heart muscle, smooth (or involuntary) muscle (the kind that moves food through your intestine, or constrict your pupils, for example), and striated (or voluntary) muscle (the kind you use to walk, type, sing, and control facial expression). It is the neuromuscular junction on the striated muscle which is stricken in Myasthenia gravis.

and now...MYASTHENIA GRAVIS

Congenital Myasthenia Gravis
In this condition, the patient is born without normal neuromuscular junctions to striated muscles. There is no effective treatment. Myasthenia gravis has been described as a recessive genetic disease in the Jack Russell terrier, the Springer Spaniel, and the Smooth Fox Terrier. The miniature dachshund gets a congenital form which actually resolves with age.

Acquired Myasthenia Gravis
This is a so-called autoimmune disease, meaning that the immune system is destroying neuromuscular junctions as if they were foreign invaders. What muscles are affected depend on which junctions have been destroyed. Therapy centers on stopping this immune reaction and prolonging what acetylcholine activity is still present. This is done with a combination of immunosuppressive agents and medications to inhibit acetylcholinesterase.

Clinical Signs / Symptoms

Symptoms include muscle weakness affecting the eyes, muscles of facial expression, throat / esophagus (in dogs), and limbs. This translates into early exercise fatigue (in about 60% of patients), megaesophagus, voice change, or difficulty swallowing.

There is an acute form that is rapidly progressive and quickly lethal. This form is associated with thymoma, a tumor of the thymus gland (located in the chest).

Because myasthenia gravis is so common, any dog with general muscle weakness, difficulty swallowing, or megaesophagus should be tested for myasthenia gravis.

Testing

In older times, testing was more complicated. Muscles were biopsied. Response to rapid acting intravenous drugs were examined in what was caked the tensilon test.  Nowadays, a simple (though not inexpensive) blood test can be done to check for antibodies against acetylcholine receptors. This blood test is falsely negative in only 2% of cases. These same antibody blood levels can be used to monitor treatment progress. When antibodies drop to less than 0.6 nmol/L, clinical signs generally resolve.

Once a dog or cat has been found to have myasthenia gravis, it is important to consider that immune mediated conditions often go together. There may be other problems afoot.

A chest radiograph set should be taken to check for thymoma.

Treatment

Myasthenia gravis often goes into remission without treatment. In one study of 53 dogs, 89% went into remission an average of 6.4 months (and within 18 months) after diagnosis. In this study, the dogs that did not go into remission all developed cancer within 3 years of their myasthenia diagnosis.

Megaesophagus
In megaesophagus , the esophagus (the tube that connects the throat and stomach and transports food) becomes flaccid and useless. Patients with this condition regurgitate their food because they cannot effectively move food into their stomachs. They lose weight because they cannot retain food. They are also highly predisposed to aspirating (inhaling) food and saliva and developing especially intractable pneumonia as a result.

It is important that this condition be recognized quickly so as to prevent debilitating weight loss and pneumonia.

Removing the thymus gland?
The thymus gland, located in the chest generally shrivels up after childhood/puppyhood/kittenhood. It is involved in the maturation of the immune system. In humans, tumors and excessive growths of the thymus frequently accompany the development of myasthenia gravis. Thymectomy (removal of the thymus gland) is a well-accepted part of treatment for myasthenia gravis in humans but is still unproven to help in the treatment of dogs and cats.

Anticholinesterases
Pyridostigmine (brand name Mestinon? is the usual medication used to prolong the action of acetylcholine. By inactivating acetylcholinesterase, the receptors that have not been destroyed by the immune system can bind acetylcholine longer. It is typically given orally 2 to 3 times daily and is associated with some nausea. This can be dealt with by diluting the medication or by giving medication on a full stomach. Other side effects can be excess tearing of the eyes, and drooling.

Immune-Suppression
Corticosteroids, such as prednisone, and similar drugs can suppress the production of the antibodies that are destroying the neuromuscular junctions. In general these medications are avoided unless the anticholinesterase therapy does not yield acceptable results. Other stronger immune suppressive drugs (such as azathioprine) are only used if there are reasons that corticosteroids cannot be used due to diabetes mellitus, high blood pressure, concurrent infection etc. or if the myasthenia is especially severe.
Vaccination should be postponed, as vaccination has been shown to exacerbate active myasthenia gravis.

Early diagnosis is important to successful therapy.[/size]

minibabyqq 2006-12-28 00:33

[table][tr][td]轉貼自4682

[size=12px][size=5][color=magenta][b]狗窩咳嗽  Kennel Cough[/b][/color][/size]

[b][size=3]狗窩咳嗽
[/size][/b][b](感染Tracheobronchitis)[/b] [b]它是什麼?[/b] 狗窩咳嗽是支氣管炎為苛刻描繪, 亂砍多數人民描述像聽起來的咳嗽 [b]。[/b]某事黏附了在我的dog.s 喉頭裡[b]。[/b] 它是類似於胸口寒冷為人和是唯一一個嚴肅的情況在特別情況(參見下面); 總之, 它決心獨自。 [b]傳染怎麼發生?[/b] 正常呼吸道有堅固保障免受侵略傳染物質。 [table=189][tr][td][table=189][tr][td][/td][/tr][tr][td][img=189,51]http://www.vin.com/ImageDBPub/IM05000/IMG00399.gif[/img][/td][/tr][tr][td][/td][/tr][/table][/td][/tr][/table]最重要這些大概是什麼稱mucociliary 自動扶梯[b]。[/b] 這個保障包括微小的hairlike 結構稱纖毛, 推出從細胞排行呼吸道, 並且黏液外套在他們。纖毛敲打被協調的時尚。殘骸, 包括傳染物質, 得到設陷井在稠黏的黏液並且纖毛移動黏液向上往殘骸和黏液的彙集也許提供並且/或者忍受的喉頭。 mucociliary 自動扶梯被以下損壞:
[list][*]運輸的重音[*]擁擠重音[*]重的塵土曝光[*]香煙煙曝光[*]傳染物質(病毒譬如reovirus 、腺病毒、parainfluenza 病毒, 和甚而慍怒病毒能創始傳染)[*]冷的溫度[*]粗劣的透氣[/list]沒有這個防護機制, 侵略的細菌, 特別是 [i]Bordetella bronchiseptica [/i]也許簡單地前進在導氣管下暢通無阻。 [i]Bordetella bronchiseptica [/i]有它自己的一些把戲: [list][*]它能束縛直接地對纖毛, 使他們無法行動在3 個小時聯絡之內。[*]它藏匿使免疫細胞失去能力通常負責任對消耗和 毀壞細菌的物質。[/list]由於它是共同使 [i]Bordetella[/i] 由至少一個其它傳染代理伴隨(譬如病毒的當中一個被列出以上), 狗窩咳嗽實際上是傳染而不是傳染複合體由一個代理。 古典地, 狗得到傳染他們被保留在一個擁擠情況以粗劣的空氣環流但許多溫暖的空氣([i]即,[/i] boarding 狗窩、接種診所、守紀組、地方公園、動物庇護所、動物醫院候診室, 或修飾客廳) 。實際上, 多數咳嗽那的起因開始在狗深刻地歸結於感染起因和通常代表某種狗窩咳嗽的形式。 [b]潛伏期是2 到14 天[/b] [b]多麼傳染性的它 是?
[/b]
[i]Bordetella[/i] 傳染可能由兔子、試驗品、豬、貓(如果他們是非常年輕和安置在小組), 和其它狗拾起。它不是傳染性的對人雖然它與[i]百日咳博德特氏菌[/i]相關 緊密地[i], [/i]百日咳代理。在狗之中它是相當傳染性的根據壓力水平、接種對較小病毒的狀態, 和暴露。 我的 醫院推薦保持所有狗當前在他們的 [i]Bordetella[/i] 接種如同很難說當他們是在一個意想不到的情況。 [b]它怎麼被對待?[/b]

雖然多數案件獨自將去, 我們喜歡認為我們能急切補救與抗生素直接地殺害 [i]Bordetella[/i] 有機體。供選擇地, 狗窩咳嗽也許被對待以咳嗽suppressants 提供舒適在自然補救期間。或抗生素和咳嗽suppressants 可能被結合。 [b]何時這是一個嚴肅的情況?
[/b]
在非常幼小小狗, 特別是那些以最近運輸歷史([i]即[/i], 寵物商店小狗) 是特別有傾向對感染tracheobronchitis 嚴厲案件(頻繁地進步對肺炎) 。 在慍怒病毒是包含的狗(通常風雨棚或寵物商店小狗), 有在嚴重後果的巨大潛力。 [b]接種選擇[/b]
有基本上二個選擇為狗窩咳嗽接種: 可注射和鼻內[b]。[/b]
可注射的是一個好選擇為進取的狗, 也許咬住如果他們的槍口接近。它提供好系統免疫只要二藥量被給在年齡以後4 個月(與一臺每年助推器) 。可注射的接種也許只導致較不嚴厲傳染和不完成預防。 鼻內接種也許被給儘早2 個星期年齡並且免疫一般持續10 個到12 個月。(這疫苗年年通常促進。) 好處這裡是, 地方免疫被刺激, 正確在自然傳染會設法採取舉行的站點。 需要4 天引起一個堅實免疫反應在鼻內接種因此它是最佳之後如果接種被給至少4 天在曝光之前。一些狗將有一些打噴嚏的或鼻放電在星期跟隨鼻內接種。概括來說, 鼻接種提供更加快速的免疫比可注射的接種。 Parainfluenza, 腺病毒類型2, 和似犬慍怒, 所有狗窩的成員咳嗽複合體, 是全部由標準DHLPP 疫苗, 基本的疫苗蓋為狗。腺病毒類型2 清液並且免疫反對腺病毒第一類型, 感染似犬肝炎代理。 [b]接種不是有用的在狗已經孵化狗窩咳嗽 若 它不改善呢?
[/b]
依照早先被注意, 這傳染一般自已限制。它應該部份地至少被改進在一個星期治療以後。如果改善未被觀察在這時間, 復校檢查(可能包括胸口的射線照相) 會是一個好想法。


Kennel Cough

[b](Infectious Tracheobronchitis)[/b] [b]What is it?[/b] Kennel cough is a bronchitis characterized by a harsh, hacking cough which most people describe as sounding like [b]?/STRONG>something stuck in my dog𠏋 throat[b].?/STRONG> It is analogous to a chest cold for humans and is only a serious condition in special circumstances (see below); in general, it resolves on its own. [b]How Does Infection Occur?[/b] The normal respiratory tract has substantial safeguards against invading infectious agents. [table=189][tr][td][table=189][tr][td][/td][/tr][tr][td][img=189,51]http://www.vin.com/ImageDBPub/IM05000/IMG00399.gif[/img][/td][/tr][tr][td][/td][/tr][/table][/td][/tr][/table]The most important of these is probably what is called the mucociliary escalator[b].[/b] This safeguard consists of tiny hairlike structures called cilia, which protrude from the cells lining the respiratory tract, and a coat of mucus over them. The cilia beat in a coordinated fashion. Debris, including infectious agents, get trapped in the sticky mucus and the cilia move the mucus upward towards the throat where the collection of debris and mucus may be coughed up and/or swallowed. The mucociliary escalator is damaged by the following:
[list][*]shipping stress[*]crowding stress[*]heavy dust exposure[*]cig>><<e distemper virus can be initiating infections)[*]Cold temperature[*]Poor ventilation[/list]Without this protective mechanism, invading bacteria, especially [i]Bordetella bronchiseptica [/i]may simply march down the airways unimpeded. [i]Bordetella bronchiseptica [/i]has some tricks of its own as well: [list][*]It is able to bind directly to cilia, rendering them unable to move within 3 hours of contact.[*]It secretes substances that disable the immune cells normally responsible for consuming and destroying bacteria.[/list]Because it is common for [i]Bordetella[/i] to be accompanied by at least one other infections agent (such as one of the viruses listed above), kennel cough is actually a complex of infections rather than infection by one agent. Classically, dogs get infected when they are kept in a crowded situation with poor air circulation but lots of warm air ([i]i.e.,[/i] a boarding kennel, vaccination clinic, obedience class, local park, animal shelter, animal hospital waiting room, or grooming parlor). In reality, most causes of coughing that begin acutely in the dog are due to infectious causes and usually represent some form of kennel cough. [b]THE INCUBATION PERIOD IS 2 TO 14 DAYS[/b] [b]How Contagious Is it?
[/b]
[i]Bordetella[/i] infection can be picked up by rabbits, guinea pigs, pigs, cats (if they are very young and housed in groups), and other dogs. It is not contagious to humans though it is closely related to [i]Bordetella pertussis, [/i]the agent of whooping cough. Among dogs it is fairly contagious depending on stress level, vaccination status, and exposure to minor viruses. My hospital recommends keeping all dogs current on their [i]Bordetella[/i] vaccinations as you never know when they be in an unexpected situation. [b]How is it Treated?[/b]

Although most cases will go away on their own, we like to think we can hasten recovery with antibiotics to directly kill the [i]Bordetella[/i] organism. Alternatively, kennel cough may be treated with cough suppressants to provide comfort during natural recovery. Or antibiotics and cough suppressants can be combined. [b]When Is it a Serious Condition?
[/b]
In very young puppies, especially those with a recent shipping history ([i]i.e[/i]., pet store puppies) are especially prone to severe cases of infectious tracheobronchitis (frequently progressing to pneumonia). In dogs where the distemper virus is involved (usually shelter or pet store puppies), there is tremendous potential for serious consequences. [b]Vaccination Options[/b]
There are basically two options for Kennel cough vaccination: injectable and intranasal[b].[/b]
Injectable is a good choice for aggressive dogs, who may bite if their muzzle is approached. It provides good systemic immunity as long as two doses are given after age 4 months (with an annual booster). Injectable vaccination may only lead to less severe infection and not complete prevention. Intranasal vaccination may be given as early as 2 weeks of age and immunity generally lasts 10 to 12 months. (Usually this vaccine is boosted annually.) The advantage here is that the local immunity is stimulated, right at the site where the natural infection would be trying to take hold. It takes 4 days to generate a solid immune response after intranasal vaccination so it is best if vaccination is given at least 4 days prior to the exposure. Some dogs will have some sneezing or nasal discharge in the week following intranasal vaccination. As a general rule, nasal vaccination provides faster immunity than injectable vaccination. Parainfluenza, Adenovirus type 2, and canine distemper, all members of the Kennel Cough complex, are all covered by the standard DHLPP vaccine, the basic vaccine for dogs. Adenovirus Type 2 serum also immunizes against Adenovirus Type 1, the agent of infectious canine hepatitis. [b]VACCINATION IS NOT USEFUL IN A DOG ALREADY INCUBATING KENNEL COUGH What if it Doesn't Improve?
[/b]
As previously noted, this infection is generally self-limiting. It should be at least improved partially after one week of treatment. If no improvement has been observed in this time, a re-check exam (possibly including radiographs of the chest) would be a good idea.
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minibabyqq 2006-12-28 00:33

[table][tr][td]轉貼自4682

[size=12px][color=red][b][size=5][color=magenta]Laryngeal 痲痺[/color]   [/size][/b][/color]


大多數我們知道喉知道作為voice 箱子和共同地位於喉頭。我們知道, laryngitis 是你無法講話的情況, 但是除那之外喉不得到想法。這是一種浩大地低估的器官。喉不是僅聲音來自的地方; 這更加重要地是呼吸管材蓋帽。喉關閉呼吸道當我們吃和喝以便我們不吸入我們的食物。如果我們需要採取深呼吸, 喉的肌肉擴展和打開為我們。喉是導氣管的監護人, 保留什麼我們想要吞下和指揮空氣在。




   

Laryngeal 痲痺收效當喉的綁架者肌肉無法適當地運轉。這不意味著擴展和打開喉為深呼吸; laryngeal 摺疊微弱地和flaccidly 簡單地跳動。這意味著當你需要深呼吸, 一doesn.t 得到一。這可能創造巨大憂慮(想像試圖採取深呼吸和發現您簡單地不能) 。憂慮導致更加迅速呼吸和更多困厄。呼吸危機從部份阻礙可能湧現創造緊急狀態和甚而死亡。

Laryngeal 痲痺突然不來。為多數狗有氣喘, 容易地疲倦在步行, 或大聲呼吸的一個相當悠久的歷史。理想地, 診斷可能被做在情況進步對緊急狀態之前。

狗以laryngeal 痲痺展示一些或所有以下標誌:

..Excess 氣喘
..Exercise 不寬容
..Voice 變動
..Loud 呼吸的聲音
..Respiratory 喘氣或困厄

通常患者是更老的大養殖狗; 最共同地受影響的養殖是拉布拉多獵犬。情況可能發生在貓但是罕見的。Bouvier des Flandres 有能影響幼小狗laryngeal 痲痺的一個遺傳性形式。

Laryngeal 痲痺零件是一張更大的圖片嗎?

這個問題不充分地仍然被回答。在一1989 學習, 所有狗以laryngeal 痲痺疾病的被測試的被顯示的證據長, 大直徑神經纖維在神經切片檢查法從後方腿。建議提出, laryngeal 痲痺代表only 起點。更加分佈廣的神經學退化。如果這是真實的, 你會懷疑我們會看一個更加明顯的疾病進步但, 實際上, 我們不。此時被獲取的(非先天) laryngeal 痲痺主要是一個先天(起因未知數) 情況。我們能仍然說, 一條狗以laryngeal 痲痺是21 倍可能開發 megaesophagus, 其它neuromuscular 疾病。

建議提出, 甲狀腺機能不足 也許是laryngeal 痲痺的起因。這個問題不充分地也被回答。我們知道, 其它neuropathies 與相關甲狀腺機能不足對治療起反應為甲狀腺機能不足但laryngeal 痲痺在一條甲狀腺機能不足的狗不會將。它也許是巧合的, 許多更舊的大養殖狗甲狀腺機能不足並且並且有laryngeal 痲痺或它也許是laryngeal 痲痺代表太被推進簡單地反應甲狀腺激素補充神經學疾病的狀態。

做診斷

為了確定如果狗有laryngeal 痲痺, 喉必須被審查並且這要求鎮靜。鎮靜的水平必須是足夠重的允許喉形象化但足夠輕使患者採取一些深呼吸。如果鎮靜太深的使診斷以至於不能是顯然的, 呼吸興奮劑叫做Dopram. (doxapram 氯化物) 靜脈內被給得刺激幾深呼吸以便喉的作用是清楚的。在一正常喉, arytenoids 軟骨被看見打開和廣泛關閉。在一被痲痺的喉他們軟綿綿地坐那裡當患者深深地呼吸。

如果患者有呼吸危機當看見獸醫, 這次診斷測試可能被插管法容易地跟隨(插入一根呼吸管在patient.s 喉頭下) 。這解除上部航線堵塞並且患者能通常呼吸, 不幸地, 鎮靜必須被維護保留管到位。

形象化喉一個更新的技術介入穿線一個endoscope 在patient.s 鼻孔下。這是棘手的但好處是鎮靜不必需。下側是, 專業設備是需要的並且患者不能是合作的。

另外測試

有是有用的在評估有laryngeal 痲痺病人的一些另外的測試。胸口射線照相是重要在排除我們提及了巨大地使laryngeal 痲痺事例複雜化) 的志向肺炎(從吸入食物材料通過non-functional 喉), megaesophagus (, 和明顯的腫瘤傳播。喉頭的射線照相排除明顯的喉頭腫瘤是還有用的。完全驗血包括甲狀腺測試應該並且包括在工作。

危機

如果laryngeal 痲痺不被對待, 呼吸危機可能湧現。在這個情況, 患者嘗試深深地呼吸和簡單地不能, 創造憂慮和呼吸企圖的一個狠毒週期。laryngeal 摺疊變得圓鼓使阻礙在喉頭更壞。patient.s 膠變得藍藍在顏色從缺乏氧氣, 並且患者開始過度加熱。為依然是不明的原因, 流體開始充斥肺並且患者開始淹沒(好像laryngeal 阻礙wasn.t 足夠致死) 。

患者必須沉著, 用水intubated 和變冷靜為了生存。當插管法被影響, 患者能通常呼吸, 氧氣可能被執行並且危機可能被削減如果它進步了太不。

但, 當然, 患者最終將必須醒。類皮質激素可能被使用減少膨脹, 但幾種外科解答的當中一個理想地是需要的。

外科解答

手術的目標, 技術被使用, 是永久地解除航線堵塞當維護喉(導氣管的保護的原始的作用) 。

Ventriculocordectomy (登岸)
登岸的手術一般被重視作為一外科對一個關於行為的問題的解決辦法, 但這並且是公平待遇為laryngeal 痲痺。通常方法介入延伸一把長的biting. 鑷子在喉頭下和咬住在聲音摺疊之外。麻醉明顯地是需要的做這並且事實外科區域是喉使正常插管法為麻醉不可能。這意味著或使用可注射的麻醉或安置氣管造口術(削減一個孔在喉頭更低下來) 並且intubating 通過那。

聲音摺疊的撤除, 當然, 並且去除patient.s 聲音, 使咆哮降低到耳語。孔由缺乏聲音摺疊牌子創造為一個更大的導氣管開頭和一般是足夠大的解除阻礙。這手術的複雜化包括可能導致阻礙在他們自己, 雖然的膨脹和聲音組織帶子的靈菌(, 如果氣管造口術被安置任何如此阻礙被繞過), 和再生物。一個供選擇的技術介入接近喉從喉頭的外面代替下來嘴。這個方法更加困難和費時但有較少帶子的發展的機會。氣管造口術, 如果有, 被允許癒合閉合。

部份Arytenoidectomy
其它外科技術介入只咬住在一聲音摺疊之外和並且咬住在arytenoids 軟骨之外在同樣邊。有更多靈菌以這個技術並且氣管造口術變得更加中意。手術介入去除一部分的喉同30% 死亡率聯繫在一起在laryngeal 痲痺患者。

Laryngeal Tieback (並且稱Lateralization Surgery)
這當前大概成為了最共同地做的手術為laryngeal 痲痺。它介入安置兩三縫合就像拉扯arytenoid 軟骨的當中一個落後。被改變位置的arytenoids 的當中一個, 喉的開頭改變(使更大) 。這個做法的首要複雜化源於唯一幾毫米位置變化在arytenoids 上是需要的事實。如果軟骨被移動太多, 喉無法適當地關閉並且志向肺炎成為一種堅固風險。這些患者共同地有堅持咳嗽在吃或喝以後。這手術同14% 手術後死亡率聯繫在一起。(在更舊的時期, 兩arytenoids 被栓了回到創造一更大的喉但栓兩塊軟骨這樣同67% 死亡率聯繫在一起因此它不再完成) 。

在2006 年4月, 美國獸醫醫療協會學報 出版了接受單邊的laryngeal tieback. 39 條狗的研究。這些39 條狗, 7 被開發的肺炎手術後地和6 這些7 從他們的肺炎恢復了。複雜化被分類作為未成年人(堵嘴的, 持續的咳嗽的, 持續的鍛煉不寬容, 脹大在手術站點等。) 根據56% 患者體驗了。當勘測, 90% 所有者感覺他們的狗改進了生活質量在手術以後。中間生存時間是12 個月在手術以後。

雉堞牆
在這手術, 甲狀腺軟骨的正方形被削減(相似與之後射手也許掩藏) 的castle.s turret.s 正方形在。這個正方形被移動今後和被再依附創造一個更寬的laryngeal 開頭。氣管造口術頻繁地必要保護免受膨脹。

在6月2001 年, 美國獸醫醫療協會學報 出版了複雜化勘測在一個小組140 條狗接受外科治療為laryngeal 痲痺。結果的總結是:

140 條狗, 34% 是拉布拉多獵犬並且80% 作為大養殖被分類了(> 48 磅) 。
82% 在經過6 年紀。
狗以部下的神經學疾病是3 倍可能死於複雜化與相關laryngeal 痲痺。
極大提高風險死的因素是: 增長的年齡、需要對於氣管造口術, 一致呼吸疾病、一致神經學疾病, 和megaesophagus 的發展。
整體34% 狗有一些種複雜化從手術。最共同的複雜化是志向肺炎(參見下面), 發生在23.6% 狗中。
狗開發志向肺炎, 大約60% 開發了它在第一14 天在手術以後。
在志向肺炎以後, 下最共同的複雜化是發生在5% 患者中的呼吸困厄。
大約3% 狗死了在手術期間或在24 小時內跟隨手術。
大約19% 狗在研究中接受了臨時氣管造口術。這些狗, 40% 有未計劃和被投入作為緊急步驟的氣管造口術。其它60% 氣管造口術計劃了作為laryngeal 痲痺手術一部分。大約有氣管造口術狗的半有一些種外科複雜化, 驚奇更多狗死氣管造口術計劃了對那些的地方它被安置了作為一個無計劃的緊急步驟的地方。(15 條狗計劃了氣管造口術並且7 他們死了, 11 條狗有緊急氣管造口術和只1 死) 。
大約8% 原物140 狗開發了複雜化超過1 年在手術以後。
MacPhail CM, Monnet E: 結果和手術後複雜化在狗接受laryngeal 痲痺的外科治療: 140 個案件(1985-1998) 。JAVMA 218(12): 1949-1955 2001 年。

志向肺炎

當只大約10% 狗被評估為laryngeal 痲痺的外科更正已經有志向肺炎, 幾乎25% 將開發志向肺炎。肺炎總是潛在地威脅生命的並且志向肺炎是特別困難的對明白因為它介入大汙染的食物微粒在肺。寬廣的光譜抗生素、可變的療法和物理療法是重要工具但, 哀傷地, 那導致原始的志向肺炎, 可能導致未來情節的部下的情況。請參見 肺炎管理 為細節在治療。


Most of us know the larynx is commonly known as the 𠁆oice box?and is located in the throat. We know that laryngitis is a condition where one cannot speak, but other than that the larynx does not get much thought. It is a vastly under-appreciated organ. The larynx is not just where sound comes from; more importantly it is the cap of respiratory tubing. The larynx closes the respiratory tract off while we eat and drink so that we do not inhale our food. If we need to take a deep breath, the muscles of the larynx expand and open for us. The larynx is the guardian of the airways, keeping whatever we want to swallow out and directing air in.




   

Laryngeal paralysis results when the abductor muscles of the larynx cannot work properly. This means no expanding and opening of the larynx for a deep breath; the laryngeal folds simply flop weakly and flaccidly. This means that when one needs a deep breath, one doesn㦙 get one. This can create tremendous anxiety (imagine attempting to take a deep breath and finding that you simply cannot). Anxiety leads to more rapid breathing and more distress. A respiratory crisis from the partial obstruction can emerge creating an emergency and even death.

Laryngeal paralysis does not come about suddenly. For most dogs there is a fairly long history of panting, easily tiring on walks, or loud breathing. Ideally, the diagnosis can be made before the condition progresses to an emergency.

Dogs with laryngeal paralysis demonstrate some or all of the following signs:

?Excess panting
?Exercise intolerance
?Voice change
?Loud breathing sounds
?Respiratory gasping or distress

The usual patient is an older large-breed dog; the most commonly affected breed is the Labrador retriever. The condition can occur in cats but is rare. The Bouvier des Flandres has a hereditary form of laryngeal paralysis that is able to affect young dogs.

Is Laryngeal Paralysis Part of a Bigger Picture?

This question is still not fully answered. In one 1989 study, all dogs with laryngeal paralysis tested showed evidence of disease in long, large diameter nerve fibers in nerve biopsies from the rear legs. The suggestion was made that laryngeal paralysis represents 㺸nly the beginning?of a more widespread neurologic degeneration. If this were true, one would suspect we would see a more obvious disease progression but, in fact, we do not. At this time acquired (non-congenital) laryngeal paralysis is largely an idiopathic (cause unknown) condition. We still can say that a dog with laryngeal paralysis is 21 times more likely to develop megaesophagus, another neuromuscular disease.

The suggestion has been made that hypothyroidism may be a cause of laryngeal paralysis. This question is also not fully answered. We know that other neuropathies associated with hypothyroidism will respond to treatment for hypothyroidism but laryngeal paralysis in a hypothyroid dog will not. It may be coincidental that many older large breed dogs are hypothyroid and also have laryngeal paralysis or it may be that the laryngeal paralysis represents a state of neurologic disease that is too advanced to respond simply to thyroid hormone supplementation.

Making the Diagnosis

In order to determine if a dog has laryngeal paralysis, the larynx must be examined and this requires sedation. The level of sedation must be heavy enough to allow the larynx to be visualized but light enough for the patient to be taking some deep breaths. If the sedation is too deep for the diagnosis to be obvious, a respiratory stimulant called Dopram?(doxapram hydrochloride) is given intravenously to stimulate several deep breaths so that the function of the larynx is clear. In a normal larynx, the arytenoids cartilages are seen to open and close widely. In a paralyzed larynx they just sit there limply while the patient breathes deeply.

If the patient is having a respiratory crisis when seeing the veterinarian, this diagnostic test can easily be followed by intubation (inserting a breathing tube down the patient𠏋 throat). This relieves the upper airway obstruction and the patient can breathe normally, unfortunately, sedation must be maintained to keep the tube in place.

A newer technique of visualizing the larynx involves threading an endoscope down the patient𠏋 nostril. This is tricky but the benefit is that sedation is not required.?The downside is that specialized equipment is needed and the patient may not be cooperative.

Additional Testing

There are some additional tests that are helpful in evaluating the patient with laryngeal paralysis. Chest radiographs are important in ruling out aspiration pneumonia (from inhaling food material through the non-functional larynx), megaesophagus (which we have mentioned tremendously complicates a laryngeal paralysis case), and obvious tumor spread. Radiographs of the throat to rule out obvious throat tumor are also helpful. Complete blood testing including thyroid tests should also be included in the work-up.

The Crisis

If laryngeal paralysis is not treated, a respiratory crisis can emerge. In this situation, the patient attempts to breathe deeply and simply cannot, creating a vicious cycle of anxiety and respiratory attempts. The laryngeal folds become swollen making the obstruction in the throat still worse. The patient𠏋 gums become bluish in color from lack of oxygen, and the patient begins to overheat. For reasons that remain unclear, fluid begins to flood the lungs and the patient begins to drown (as if the laryngeal obstruction wasn㦙 lethal enough).

The patient must be sedated, intubated and cooled down with water in order to survive. As soon as intubation is effected, the patient can breathe normally, oxygen can be administered and the crisis can be curtailed if it has not progressed too far.

But, of course, eventually the patient will have to wake up. Corticosteroids can be used to reduce the swelling, but ideally one of several surgical solutions is needed.

Surgical Solutions

The goal of surgery, whichever technique is used, is to relieve the airway obstruction permanently while maintaining the original function of the larynx (protection of the airways).

Ventriculocordectomy (De-Barking)
De-barking surgery is generally thought of as a surgical solution to a behavioral problem, but it is also a fair treatment for laryngeal paralysis. The usual method involves extending a long 弎iting?forceps down the throat and biting out the vocal folds. Obviously anesthesia is needed to do this and the fact that the surgical area is the larynx makes normal intubation for anesthesia impossible. This means either using injectable anesthesia or placing a tracheostomy (cutting a hole in the throat lower down) and intubating through that.

Removal of the vocal folds, of course, also removes the patient𠏋 voice, reducing barking to a whisper. The hole created by the absence of the vocal folds makes for a larger airway opening and is generally large enough to relieve the obstruction. Complications of this surgery include swelling and bleeding (which can cause obstruction in themselves, though, if a tracheostomy is placed any such obstruction is bypassed), and regrowth of a webbing of vocal tissue. An alternative technique involves approaching the larynx from the outside of the throat instead of down the mouth. This method is more difficult and time consuming but has less chance of the development of webbing. A tracheostomy, if any, is allowed to heal closed.

Partial Arytenoidectomy
Another surgical technique involves only biting out one vocal fold and also biting out the arytenoids cartilage on the same side. There is more bleeding with this technique and a tracheostomy becomes more desirable. Surgeries involving removing part of the larynx have been associated with a 30% mortality rate in laryngeal paralysis patients.

Laryngeal Tieback (also called Lateralization Surgery)
This has probably become currently the most commonly performed surgery for laryngeal paralysis. It involves placing a couple of sutures in such a way as to pull one of the arytenoid cartilages backward. By repositioning one of the arytenoids, the opening of the larynx is changed (made larger). The chief complication of this procedure stems from the fact that only a few millimeters of position change in the arytenoids are needed. If the cartilage is moved too much, the larynx cannot properly close and aspiration pneumonia becomes a substantial risk. Commonly these patients have a persistent cough after eating or drinking. This surgery has been associated with a 14% postoperative mortality rate. (In older times, both arytenoids were tied back to create a still larger larynx but tying off both cartilages in this way was associated with a 67% mortality rate so it is no longer done).

In April 2006, the Journal of the American Veterinary Medical Association published a study of 39 dogs who had undergone unilateral laryngeal tieback.?Of these 39 dogs, 7 developed pneumonia post-operatively and 6 of these 7 recovered from their pneumonia. Complications classified as minor (gagging, continued coughing, continued exercise intolerance, swelling at the surgery site etc.) were experienced by 56% of patients. When surveyed, 90% of owners felt their dogs had improved life quality after surgery. Median survival time was 12 months after surgery.

Castellation
In this surgery, a square of the thyroid cartilage is cut (similar to a castle𠏋 turret𠏋 square behind which an archer might hide). This square is moved forward and reattached to create a wider laryngeal opening. A tracheostomy is frequently needed to protect from swelling.

In June of 2001, the Journal of the American Veterinary Medical Association published a survey of complications in a group of 140 dogs receiving surgical treatment for laryngeal paralysis. A summary of the results is:

Of the 140 dogs, 34% were Labrador retrievers and 80% were classified as large breed (>48 lbs).
82% were over 6 years of age.
Dogs with underlying neurologic disease were 3 times more likely to die from complications associated with laryngeal paralysis.
Factors that significantly raised the risk of dying were: increasing age, need for a tracheostomy, concurrent respiratory disease, concurrent neurologic disease, and the development of a megaesophagus.
Overall 34% of dogs had some kind of complication from surgery. The most common complication was aspiration pneumonia (see below), which occurred in 23.6% of dogs at some point.
Of the dogs that developed aspiration pneumonia, about 60% developed it in the first 14 days after surgery.
After aspiration pneumonia, the next most common complication was respiratory distress which occurred in 5% of patients.
Approximately 3% of dogs died during surgery or in the 24 hours following surgery.
About 19% of the dogs in the study received temporary tracheostomies. Of these dogs, 40% had tracheostomies that were not planned and were put in as an emergency procedure. The other 60% of tracheostomies were planned as part of the laryngeal paralysis surgery. About half of the dogs that had tracheostomies had some kind of surgical complication, surprisingly more dogs died where the tracheostomy was planned vs. those where it was placed as an unplanned emergency procedure. (15 dogs had planned tracheostomies and 7 of them died, 11 dogs had emergency tracheostomies and only 1 died).
Approximately 8% of the original 140 dogs developed complications more than 1 year after surgery.
MacPhail CM, Monnet E: Outcome of and postoperative complications in dogs undergoing surgical treatment of laryngeal paralysis: 140 cases (1985-1998). JAVMA 218(12): 1949-1955, 2001.

Aspiration Pneumonia

While only about 10% of dogs being evaluated for surgical correction of laryngeal paralysis already have aspiration pneumonia, nearly 25% will develop aspiration pneumonia at some point. Pneumonia is always potentially life-threatening and aspiration pneumonia is particularly difficult to clear since it involves large contaminated food particles in the lung. Broad spectrum antibiotics, fluid therapy and physical therapy are important tools but, sadly, the underlying condition that led to the original aspiration pneumonia, is likely to produce future episodes. Please see Pneumonia Management for details on treatment.[/size]
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minibabyqq 2006-12-28 00:34

轉貼自4682

[size=12px][size=5][color=magenta][b]氣管崩潰  Tracheal Collapse[/b][/color][/size]

[b][size=3]氣管崩潰
[/size][/b][b]什麼是氣管無論如何?[/b] [table=288][tr][td][table][tr][td][table][tr][td][img=288,157]http://www.vin.com/ImageDBPub/VP05000/IMG01849.GIF[/img]
[/td][/tr][/table][/td][/tr][/table][/td][td=1,1,5][/td][/tr][/table]氣管是科學名字對於windpipe, 連接鼻子、嘴, 和喉頭到肺的管。氣管被認為是一支相當剛性管。它包括肌肉連接一個小組軟骨圓環。圓環實際上不是完全圈子; 他們形成C 以C 飾面的無定論的結尾朝著動物的後面。這塊肌肉報道C 的無定論的結尾稱氣管膜。

當膜片(平的肌肉分離腹部從胸口洞) 鋪平和肋間的肌肉(肌肉在肋骨之間) 行動, 空氣被吮入肺。肌肉移動相反方向並且空氣被推出肺。氣管擔當管道帶領空氣進入胸口。一部分的氣管是在喉頭但它延伸到胸口以便我們能看氣管作為有一個intrathoracic 部份和一個extrathoracic 部份。
[b]為什麼氣管會崩潰?[/b] [table=288][tr][td][table][tr][td][table][tr][td][img=288,125]http://www.vin.com/ImageDBPub/VP05000/IMG01850.GIF[/img]
[/td][/tr][/table][/td][/tr][/table][/td][td=1,1,5][/td][/tr][/table]Tracheas 崩潰因為C 軟骨鋪平由於微弱的軟骨。當C 丟失它的曲度, 氣管橫跨得到寬鬆和磁碟。而不是是緊的肌肉覆蓋物, 膜行動當空氣通過氣管。當空氣衝入胸口, intrathoracic 氣管的膜迅速增加向外並且當空氣衝, intrathoracic 氣管的膜下垂下來入C 軟骨導致鎖柱。膜的發癢的感覺接觸氣管襯裡引起咳嗽並且如果阻礙中斷呼吸, 患者也許成為困厄。如果崩潰是在extrathoracic (並且叫子宮頸) 氣管, 對面發生; 崩潰發生在吸入和迅速增加在發散作用期間期間。 [table=389][tr][td][table=389][tr][td][/td][/tr][tr][td][img=389,244]http://www.vin.com/ImageDBPub/VP05000/IMG01856.GIF[/img][/td][/tr][tr][td][b][size=1][color=#0c0c75]患者X-射線與倒塌的氣管吸入氣管- 由閃動的黃線概述- 是相對地正常的[/color][/size][/b][/td][/tr][/table][/td][/tr][/table][table=288][tr][td][table=288][tr][td][b][size=1][color=#0c0c75][/color][/size][/b][/td][/tr][tr][td][b][size=1][color=#0c0c75][img=288,166]http://www.vin.com/ImageDBPub/VP05000/IMG01852.GIF[/img][/color][/size][/b][/td][/tr][tr][td][b][size=1][color=#0c0c75]同樣患者呼氣(注意氣管崩潰是更加發出音的)[/color][/size][/b][/td][/tr][/table][/td][/tr][/table]氣喘或迅速呼吸為任一個原因使崩潰和憂慮更壞, 不幸地傾向於引起更加迅速呼吸和困厄的一個狠毒週期。
做事更壞的平靜是炎症引起在氣管。崩潰創造增加的分泌物和炎症因而促進更多咳嗽創造更多炎症。氣管的組織改變和最後丟失它的正常特徵並且情況得到越□越壞。

氣管也許倒塌沿它的整個長度, 只在intrathoracic 部分, 或只在extrathoracic 部分。崩潰最共同地是在氣管進入胸口的它的更壞的權利。 [table=288][tr][td][table=288][tr][td][/td][/tr][tr][td][img=288,179]http://www.vin.com/ImageDBPub/VP05000/IMG01853.GIF[/img][/td][/tr][tr][td][b][size=1][color=#0c0c75]患者和上述一樣, 一年後; 氣管崩潰進步了從適度對嚴厲[/color][/size][/b][/td][/tr][/table][/td][/tr][/table][b]什麼動物是受影響的?[/b]
受害者幾乎總是玩具養殖狗, 特別是長捲毛狗、約克夏狗, 和Pomeranians 。疾病變得疑難在中間年齡但通常可能發生在任一年齡。那導致被鋪平的C 圓環的軟骨瑕疵似乎遺傳性。

許多狗與倒塌的tracheas 曾經不顯示症狀, 然而, 直到第二個問題使事複雜化。提出症狀的因素也許有:
[list][*]肥胖病[*]麻醉介入一支氣管內管的安置[*]狗窩咳嗽或其它呼吸傳染的發展[*]增加的呼吸刺激劑在空氣(香煙煙、塵土, 等。)[*]心臟擴大(心臟可能得到很大它按在氣管)[/list]如果一個次要因素譬如那些的當中一個被列出以上發生和做一根早先偶然發生的倒塌的氣管問題, 經常撤除次要因素(減重節目, 得到空氣過濾器, 等。) 可以清理倒塌的氣管的症狀。
[b]治療[/b]
以下步經常是有用的在氣管崩潰患者的長期管理:
[list][*]如果任何以上被列出的次要問題是重要的事物, 他們必須演講。這也許意味, 所有者放棄香煙或狗繼續一個正式減重節目或其它治療解決惡化問題。[*]狗與倒塌的tracheas 變得無法對高效率地清楚感染有機體從他們的更低的呼吸道。抗生素也許是需要的清理傳染。[*]咳嗽suppressants 譬如hydrocodone 或torbutrol 也許是得心應手的。[*]類皮質激素譬如強體松和黏液的相關激素裁減分泌物有效但最好被使用根據一個短期依據只由於副作用潛在。長期用途也許促進傳染和進一步減弱軟骨。[*]導氣管擴張肌譬如茶鹼或terbutaline 是有爭議的因為他們也許膨脹更低的導氣管但不是實際氣管。由膨脹更低的導氣管, 然而, 壓力在胸口在吸入期間不是作為偉大並且氣管不能崩潰作為很大地。[/list]在100 條狗的一項最近回顧展研究中與崩潰的氣管, 71% 反應了次要因素的療程和管理(肥胖病、刺激劑在空氣, 等), 7% 有疾病那麼嚴厲他們死了在一個月診斷之內, 6% 有嚴厲另外的疾病問題, 並且其它16% 感覺是候選人為外科治療。
[b]緊急狀態[/b]
患者的困厄可能到達水平很嚴厲, 通常桃紅色黏膜變得藍藍並且崩潰可能收效。當這發生, tranquilization 是有用解除使重呼吸和咳嗽永存的憂慮。氧氣療法和咳嗽suppressants 並且幫助。如果患者到達困厄似乎極端的點或如果崩潰收效, 對待這緊急狀態和衝寵物對緊急獸醫關心。
[b]手術?[/b]
如果醫療管理不導致令人滿意的結果, 它是可能的, 手術也許是好處。基本上, 一條剛性假肢被安置和被結合在氣管附近有效地創造一支non-collapsible 管。這是主要有效的只要倒塌氣管 的部份是外在的對胸口。如果intrathoracic 氣管是包含的, 手術獲得較不成功, 更加昂貴, 並且假肢必須被定□根據具體patient.s 測量。
在所有手術案件, 更加年輕患者, 更加成功的手術是可能是以成功下降在患者在年齡6 年。崩潰的嚴肅在手術之前不是一個巨大因素在獲得一個成果; 改善被報告在75% 到85% 患者中。
一個新技術被探索使用一條自已擴展不鏽鋼假肢。  研究報告24 狗的結果接受這種治療被出版了於2004 年1月。  這些狗, 96% 顯示了改善在手術以後。二條狗死了在第一星期之內由於stent 安置複雜化。  一條狗體驗了一些靈菌。  在這30% 被報告免於完全地症狀之後, 61% 被顯示明顯改善, 和4% 繼續有症狀。這看來是一個有為的技術但只仍然被使用了在很小數量的患者。
氣管崩潰外科療法要求手術專家。  如果你不是在職員或無法預定, 提及可能被安排。
[b]有是伴生的肝臟病嗎?[/b]
在[i]獸醫內科 美國學院學報的[/i]July/August 問題, 一個小組研究員由Natali B. Bauer 帶領追求共同發現擴大的肝臟在狗以氣管崩潰。她的小組看26 條狗以氣管崩潰和與42 條狗比較了肝功能測試結果沒有氣管崩潰。百分之九十二(92%) 狗以氣管崩潰被發現有反常結果。接受stent 安置協助他們呼吸的狗顯示了改善在這些測試。它結束, 氧氣剝奪從崩潰導致重大肝臟病在許多氣管崩潰患者。它進一步建議, 氣管崩潰患者有肝功能測試被評估作為支援療程也許是有用的肝臟。


[b]What Is the Trachea Anyway?[/b] [table=288][tr][td][table][tr][td][table][tr][td][img=288,157]http://www.vin.com/ImageDBPub/VP05000/IMG01849.GIF[/img]
[/td][/tr][/table][/td][/tr][/table][/td][td=1,1,5][/td][/tr][/table]Trachea is the scientific name for windpipe, the tube that connects the nose, mouth, and throat to the lungs. The trachea is meant to be a fairly rigid tube. It consists of muscle connecting a group of cartilage rings. The rings are actually not complete circles; they form a C with the open end of the C facing towards the animal's back. This muscle covering the open end of the C is called the tracheal membrane.

When the diaphragm (the flat muscle separating the abdomen from the chest cavity) flattens and the intercostal muscles (the muscles between the ribs) move, air is sucked into the lung. The muscles move the opposite direction and air is pushed out of the lung. The trachea serves as a pipeline bringing air into the chest. Part of the trachea is in the throat but it extends into the chest as well so that we can look at the trachea as having an intrathoracic portion and an extrathoracic portion.
[b]Why Would a Trachea Collapse?[/b] [table=288][tr][td][table][tr][td][table][tr][td][img=288,125]http://www.vin.com/ImageDBPub/VP05000/IMG01850.GIF[/img]
[/td][/tr][/table][/td][/tr][/table][/td][td=1,1,5][/td][/tr][/table]Tracheas collapse because the C cartilage flattens due to weak cartilage. When the C loses its curvature, the tracheal across the gets loose and floppy. Instead of being a tight muscle covering, the membrane moves as air passes through the trachea. When air rushes into the chest, the membrane of the intrathoracic trachea balloons outward and when air rushes out, the membrane of the intrathoracic trachea droops down into the C cartilage causing an occlusion. The tickling sensation of the membrane touching the tracheal lining generates coughing and if the obstruction interrupts breathing, the patient may become distressed. If the collapse is in the extrathoracic (also called the cervical) trachea, the opposite occurs; the collapse occurs during inhalation and the ballooning during exhalation. [table=389][tr][td][table=389][tr][td][/td][/tr][tr][td][img=389,244]http://www.vin.com/ImageDBPub/VP05000/IMG01856.GIF[/img][/td][/tr][tr][td]x-ray of patient with collapsed trachea inhaling trachea - outlined by flashing yellow line - is relatively normal[/td][/tr][/table][/td][/tr][/table][table=288][tr][td][table=288][tr][td][/td][/tr][tr][td][img=288,166]http://www.vin.com/ImageDBPub/VP05000/IMG01852.GIF[/img][/td][/tr][tr][td]same patient exhaling (note the trachea collapse is much more pronounced)[/td][/tr][/table][/td][/tr][/table]Panting or rapid breathing for any reason makes the collapse and anxiety worse, which unfortunately tends to generate more rapid breathing and a vicious cycle of distress.
Making things worse still is the inflammation generated in the trachea. The collapse creates increased secretion and inflammation thus promoting yet more coughing which creates yet more inflammation. Ultimately the tissue of the trachea changes and loses its normal characteristics and the condition gets worse and worse.

The trachea may be collapsed along its entire length, only in the intrathoracic section, or only in the extrathoracic section. Most commonly the collapse is at its worse right where the trachea enters the chest. [table=288][tr][td][table=288][tr][td][/td][/tr][tr][td][img=288,179]http://www.vin.com/ImageDBPub/VP05000/IMG01853.GIF[/img][/td][/tr][tr][td]Same patient as above, a year later; trachea collapse has progressed from moderate to severe[/td][/tr][/table][/td][/tr][/table][b]What Animals Are Affected?[/b]
The victim is almost always a toy breed dog, especially poodles, Yorkshire terriers, and Pomeranians. The disease usually becomes problematic in middle age but can occur at any age. The cartilage defect that leads to the flattened C rings seems to be hereditary.

Many dogs with collapsed tracheas do not ever show symptoms, however, until a second problem complicates things. Factors that bring out symptoms might include:
[list][*]Obesity[*]Anesthesia involving the placement of an endotracheal tube[*]Development of kennel cough or other respiratory infection[*]Increased respiratory irritants in the air (cigarette smoke, dust, etc.)[*]Heart enlargement (the heart can get so big that it presses on the trachea)[/list]If a secondary factor such as one of those listed above should occur and make a previously incidental collapsed trachea a problem, often removal of the secondary factor (weight loss program, getting an air filter, etc.) may clear up the symptoms of the collapsed trachea.
[b]Treatment[/b]
The following steps are often helpful in long-term management of the tracheal collapse patient:
[list][*]If any of the above listed secondary problems are of concern, they must be addressed. This may mean that the owner gives up cigarettes or that the dog goes on a formal weight loss program or other treatment to resolve the exacerbating problem.[*]Dogs with collapsed tracheas become unable to efficiently clear infectious organisms from their lower respiratory tracts. Antibiotics may be needed to clear up infection.[*]Cough suppressants such as hydrocodone or torbutrol may be handy.[*]Corticosteroids such as prednisone and related hormones cut secretion of mucus effectively but are best used on a short term basis only due to side-effects potential. Long-term use may promote infection and weaken cartilage further.[*]Airway dilators such as theophylline or terbutaline are controversial as they may dilate lower airways but not the actual trachea. By dilating lower airways, however, the pressure in the chest during inhalation is not as great and the trachea may not collapse as greatly.[/list]In a recent retrospective study of 100 dogs with collapsing trachea, 71% responded to medication and management of secondary factors (obesity, irritants in the air, etc.), 7% had disease so severe that they died within one month of diagnosis, 6% had severe additional disease problems, and the other 16% were felt to be candidates for surgical treatment.
[b]Emergency[/b]
The patient's distress can reach a level so severe that the normally pink mucous membranes become bluish and collapse can result. When this occurs, tranquilization is helpful to relieve the anxiety that perpetuates the heavy breathing and coughing. Oxygen therapy and cough suppressants also help. If the patient reaches the point where distress seems extreme or if collapse results, treat this an emergency and rush the pet to emergency veterinary care.
[b]Surgery?[/b]
If medical management does not produce satisfactory results, it is possible that surgery may be of benefit. Basically, a rigid prosthesis is placed and bonded around the trachea effectively creating a non-collapsible tube. This is largely effective as long as the portion of trachea that is collapsed is external to the chest. Should the intrathoracic trachea be involved, the surgery becomes far less successful, more expensive, and the prosthesis must be ordered according to the specific patient𠏋 measurements.
In all surgery cases, the younger the patient, the more successful the surgery is likely to be with success dropping off in patients over age 6 years. Severity of the collapse prior to surgery is not a tremendous factor in obtaining a successful outcome; improvement is reported in 75% to 85% of patients.
A new technique is being explored using a self-expanding stainless steel prosthesis.  A study reporting results of 24 dogs receiving this treatment was published in January 2004.  Of these dogs, 96% showed improvement after surgery. Two dogs died within the first week due to stent placement complications.  One dog experienced some bleeding.  After this 30% were reported to be completely free of symptoms, 61% showed marked improvement, and 4% continued to have symptoms. This appears to be a promising technique but has still only been used in a small number of patients.
Surgical therapy of tracheal collapse requires a surgery specialist.  If one is not on staff or cannot be scheduled, referral can be arranged.
[b]Is There Associated Liver Disease?[/b]
In the July/August issue of the [i]Journal of the American College of Veterinary Internal Medicine[/i], a group of researchers led by Natali B. Bauer pursued the common finding of enlarged liver in dogs with tracheal collapse. Her group looked at 26 dogs with tracheal collapse and compared liver function test results to 42 dogs without tracheal collapse. Ninety-two percent (92%) of dogs with tracheal collapse were found to have abnormal results. Dogs that received stent placement to assist their breathing showed improvement in these tests. It was concluded that oxygen deprivation from the collapse had resulted in significant liver disease in many tracheal collapse patients. It was further recommended that tracheal collapse patients have liver function tests evaluated as liver supportive medications may be helpful.[/size]

minibabyqq 2006-12-28 00:35

[table][tr][td]轉貼自4682

[size=12px][color=red][size=5][b][color=magenta]Herpes 病毒傳染 Herpes Virus Infection[/color]   [/b][/size][/color]


似犬herpesvirus 一般指CHV, 和是小狗死亡的主導的起因, 特別是在小狗一個到三個星期年齡。我們有所有被聽說的交配動物者說某事像這樣- ' 小狗是美好的今晨, 但另一方面他們停止吃和死了在我能做任何東西之前!' 小狗死用這種方式, 有原因懷疑CHV 。
傳輸

似犬herpesvirus 是影響許多小狗, 造成分散死亡和偶爾地一件整個廢棄物的死亡的一種病毒疾病。病毒生活在公和母 狗 再生和呼吸道, 可能性被傳送。病毒堅持在女性的陰道分泌物和男性的精液。依照在許多herpes 傳染被發現在其它種類, 成人動物能居住幾年來沒有明顯的標誌; 這些叫做'無症狀 載體。' 這意味著成年男性和女性狗不能保留傳染和傳送疾病幾年來當顯示疾病症狀。

小狗能成為傳染了幾個方式。病毒能橫渡胎盤和傳染他們當他們仍然是在子宮體之內, 或他們也許成為暴露從陰道分泌物在誕生期間。病毒能並且變得空中從母親的鼻分泌物, 因此一旦出生, 小狗能實際上吸入病毒當呼吸。小狗能容易地傳播病毒從一個到另一個。最後, 病毒可能由吃傳送被傳染的材料。

症狀

一旦暴露, 一般需要一個星期使症狀出現。鑒於此, 您能容易地看為什麼1 隻到3 隻星期小狗是在最高的風險。嚴厲地被傳染的個體將成為壓下, 將停止護理, 和將哭泣。他們的排匯物軟和黃綠。他們的 肝臟 擴大並且他們的腹部是痛苦的。肝臟成為損壞和可能通常不再起作用。一些小狗開發呼吸標誌和鼻放電。其他人開發疹在他們的腹部。 出血 譬如鼻子流血並且小挫傷在 黏膜 或皮膚也許出現。一些小狗將顯示神經系統標誌譬如盲目性和搖擺。小狗通常死在24-48 個小時顯示之內疾病症狀。

沒有所有小狗被暴露出生時變得不適, 並且許多不顯示標誌根本或開發唯一輕微的壅塞和恢復在幾天之內。小狗被暴露在六個星期年齡以後有補救的一次更好的機會。更舊的小狗開發疾病由與母親聯繫的被傳染, 但正常出現, 鼻分泌物。那些居住經常顯現出成載體成人像他們的父母。

看起來, 病毒興旺最好在溫度在99.F 附近, 因此這也許幫助解釋為什麼更舊的小狗是在較少風險因為他們的體溫通常是在101.5.F 附近, 並且那更加幼小的小狗是更低。

成人載體典型地不陳列明顯的症狀, 然而, 小水泡像損害可以偶爾地是著名在陰道牆壁上。

做診斷

似犬herpesvirus 是主導的死因的當中一個在新出生小狗。上述標誌一次顯現出, 死亡經常隨後而來在48 個小時。疾病迅速地傳播通過廢棄物因為被傳染的小狗是高度傳染性的。我們懷疑herpes 許多盒錯誤地被診斷作為混亂譬如parvovirus 和coronavirus 。

已故的小狗驗屍由獸醫病理學家將顯露典型herpes 損害。診斷出血性的損害將被發現在腎臟和肝臟之內, 並且肺通常將被充塞。受影響的器官將有細胞包含疾病的典型標誌。

治療和預防

沒有當前具體治療為似犬herpes 。所有治療是瞄準的支援關心。更舊的小狗可能被強迫進食和被對待與anti-diarrheal 療程。小狗的生存率少於三個星期年紀是窮的。嚴厲地被傳染的小狗迅速地將死。殘餘的小狗應該被保持溫暖(100.F) 直到病毒聽其自然。預期, 接種將被開發保護免受這種疾病。

作為預防實踐, 你應該確定小狗的環境溫度被保持溫暖以whelping 箱子、熱燈, 等。

總而言之, 你看上部呼吸傳染在小狗少於8 個星期年齡, CHV 應該被考慮。並且, CHV 是主導的死因在1 隻到3 隻星期小狗, 並且更舊的小狗也許死。死亡突然將發生, 以一點點或沒有警告, 並且一隻小狗甚至一件整個廢棄物也許消滅在24 小時期間內。這特別是沮喪廢棄物昨天看上去愉快和健康, 並且一些今天是不適或已經死。記住, 母親可以是載體並且未來廢棄物也許是受影響的除非她開發自然 免疫。沒有治療為她或為小狗。


Canine herpesvirus is generally referred to as CHV, and is a leading cause of puppy deaths, especially in puppies one to three weeks of age. We have all heard of breeders saying something like this - 'The puppies were fine this morning, but then they stopped eating and died before I could do anything!' Anytime puppies die in this fashion, there is a reason to suspect CHV.
Transmission

Canine herpesvirus is a viral disease that affects many puppies, causing sporadic deaths and occasionally the death of an entire litter. The virus lives in the reproductive and respiratory tracts of male and female dogs and can be sexually transmitted. The virus persists in the female's vaginal secretions and the male's semen. As in many herpes infections found in other species, adult animals can live for years with no apparent signs; these are called 'asymptomatic carriers.' This means the adult male and female dogs can remain infected and transmit the disease for years while showing no signs of disease themselves.

Puppies can become infected several ways. The virus can cross the placenta and infect them while they are still within the uterus, or they may become exposed from vaginal secretions during birth. The virus can also become airborne from nasal secretions of the mother, so once born, the pup can actually inhale the virus while breathing. Puppies can easily spread the virus from one to another. Lastly, the virus can be transmitted by eating infected materials.

Symptoms

Once exposed, it generally takes about a week for symptoms to appear. With this in mind, you can easily see why 1 to 3 week-old puppies are at the highest risk. Severely infected individuals will become depressed, stop nursing, and cry. Their feces will be soft and yellow-green. Their livers enlarge and their abdomens are painful. The liver becomes damaged and can no longer function normally. Some puppies develop respiratory signs and nasal discharge. Others develop a rash on their abdomen. Hemorrhages such as nose bleeds and small bruises on the mucous membranes or skin may appear. Some puppies will show nervous system signs such as blindness and staggering. Puppies usually die within 24-48 hours of showing signs of disease.

Not all pups exposed at birth become ill, and many show no signs at all or develop only a slight congestion and recover within a few days. Puppies exposed after six weeks of age have a better chance of recovery. Older puppies develop the disease by coming in contact with the mother's infected, but normal-appearing, nasal secretions. Those that live often develop into carrier adults just like their parents.

It appears that the virus thrives best at a temperature of around 99ºF, so this may help to explain why older puppies are at less risk since their body temperature is usually around 101.5ºF, and that of younger puppies is lower.

Adult carriers typically exhibit no obvious symptoms, however, small blister-like lesions may occasionally be noted on the vaginal wall.

Making a diagnosis

Canine herpesvirus is one of the leading causes of death in newborn puppies. Once the above signs develop, death often follows in 48 hours. The disease spreads rapidly through the litter as infected puppies are highly contagious. We suspect many cases of herpes are wrongly diagnosed as disorders such as parvovirus and coronavirus.

Autopsies of deceased puppies by a veterinary pathologist will reveal the characteristic herpes lesions. Diagnostic hemorrhagic lesions will be found within the kidney and liver, and the lungs will usually be congested. The affected organs will have cells containing characteristic signs of the disease.

Treatment and prevention

Currently there is no specific treatment for canine herpes. All treatment is aimed at supportive care. Older puppies can be force-fed and treated with anti-diarrheal medication. The survival rate of puppies less than three weeks old is poor. Severely infected puppies will die rapidly. The remaining puppies should be kept warm (100ºF) until the virus has run its course. It is hoped that a vaccination will be developed to protect against this disease.

As a preventive practice, one should make sure the environmental temperature of the puppies is kept warm with whelping boxes, heat lamps, etc.

In conclusion, anytime one sees upper respiratory infections in puppies less than 8 weeks of age, CHV should be considered. Also, CHV is a leading cause of death in 1 to 3 week-old pups, and even older puppies may die. The deaths will occur suddenly, with little or no warning, and one pup or even an entire litter may perish within a 24-hour period. This is especially disheartening when yesterday the litter appeared happy and healthy, and today some are ill or have already died. Remember, the mother may be a carrier and future litters may be affected unless she develops a natural immunity. There is no treatment for her or for the puppies.[/size]
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minibabyqq 2006-12-28 00:35

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[size=12px][color=red][size=5][b][color=magenta]心臟解剖學& 發展 Heart Anatomy & Development[/color]   [/b][/size][/color]


在小狗, 最頻繁地被診斷的反常性是那些與相關循環系統。所有小狗應該有他們最初的獸醫檢查在十二個星期年齡以前因此心臟作用可能被監測。多數 先天 心臟瑕疵可能被查出在這童年年齡在聽診器的幫助下。許多心臟瑕疵起因反常心音叫私語。私語是動盪或反常血流的結果由變窄的船創造, 閥門, 或反常開頭在心臟分庭之間。雖然許多小狗也許有不是嚴肅的混亂的結果的心臟私語, 他們能表明生活威脅發展問題在心臟和它的嚴密聯繫的船之內。
狗的循環系統與那是相當相似人。心臟有四分庭。二上部分庭是左右心房, 當更強, 更低的分庭是正確和左 心室。

血液退出 組織, 旅行往心臟, 和進入正確的 心房。從那裡它搬入右心室。右心室抽血液從身體入肺交換二氧化碳(由多孔的新陳代謝導致) 為氧氣。血液, 現在富有在氧氣, 留下肺通過 肺 靜脈和進入左心房。左心房抽血液到左心室。左心室沉重是肌肉的, 和因此, 最強分庭。左心室抽血液通過偉大的主動脈, 身體把血液和氧氣供給。

分庭被分離從互相由肌肉和一系列的閥門。房室的閥門分離正確的心房和右心室, 當二尖瓣分離左心房從左心室。各個分庭和閥門必須起作用在被協調的努力為了心臟對泵浦高效率地。

先天心臟和船瑕疵

血液從胎兒遊遍它接受氧氣從母親的臍帶並且廢品和二氧化碳通過對母親。肺不發揮作用直到誕生, 那時嬰兒暴露於適於吸入的空氣。血液在胎兒繞過因此肺和流動直接地從右胸分庭到左邊通過船稱ductus arteriosus 。出生時, ductus arteriosus 永遠關閉, 強迫血液流經肺為oxygen/carbon 二氧化物交換。同樣在胎兒之內, 船繞過 肝臟 直到誕生。胎兒依靠母親的肝臟提供需要的作用。出生時, 船關閉並且嬰兒的血液然後尋址通過小狗的肝臟。


In the puppy, the most frequently diagnosed abnormalities are those associated with the circulatory system. All puppies should have their initial veterinary exam by twelve weeks of age so the heart functions can be monitored. Most congenital heart defects can be detected at this early age with the aid of a stethoscope. Many heart defects cause abnormal heart sounds called murmurs. Murmurs are the result of turbulent or abnormal blood flow created by narrowed vessels, valves, or abnormal openings between heart chambers. Although many puppies may have heart murmurs that are not the result of serious disorders, they can indicate life threatening developmental problems within the heart and its closely associated vessels.
The dog's circulatory system is quite similar to that of humans. The heart has four chambers. The two upper chambers are the left and right atria, while the stronger, lower chambers are the right and left ventricles.

Blood exits the tissues, travels toward the heart, and enters the right atrium. From there it moves into the right ventricle. The right ventricle pumps blood from the body into the lungs to exchange carbon dioxide (produced by cellular metabolism) for oxygen. Blood, now rich in oxygen, leaves the lungs through the pulmonary vein and enters the left atrium. The left atrium pumps blood to the left ventricle. The left ventricle is the most heavily muscled, and therefore, the strongest of the chambers. The left ventricle pumps blood through the great aorta, which supplies the body with blood and oxygen.

The chambers are separated from one another by muscle and a series of valves. The atrioventricular valve separates the right atrium and right ventricle, while the mitral valve separates the left atrium from the left ventricle. Each chamber and valve must function in a coordinated effort in order for the heart to pump efficiently.

Congenital heart and vessel defects

Blood from the fetus travels through the umbilical cord where it receives oxygen from the mother and waste products and carbon dioxide are passed to the mother. The lungs serve no function until birth, at which time the infant is exposed to breathable air. Blood in the fetus therefore bypasses the lungs and flows directly from the right heart chambers to the left via a vessel called the ductus arteriosus. At birth, the ductus arteriosus closes off forever, forcing blood to flow through the lungs for the oxygen/carbon dioxide exchange. Similarly within the fetus, vessels bypass the liver until birth. The fetus depends on the mother's liver to provide needed functions. At birth, the vessels close and the infant's blood is then routed through the puppy's liver.[/size]
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minibabyqq 2006-12-28 00:36

[table][tr][td]轉貼自4682

[size=12px][color=magenta][size=5][b]呼吸系統的解剖學& 作用Anatomy & Function of the Respiratory System  [/b][/size]
[/color]

解剖學

在誕生之後, 一旦第一呼吸被採取, 小狗有一個充分地功能呼吸系統。呼吸系統由鼻孔(鼻孔), 鼻洞、靜脈竇在頭骨之內, 咽(後面嘴), 喉(發聲器), 氣管(windpipe), 支氣管(氣管的分支進入肺), 和肺基本上組成。

狗有右和左肺, 像人。肺的雙方被劃分進一步成部分, 或耳垂。在多孔的水平, 肺是富有的在空中氣渦裡叫做小窩。是這裡, 血液牌子與各自的細胞接觸在肺並且氧氣被交換為二氧化碳。小窩通過微觀血管一個浩大的網路供應以血絲著名。

正常呼吸的過程

當狗吸入, 新鮮空氣行動通過鼻子(或嘴), 咽, 和喉向氣管。氣管運載空氣對支氣管, 反之供應肺。空氣交換發生在小窩並且被使用的空氣跟隨新空氣相反道路: 通過入支氣管, 入氣管, 通過喉和咽, 最後退出通過鼻子或嘴。

呼吸相對地簡單和由肋骨肌肉(肋間) 並且一塊偉大的內部肌肉的運動的行動完成稱膜片。膜片肌肉分離胸口, 包含心臟和肺, 從舉行肚腑、胃、肝臟、 膀胱, 等的腹部。當這塊偉大的肌肉行動朝腹部, 它創造消極壓力和拉扯新鮮空氣和氧氣入肺, 導致狗呼吸(吸入) 。胸口洞圍攏肺是真空, 如此允許肺容易地膨脹狗吸入。當肌肉前進(往動物的頭), 它導致肺壓縮和力量空氣(呼氣), 如此趕走身體被使用的空氣。

呼吸系統的作用

狗的呼吸系統為二個目的服務。首先, 這是身體的二氧化碳用氧氣替換的交換機制。這並且是一個獨特的冷卻系統。因為狗沒有汗水封墊(除了在他們的腳), 他們無法perspire 降低他們的體溫如人。冷卻他們必須艱苦呼吸的他們的身體(氣喘) 。由呼吸更加快速, 溫暖的空氣被交換從身體為更加涼快的外部空氣。另外, 濕氣在呼吸系統之內蒸發, 更加進一步冷卻這些表面。所以, 肺作用交換二氧化碳為氧氣和冷卻身體。


Anatomy

Shortly after birth, once the first breaths are taken, a puppy has a fully functional respiratory system. The respiratory system is basically composed of the nares (nostrils), nasal cavity, sinuses within the skull, pharynx (back of the mouth), larynx (voice box), trachea (windpipe), bronchi (the branches of the trachea going into the lungs), and the lungs.

Dogs have right and left lungs, just like humans. Both sides of the lungs are further divided into sections, or lobes. At the cellular level, the lungs are rich in air pockets called alveoli. It is here that the blood makes contact with the individual cells in the lungs and oxygen is exchanged for carbon dioxide. Alveoli are supplied by a vast network of microscopic blood vessels known as capillaries.

The normal breathing process

As a dog inhales, fresh air moves through the nose (or mouth), pharynx, and larynx to the trachea. The trachea carries the air to the bronchi, which in turn supply the lungs. Air exchange occurs in the alveoli and the used air follows the opposite path of new air: passing into the bronchi, into the trachea, through the larynx and pharynx, finally exiting through the nose or mouth.

Breathing is relatively simple and is accomplished by the actions of the rib muscles (intercostals) and the movement of a great internal muscle called the diaphragm. The diaphragm muscle separates the chest, containing the heart and lungs, from the abdomen which holds the intestines, stomach, liver, bladder, etc. As this great muscle moves toward the abdomen, it creates a negative pressure and pulls fresh air and oxygen into the lungs, causing the dog to breathe in (inhale). The chest cavity surrounding the lungs is a vacuum, thus allowing the lungs to inflate easily when the dog inhales. When the muscle moves forward (towards the animal's head), it causes the lungs to compress and force air out (exhale), thus ridding the body of used air.

Functions of the respiratory system

The dog's respiratory system serves two purposes. First, it is the exchange mechanism by which the body's carbon dioxide is replaced with oxygen. It is also a unique cooling system. Since dogs do not have sweat glands (except on their feet), they cannot perspire to lower their body's temperature like humans do. To cool their body they must breathe harder (pant). By breathing faster, warm air is exchanged from the body for the cooler outside air. Additionally, moisture within the respiratory system evaporates, further cooling these surfaces. Therefore, the lungs function both to exchange carbon dioxide for oxygen and to cool the body.[/size]
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[size=12px][color=magenta][size=5][b]Hemodialysis 為伴侶動物 Hemodialysis for Companion Animals  [/b][/size]
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這對待腎臟失敗各種各樣的方法在狗和貓, 範圍從標準醫療管理對腎臟移植和透析。



什麼是透析?

透析是對待腎臟失敗方法。自然廢品加強在身體並且腎臟應該排泄許多這些毒素在尿。當腎臟失敗, 毒素水平加強。 透析幫助去除這些毒素。

有透析的2 個形式可利用:

1 。Hemodialysis, 直接地從血液去除毒素。

2 。腹膜透析, 從身體去除毒素通過流體安置了在腹部。

透析從事擴散的原則。毒素從高濃度行動(病的患者的身體) 區域向低毒素含量(流體區域被供應在透析過程中) 。

這與可變的療法怎麼不同?

當腎臟失敗, 他們無法去除許多個毒素微粒在血液的各張通行證通過腎臟, 但是他們仍然去除一些毒素。 單程改進腎臟的能力去除毒素將增加流體的容量在血液。

流體通過射入給口頭或在皮膚之下得到吸收入血液。流體可能並且被給直接地入靜脈(靜脈內流體) 。流體與血液混合並且心臟抽它通過身體, 包括對腎臟。

透析不依靠腎臟去除毒素。它提供去除毒素一個整體另外方式從身體由 執行腎臟的作用在身體之外。

誰會受益於透析?

Hemodialysis 是可利用的為狗和貓。

它可能被使用為深刻或慢性腎臟失敗, 雖然這些提供二個非常不同的情況。

多數hemodialysis 是為深刻腎臟失敗-- 這些是有某一機會為腎臟修理的患者, 並且也許因而需要透析只長期足夠支持他們直到腎臟癒合了。

在一些情況, 寵物以慢性腎臟失敗開始在hemodialysis 。在這個設置, 它意欲是一種規則治療為患者的生活的剩餘。

它可能並且被使用為某些型ot toxicosis 。不凍液毒化(1,2-亞乙基二醇) 是最共同的毒物被對待以hemodialysis 。


Hemodialysis

Hemodialysis 介入去除毒素直接地從血液。因而, 我們必須有方式得到血液從血液對機器, 和然後退回被洗滌的血液回到患者。

Hemodialysis 要求有導尿管或針被安置在血管。

Hemodialysis 要求一個特別hemodialysis 機器, 並且有少量地方被裝備做hemodialysis 在動物。

Hemodialysis 是有效的每單位時間比腹膜透析。



何時hemodialysis 應該開始?

由於有可觀的風險和費用與相關hemodialysis, 它是後備的直到標準療法(靜脈內流體、療程, 等。) 證明了無效。

有立刻腎臟失敗的威脅生命的複雜化病人, 像高的鉀水平, 或流體在肺, 也許受益於直接透析。

吃了一種毒物可能被取消以透析的患者(像不凍液) 應該儘快滲析(有希望地在6 個小時之內) 為最大的好處。

什麼發生當hemodialysis 開始?

訪問對血液

由於hemodialysis 介入洗滌血液, 對血液的通入是必要的。在動物中, 這做與導尿管。

導尿管是一支雙面的導尿管被做特別是為hemodialysis 。 在許多情況下, 它必須外科地被安置, 在一般麻醉之下。

一旦導尿管被安置, 它意欲保留在患者為治療的期間, 也許是由一個月或更多決定。

在一些高風險設置, 另外類型導尿管可能被安置以唯一鎮靜。導尿管意志只持續幾種治療。

治療日程表- 開始

當患者首先開始在hemodialysis, 他們必須逐漸介紹, 給他們時刻適應。

第一治療通常是短的, 大約1.5 到2 個小時。

第二種治療次日通常發生, 和是一少許更長的, 大約3 個小時。

第三種治療, 通常在第三天, 可能是4-5 個小時。這日程表適應單獨患者的需要。

治療日程表- 標準治療

一旦患者適應治療, 治療發生3 天每星期(星期天、星期二, 和星期四在AMC) 。

治療時間是4 個小時為貓, 5 個小時為狗。除治療時間之外, 通常需要一個小時之後準備患者在治療和一個小時之前完成。

關心在醫院

透析替換許多腎臟的作用, 但它無法替換他們全部。

透析病人在治療最初的階段將需要停留在醫院在治療之間為持續的衛生保健。

這包括可變的治療、抗生素、反潰瘍療程, 和許多其它療程。由於這些動物頻繁地嘔吐, 他們需要得到他們的療程通過射入。

在這個階段, 他們需要恆定的監視, 事像血壓、尿生產、血液計數, 等。

家庭關心

一旦患者是更加穩定的, 和能採取療程以口或由哺養頻繁地需要在補救 階段期間) 的管(, 他們也許能回家在治療之間。患者會回來在一個星期治療預定的三天。

寵物仍然回家與透析導尿管到位。導尿管由繃帶蓋在脖子上。它在家不需要關心除之外保持繃帶乾淨和乾燥。

多久我的寵物將需要透析?

當透析被使用為深刻腎臟失敗, 它繼續直到腎臟得到更好或它變得清晰, 腎臟從未癒合。

多半時間, 任何腎臟修理發生在4 個星期以前發生□。

偶爾地腎臟將癒合快, 並且一半時間(50% 患者), 他們不癒合根本。

以慢性腎臟失敗, 腎臟永久地被損壞。透析每個星期三次繼續為患者的生活的剩餘。

將這牌子我寵物活更長嗎?

完全腎臟停工將導致一個動物死在4 天之內。但是, 它佔去4 個星期使腎臟癒合從深刻傷害。透析意欲支持患者在那醫治用的時間期間。

沒有所有寵物以深刻腎臟失敗能恢復, 以透析。大約半這些患者死, 儘管所有我們的努力。

但是, 大約半這些患者居住, 並且他們未被預計做如此沒有透析支持他們。他們也許完全地恢復沒有持久的作用, 或他們也許最終獲得慢性腎臟失敗和需要特別飲食和療程幫助支持他們。

寵物以慢性腎臟失敗在透析比他們會有沒有透析也許終生居住一年久, 雖然沒有所有患者將居住這長。





我的寵物怎麼將感覺關於透析?

多數動物採取很好對透析。他們清楚地感到好在治療的結尾, 和將請求食物或將想要出去和演奏, 是事他們不能被哄騙做在治療之前。

在治療期間, 他們坐在一張被緩衝的桌, 與毯子, 和技術員由他們的邊安慰他們。

動物不似乎有同樣程度疲倦在透析以後那許多人經驗。


有是任何風險嗎?

任何主要醫療或外科治療具有風險, 並且這並且是可靠對於透析。一些風險的歸結於做法並且一些歸結於腎臟失敗。職員被訓練認可潛在的問題, 因此直接治療或預防措施可能被使用。

here are a variety of methods of treating kidney failure in dogs and cats, ranging from standard medical management to kidney transplantation and dialysis.



What is Dialysis?

Dialysis is a method of treating kidney failure. Natural waste products build up in the body and the kidneys are supposed to excrete many of these toxins in the urine. When the kidneys fail, the toxin levels build up. Dialysis helps to remove these toxins.

There are 2 forms of dialysis available:

1. Hemodialysis, which removes toxins directly from the blood stream.

2. Peritoneal dialysis, which removes toxins from the body by way of fluid placed in the belly.

Dialysis works on the principle of diffusion. Toxins move from an area of high concentration (the sick patient's body) to an area of low toxin concentration (the fluid supplied in the dialysis process).

How does this differ from fluid therapy?

When the kidneys are failing, they cannot remove as many toxin particles in each pass of the blood through the kidney, but they still remove some of the toxins. One way to improve the kidney's ability to remove toxins is to increase the volume of fluid in the blood.

Fluids given orally or by injection under the skin get absorbed into the bloodstream. Fluids can also be given directly into the veins (intravenous fluids). The fluid mixes in with the blood and the heart pumps it through the body, including to the kidneys.

Dialysis does not depend on the kidneys to remove toxins. It provides a whole different way of removing the toxins from the body by performing the function of the kidney outside the body.

Who would benefit from dialysis?

Hemodialysis is available for both dogs and cats.

It can be used for acute or chronic kidney failure, although these provide two very different situations.

Most hemodialysis is for acute kidney failure --These are patients who have some chance for kidney repair, and thus may need dialysis only long enough to support them until the kidneys have healed.

In some circumstances, pets with chronic kidney failure are started on hemodialysis. In this setting, it is intended to be a regular treatment for the rest of the patient's life.

It can also be used for certain types ot toxicosis. Antifreeze poisoning (ethylene glycol) is the most common poison treated with hemodialysis.


Hemodialysis

Hemodialysis involves removing toxins directly from the bloodstream. Thus, we must have a way to get the blood from the bloodstream to the machine, and then return the cleansed blood back to the patient.

Hemodialysis requires having a catheter or needle placed in a blood vessel.

Hemodialysis requires a special hemodialysis machine, and there are few places equipped to do hemodialysis on animals.

Hemodialysis is more effective per unit time than peritoneal dialysis.



When should hemodialysis be started?

Because there is considerable risk and cost associated with hemodialysis, it is reserved until standard therapy (intravenous fluids, medications, etc.) have proven ineffective.

Patients with immediately life-threatening complications of kidney failure, like high potassium levels, or fluid in the lungs, may benefit from immediate dialysis.

Patients who have eaten a poison that can be removed with dialysis (like antifreeze) should be dialyzed as soon as possible (hopefully within 6 hours) for maximal benefit.

What happens when hemodialysis is started?

Access to the bloodstream

Because hemodialysis involves cleansing the blood, access to the bloodstream is necessary. In animals, this is done with a catheter.

The catheter is a two-sided catheter made especially for hemodialysis. In most cases, it has to be placed surgically, under general anesthesia.

Once the catheter is placed, it is intended to remain in the patient for the duration of treatment, which may be up to a month or more.

In some high risk settings, a different type of catheter can be placed with only sedation. The catheter will only last for a few treatments.

Treatment schedule - Getting started

When a patient is first started on hemodialysis, they must introduced gradually, to give them time to adapt.

The first treatment is usually short, around 1.5 to 2 hours.

The second treatment usually occurs the next day, and is a little longer, around 3 hours.

The third treatment, usually on the third day, can be 4-5 hours. This schedule is adapted to the individual patient's needs.

Treatment Schedule - Standard treatments

Once the patient is adapted to treatment, the treatments occur 3 days a week (Sunday, Tuesday, and Thursday at AMC).

The treatment time itself is 4 hours for cats, 5 hours for dogs. In addition to the treatment time, it usually takes about an hour to prepare the patient before treatment and an hour afterwards to finish up.

Care in the hospital

Dialysis replaces many of the functions of the kidneys, but it cannot replace them all.

Dialysis patients in the initial stages of treatment will need to stay in the hospital between treatments for ongoing medical care.

This includes fluid treatments, antibiotics, anti-ulcer medications, and many other medications. Because these animals are frequently vomiting, they need to get their medications by injection.

In this stage, they need constant monitoring, of things like blood pressure, urine production, blood counts, etc.

Home Care

Once the patient is more stable, and can take medications by mouth or by feeding tube (which is frequently needing during the recovery stage), they may be able to go home between treatments. The patient would return on the three days a week treatments are scheduled.

The pet goes home with the dialysis catheter still in place. The catheter is covered by a bandage around the neck. It needs no care at home other than to keep the bandage clean and dry.

How long will my pet need dialysis?

When dialysis is used for acute kidney failure, it is continued until the kidneys get better or it becomes clear that the kidneys are never going to heal.

Most of the time, whatever kidney repair is going to happen has occurred by 4 weeks.

Occasionally the kidneys will heal sooner, and half the time (50% of patients), they don't heal at all.

With chronic kidney failure, the kidneys are permanently damaged. Dialysis is continued three times a week for the rest of the patient's life.

Will this make my pet live longer?

Complete kidney shutdown will cause an animal to die within 4 days. However, it takes up to 4 weeks for the kidney to heal from acute injuries. Dialysis is intended to support the patient during that healing time.

Not all pets with acute kidney failure can recover, even with dialysis. About half of these patients die, despite all of our efforts.

However, about half of these patients live, and they were not expected to do so without dialysis to support them. They may recover completely with no lasting effects, or they may end up with chronic kidney failure and need special diets and medications to help support them.

Pets with chronic kidney failure on life-long dialysis may live a year longer than they would have without dialysis, although not all patients will live this long.





How will my pet feel about dialysis?

Most animals take well to dialysis. They clearly feel better at the end of a treatment, and will ask for food or want to go out and play, which are things they couldn't be coaxed to do before the treatment.

During the treatment, they sit on a cushioned table, with a blanket, and a technician by their side to comfort them.

Animals don't seem to have the same degree of tiredness after dialysis that many people experience.


Are there any risks?

Any major medical or surgical treatment carries risks, and this is true for dialysis also. Some of the risk's are due to the procedure and some are due to the kidney failure itself. The staff is trained to recognize potential problems, so immediate treatment or preventive measures can be used.[/size]
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[size=12px][color=red][size=5][b][color=magenta]肛門封墊(Sacs) Anal Glands (Sacs)[/color]   [/b][/size][/color]


肛門封墊疾病是一個共同的問題在狗和貓。肛門封墊, 並且叫做' 肛門sacs, ' 可能成為衝擊, 傳染, 和膿腫。受影響的寵物也許舔肛門區域, ' scoot ' 沿地板, 或有有排糞的問題。這篇文章將幫助您更好瞭解肛門封墊。

肛門封墊的地點和作用

當狗或貓被觀看從後面, 肛門封墊(並且叫做肛門sacs) 位於在各和輕微地在肛門開頭之下的邊, 在4 時和8 時位置。一支微小的輸送管或管帶領在皮膚之下一個開頭直接地在肛門旁邊。

所有掠食性動物, 是否他們是犬或felines 在狂放或臭鼬在您的後院, 有肛門封墊。他們不同地使用他們。臭鼬從這些封墊釋放分泌物作為防禦的形式, 當狗使用它主要為領土標號或作為通信的形式。在狗和貓, 在凳子通過時候, 它應該施加足夠的壓力在肛門封墊, 一些分泌物被放置在凳子的表面。他們發現的其它狗和貓然後能告訴誰是在鄰里, 由嗅凳子。另外, 狗和貓互相認可由嗅到在肛門的一般區域, 因為各個動物的肛門封墊生產一種獨特的氣味。

肛門封墊的疾病

肛門封墊裝緊、傳染, 和膿腫可能發生。這怎麼: 因為各種原因, 譬如動物的相應一致, 封墊的分泌物的厚度, 或凳子、這些封墊和他們的輸送管的軟性經常成為堵塞, 或' 衝擊。' 當這發生, 動物將坐下在它的後方處所和將扯拽它的肛門區域橫跨地板或地面。這叫' scooting 。' 狗和貓也許過份地舔肛門區域。被衝擊的肛門封墊是非常, 非常共同的問題為狗, 特別是更小的養殖。

肛門封墊也許並且成為傳染和膿腫。細菌做他們的方式成封墊, 大概通過輸送管。這是一個非常痛苦的情況, 並且您可以看的第一標誌是動物試圖咬住或抓當您接觸區域在尾巴附近。

治療和預防

當封墊成為衝擊, 獸醫, groomer, 或寵物的所有者必須清除他們, 或' 表達了他們。這倒空所有材料封墊。它由施加做壓力與手指, 開始在封墊和然後推擠之下向上。在一些狗, 這需要做每個星期或二。

被衝擊的封墊不影響寵物的整體健康。問題是, 寵物也許傷害肛門區域當scooting 橫跨地面, 或釋放分泌物在地毯或地板。並且這材料有可怕的氣味。

肛門封墊膿腫必須是lanced 由獸醫, 並且抗生素通常被給寵物七到14 天。使用溫暖的壓縮在區域經常幫助免除一些痛苦和減少脹大。次要問題有時發生以膿腫, 因為他們也許造成 也許 影響神經和肌肉在這個區域的傷痕組織或其它損傷。這可能導致糞便無節制, 意味寵物無法保留它的凳子。

如果一隻單獨寵物只有有封墊的一個偶爾的問題, 他們可能被處理依照必要。但是, 為寵物以重覆的或 慢性 問題, 封墊的外科撤除被推薦。以所有問題聯繫這些封墊這些封墊的撤除被消滅為寵物的生活剩下的時間。雖然一個相當簡單的做法, 複雜化譬如糞便無節制可能很少發生。

狗以週期性肛門封墊裝緊經常被安置在高纖維飲食。高的纖維使動物的凳子更加龐大。凳子將施加更多壓力在肛門封墊並且封墊有希望地將自我表達當動物排糞。有高的纖維狗食幾個商業品牌可利用。動物也許用麩皮或療程並且被補充譬如將增加凳子的大多數的Metamucil 。



Anal gland disease is a common problem in dogs and cats. The anal glands, also called 'anal sacs,' can become impacted, infected, and abscessed. Affected pets may lick the anal area, 'scoot' along the floor, or have problems with defecation. This article will help you better understand anal glands.

Location and function of anal glands

As the dog or cat is viewed from behind, anal glands (also called anal sacs) are located on each side of and slightly below the anal opening, at the 4 o'clock and 8 o'clock positions. A tiny duct or tube leads under the skin to an opening directly beside the anus.

All predators, whether they are canines or felines in the wild or skunks in your backyard, have anal glands. They just use them differently. Skunks discharge the secretion from these glands as a form of defense, while dogs use it primarily for territorial marking or as a form of communication. In dogs and cats, every time a stool is passed, it should put enough pressure on the anal glands that some of the secretion is deposited on the surface of the stool. Other dogs and cats are then able to tell who has been in the neighborhood, just by sniffing the stools they find. Additionally, dogs and cats recognize each other by smelling each other in the general area of the anus, since each animal's anal glands produce a unique scent.

Diseases of the anal glands

Anal gland impactions, infections, and abscesses can occur. Here is how: For various reasons, such as the conformation of the animals, the thickness of the gland's secretions, or the softness of the stool, these glands and their ducts often become clogged, or 'impacted.' When this occurs, the animal will sit down on its rear quarters and drag its anal area across the floor or ground. This is called 'scooting.' Both dogs and cats may lick the anal area excessively. Impacted anal glands are a very, very common problem for dogs, especially the smaller breeds.

Anal glands may also become infected and abscess. Bacteria make their way into the glands, probably through the ducts. This is a very painful condition, and the first sign you may see is that the animal attempts to bite or scratch when you touch the area near the tail.

Treatment and prevention

When the glands become impacted, a veterinarian, groomer, or the pet's owner must clean them out, or 'express' them. This empties the glands of all material. It is done by applying pressure with the finger, start below the gland and then pushing upwards. In some dogs, this needs to be done every week or two.

Impacted glands do not affect the overall health of the pet. The problem is that pets may injure the anal area when scooting across the ground, or discharge the secretion on the carpet or floor. And this material has a terrible odor.

Anal gland abscesses must be lanced by a veterinarian, and antibiotics are usually given to the pet for seven to 14 days. Using warm compresses on the area often helps to relieve some of the pain and reduce swelling. Secondary problems sometimes occur with abscesses, as they may cause scar tissue or other damage that may affect the nerves and muscles in this area. This can cause fecal incontinence, meaning the pet cannot retain its stools.

If an individual pet only has an occasional problem with the gland, they can be dealt with as needed. However, for pets with repeated or chronic problems, surgical removal of the glands is recommended. With the removal of these glands all problems associated with these glands are eliminated for the remainder of the pet's life. Although a fairly simple procedure, complications such as fecal incontinence can rarely occur.

Dogs with recurrent anal gland impactions are often placed on a high fiber diet. The high fiber makes the animal's stool more bulky. The stool will put more pressure on the anal glands and hopefully the glands will express themselves when the animal defecates. There are several commercial brands of high fiber dog food available. Animals may also be supplemented with bran or medications such as Metamucil which will increase the bulk of the stool[/size]
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minibabyqq 2006-12-28 00:38

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[size=12px][color=red][size=5][b][color=magenta]Trombiculiasis (Chiggers)[/color]   [/b][/size][/color]


Chiggers 是是存在在美國過程中的中央部分的共同的皮膚寄生生物。科學名字對於chiggers 是 Trombicula 小蜘蛛, 並且他們是亦稱收穫小蜘蛛。這些小蜘蛛能傳染和叮咬人、狗, 和貓, 和導致嚴厲發癢。當他們難防止, 他們相對地容易對待。
Chiggers 被發現在最高的數字在春天期間和通常落在像草區域, 特別在多白粉土壤。chigger 小蜘蛛是一隻小帶紅色橙色小蜘蛛關於別針的頭的大小。

什麼是chiggers 的生命週期?

這是騷擾動物和導致激怒這隻小蜘蛛的幼蟲形式。
蛋下在土壤和在植被附近在仲夏。幼蟲孵化從蛋和爬行主人動物(即; 狗, 貓, 人) 。他們附有自己, 哺養在流體在組織幾天, 和然後留下主人。他們然後蛻變入若蟲階段, 和然後成熟入成人。生命週期被完成在50-55 天。在北區域, 有1-2 個世代每年, 在南部的區域, 小蜘蛛可能整年再生產。

什麼是chiggers 症狀?

在狗, chiggers 可能被發現在腿、頭, 和腹部附近。在貓, 他們佔去住所在耳朵的裡面, 經常能被看見與肉眼。他們說看起來像辣椒粉。Chiggers 不能導致任何症狀在一些動物; 其他人也許抓在chiggers 是存在的區域。在人, 小蜘蛛通常沒被看見, 但是叮咬將生產小鞭痕, 通常在腳腕附近, 強烈地發癢幾天。

大批出沒與chiggers 怎麼被診斷?

小蜘蛛被刮從貓的耳朵的內在表面或狗, 可能被辨認在顯微鏡下。但是, 由於典型帶紅色顏色和地點, 診斷可能由視力檢查經常使正義。

大批出沒與chiggers 怎麼被對待和被防止?

治療相對地簡單和包括或者兩三個基於除蟲菊酯的垂度分開被間隔兩三個星期, 或一種典型antiparasite 藥物的 應用像Tresaderm 對一個地方化的區域譬如耳朵。典型或可注射的類固醇可能被執行對動物幾天幫助緩和任何發癢。

避免chiggers 被發現的區域大概是一個好想法因為他們看上去年復一年居住在同樣地點。

我可以得到chiggers 從我的寵物嗎?

它是非常不太可能的, 您會得到chiggers 從您的寵物。如果您和您的寵物兩個有chiggers, 您兩個大概走了通過有許多chiggers 在環境裡的區域。

總結

小蜘蛛可能被辨認在狗, 特別在嚴厲大批出沒。在貓, 您可以看抓耳朵和典型精確定位大小的紅色小蜘蛛在耳朵的內在表面。如果您懷疑chiggers, 與您的獸醫聯繫和得到適當的典型治療。

Chiggers are common skin parasites that are present throughout the central part of the United States. The scientific name for chiggers is Trombicula mites, and they are also known as harvest mites. These mites can infect and bite people, dogs, and cats, and cause severe itching. While they are difficult to prevent, they are relatively easy to treat.
Chiggers are usually found in the highest numbers during the spring and fall in grassy areas, particularly in chalky soils. The chigger mite is a small reddish-orange mite about the size of the head of a pin.

What is the life cycle of chiggers?

It is the larval form of this mite which infests animals and causes the irritation.
Eggs are laid in soil and around vegetation in late summer. Larvae hatch from the eggs and crawl onto a host animal (e.g.; dog, cat, human). They attach themselves, feed on fluids in the tissue for several days, and then leave the host. They then molt into a nymph stage, and then mature into adults. The life cycle is completed in 50-55 days. In northern areas, there are 1-2 generations per year, in southern areas, the mites can reproduce all year long.

What are the symptoms of chiggers?

In dogs, chiggers can be found around the legs, head, and abdomen. In cats, they often take up residence on the inside of the ears and can be seen with the naked eye. They are said to look like paprika. Chiggers may not cause any symptoms in some animals; others may scratch at the area where the chiggers are present. In people, the mite is usually not seen, but the bite will produce a small welt, usually around the ankles, that itches intensely for several days.

How is an infestation with chiggers diagnosed?

The mite can be scraped from the inner surface of the cat's ear or off of the dog and can be identified under the microscope. However, because of the characteristic reddish color and location, a diagnosis can often be made just by visual inspection.

How is an infestation with chiggers treated and prevented?

The treatment is relatively simple and consists of either a couple of pyrethrin-based dips spaced a couple of weeks apart, or the application of a topical antiparasite drug like Tresaderm to a localized area such as the ears. Topical or injectable steroids can be administered to the animal for several days to help alleviate any itching.

Avoiding areas where chiggers are found is probably a good idea because they appear to live in the same locations year after year.

Can I get chiggers from my pet?

It is very unlikely that you would get chiggers from your pet. If you and your pet both have chiggers, you probably both walked through an area where there were numerous chiggers in the environment.

Summary

The mites can be identified on the dog, particularly in severe infestations. In cats, you may see the scratching of the ears and the characteristic pinpoint-sized red mites on the inner surface of the ears. If you suspect chiggers, contact your veterinarian and get the proper topical treatment.[/size]

minibabyqq 2006-12-28 00:38

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[size=12px][color=red][size=5][b][color=magenta]Pneumonyssoides (鼻小蜘蛛)[/color] [/b][/size][/color]  


鼻小蜘蛛是共同性但傳染狗和狂放的犬鼻道很少的被診斷的小蜘蛛。科學名字對於鼻小蜘蛛是 Pneumonyssoides caninum。
什麼是鼻小蜘蛛大批出沒的症狀?

大批出沒與這隻小蜘蛛通常不導致任何嚴肅的症狀, 然而, 一些狗也許開發重的傳染, 將遭受回合打噴嚏或鼻子流血。其它狗也許開發 慢性 鼻放電從傳染。

鼻小蜘蛛大批出沒怎麼被診斷?

小蜘蛛居住在鼻道裡面, 但一些小蜘蛛到鼻孔的外面邊緣將旅行。一條健康狗成為傳染它有鼻子對鼻子聯絡與一條被傳染的狗。如果傳染導致症狀, 小蜘蛛可能由採取鼻道的拖把和應用辨認它嚮顯微鏡幻燈片。有通常很大數量的小蜘蛛可看見在幻燈片如果活躍傳染是存在。

鼻小蜘蛛大批出沒怎麼被對待和被防止?

治療是非常直接的和包括執行口頭 ivermectin。這是 標記 對ivermectin 的用途在狗, 並且藥物必須被執行由或在獸醫的直接推薦之下。預防包括保留您的狗在聯絡外面與被傳染的或離群狗。

我可以得到鼻小蜘蛛從我的狗嗎?

不。 Pneumonyssoides caninum 只騷擾狗。

總結

大批出沒與這隻小蜘蛛頻繁地不被診斷, 而是應該被考慮作為慢性打噴嚏, 鼻出血, 或鼻放電的起因在狗。幸運地, 如果它被懷疑, 它被診斷和容易地被對待。


Nasal mites are a common but rarely diagnosed mite that infects the nasal passages of dogs and wild canines. The scientific name for nasal mites is Pneumonyssoides caninum.
What are the symptoms of a nasal mite infestation?

Infestation with this mite usually does not cause any serious symptoms, however, some dogs may develop a heavy infection and will suffer from bouts of sneezing or nose bleeds. Other dogs may develop a chronic nasal discharge from the infection.

How is a nasal mite infestation diagnosed?

The mite lives inside the nasal passages, but some mites will travel to the outer edges of the nostril. A healthy dog becomes infected when it has nose-to-nose contact with an infected dog. If the infection causes symptoms, the mite can be identified by taking a swab of the nasal passage and applying it to a microscope slide. There are usually a large number of mites visible on the slide if an active infection is present.

How is a nasal mite infestation treated and prevented?

Treatment is very straightforward and consists of administering oral ivermectin. This is an off-label use of ivermectin in dogs, and the drug must be administered by or under the direct recommendation of a veterinarian. Prevention includes keeping your dog out of contact with infected or stray dogs.

Can I get nasal mites from my dog?

No. Pneumonyssoides caninum only infests dogs.

Summary

Infestation with this mite is not frequently diagnosed, but should be considered as a cause of chronic sneezing, nosebleeds, or nasal discharge in dogs. Fortunately, if it is suspected, it is easily diagnosed and treated.[/size]
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minibabyqq 2006-12-28 00:39

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[size=12px][size=5][color=red][b][color=magenta]Demodectic Mange[/color]  [/b][/color][/size]


Demodectic mange (亦稱紅色mange 、囊泡mange, 或小狗mange) 是癩, 一般幼小狗, 由小蜘蛛, Demodex canis 導致。它也許使您驚奇知道, 各種各樣的種類demodectic 小蜘蛛居住在實際上每條成人狗和多數人的身體, 沒有導致任何害處或激怒。這小(0.25 毫米) ' 鱷□像' 小蜘蛛居住在頭髮濾泡(即, 毛孔在頭髮軸通過) 的皮膚之內, 因此命名囊泡mange 裡面。在人, 小蜘蛛通常被發現在皮膚、眼皮, 和鼻子的摺痕。
疾病與被壓制的免疫系統關係了

是否Demodex 導致害處對狗取決於動物的能力保留小蜘蛛在控制之下。Demodectic mange 不是窮地被保留的或骯髒的狗窩疾病。這一般是有不充分或窮地被開發的免疫系統或更舊的狗 遭受一個沮喪的免疫系統幼小狗的疾病。

什麼是Demodex canis 的 生命週期?

demodectic 小蜘蛛在狗上度過它的整個生活。蛋由一位懷孕女性, 艙口蓋下, 和然後成熟從幼蟲到若蟲對成人。生命週期應該需要20-35 天。

Demodex canis 怎麼 被傳送?

小蜘蛛直接地從母親轉移到小狗在第一星期生活之內。小蜘蛛的傳輸是由直接聯繫唯一。那是母親和小狗一定完全接觸, 因為寄生生物無法生存動物。這重要因為它意味狗窩或臥具區域不成為沾染, 並且因此環境不需要被對待。損害, 如果禮物, 作為這首先通常出現在小狗的頭附近, 最是區域與母親聯繫。實際上每個母親運載和轉移小蜘蛛到她的小狗。多數小狗對小蜘蛛的作用不是免疫的和顯示臨床標誌或損害。一些不是免疫的並且它是這些顯現出成mange 盛放的案件。

什麼是demodectic mange 的標誌?

對mange 小蜘蛛是敏感的也許開發一些的個體(少於5) 被隔絕的損害(地方化的mange) 或他們也許推斷了mange, 在, 有超過5 損害介入身體的整個身體或區域情況下。多數損害以或者形式顯現出在四個月年齡以後。

demodectic mange 的損害和標誌通常介入掉頭發、有殼, 紅色皮膚和時常, 一次油膩或潮濕出現。小蜘蛛喜歡居住在頭髮濾泡, 那麼在許多情況下, 掉頭發是第一著名的標誌。通常, 掉頭發開始在槍口、眼睛, 和其它區域附近在頭。在地方化的mange, 幾個圓有殼的區域最頻繁地將是著名, 在槍口附近。大多這些損害願自已癒合當小狗變得更舊和開發他們自己的 免疫。堅持損害將需要以後將被描述的治療。在整體是介入的案件(廣義mange), 有將是掉頭發區域在整個外套, 包括頭、脖子、腹部、腿, 和腳。皮膚沿頭, 邊, 和後面將是有殼的和經常激起了。它將崩裂和經常將滲流純淨流體。頭髮缺乏, 但皮膚經常將是油膩的對接觸。一些動物能變得相當不適和開發熱病, 丟失他們的胃口, 和變得lethargic 。有廣義demodectic mange 需要直接蒼勁的治療病人。

demodectic mange 怎麼被診斷?

一旦Demodectic mange 被懷疑, 它可能由皮膚通常證實刮或 切片檢查法, 在, 小蜘蛛能在顯微鏡的幫助下被看見情況下。他們是太小以至於不能被看見與肉眼。成人出現像微小, 鱷□像小蜘蛛。記得, 這些小蜘蛛, 那麼獨自, 是存在在每條狗他們不構成mange 診斷。小蜘蛛必須被結合與損害為mange 診斷被做。

demodectic mange 怎麼被對待?

Demodectic mange 的治療通常被完成與化妝水、垂度, 和香波。幸運地, 90% demodectic mange 案件地方化, 唯一幾個小範圍是介入, 可能典型地經常被對待。是成功的幾年來的治療是1% 魚藤酮 軟膏(Goodwinol 軟膏), 或最近, 5% 過氧化苯□膠凝體每日被應用。階段性地沐浴與過氧化苯□香波和哺養高質量飲食和一multivitamin 與脂肪酸也許並且幫助一些狗。大多這些地方化的損害獨自將癒合和過度不要求進取的治療。

如果狗顯現出廣義demodicosis 更加進取的治療通常必需。研究表示, 在顯現出的30% 和50% 狗之間廣義形式獨自將恢復沒有治療, 但治療總仍然被推薦為廣義形式。選擇的治療繼續是Amitraz 垂度運用了每二個星期。 Amitraz 是有機磷酸鹽, 和一般是可利用的以產品名稱Mitaban 。這是處方產品, 應該被申請以關心。人應該總佩帶橡膠手套當應用它嚮他們的狗, 和它應該被申請在一個區域以充分透氣。它建議, longhaired 狗突然被截去, 以便垂度可能聯繫好聯絡與皮膚。在浸洗前, 狗應該沐浴以過氧化苯□香波幫助取消油和多孔的殘骸。

多數狗與廣義demodicosis 要求在4 個和14 個垂度之間。在第一三個或四個垂度, 皮膚刮應該進行確定之後如果小蜘蛛被消滅了。垂度應該繼續直到有是沒有小蜘蛛被發現在皮膚scrapings 被採取在2 種連續治療以後。一些狗開發鎮靜或噁心當浸洗, 並且玩具養殖對amitraz 特別是是敏感的。半力量垂度應該被使用在這些敏感動物。

Ivermectin 不應該被使用在大牧羊犬和相似的養殖。
一些狗不能對這種治療起反應, 並且垂度的頻率也許必須被增加或另外的治療也許需要被設立。二個其它產品, 雖然他們不被准許為demodectic mange 的治療, 由獸醫皮膚病學家和普通開業醫生廣泛應用以一些好結果。這些的當中一個是 ivermectin, 是有效成分在Heartgard, 然而, 集中在Heartgard 不將足夠高是有效的反對Demodex 。液體ivermectin 更大的每日藥量必須被給和應該只被使用在接近的獸醫監督下。其它藥物, Milbemycin oxime (攔截機), 每日並且被給了並且證明是有效的在沒有反應Mitaban 的50% 狗浸洗。

推斷了demodicosis 的狗經常有部下的皮膚傳染, 因此抗生素經常被給為一幾個星期治療。另外, 我們通常推薦狗被投入在一個好multivitamin/ 脂肪酸 補充。由於Demodex 茂盛在狗以一個被壓制的免疫系統, 它是明智檢查免疫系統疾病的根本原因, 特別如果動物更舊當他們開發情況。

對養殖的預測和衝擊

Demodectic mange 不是一個 被繼承的 情況, 但是允許小狗是易受小蜘蛛的被壓制的免疫系統可能是。記得, 所有小狗接受小蜘蛛從他們的母親, 但只一些有無效的免疫系統和開發mange 。這種敏感性可能基因上通過通過世代。有demodectic mange 的歷史, 和他們的父母和兄弟姐妹的個體, 不應該養殖。通過仔細養殖, 廣義demodicosis 多數案件能被消滅。

我可以得到 Demodex 從我的狗嗎?

Demodex 小蜘蛛的各種各樣的 種類 傾向於騷擾只主人動物的一個種類, 即, Demodex canis 騷擾狗, Demodex bovis 騷擾牛, 並且 Demodex folliculorum 騷擾人。

結論

總而言之, 幾重要點應該被重覆。小蜘蛛從母親轉移到子孫在最初的少數天生活。掉頭發的第一標誌通常不發生直到在四個月年齡之後。Demodectic mange 是幾乎總可醫治或可控制的以堅持治療, 除了在罕見的案件與非常免疫被壓制的個體。考慮到demodectic mange 的發展的免疫系統情況可能是一個被繼承的情況, 和養殖這些動物不應該發生。



Demodectic mange (also known as red mange, follicular mange, or puppy mange) is a skin disease, generally of young dogs, caused by the mite, Demodex canis. It may surprise you to know that demodectic mites of various species live on the bodies of virtually every adult dog and most human beings, without causing any harm or irritation. These small (0.25 mm) 'alligator-like' mites live inside of the hair follicles (i.e., the pore within the skin through which the hair shaft comes through), hence the name follicular mange. In humans, the mites usually are found in the skin, eyelids, and the creases of the nose.
Disease related to suppressed immune system

Whether or not Demodex causes harm to a dog depends on the animal's ability to keep the mite under control. Demodectic mange is not a disease of poorly kept or dirty kennels. It is generally a disease of young dogs that have inadequate or poorly developed immune systems or older dogs that are suffering from a depressed immune system.

What is the life cycle of Demodex canis?

The demodectic mite spends its entire life on the dog. Eggs are laid by a pregnant female, hatch, and then mature from larvae to nymphs to adults. The life cycle is believed to take 20-35 days.

How is Demodex canis transmitted?

The mites are transferred directly from the mother to the puppies within the first week of life. Transmission of the mites is by direct contact only. That is, the mother and puppy must be physically touching, as the parasite cannot survive off of the animal. This is important because it means the kennel or bedding area does not become contaminated, and therefore the environment need not be treated. Lesions, if present, usually appear first around the puppy's head, as this is the area most in contact with the mother. Virtually every mother carries and transfers mites to her puppies. Most puppies are immune to the mite's effects and display no clinical signs or lesions. A few are not immune and it is these that develop into full-blown cases of mange.

What are the signs of demodectic mange?

Individuals that are sensitive to the mange mites may develop a few (less than 5) isolated lesions (localized mange) or they may have generalized mange, in which case, there are more than 5 lesions involving the entire body or region of the body. Most lesions in either form develop after four months of age.

The lesions and signs of demodectic mange usually involve hair loss, crusty, red skin and at times, a greasy or moist appearance. The mites prefer to live in the hair follicles, so in most cases, hair loss is the first noted sign. Usually, hair loss begins around the muzzle, eyes, and other areas on the head. In localized mange, a few circular crusty areas will be noted, most frequently around the muzzle. Most of these lesions will self heal as the puppies become older and develop their own immunity. Persistent lesions will need treatment that will be described later. In cases in which the whole body is involved (generalized mange), there will be areas of hair loss over the entire coat, including the head, neck, abdomen, legs, and feet. The skin along the head, side, and back will be crusty and oftentimes inflamed. It will often crack and ooze a clear fluid. Hair will be scant, but the skin itself will often be oily to the touch. Some animals can become quite ill and develop a fever, lose their appetite, and become lethargic. Patients with generalized demodectic mange need immediate vigorous treatment.

How is demodectic mange diagnosed?

Once Demodectic mange is suspected, it can usually be confirmed by a skin scraping or biopsy, in which case, the mites can be seen with the aid of a microscope. They are too small to be seen with the naked eye. The adults appear as tiny, alligator-like mites. Remember that these mites are present in every dog, so by themselves, they do not constitute a diagnosis of mange. The mite must be coupled with the lesions for a diagnosis of mange to be made.

How is demodectic mange treated?

The treatment of Demodectic mange is usually accomplished with lotions, dips, and shampoos. Fortunately, 90% of demodectic mange cases are localized, in which only a few small areas are involved and can often be treated topically. A treatment that has been successful for years has been a 1% rotenone ointment (Goodwinol ointment), or more recently, a 5% benzoyl peroxide gel applied daily. Bathing periodically with a benzoyl peroxide shampoo and feeding a high quality diet and a multivitamin with a fatty acid may also help some dogs. Most of these localized lesions will heal on their own and do not require overly aggressive treatment.

If a dog develops generalized demodicosis more aggressive treatment is usually required. Studies show that between 30% and 50% of dogs that develop the generalized form will recover on their own without treatment, but treatment is still always recommended for the generalized form. The treatment of choice continues to be Amitraz dips applied every two weeks. Amitraz is an organophosphate, and is generally available under the product name Mitaban. It is a prescription product and should be applied with care. Humans should always wear rubber gloves when applying it to their dog, and it should be applied in an area with adequate ventilation. It is recommended that longhaired dogs be clipped short, so that the dip can make good contact with the skin. Prior to dipping, the dog should be bathed with a benzoyl peroxide shampoo to help remove oil and cellular debris.

Most dogs with generalized demodicosis require between 4 and 14 dips. After the first three or four dips, a skin scraping should be performed to determine if the mites have been eliminated. Dips should continue until there have been no mites found on the skin scrapings taken after 2 successive treatments. Some dogs develop sedation or nausea when dipped, and toy breeds in particular are sensitive to amitraz. Half strength dips should be used on these sensitive animals.

Ivermectin should not be used in Collies and similar breeds.
Some dogs may not respond to this treatment, and the frequency of the dips may have to be increased or additional treatments may need to be instituted. Two other products, which though they are not licensed for the treatment of demodectic mange, are being widely used by veterinary dermatologists and general practitioners with some good results. One of these is ivermectin, which is the active ingredient in Heartgard, however, the concentration in Heartgard is not high enough to be effective against Demodex. Larger daily doses of liquid ivermectin must be given and should only be used under close veterinary supervision. Another drug, Milbemycin oxime (Interceptor), has also been given daily and been shown to be effective on up to 50% of the dogs that did not respond to Mitaban dips.

Dogs that have generalized demodicosis often h>><<atment. In addition, we usually recommend the dog be put on a good multivitamin/ fatty acid supplement. Because Demodex flourishes on dogs with a suppressed immune system, it is wise to check for underlying causes of immune system disease, particularly if the animal is older when they develop the condition.

Prognosis and impact on breeding

Demodectic mange is not an inherited condition, but the suppressed immune system that allows the puppy to be susceptible to the mites can be. Remember that all puppies receive the mites from their mother, but only a few have ineffective immune systems and develop the mange. This sensitivity can be passed genetically through generations. Individuals that have a history of demodectic mange, and their parents and siblings, should not be bred. Through careful breeding, most cases of generalized demodicosis could be eliminated.

Can I get Demodex from my dog?

The various species of Demodex mites tend to infest only one species of host animal, i.e., Demodex canis infests dogs, Demodex bovis infests cattle, and Demodex folliculorum infests humans.

Conclusion

In conclusion, a few important points should be repeated. The mites are transferred from the mother to offspring in the first few days of life. The first sign of hair loss usually does not occur until after four months of age. Demodectic mange is almost always curable or controllable with persistent treatment, except in rare cases with very immune suppressed individuals. The immune system condition that allows for the development of demodectic mange can be an inherited condition, and breeding of these animals should not occur.

References and Further Reading[/size]

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[size=12px][color=red][size=5][b][color=magenta]Cushing 的疾病(Hyperadrenocorticism)[/color] [/b][/size][/color]  


Cushing 的疾病(hyperadrenocorticism) 是情況那結果從 慢性 生產過剩太多 糖皮質激素 在身體。在正常狗, 腦下垂體生產激素稱ACTH, 刺激腎上腺封墊生產類固醇激素糖皮質激素必要為許多系統的作用在身體。如果某事進來錯誤在腦下垂體或腎上腺封墊和糖皮質激素太多被生產, Cushing 的疾病然後顯現出。這是一種非常複雜的疾病以大範圍症狀和起因。這篇文章將設法給疾病、它的症狀, 怎麼它被診斷, 並且它的治療的一個簡明的描述。

誰得到hyperadrenocorticism?

Cushing 的疾病被認為中間年齡疾病和更舊的狗和貓。它是共同在狗。這種疾病是相似在貓除了在貓由80% 決定並且有一致 糖尿病mellitus。這篇文章將提到問題如同它發生在狗。患疾病的通常年齡是大約六或七年以二到十六年的範圍。有相等的發行在男性之間並且女性和那裡不看來是疾病的增量在任何一養殖。

症狀

為狗最後被診斷以Cushing 的疾病, 掉頭發是所有者第一次帶來他們的狗為評估的最共同的原因的當中一個。

由於慢性地被舉起的glucocorticoids (類固醇), 受影響的狗開發劇烈的臨床標誌和損害的一個經典組合。疾病慢慢地進步。研究表示, 多數狗有至少疾病的一種症狀從一個到在疾病六年被診斷了之前。由於症狀那麼逐漸發生, 所有者經常歸因於對"老年齡的變動。" 一些狗將有只一種症狀, 當其他人也許有許多。

增加的水消耗量和排尿: 最共同的症狀是水和總值增加的排尿的增加的消耗量(polyuria/polydipsia) 。狗喝在二並且十倍之間正常相當數量水和在排尿的總值增量隨後而來。這種症狀是存在完全成功85% 所有動物以Cushing 的疾病。早先管教得好的動物也許開始有事故因為他們的膀胱用尿的生產過剩迅速填裝。

增加在胃口: 在胃口的增量(polyphagia) 是出現大約80% 受影響的動物的其它共同的臨床症狀。狗也許開始竊取食物, 進入垃圾, 連續乞求, 和變得非常防護他們的食物。儘管有其它症狀, 所有者也許認為, 狗是好由於他的好胃口。

胃腸擴大: 胃腸擴大是一種共同的症狀在80% 受影響的狗中。potbellied 出現是轉移油脂到胃腸區域和減弱和浪費的結果肌肉大量在腹部。



掉頭發和稀薄的皮膚: 掉頭發和變薄皮膚是還共同的症狀在狗以Cushing 的疾病。它估計, 在50% 和90% 受影響的動物之間開發這些症狀。掉頭發(脫髮症) 是最共同的原因的當中一個所有者帶來他們的狗為評估。掉頭發開始在穿戴區域譬如手肘和通常進步對側面和腹部直到最終唯一頭和肢有頭髮。皮膚也許變得稀薄和容易地被損壞和並且減慢癒合。

增加的氣喘, 週期性尿道傳染, 或損失在再生能力是其它症狀經常被注意以這種疾病。

Cushing 的疾病有二個形式

有疾病的二個不同分明形式。有腦下垂體的依賴hyperadrenocorticism (PDH) 並且有一種基於腎上腺的疾病。

腦下垂體的依賴hyperadrenocorticism: PDH 介入促腎上腺皮質激素的oversecretion 由腦下垂體。促腎上腺皮質激素是刺激腎上腺封墊導致glucocorticoids 的激素。腦下垂體是很可能overproducing 促腎上腺皮質激素由於一個腦下垂體的腫瘤。疾病的PDH 形式負責對大約80% 似犬Cushing 的疾病箱子。

基於腎上腺的hyperadrenocorticism: 疾病的基於腎上腺的形式通常是導致glucocorticoids 的oversecretion 一個腎上腺腫瘤的結果。腎上腺腫瘤負責對大約20% Cushing 的疾病箱子。有並且疾病的形式叫做"發生由於給類固醇動物大劑量的醫原性" Cushing 的疾病。以這疾病的形式, Cushing 的疾病症狀將走開一旦類固醇被中斷。

診斷

它建議, 任一條狗被懷疑有Cushing 的疾病應該有完全血液計數、化學外形, 和尿分析執行作為評估的一定期部份。

Cushing 的疾病提出以各種各樣的症狀, 也許並且被介入以幾個不同的疾病過程。所以, 它建議, 任一條狗被懷疑有Cushing 的疾病應該有 完全血液計數(CBC), 血液化學盤區, 和 尿分析 執行作為評估的一定期部份。共同的反常性在這些測試包括增量在鹼性磷酸鹽裡, 和ALT (肝臟酵素), 增加的膽固醇, 被減少的小圓麵包(腎臟功能考驗), 和稀釋尿(低比重) 。

有可能執行得到Cushing 的疾病一個明確的診斷的幾個不同的測試。許多時間獸醫也許執行超過一個測試幫助證實診斷或確定哪個疾病的形式是存在。Cushing 的疾病診斷, 然而, 應該從未使根據實驗室試驗單獨。狗需要顯示疾病的症狀, 和有病史一致與診斷。

三個最共同的"掩護" 測試是尿cortisol:creatinine 比率、低藥量dexamethasone 鎮壓測試, 和超聲波。

尿Cortisol:Creatinine 比率: 在這個測試, 所有者在家一般收集尿樣(動物不被注重) 的地方。樣品由獸醫寄發到一個特別實驗室為測試。多數狗以Cushing 的疾病有一個反常結果。但是, 有可能並且導致反常結果的其它疾病。如此如果這個測試是反常, 進一步診斷測試應該執行。

低藥量Dexamethasone 鎮壓測試: 低藥量dexamethasone 鎮壓測試是有用的在診斷的Cushing 的疾病在狗。當給dexamethasone 低藥量, 正常狗顯示在血液+化皮質酮水平的明顯減退當測試8 個小時以後。多數狗(超過90%) 以Cushing 的疾病沒有在+化皮質酮水平的減退在被給dexamethasone 以後。結果可能有時幫助確定哪種疾病類型是存在。

胃腸超聲波: 胃腸超聲波是有用的在三個方面。首先, 這是一個好測試評估所有胃腸器官在狗。第二, 它使用學習腎上腺封墊的大小和形狀。腎上腺封墊在腦下垂體的依賴hyperadrenocorticism 通常是正常在大小或擴大。如果腫瘤是存在然而, 一個腎上腺封墊經常是反常地大或參差不齊的形狀。終於, 如果腫瘤被懷疑, 超聲波可能幫助辨認任一轉移對其它器官。

有從前通常被使用援助在Cushing 的疾病診斷在狗的二個測試。他們是大劑量dexamethasone 鎮壓測試和促腎上腺皮質激素刺激測試。

大劑量Dexamethasone 鎮壓測試: 這驗血被使用設法區別在腦下垂體的依賴hyperadrenocorticism 和基於腎上腺的hyperadrenocorticism 之間。

促腎上腺皮質激素刺激測試: 這是今天是較不常用在Cushing 的疾病診斷的其它測試。被使用在這個測試的促腎上腺皮質激素激素準備變得非常昂貴和有時難獲取。它不會區別在二類型hyperadrenocorticism 之間, 但是它也許援助在診斷在困難的案件。它是最常用評估療法的有效率。

治療

治療包括幾個不同的選擇。根據疾病類型, 手術可能做。如果一個腎上腺腫瘤被辨認, 那麼外科撤除也許是一個可行選擇。有可能侵略腎上腺封墊並且他們的治療將根據特殊腫瘤類型的幾個腫瘤的不同的形式。有成功地做手術去除受影響的腦下垂體以疾病的腦下垂體的形式的幾位外科醫生。但是, 這是一個非常專業做法和共同地不執行以疾病的腦下垂體的形式。

Nonsurgical 治療是經常半新治療為似犬Cushing 的疾病多數案件。

非外科治療是經常半新治療為似犬Cushing 的疾病多數案件。大約80% Cushing 的疾病箱子在狗是腦下垂體的型, 和因為腎上腺和腦下垂體的型有效地將反應一些口頭治療, 許多獸醫不進行診斷必要區別在二個不同形式之間。有當前幾個不同的口頭療程被使用對待似犬Cushing 的疾病。

Lysodren: 近來, Lysodren (亦稱mitotane, 和o, p' 雙對氯苯基二氯乙烷) 是唯一的治療可利用為腦下垂體的依賴Cushing 的疾病。它方便使用和是相對地低廉的和大概仍然是廣泛被應用的治療。下側這種藥物是, 它可能有一些嚴肅的副作用並且規則血液監視需要執行。在療法的初期階段期間, 狗必須非常仔細地被監測, 並且那裡必須是接近的通信在獸醫和所有者之間。

對Lysodren 的用途是有些像化療。這有效在毀壞生產類皮質激素激素腎上腺封墊的細胞旁邊。當類皮質激素生產的細胞的數量被減少, 即使腦下垂體繼續生產剩餘促腎上腺皮質激素, 腎上腺封墊較不能反應, 因此相當數量糖皮質激素被生產被減少。問題出現當太多腎上腺皮質激素被殺害。動物也許然後需要被安置在強體松, 或短或長期。Lysodren 每日最初地被給當動物被監測為在症狀的減退(水消耗量, 胃口) 。在最初的療法的第8 或第9 天, 狗需要被審查並且促腎上腺皮質激素刺激測試執行確定如果藥物運作。如果目標達到, 維護療法開始。如果目標未被到達, 狗然後保留在每日療程3 到7 另外的天和一般被復校直到適當的結果達到。如果狗變得lethargic, 嘔吐, 或有腹瀉, 或如果治療不運作在30 天旁邊, 那麼治療計劃被複評。如果治療是成功的, 那麼症狀應該解決在4 個到6 個月內。狗的某一百分比將復發和將需要再接受每日療法在他們的生活中。如果狗曾經變得不適當在Lysodren, Lysodren 應該立刻被停止和狗應該由獸醫審查。狗將需要是在Lysodren 在他有生之年。

Ketoconazole: Ketoconazole 是 廣泛地被使用了從中間80s 的一個口頭殺真菌劑的代理。ketoconazole 的當中一個副作用是, 它干涉類固醇激素綜合。它贏得了因此一些聲望作為一種治療為Cushing 的疾病。但是, 它今天很少被使用。

L-deprenyl (Anipryl): L-deprenyl (Anipryl) 主張了為Cushing 的疾病的治療在狗, 但它的有效率開始了問題。

Trilostane: Trilostane 是使用對待一些狗以Cushing 的疾病的一種更新的治療。它是更加昂貴的, 但也許是一種供選擇的治療為狗以腎上腺腫瘤。和與Lysodren, 狗一再被再檢查在初期階段治療期間, 並且促腎上腺皮質激素刺激測試執行。在許多情況下, 在藥量需要被增加的幾個月療法之後。

總結

Cushing 的疾病是影響中間年齡對更舊的狗的疾病。受影響的動物有一個典型介紹包括增加的水消耗量和收效增加的排尿、增加的胃口、掉頭發, 和一次potbellied 出現。有幾次診斷測試可利用, 並且幾種治療。

Cushing's disease (hyperadrenocorticism) is a condition that results from the chronic overproduction of too much glucocorticoid in the body. In the normal dog, the pituitary gland produces a hormone called ACTH, which stimulates the adrenal gland to produce the steroid hormone glucocorticoid necessary for the function of many systems in the body. If something goes wrong in the pituitary gland or adrenal gland and too much glucocorticoid is produced, then Cushing's disease develops. This is a very complicated disease with a wide range of symptoms and causes. This article will try to give a concise description of the disease, its symptoms, how it is diagnosed, and its treatment.

Who gets hyperadrenocorticism?

Cushing's disease is considered a disease of middle age and older dogs and cats. It is much more common in dogs. This disease is similar in cats except that in cats up to 80% also have concurrent diabetes mellitus. This article will refer to the problem as it occurs in dogs. The usual age of contracting the disease is around six or seven years with a range of two to sixteen years. There is equal distribution between males and females and there does not appear to be an increase of the disease in any one breed.

Symptoms

For dogs ultimately diagnosed with Cushing's disease, hair loss was one of the most common reasons the owners first brought their dog in for evaluation.

As a result of the chronically elevated glucocorticoids (steroids), the affected dogs develop a classic combination of dramatic clinical signs and lesions. The disease progresses slowly. A study showed that most dogs had at least one symptom of the disease from one to six years before the disease was diagnosed. Because the symptoms occur so gradually, the owner often attributes the changes to "old age." Some dogs will have only one symptom, while others may have many.

Increased Water Consumption and Urination: The most common symptom is increased consumption of water and the resultant increased urination (polyuria/polydipsia). The dogs drink between two and ten times the normal amount of water and the resultant increase in urination follows. This symptom is present in over 85% of all animals with Cushing's disease. Previously housebroken animals may begin to have accidents because their bladders fill quickly with the overproduction of urine.

Increase in Appetite: Increase in appetite (polyphagia) is another common clinical symptom that shows up in around 80% of the affected animals. Dogs may begin stealing food, getting into the garbage, begging continuously, and become very protective of their food. Despite having other symptoms, the owner may feel that the dog is okay because of his good appetite.

Abdominal Enlargement: Abdominal enlargement is a common symptom in up to 80% of the affected dogs. The potbellied appearance is a result of the shifting of fat to the abdominal area and a weakening and wasting of muscle mass in the abdomen.



Hair Loss and Thin Skin: Hair loss and thinning of the skin are also common symptoms in dogs with Cushing's disease. It is estimated that between 50% and 90% of the affected animals develop these symptoms. Hair loss (alopecia) is one of the most common reasons that owners bring their dog in for evaluation. The hair loss usually starts over the areas of wear such as the elbows and progresses to the flanks and abdomen until eventually only the head and extremities have hair. The skin may also become thin and be easily damaged and slow to heal.

Increased panting, recurrent urinary tract infections, or losses in reproductive ability are other symptoms often noted with this disease.

Cushing's Disease has two forms

There are two different distinct forms of the disease. There is pituitary dependent hyperadrenocorticism (PDH) and there is an adrenal-based disease.

Pituitary dependent hyperadrenocorticism: PDH involves the oversecretion of ACTH by the pituitary gland. ACTH is a hormone that stimulates the adrenal gland to produce glucocorticoids. The pituitary gland is most likely overproducing ACTH because of a pituitary tumor. The PDH form of the disease is responsible for around 80% of the cases of canine Cushing's disease.

Adrenal-based hyperadrenocorticism: The adrenal-based form of the disease is usually a result of an adrenal tumor that causes an oversecretion of glucocorticoids. Adrenal tumors are responsible for around 20% of the cases of Cushing's disease. There is also a form of the disease called "iatrogenic" Cushing's disease that occurs as a result of giving the animal high doses of steroids. In this form of the disease, symptoms of Cushing's disease will go away once the steroids are discontinued.

Diagnosis

It is recommended that any dog suspected of having Cushing's disease should have a complete blood count, chemistry profile, and urinalysis performed as a routine part of the evaluation.

Cushing's disease can present with a variety of symptoms and may also be involved with several different disease processes. Therefore, it is recommended that any dog suspected of having Cushing's disease should have a complete blood count (CBC), blood chemistry panel, and urinalysis performed as a routine part of the evaluation. Common abnormalities in these tests include increases in alkaline phosphatase, and ALT (liver enzymes), increased cholesterol, decreased BUN (a kidney function test), and dilute urine (low specific gravity).

There are several different tests that can be performed to get a definitive diagnosis of Cushing's disease. Many times the veterinarian may perform more than one test to help confirm the diagnosis or to determine which form of the disease is present. A diagnosis of Cushing's disease, however, should never be made on the basis of laboratory tests alone. The dog needs to be showing symptoms of the disease, and have a medical history consistent with the diagnosis.

The three most common "screening" tests are the urine cortisol:creatinine ratio, the low dose dexamethasone suppression test, and ultrasound.

Urine Cortisol:Creatinine Ratio: In this test, the owner generally collects a urine sample at home (where the animal is not stressed). The sample is sent by the veterinarian to a special laboratory for testing. Most dogs with Cushing's disease have an abnormal result. However, there are other diseases that can also cause abnormal results. So if this test is abnormal, further diagnostic testing should be performed.

Low Dose Dexamethasone Suppression Test: The low dose dexamethasone suppression test is useful in diagnosing Cushing's disease in dogs. When given low doses of dexamethasone, normal dogs show a marked decrease in blood cortisol levels when tested 8 hours later. Most dogs (more than 90%) with Cushing's disease do not have a decrease in cortisol level after being given dexamethasone. The results can sometimes help determine which type of disease is present.

Abdominal Ultrasound: Abdominal ultrasound is helpful in three respects. First, it is a good test to evaluate all of the abdominal organs in the dog. Secondly, it is used to study the size and shape of the adrenal glands. The adrenal glands in pituitary dependent hyperadrenocorticism are usually normal in size or enlarged. If a tumor is present however, one adrenal gland is often abnormally large or of uneven shape. Finally, if a tumor is suspected, ultrasound can help identify any metastasis to other organs.

There are two tests that were used more commonly in the past to aid in the diagnosis of Cushing's disease in dog. They are the high dose dexamethasone suppression test and the ACTH stimulation test.

High Dose Dexamethasone Suppression Test: This blood test is used to try to distinguish between pituitary dependent hyperadrenocorticism and adrenal-based hyperadrenocorticism.

ACTH Stimulation Test: This is another test that is less commonly used in the diagnosis of Cushing's disease today. The ACTH hormone preparation that is used in this test has become very expensive and sometimes difficult to acquire. It will not distinguish between the two types of hyperadrenocorticism, but it may aid in the diagnosis in difficult cases. It is most commonly used to evaluate the effectiveness of therapy.

Treatment

Treatment consists of several different options. Depending on the type of disease, surgery can be performed. If an adrenal tumor is identified, then surgical removal may be a viable option. There are several different forms of tumors that can invade the adrenal gland and their treatment will be based on the particular tumor type. There are a few surgeons that have successfully performed surgery to remove the affected pituitary gland in the pituitary form of the disease. However, this is a very specialized procedure and is not commonly performed in the pituitary form of the disease.

Nonsurgical treatment is the most often used treatment for most cases of canine Cushing's disease.

Non surgical treatment is the most often used treatment for most cases of canine Cushing's disease. About 80% of the cases of Cushing's disease in the dog are of the pituitary type, and since both the adrenal and the pituitary type will respond effectively to some of the oral treatments, many veterinarians do not perform the diagnostics necessary to distinguish between the two different forms. There are currently several different oral medications being used to treat canine Cushing's disease.

Lysodren: Until recently, Lysodren (also known as mitotane, and o,p'-DDD) was the only treatment available for pituitary dependent Cushing's disease. It is convenient to use and is relatively inexpensive and is still probably the most widely used treatment. The downside of this drug is that it can have some serious side effects and regular blood-monitoring needs to be performed. During the initial phases of the therapy, the dog must be very carefully monitored, and there must be close communication between the veterinarian and the owner.[/size]
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minibabyqq 2006-12-28 00:40

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[size=12px][color=red][size=5][b][color=magenta]睪丸腫瘤 Testicular Tumors[/color]  [/b][/size][/color]


睪丸腫瘤被考慮最共同的 腫瘤的當中一個 在更舊的原封(unneutered) 公狗。整體發生在狗不是非常高的由於被刪改的很大數量的狗。但是, 在原封男性尾隨這些腫瘤被認為相當共同。腫瘤通常相當容易認出和診斷。治療包括 宮刑 和通常是治病的。
哪條狗是在危險中開發睪丸腫瘤?

睪丸腫瘤是最共同在原封(unneutered) 更舊的公狗。但是, 他們能發生在任一年齡原封男性。那裡不看來是任何養殖嗜好為這個腫瘤。睪丸腫瘤的當前的起因是未知的。有一的狗或不下降的兩個睪丸(cryptorchid) 比狗是13 倍可能開發一個腫瘤在undescended 睪丸與正常睪丸。除了這些腫瘤增加的風險在cryptorchid 狗, 其它風險因素不是欣然明顯的。

有是不同的類型睪丸腫瘤嗎?

有三共同的類型睪丸腫瘤: Sertoli 細胞腫瘤、seminomas, 和細胞間的細胞腫瘤。當有在類型上的區別腫瘤, 他們相似地經常被對待和因此共同地放在一起作為睪丸腫瘤。

什麼是症狀?

Sertoli 細胞腫瘤 顯示睪丸和scrotal 區域的膨脹症狀。如果狗是cryptorchid, 膨脹將發生在腹股溝或胃腸區域根據睪丸的地點。50% Sertoli 細胞腫瘤將生產女性荷爾蒙並且狗將遭受hyperestrogenism 症狀。這些包括擴大的攝護腺封墊、擴大的乳房封墊和乳頭、對稱掉頭發、貧血症, 和傾向吸引其它男性狗。Sertoli 細胞腫瘤也許 metastasize 對腹部, 肺, 胸腺, 並且腦子, 然而, 這發生在少於15% 箱子中。

Seminomas 並且將出現作為睪丸、陰囊, 和腹股溝或胃腸區域的脹大。Seminomas 產物女性荷爾蒙或metastasize 在少於5% 被報告的案件中。

細胞間的細胞腫瘤 顯示非常少量症狀, 不生產女性荷爾蒙或不metastasize 。他們通常是偶然發生的研究結果和沒認為問題。

睪丸腫瘤怎麼被診斷?

診斷根據歷史、介紹、和病理性證明通過 切片檢查法 或被去除的腫瘤的微觀考試。狗被懷疑一個睪丸腫瘤應該並且有胃腸和胸部X光檢查轉移並且 化學盤區 和 血液計數(CBC)。

什麼是治療為睪丸腫瘤?

治療通常包括外科宮刑。由於睪丸撤除的成功和轉移的低率, 宮刑經常是唯一的治療需要。一些狗成功地被對待了以 化療 並且在有轉移的狗, 化療有時被推薦。

什麼是預測為開發睪丸腫瘤的狗?

預測為狗以被對待的睪丸癌症通常是非常好的。轉移的低率使外科宮刑非常成功和治病在多數狗。開發hyperestrogenism 從Sertoli 細胞腫瘤的狗經常將有症狀退化, 一旦腫瘤被去除了。在導致貧血症的嚴厲 hyperestrogenism, 一些動物也許要求滲流和更加進取的治療。預測為metastasized 是被守衛的睪丸腫瘤並且結果廣泛變化根據地點、型, 和治療。

睪丸腫瘤怎麼可能被防止?

睪丸癌症容易地被防止, 並且以好宮刑政策能從似犬人口實際上被消滅。
睪丸腫瘤容易地防止通過公狗的定期宮刑。宮刑在幼小狗防止侵略, 漫遊, 尿標號, 和各種各樣的其它不需要的男性行為。手術是安全和相對地低廉的, 和從長遠看存所有者金錢。被使用為養殖的狗可能被刪改當他們不再被使用為養殖。是cryptorchid 的狗應該總被刪改和所有者應該堅持, 兩個睪丸被去除。因為cryptorchidism 認為是一個被繼承的特徵, cryptorchid 狗應該從未被使用為養殖。由於被保留的睪丸是13 倍可能開發腫瘤, 它應該總被去除。


Testicular tumors are considered one of the most common tumors in older intact (unneutered) male dogs. The overall incidence in dogs is not very high because of the large number of dogs that are castrated. However, in intact male dogs these tumors are considered fairly common. The tumors are usually fairly easy to recognize and diagnose. Treatment consists of castration and is usually curative.
Which dogs are at risk to develop testicular tumors?

Testicular tumors are most common in intact (unneutered) older male dogs. However, they can occur in intact males of any age. There does not appear to be any breed predilection for this tumor. The current cause of testicular tumors is unknown. Dogs that have one or both testicles that are not descended (cryptorchid) are 13 times more likely to develop a tumor in the undescended testicle than dogs with normal testicles. Except for the increased risk of these tumors in cryptorchid dogs, no other risk factors are readily apparent.

Are there different types of testicular tumors?

There are three common types of testicular tumors: Sertoli cell tumors, seminomas, and interstitial cell tumors. While there are differences in the types of tumors, they are often treated similarly and are therefore commonly lumped together as testicular tumors.

What are the symptoms?

Sertoli cell tumors show symptoms of swelling of the testicular and scrotal area. If the dog is cryptorchid, the swelling will occur in the inguinal or abdominal area depending on the location of the testicle. Up to 50% of the Sertoli cell tumors will produce estrogen and the dog will suffer symptoms of hyperestrogenism. These include an enlarged prostate gland, enlarged mammary glands and nipples, symmetrical hair loss, anemia, and the tendency to attract other male dogs. Sertoli cell tumors may metastasize to the abdomen, lung, thymus, and brain, however, this occurs in less than 15% of the cases.

Seminomas will also appear as swellings of the testicle, scrotum, and inguinal or abdominal area. Seminomas produce estrogen or metastasize in less than 5% of the reported cases.

Interstitial cell tumors show very few symptoms and do not produce estrogen or metastasize. They are usually incidental findings and not considered to be much of a problem.

How are testicular tumors diagnosed?

Diagnosis is based on history, presentation, and pathological identification through a biopsy or microscopic examination of the removed tumor. Dogs suspected of a testicular tumor should also have abdominal and chest x-rays to check for metastasis as well as a chemistry panel and a blood count (CBC).

What is the treatment for testicular tumors?

Treatment usually consists of surgical castration. Because of the success of testicular removal and the low rate of metastasis, castration is often the only treatment needed. Some dogs have been treated successfully with chemotherapy and in dogs that have metastasis, chemotherapy is sometimes recommended.

What is the prognosis for dogs that develop testicular tumors?

The prognosis for dogs with treated testicular cancer is usually very good. The low rate of metastasis makes surgical castration very successful and curative in most dogs. Dogs that develop hyperestrogenism from Sertoli cell tumors will often have a regression of symptoms, once the tumor has been removed. In severe hyperestrogenism that results in anemia, some animals may require transfusions and more aggressive treatment. The prognosis for testicular tumors that have metastasized is more guarded and the outcome varies widely depending on location, type, and treatment.

How can testicular tumors be prevented?

Testicular cancer is easily prevented, and with good castration policies could be virtually eliminated from the canine population.
Testicular tumors are easily prevented through routine castration of male dogs. Castration in young dogs prevents aggression, roaming, urine marking, and a variety of other unwanted male behaviors. The surgery is safe and relatively inexpensive, and in the long run saves the owner money. Dogs that are used for breeding can be castrated when they are no longer used for breeding. Dogs that are cryptorchid should always be castrated and the owner should insist that both testicles be removed. Since cryptorchidism is considered to be an inherited trait, cryptorchid dogs should never be used for breeding. Because the retained testicle is 13 times more likely to develop a tumor, it should always be removed.[/size]
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minibabyqq 2006-12-28 00:45

[color=Magenta][size=5][b]牙冠療法 CROWN THERAPY  [/b][/size][/color]


冠療法是一個選擇在殘破或害病的牙裡。很少是它醫療上必要, 雖然它可能改進牙的作用和美學。冠predominately 被製造增加一顆破碎的牙的力量和大小。

冠療法是一種非常共同的治療在美學是頭等重要的人的牙科方面。但是, 它不是近作為共同性在動物牙科中。任一顆破碎的牙可能被加冠, 然而它總不做。有這的幾個原因。第一原因是財政的, 冠是典型地作為或昂貴比根運河做法。第二, 由於犬齒的曲度在狗, 塑造牙接受冠可能實際上減弱牙。這是只真實的如果牙輕微地只被傷。終於, 一種另外的麻醉劑必需安置冠在它被創造了之後。

熔鑄金屬合金, 全篇報導冠在Schutzhund 狗被安置防止穿戴叮咬袖子訓練。  


一個徵兆為冠療法是一顆嚴厲地損壞的牙, 或一個可能將接受更多損傷如果留給無保護。冠可能被使用重建搪瓷船腹的損失在一顆破碎的牙。這是outcropping 牙在保護膠免受精神創傷由正常嚼的活動造成的gumline 之上。其它徵兆是在工作狗。警察、Schutzhund 和敏捷性狗也許有嚴厲穿戴或破裂, 可能將繼續損壞他們的牙和在許多情況下會受益於一個防護冠。有重大結構疾病有或沒有破裂的牙應該被加冠。最共同的綜合症狀在這類是 搪瓷發育不全 和 籬笆chewer 或籠子biter 綜合症狀。

冠療法在狗和貓可能是為維護牙的一個有效的工具, 並且增加殘餘的牙的大小。但是, 由於巨大叮咬力量動物可能顯現出, 那裡是極限對我們的能力增加冠高度。被加冠的牙無法是相同照原樣。切開邊緣(要訣) 牙應該是較不然後對應的正常牙的高度。這是因為我們要正常牙採取更多精神創傷。另外, 您無法完全地加強被終止在或者靠近膠線的牙。這些規則的原因是物理, 冠可能被製作, 但他們很有可能被終止的歸結於槓桿作用。

一些大小局限可能由對崗位和核心積累的用途擴大。這由創造根運河的模子和有完成由或膠合一個金屬崗位在根運河和加強滋補材料區域在它附近, 或崗位被做作為冠一部分。這些是非常先進的規程, 但可能是有效的如果適當地做。但是, 物理仍然申請, 並且我們無法完全地重建一顆殘破的牙。

下考慮在冠療法是類型材料被用於。最共同是被熔鑄的金屬、鈦, 或不鏽鋼。這冠材料是最強可利用的, 和要求最少冠撤除。這是選擇冠材料當力量比美學重要。White 冠, 是瓷熔化了在金屬冠, 被使用在人為審美物產。有幾個原因我們經常不使用這些在動物中。首先, 它難匹配牙顏色在動物中; 這限制有用性在展示狗, 如同法官能通常注意。其次, 因為有二層數, 冠準備必須厚實的比對於金屬冠。這更加進一步減少crown/tooth 結構的力量。終於, 在時間期間患者不變地將損壞瓷和因此在底下暴露鹼金屬的區域。有一些新材料當前被開發提高冠的美學, 當不犧牲同樣多力量。Inceram 。是被發展用於人和動物的所有陶瓷冠。冠比金屬冠少許厚實的, 和幾乎像強。這不是一次完善的牙比賽, 但從距離看起來好。我不會使用這材料在工作狗, 但是為寵物這可能是一個好選擇。

Crown therapy is an option in broken or diseased teeth. Rarely is it medically necessary, although it can improve function and aesthetics of the teeth. Crowns are predominately fabricated to increase the strength and size of a fractured tooth.

Crown therapy is a very common treatment in human dentistry where aesthetics are of prime importance. However, it is not near as common in animal dentistry. Any fractured tooth can be crowned, however it is not always done. There are several reasons for this. The first reason is financial, crowns are typically as or more expensive than the root canal procedure itself. Secondly, due to the curvature of the canine teeth in dogs, shaping the tooth to accept a crown can actually weaken the tooth. This is only true if the tooth is only broken slightly. Finally, an additional anesthetic is required to place the crown after it has been created.

Cast metal alloy, full coverage crowns in a Schutzhund dog placed to prevent wear from bite sleeve training.  


One indication for crown therapy is a severely damaged tooth, or one that will likely undergo more damage if left unprotected. A crown can be used to rebuild the loss of the enamel bulge on a fractured tooth. This is an outcropping of the tooth just above the gumline that protects the gums from trauma caused by normal chewing activity. Another indication is in working dogs. Police, Schutzhund and agility dogs may have severe wear or fractures and will likely continue to damage their teeth and in many cases would benefit from a protective crown. Teeth that have significant structural disease with or without fracture should be crowned. The most common syndromes in this class are enamel hypoplasia and fence chewer or cage biter syndrome.

Crown therapy in dogs and cats can be an effective tool for maintaining the tooth, as well as increasing the size of the remaining tooth. However, due to the tremendous bite forces animals can develop, there are limits to our ability to increase crown height. The crowned tooth cannot be the same as it was. The incisal edge (tip) of the tooth should be less then the height of the corresponding normal tooth. This is because we want the normal tooth to take more of the trauma. In addition, you cannot build up a tooth completely that is broken off at or near the gum line. The reasons for these rules are physics, the crowns can be made, but they will in all likelihood be broken off due to leverage.

Some of the size limitations can be extended by the use of post and core build-ups. This is accomplished by either gluing a metal post in the root canal and building up an area of restorative material around it, or by creating a mold of the root canal and having the post made as part of the crown. These are very advanced procedures, but can be effective if done properly. However, physics still applies, and we cannot completely rebuild a broken tooth.

The next consideration in crown therapy is the type of material used. The most common is cast metal, titanium, or stainless steel. This crown material is the strongest available, and requires the least crown removal. This is the crown material of choice when strength is more important than aesthetics. 㜁hite crowns? which are porcelain fused over a metal crown, are used in people for the aesthetic properties. However there are several reasons that we do not use these often in animals. First, it is difficult to match the tooth color in animals; this limits usefulness in show dogs, as a judge can usually notice. Second, since there are two layers, the crown preparation must be thicker than for metal crowns. This further reduces the strength of the crown/tooth structure. Finally, over time the patient will invariably damage the porcelain and therefore expose areas of the base metal underneath. There are some new materials being developed currently to enhance the aesthetics of the crown, while not sacrificing as much strength. 𨧻nceram?is an all ceramic crown that is being developed for use in people and animals. The crown is only slightly thicker than a metal crown, and almost as strong. It is not a perfect tooth match, but from a distance looks good. I would not use this material in a working dog, but for a pet it can be a good choice.

minibabyqq 2006-12-28 00:50

[color=Magenta][size=5][b]NON-VITAL (死的) 牙 #NON-VITAL (DEAD) TEETH   [/b][/size][/color]


有許多起因為牙死亡在動物中。可怕部份是, 這些動物幾乎從未將顯示痛苦的向外標誌, 因此他們經常未被注意。最共同是根運河成為暴露, 和與 殘破的牙、 深骨損害, 或一顆嚴厲地 破舊的牙。這些情況是明顯的在口頭檢查, 和被談論在他們自己的頁。有, 然而, 時期何時牙將是原封的, 但將是非重要的無論如何。一起因是 進步對 牙的尖頂的牙周損害(或底部) 並且傳染牙通過底部。這通常被發現在預防(清潔期間) 當獸醫發現一個非常深口袋。牙齒射線照相是必要證實診斷。  

另一死因在一顆原封牙必須處理供血對牙。一是, 系統傳染可能影響牙通過牙的尖頂。其他是由供血的中斷。中斷通常發生由於重大精神創傷, 或對下頜或牙。您可以看在這種情況下的唯一的向外標誌是牙的色變。沒有變色的所有牙是死的, 然而, 因此我推薦牙齒射線照相在所有變色的牙確定牙的生命力。並且, 沒有是死的所有牙將變色, 因此, 一些獸醫牙醫推薦充分的嘴射線照相在所有牙齒規程期間。


There are many causes for tooth death in animals. The scary part is that these animals will almost never show outward signs of pain, therefore they often go unnoticed. The most common is when the root canal becomes exposed, as with a broken tooth, deep carious lesion, or a severely worn tooth. These conditions are apparent on oral exam, and are discussed on their own pages. There are, however, times when the tooth will be intact, but will be non-vital anyway. One cause is a periodontal lesion that progresses to the apex (or bottom of the tooth) and infects the tooth through the bottom. This is usually discovered during a prophylaxis (cleaning) when the veterinarian finds a very deep pocket. Dental radiographs are necessary to confirm the diagnosis.  

The other cause of death in an intact tooth has to do with the blood supply to the tooth. The first is that a systemic infection can affect the tooth through the apex of the tooth. The other is by a disruption of the blood supply. The disruption usually occurs due to a significant trauma, either to the jaw or the tooth itself. The only outward sign you may see in this case is a discoloration of the tooth. Not all the teeth that are discolored are dead, however, so I recommend dental radiographs on all discolored teeth to determine the vitality of the tooth. Also, not all teeth that are dead will be discolored, for this reason, some veterinary dentists recommend full mouth radiographs during all dental procedures.

minibabyqq 2006-12-28 00:54

[color=Magenta][b][size=5]牙齒預防(清潔) DENTAL PROPHYLAXIS (CLEANING)   [/size][/b][/color]


一牙齒預防不僅執行得清洗牙, 而且評估口腔為也許是存在的所有其它問題。清潔不僅包括什麼您能看, 而且區域在gumline 之下, 是最重要的部份。因此, Non 麻醉劑清潔不是一個可行選擇。區域在gumline 之下, 以及嘴的裡面有效地不被清洗。另外, 牙不被擦亮, 當我們知道將離開被清洗的表面粗礪和將增加匾細菌緊持和將催促牙齒疾病。我們構想一四步預防給我們的患者最大好處可利用。

在prophaxis 可能開始之前, 患者必須被安置在一般麻醉劑之下。這很大地將增加清潔的耐心舒適和有效率。另外, 它允許我們安置一支氣管內管在患者的氣管。這將保護肺免受從牙被去除的細菌。

預防:

步驟1 。 Supragingival 清潔: 這清洗區域在gumline 之上。它 由機械過秤者通常完成在我們的動物患者。這增加速度, 清潔可能執行, 減少麻醉的時間。

步驟2 。 Subgingival 清潔: 這清洗區域在gumline 之下。在我們的動物 患者, 這是最重要的步的當中一個。subgingival 匾和結石是什麼導致 牙周疾病。這是最共同的疾病被診斷在所有動物患者。清洗牙表面將做牙看起來精密, 但實際上少許醫療上做了為患者。

步驟3 。 擦亮: 匾和結石的機械撤除導致 微觀粗化牙表面。這粗化增加牙的強的能力為匾和結石, 快速地將積累和增加牙周疾病進步快速性。擦亮使表面光滑和將減少匾的黏著性能力。

步驟4 。 (Subgingival/Sulcal) Lavage: 結垢和擦亮牙將導致很多殘骸成為設陷井在膠之下。這將導致地方炎症, 並且增量未來牙周疾病的機會。因此我們柔和地沖洗齒齬用一種抗菌解答, 或如果牙周疾病是存在, 我們將使用鹽解答。

步驟5 。 氟化物治療: 這是對氟化物泡沫的用途懷孕牙與 氟化物, 因為動物don.t 通常得到他們的牙被刷。氟化物的好處是, 它硬化牙質, 減少牙敏感性, 和被報告減速似貓的口頭Resorptive 損害的形成, 並且是反匾。

步驟6 。 治療計劃: 這步是牙和整個口腔被評估的地方, 使用不僅我們的眼睛, 但一根牙周探針確定如果有一個牙周口袋。終於, 牙齒射線照相被採取確定疾病過程禮物的程度。使用所有這些形式, 計劃被開發(與所有者被輸入) 重建patient.s 口頭健康。

步驟7 。 牙齒繪製: 所有恰當口頭研究結果和治療在將來被回報 和計劃被安置在一張牙齒圖在患者永久 病歷。這將允許獸醫多年來跟隨患者 進展(或退化) 。

這些是我們隨後而來保證的步患者離開與一張乾淨的嘴。但是, 牙齒關心不結束那裡。在24 小時之內, 匾已經開始形成在牙, 並且牙周疾病過程開始。這是 家庭關心 進來的地方。想像什麼會發生在您嘴如果您從未刷牙, 所有清潔在世界won.t 保留您的嘴健康。


DENTAL PROPHYLAXIS (CLEANING)

  
A dental prophylaxis is performed not only to clean the teeth, but also to evaluate the oral cavity for any other problems that might be present. The cleaning not only includes what you can see, but also the area under the gumline, which is the most important part. For this reason, 幞on-anesthetic?cleaning is not a viable option. The area under the gumline, as well as the inside of the mouth is not cleaned effectively. In addition, the teeth are not polished, which as we know will leave the cleaned surface rough and increase the adherence of plaque bacteria and hasten dental disease. We have devised a seven-step prophylaxis to give our patients the maximum benefit available.

Before the prophaxis can begin, the patient must be placed under general anesthetic. This will greatly increase patient comfort and effectiveness of cleaning. In addition, it allows us to place an endotracheal tube in the patient's trachea. This will protect the lungs from the bacteria that are being removed from the teeth.

PROPHYLAXIS:

Step 1. Supragingival cleaning: This is cleaning the area above the gumline. It is usually accomplished by mechanical scalers in our animal patients. This increases the speed that the cleaning can be performed, which decreases anesthetic time.

Step 2. Subgingival cleaning: This is cleaning the area under the gumline. In our animal patients, this is one of the most important steps. The subgingival plaque and calculus is what causes periodontal disease. This is the most common ailment diagnosed in ALL animal patients. Cleaning the tooth surface will make the teeth look nice, but in reality has done little medically for the patient.

Step 3. Polishing: The mechanical removal of the plaque and calculus causes microscopic roughening of the tooth surface. This roughening increases the retentive ability of the tooth for plaque and calculus, which will buildup faster and increase the rapidity of periodontal disease progression. Polishing will smooth the surface and decrease the adhesive ability of plaque.

Step 4. (Subgingival/Sulcal) Lavage: The scaling and polishing of the teeth will cause a lot of debris to become trapped under the gums. This will cause local inflammation, as well as increase the chance of future periodontal disease. For this reason we gently flush the gingiva with an antibacterial solution, or if periodontal disease is present, we will use saline solution.

Step 5. Fluoride treatment: This is the use of fluoride foam to impregnate the teeth with fluoride, since animals don㦙 usually get their teeth brushed. The benefits of fluoride are that it hardens the dentin, decreases tooth sensitivity, and is reported to retard the formation of Feline Oral Resorptive Lesions, and be anti-plaque.

Step 6. Treatment planning: This step is where the teeth and entire oral cavity are evaluated, using not only our eyes, but a periodontal probe to determine if there is a periodontal pocket. Finally, dental radiographs are taken to determine the extent of the disease process present. Using all of these modalities, a plan is developed (with the owners input) to reestablish the patient𠏋 oral health.

Step 7. Dental Charting: All of the pertinent oral findings and treatment rendered and planned in the future is placed on a dental chart in the patients permanent medical record. This will allow the veterinarian to follow the patients progress (or regression) through the years.

These are the steps that we follow to ensure that the patient leaves with a clean mouth. However, dental care does not end there. Within 24 hours, plaque has already started to form on the teeth, and the periodontal disease process starts over. This is where Home Care comes in. Imagine what would happen in you mouth if you never brushed your teeth, all the cleanings in the world won㦙 keep your mouth healthy.
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