News

  • 16 Jan 2019 9:52 PM | Kin Shing Lin

    Namaste!

    Last year, in HKVNA’s newsletter we shared how we started Home Street Home: Nepal Community Dog TNR Project, why we choose Trap-Neuter-Return (TNR) approach and the success of neutering and vaccinating 203 community dogs in April 2018.

    In months of making, we finally have a good news to share with you: our next TNR program for community dogs in Nepal will be held in May 2019.

    With the success of last year, our target this year will be doubled to 400 dogs. We are confident that we can reach this target, but we will need support from veterinary volunteers including both vet surgeon and vet nurses/assistants. Working together with the local team, you will be able to help us achieve this intensive TNR program. Your skills can save life.

    If you are interested in contributing your time and skills, and have a unique travelling experience, please check out the program details on our website https://www.hshtnr.com. You can find out how other volunteers in 2018 said about their experiences too.

    No matter you are interested in joining the overseas volunteer trip or supporting the project at the background, please fill in the application form via our website, we will be in touch with you. If you have any questions, please do not hesitate to contact us by email hshtnr.asia@gmail.com or send us message on our Facebook page https://www.facebook.com/communitydognepal.

    We wish you a Happy Chinese New Year and looking forwards to working with you together to improve the living conditions of community dogs in Nepal.

    Chuen Man Chang

    Founder of Home Street Home: Nepal Community Dog TNR Project


    Namaste!

    在去年9月的HKVNA的通訊中,我們分享了 「誰家的毛孩」:尼泊爾社區狗隻絕育計劃是如何開始、為什麼我們選擇「捕捉、絕育、放回」(TNR)手法以及在2018年4月份成功為203頭社區狗隻完成育和接種狂犬病疫苗。

    經過多個月的準備,我們很高興為你們帶來一個喜訊: 下一個為了幫助尼泊爾社區狗隻的絕育計劃,將於20195舉行。

    隨著去年的成功,今年的目標將增加一倍,達到400頭社區狗隻。雖然我們有信心能實現這一目標,但我們需要獸醫專業的義工的支持,包括獸醫和獸醫護士/助理。您的技能可以拯救生命。通過與當地團隊合作,您將能幫助我們實現這密集式的TNR計劃。

    如果您有興趣貢獻您的時間和技能,並享受獨特的旅遊體驗,請在我們的網站https://www.hshtnr.com閱有關計劃詳情。在網頁裡您亦可以找到2018年的義工們如何評價他們的經驗。無論您有興趣參加海外義工服務團或在幕後支持計劃,請通過我們的網站填寫義工申請表格,我們將與您聯繫。如果您有任何疑問,請隨時通過電子郵件hshtnr.asia@gmail.com與我們聯繫,或在我們的Facebook 網頁中發給我們送訊。 

    我們祝你春節快樂,並期待與您攜手合作,為改善尼泊爾社區狗隻的生活條件而努力。

    張邨文

    「誰家的毛孩」尼泊爾社區狗隻絕育計劃創辦人

  • 21 Aug 2018 7:43 PM | Rocky Sham (Administrator)

    邀請義工參與海洋公園主辦的野生猴子數目管理計劃

          你知道嗎?原來香港的野生猴子(普通獼猴)是於第一次世界大戰其間引入的物種,目的是要把生長在九龍水塘的一種有毒植物吃掉以保障食水安全。但這種外來猴子的數量在過去30年間不斷增加,不但對遊覽郊野公園的市民造成的不便,更會影響本土生態,例如與本土動物競爭食物及棲息地。

          為了長遠控制其數量增長,海洋公園獸醫院與海洋公園保育基金及漁農自然護理署合作,進行「野猴絕育計劃」,替金山、獅子山及城門郊野公園的野生猴子施行絕育手術。現誠意邀請大家成為此計劃之義工,使計劃得以順利進行,保育香港的生態環境。

           義工工作主要為協助獸醫及工作人員完成整個野猴絕育過程,包括搬運物資及工具、安排野猴進入獸籠、資料記錄等。

    如有興趣加入義工行列,請聯絡

    Joey Heung 

    電話: 39232684    電郵: joey.heung@oceanpark.com.hk


    Inviting volunteers for Ocean Park Monkey Contraception Project Operation

           To limited the population growth of wild monkey in Hong Kong, Veterinary Department is working on the Monkey Contraception Project with OPCFHK and Agriculture, Fisheries and Conservation Department this year. We will administer contraceptives to wild monkeys in Kam Shan, Lion Rock and Shing Mun Country Park, and we would like to invite volunteers to have a smooth procedure for each operation date.

     For those who interested to participate in this project, please contact :

    Joey Heung 

    Tel: 39232684    Email: joey.heung@oceanpark.com.hk

    安排獼猴進入獸籠 Cage capture

    為獼猴施鎮靜針Sedative injection

    進行絕育手術Conceptive operation in progress


  • 11 Aug 2018 12:24 PM | Rocky Sham (Administrator)

    「誰家的毛孩」:尼泊爾社區狗支援計劃」

    Namaste! 這是尼泊爾人打招呼的用詞。大家好,我是張邨文「誰家的毛孩」 計劃的創辦人。感謝HKVNA 讓我們在這通訊與大家分享有關我們的計劃。

    我們的計劃可追溯至2015年我在尼泊爾遇上7.8級地震的故事開始。在參與震後的救災工作的同時,我個別地拯救和醫治傷病的狗隻,但很快我便意識到問題的嚴重性。據估計,單單在加德滿都和拉利布爾( Latlipur)兩個城市已有22,000隻在社區裡生活的狗隻,更遑論在其他城市加起來的總數量。為了改善社區狗隻數目過剩的情況,需要一個更有效的介入方法。這就是我建立「誰家的毛孩」計劃的原因,透過「捕捉、絕育、放回」的手法,人道地管理狗隻的數量。「捕捉、絕育、放回」的英文寫法是Trap, Neuter, Return (TNR), 作為獸醫專業背景的你們,可能已聽過這手法,所以在此我不作詳細解釋。

    我本身並非來自獸醫專業背景,也不屬於任何動物組織,但我相信只要有決心,任何人也能夠為有需要的動物做點事。2017年,在加德滿都一個震後營裡,我們籌辦了首次TNR計劃;為66隻社區狗完成了絕育手術和瘋狗症疫苗注射。而在2018年,我們的計劃首次有香港的獸醫專業團隊參與,並取得空前的成功。在短短兩星期內,我們在加德滿都以外的地區Karvepalanchok成功為203隻社區狗隻進行了絕育和瘋狗症疫苗注射。這包括了90隻雌性和113隻雄性的狗隻。 是次計劃的成功,可歸納為四方面。首先,這是香港獸醫專業團隊首次參加尼泊爾的TNR計劃。而為了減低在捕捉過程對狗隻造成的壓力,我們歷史性地在尼泊爾引入捕狗籠。第三,我們使用了大量獨立狗籠確保了動物在運送和在手術前後的安全。最後,非獸醫背景的義工們對狗隻在手術前後的照顧的無微不至,令整個計劃的過程更人道。


    最後,為何在尼泊爾推行TNR計劃可是我最經常被問到的問題。首先,社區狗隻的數量過剩,對公共衛生造成一定影響。當中最令人關注的是人或牲畜因被狗隻咬傷後而感染瘋狗症。不幸的是,兒童是風險最高的一群。據估計,在尼泊爾每年仍然有約200人因感染瘋狗症而死亡。當人與狗隻之間的關係變得緊張時,不人道的方法有時會被使用來控制狗隻的數目。TNR計劃正好為當地的社區提供了另類的方案,以倡議動物福利為本的原則處理狗群數量過剩的問題。如以上的原因都未能服你的話,緣份能解釋一切吧!一個計劃的誕生需要眾多因素的配合,人脈網絡、資源和籌劃者的決心等等。但我相信先有了接觸的緣份,而你對當地的人和動物生了一份感情也是不可缺少的。服務動物跟服務人一樣,除了理性的頭腦,也要有情感的一面吧。

    這次由香港的動物義工跨越國界,實踐對動物的大愛並無界限的行動,為未來在尼泊爾的社區狗隻TNR計劃奠定了良好的基礎。如果你也希望為尼泊爾的社區狗出一分力並成為我們的義工,可前往我們的網頁填寫義工申請表格,又或在我們的Facebook網頁了解我們的最新動態。


    網頁:https://www.hshtnr.com 

    Facebook: https://www.facebook.com/communitydognepal

    Youtube video of TNR program in April: https://youtu.be/VOcl3TvxEIU



  • 3 Apr 2018 8:52 PM | Rocky Sham (Administrator)

    CANINE PANCREATITIS PART I

    Dr Hilary Lam BVSc, PgCert, MVS

    Pancreatitis is defined as inflammation of the pancreas. It can be categorized into acute, chronic, or acute on chronic.

    CLINICAL SIGNS

    In mild cases, clinical signs include decreased appetite, occasional vomiting and diarrhoea. In life-threatening cases, clinical presentation may involve systemic inflammatory response syndrome and multiple-organ dysfunction syndrome or even death.

    BREED PREDILECTION AND RISK FACTORS

    Any breed can be affected. Schnauzer, Yorkshire Terrier, Spaniels, Boxers, Shetland Sheepdog, Collies are overrepresented.

    Risk factor includes obesity (2.6x), endocrine diseases such as Diabetes, hypothyroidism, hyperadrenocorticism have been associated with pancreatitis. Other risk factors have been suggested: table scraps given in the preceding week or generally (2x); unusual food items consumed prior to presentation (4x-6x more likely); dietary indiscretion of items in the trash (13 x).

    DIAGNOSTIC TEST

    Blood test CBC should be performed to screen for underlying anaemia, dehydration, leukocytosis, thrombocytopenia.

    Biochemistry profile may help to detect hepatic, renal changes and electrolytes loss secondary to inflammation and dehydration. Lipase and amylase have poor sensitivity and specificity for pancreatitis (Amylase 14-73%, Lipase 18%-69%). Canine pancreatic specific lipase by Idexx Snap cPL has a positive predictive value of 54% if the level is >200ug/L. For VetScan cPL Rapid Test there is a positive predictive value of 54% if its >200ug/L and 75% if its >400ug/L.

    Imaging such as ultrasound may be used to identify changes (e.g. hypoechogenicity, mixed echogenicity with hyperechoic mesenteric tissue, any sign of biliary obstruction, free fluid, corrugation of duodenum, ileus).

    CT scan may help to distinguish any further sign of abscessation or mass lesion including neoplasia, may also help in diagnosing necrotizing pancreatitis. Most of the time its use is prohibited by cost, assess to facility and owner's willingness to allow their sick pet to undergo general anesthesia.

    Histopathology examination of the pancreas is the gold standard. However, most patients do not require surgery.

    MEDICAL TREATMENT

    Intravenous fluid should be used to correct dehydration, maintenance and losses.

    Pain relief include opioids (Fentanyl, methadone, buprenorphine) may help to relief abdominal pain. Constant infusion with ketamine, lidocaine may be used. Steroids or non-steroidal anti-inflammatories may worsen compromised renal status, intestinal ulceration.

    Anti-vomiting therapy include maropitant, ondansetron, dolasetron can be considered. Maropitant is shown to be more effective than metoclopramide.

    Gastroprotectants such as pantoprazole, omeprazole, famotidine, sucralfate can be used to treat gastric ulceration secondary to pancreatitis.

    Antibiotics therapy is rarely indicated Most pancreatitis are sterile, however in selected cases may be beneficial.

    Fresh frozen plasma has shown little benefit and costly, and one article have suggested its use may increase mortality. Anecdotally some veterinarians think it will shorten hospital time.

    Nutritional support is important for recovery. Early enteral nutrition is recommended to improve gut barrier function and decrease bacterial translocation. The idea of holding off water and food in pancreatitis patient has little evidence of support. Trickle feeding is recommended. Total parenteral nutrition may provide adequate calories via central venous catheter but does not prevent villi atrophy. Commonly low-fat diet with high digestibility is recommended.

    Surgical intervention is rarely indicated except following condition: biliary tract obstruction, peritonitis, pancreatic abscess. Surgical lavage, debridement of necrotic tissue, jejunostomy tube placement maybe helpful in some severe clinical cases.

    References

    1. Hand M, Zicker SC, Novotny BJ. Acute and chronic pancreatitis In Hand M, Zicker SC, Novotny BJ: Small Animal Clinical Nutrition Quick Consult. Mark Morris Institute, 2011, pp 208-212.

    2. Justin S. To feed or Knot to Feed? Controversies in the Nutritional Management of Pancreatitis. TVP. Nov/Dec, 2016, pp45-51

    3. Sedlacek H.S., Ramsey, D.S., Boucher, J.F., et. al.. Comparative efficacy of maropitant and selected drugs in preventing emesis induced centrally or peripherally acting emetogens in dogs. J Vet Pharmachol Ther. 2008. 31:533-537.

    4. Villaverde C. Nutritional management of exocrine pancreatic diseases. In Fascetti AJ, Delaney SJ: Applied Veterinary Clinical Nutrition. Somerset, NJ: John Wiley & Sons, 2012, pp 221-234.

    5. Washabau R.J. In Washabau RJ, Day MJ. Canine and Feline Gastroenterology- Pancreas. St. Louis: Saudners Elsevier, 2013, pp799-848.

    6. Xenoulis, P.G., Suchodolski, J.S., Steiner, J.M.. Chronic pancreatitis in dogs and cats. Compend Cont Ed Pract Vet. 2008; 30,3:pp166-180.




    CANINE PANCREATITIS PART II

     

    In part II, we will briefly discuss on feeding recommendations for canine pancreatitis patient.

     

    HOW MUCH TO FEED?

    In hospital canine patients with pancreatitis should be aimed to feed to the estimated resting energy expenditure by the following simple equation:

    1. RER (kcal/day) = 70 × (BW kg)0.75 *

    2. RER (kcal/day) = 30 × (BW kg) + 70

    * Equation can be used as an approximation of RER for 5-25kg dogs

     

    Commercial available low fat enteral diets can be recommended for discharge or for patients that are severely hyperlipidemic. Choices include:

    Brand of low fat diet

    Fat content of dried food

    (g/1000kcal)

    Fat content of canned food

    (g/1000kcal)

    Prescription Diet i/d Low Fat

    (hillspet.com)

    20

    23

    Veterinary Diet Gastrointestinal Low Fat

    (royalcanine.com)

    19

    18

    Most sick animals may require assistive feeding. Many veterinarians may consider syringe feeding but note that it has the risk of food aversion and aspiration, so care should be taken when performed. Some practitioners, nutritionist, internist may consider nasoesophageal or nasogastric tubes as an alternative way of managing canine pancreatitis. Esophagostomy tubes are generally reserved for severe chronic pancreatitis in dogs.

     

    Hyperlipidaemia is associated higher risk of pancreatitis. Dogs with hyperlipidemia they should receive minimally 14g of fat per 1000 kcal. Fat free diets are not recommended as minimal intake of dietary fat is required for absorption of fat-soluble vitamins and as a source of essential fatty acids.

     

    Dietary fat may be saturated or unsaturated and have different lengths of fatty acid chains. Omega 3 e.g. docosahexaenoic acid (DHA) , alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) may reduce pancreatic inflammation. Each omega 3 capsule add 1 g of fat to a dogs intake, thus omega 3 supplementation should be used judiciously. Furthermore extended administration is recommended thus patients with chronic pancreatitis is more likely to benefit compared to acute pancreatitis.

     

    Proper storage of food is recommended as improper food storage may lead to oxidization or rancid of fat.

     

    Long term nutritional recommendations

    Patients with acute pancreatitis may make full recover and may consider slowly transition the animal in the previous diet or intended maintenance diet. And advise should be given to avoid risk factor such as abrupt food changes, tablet scraps, excessive amount of treats, obesity, trash bin scavenging)

     

    Patients with chronic pancreatitis

    The evidence for dietary fat restriction in chronic canine pancreatitis is based on clinical impression. There have been articles published the maximal dietary fat concentration is 24g-25g/ 1000kcal.


  • 3 Apr 2018 8:50 PM | Rocky Sham (Administrator)

    Common antiseptics for veterinary use

    Dr Hilary Lam BVSc, PgCert, MVS

    Chemicals commonly used as antiseptics include: Alcohols (e.g. ethanol, isopropanol), Halogens (e.g. iodine idophores), Biguanides (e.g. chlorohexadine), Oxidizing agents (e.g. benzyl peroxide, hydrogen peroxide), Metals (e.g. merbromin, silver), Detergents (e.g. quaternary ammonium compounds). In this issue we will briefly focus on the most commonly encountered antiseptics avaliable in the market.

    Alcohols

    Examples of alcohols antiseptics include ethyl alcohol (70% ethanol), isopropyl alcohol (50% isopropanol). Isopropanol is slightly more potent than ethanol because of its greater depression of surface tension. Alcohol-based rinses have rapid acting antiseptic and wide germicidal effects. It has limited residual activity due to evaporation. Its efficacy will be reduced in present of organic matter and it is not effective against bacterial or fungal spores. It can be safely used on intact skin surface as "Rubbing Alcohol", however it is not indicated to be use on large or deep wound, eyes and mucosal surfaces.

    Halogens

    Iodine is a potent germicidal agent with a wide spectrum of acitivity and low toxicity to tissue. When iodine dissolves in ethanol, its antibacterial acitivity will be enhanced. Iodine alone has limited activity in presence of organic matter. Povodine iodine (PVP-I) is effective against bacteria, viruses, fungi and spore and its activity will not be affected in presence of organic matter. PVP-I as been found to kill 99% of methicilin-resistant Staphylococcus aureus after 10 seconds contact . It is important to note that its activity is lost when color change is observed. In general it does not sting, but may cause staining and may be corrosive to metals. Its use in animals with thyroid disease should be avoided.

    Biguanides

    Chlorohexadine 0.1% aqueous solution has potent activity against gram-positive bacteria. It is not effective against gram-negative bacteria, spores, and most viruses. Its function will be affected by high level of organic matter such as pus, blood or hard water. 4% emulsion of chlorhexadine gluconate is used as skin cleanser for veterinary patients with dermatological problem. Chlorohexadine activity can be enhanced by alcohols their mixtures (e.g. 0.5% chlorohexadine in 70% isopropanol), which is commonly found in hand rinse. It is commonly used as a wound cleanser, surgical scrubs due its antiseptic properties and low potential for systemic toxicity.


    Oxidizing agents

    Hydrogen peroxide 3% has effervescent action that liberates oxygen when in contact with catalase present on wound surface and mucous membrane. It can remove pus and cellular deris. However its use is limited by irritation and toxic to the underlying tissue, furthermore, its action is short acting and limited to the surperficial layer of the applied surface.

    Benzoyl peroxide is commonly found in petshop products or over-the-counter in human pharmacy. Benzoyl peroxide slowly releases oxygen to act as antiseptic. It is ocassionally used to treat pyoderma in dogs, and it also has keratolytic and antiseborrheic activity. It may cause some skin irritation in some patients.

    Metals

    Merbromin is an organomercuric disodium salt compound. It stains tissue a brilliant red tinged color with a yellow green fluorescence. It is a weak antiseptic and will have limited acitvity in presence of organic matter and alkaline environment. Use of mercurial aneitseptics has decreased, partily because of their environmental persistence and contaminat potential. It should be avoided in large wound which may result in toxicity due to significant absorption.

    Silver compounds can have caustic, antibacterial effect. 0.1% aqueous silver solution is bactericidal but some what irritating, whereas a 0.01% solution is bateriostatic. Colloidal silver compounds, which release silver ions slowly, are bacteriostatic and have a more sustained effect. They do not irritate tissue and have little astringent or caustic effect. They are generally used as mild antiseptics and in ophthalmic preparations.

    Detergents

    Quarternary ammonium compounds examples include benzalkonium chloride, benzathonium chloride, cetylpyridnium chloride, dodecyl dimethyl ammonium bromide, dioctyl dimethyl ammonium bromide ) with an ionizable halogen such as bromide, iodide, or chloride. Quarternary ammonium compounds are effective against most bacteria, enveloped viruses, some fungi, protozoa but not effective against non-enveloped viruses, mycobacteria and spores. The major site of action appears to be the cell membrane. The activity of older generation of the compounds will be reduced by hard water, porous or fibrous materials that absorb them. Soap, proteins, fatty acids, phosphates, blood and tissue debris will limit its use. Aqueous solution 1:1,000 to 1:5,000 have good antimicrobial activity and is commonly used as disinfectant for instruments and surfaces. Concentration > 1% will injury to mucous membranes. When applied to skin they may form a film under which micro-oganisms can survive, which limits the reliablity as antiseptics.


  • 3 Apr 2018 8:40 PM | Rocky Sham (Administrator)

    傷口急救自助錦囊

    Dr.Jenny

    作為一個助護如果身邊的小動物有意外發生受傷時,能基本認識傷口的處理知識,在送往獸醫診所前給予適當的護理,能幫助獸醫更快更有效地治療傷口,小小的一個舉動可能救回小動物一命!

    1. 割傷 - 紮緊敷冰減低出血量

    小動物如果被利器或尖銳物品割傷而流血,可視乎牠的流血速度來判斷傷勢。若果血從傷口慢慢滲出,代表只是靜脈血管受傷,傷勢並不嚴重;但如果血流的速度快而且量很多,或是心臟、頸部附近等接近大動脈的地方割傷,均有可能傷及大動脈,不應把利器拔出,應馬上求醫(請用最快的速度)。

    處理方法

    應用清水沖洗狗隻的傷口,若流血太多,應紮緊傷口上方位置,以減低血流速度,防止流血過多,應注意不可紮太長時間,以免傷口下方因缺血潰爛。若傷口仍然大量出血,應以濕毛巾輕輕包住傷口,以保持傷口濕潤,再在毛巾外敷上冰塊,令血管收縮,減少流血。(但不要直接在傷口敷冰)

    止血後用已稀釋的消毒藥水 (hibitane/chlorhexidine) 或碘酒清洗。為了保持傷口空氣流通,如非太嚴重儘量不要包紮,但應配戴頭罩,以免狗隻舔傷口。若然傷口太深或流血不止,應盡快將愛犬送往獸醫診所治療。

    2. 夾傷 - 小心檢查免骨折

    狗隻被門夾傷或被重物壓傷等均屬常見的家居意外,在關門前或是搬動重物前,需留意小動物的位置,以免令牠們受傷。

    處理方法

    先將夾傷小動物的物品移開,如果夾傷的部位流血,應要先為小動物止血。小心檢查牠被夾傷的情況,避免翻動受傷的部份,避免造成二度傷害。若果小動物被夾傷不願走動,或是夾傷的肢體無力,這代表可能有骨折的情況,處理骨折黃金時期是三天內,宜用軟墊墊起小動物或用支架固定(softban, vetwrap, bandage),並馬上送醫治療。

    3. 咬傷 - 消毒傷口防感染

    若果同時飼養兩隻或以上的狗隻,或者出門時遇到其它狗,牠們通常會互嗅、打招呼和一起玩,若性格不合可能會產生敵意,甚至大打出手。狗隻打架,會出現咬傷或皮膚撕裂等,可視乎傷口的深度來判定傷勢,但獸醫建議若果愛犬被咬傷應送到診所診治,以免狗隻間病菌傳播。

    處理方法

    先以碘酒或消毒藥水仔細清洗傷口表面,若在外欠缺急救用品則可以清水沖

    洗,以免受細菌感染。要注意被咬傷的傷口通常有上下兩邊(一對傷口),謹記兩邊都要清洗,將傷口附近的毛剪短,以方便護理,傷口深的話應將狗隻送往診

    所治療;若果遇上舌頭咬傷的情形,由於舌頭血管分佈較多,須由獸醫診

    治。在送往診所時應以乾淨的紗布按住出血傷口,以防流血不止。

    4. 燙傷 - 沖水可減傷勢

    如果被燒傷或燙傷,傷口位置會出現紅腫;若被腐蝕性化學物灼傷的位置有更明顯傷口。燒傷或燙傷一般而言對小動物造成的傷害較為嚴重,會讓皮膚失去保濕及抵抗能力,傷口容易被細菌感染,更可使皮膚大面積壞死脫落,甚至危及生命。

    處理方法

    傷口部份應即時用大量室溫清水或生理鹽水沖洗傷口 (切勿用碘油消毒藥水

    清洗),以減輕疼痛和對皮膚深層組織的損害。傷口面積小的無需包紮,保持

    涼爽的環境助傷口復原;但若燙傷範圍較大,可以繃帶包紮傷口 (加上獸醫

    給予的保濕殺菌藥膏,如沒有請使用藥用蜜糖),隔日更換一次繃帶,以防感染進一步加劇。應留意萬一傷口一直紅腫或燙傷範圍太大,應馬上把狗隻送往診所治療,情況嚴重可能需要麻醉處理。

    Side box 1 - 急救藥箱保平安

    不少人家中也備有急救藥箱,但狗隻和人類的結構不同,大部份藥物都不能

    共用,狗主應為愛犬準備一個急救藥箱,以備不時之需,裡面應包括:

    i. 生理鹽水

    ii. 碘酒

    iii. 已稀釋的消毒藥水 (不含火酒成份): Hibitane

    iv. 動物用消炎藥膏 (不含類固醇): silverzine, silversurf

    v. 繃帶,紗布

    vi. 凡士林

    Side box 2 - 頭罩口罩不可缺

    處理任何傷口之前,應先為狗隻戴上頭罩或口罩,以免牠在疼痛的情況下誤

    傷咬人;而處理傷口後亦應戴上頭罩,以免狗隻舔傷口造成細菌感染。

    緊記

    不要用火酒在傷口上面消毒

    不要用有類固醇成份的藥膏,以免減慢傷口康復

    如無必要請保持傷口空氣流通,不要包紮


  • 3 Apr 2018 8:02 PM | Rocky Sham (Administrator)

    Evidence of use of glucosamine, chondroitin, methy-sulfonylmethane (MSM) and green lipped mussel for osteoarthritis in dogs and cats

    Dr Hilary Lam BVSc, PgCert, MVS. Happy Valley Veterinary Clinic

    Nutraceuticals in human and veterinary medicine often fall into a grey zone of regulation and yet its has developed into a billion dollar industry over the decades. In the early 1990s there has been an increasing attention of using dietary supplements for our furry friends with osteoarthritis (OA). Their efficacy has been widely advertised on television, newspapers and the internet. Let's have a deeper understanding of evidence based medicine (EBM) behind these nutraceuticals.

    Different regulatory bodies use different systems to rank the strength of evidence of scientific studies. Evidence-based ranking system used by Food and Drug Administration's (FDA) aims to provide the reader with a sense of reliability of the data presented to them and how comfortable they can be with the results. The system categorizes study results into 4 levels: 1) High, 2) Moderate, 3) Low level, 4) Extremely low level of comfort. 'High level of comfort' means that qualified researchers agree that specific claim is scientifically valid, while the latter ones usually have a relatively lower consistency which are based on relatively low quality studies.

    Evidence based behind glucosamine, chondroitin, MSM, green lipped mussels in OA dogs

    There are numerous nutraceutical preparations available over the counter containing glucosamine, chondroitin and methyl-sulfonylmethane (MSM) and green lipped mussel for joint supplementation in dogs. Main rationale behind their use is aim for synthesis of articular cartilage, which may help to repair or slow down the damage of cartilage. There are anecdotal evidence and tissue culture to support their an anti-inflammatory and analgesic effect.  Two scientifically valid trials examined the use of glucosamine hydrochloride, chrondroitin as major components for improving clinical signs for OA in dogs. Interestingly, one study subjectively showed a positive effect, while the second one showed no significant effect. In clinical situation, confusion arises in which study one should use to help make decision whether to use the products. Overall we can concluded that the use of glucosamine, chondrontin in OA dogs is of “low to moderate level of comfort".

    On the other hand, there were three trials performed to evaluate the use of green lipped mussels in OA dogs. All trials subjectively showed a positive effect with some uncertainties existed. In general, we believe that green-lipped muscle has a "moderate level of comfort “that it will show positive effects on OA dogs.

    Evidence base behind glucosamine , chondroitin, MSM, green lipped mussels in OA cats

    In 2014, total 30 with painful cats with OA underwent a study, Group 1 (17 cats) receiving meloxicam and Group 2 (13 cats) receiving glucosamine and chondroitin supplement for 70 days were compared. Although meloxicam showed marked improvement on initial stage. When placebo was used in the second part of the trial, results showed that glucosamine/ chondroitin group was found to have longer lasting effect compared to the meloxicam group. Based on the above reference, glucosamine, chondroitin supplement in cats with OA has “moderate level of comfort”. MSM and Green lipped mussel extract is also popular however its mode of action in cats is uncertain, more evidence based studies is required to prove its clinical application in cats.

    Side effects of glucosamine

    Side effects of glucosamine in dogs and cats are rare which may include gastrointestinal upset as the most commonly reported sign.  The proof of diabetes mellitus may be precipitated after use of glucosamine has not been substantiated. 

    In conclusion, there have been discrepancy between the claim of nutraceuticals for joint health on media and the data presented based on EBM medicine. Overall these nutraceuticals have certain role in multimodal approach in management of OA in small animals and it is important for us to develop a scientific understanding of these nutraceuticals so that we can provide the best recommendation for our furry friends.

    Evidence based medicine- integrating individual clinical expertise with the best available external clinical evidence from systematic research.

    Anecdotal - knowledge based on isolated observations and not yet verified by controlled scientific studies.

    References:

    Budsberg, SC. Pacific Veterinary Conference 2015. "Evidence of Use of Nutraceuticals in osteoarthiritis 'Joint Juice' Insane Quackery or is the Internet Right?"

    S Little. August's Consultations in Feline Internal Medicine, Volume 7, 1st Edition. Saunders, 2015, pp 965.


  • 3 Apr 2018 7:19 PM | Rocky Sham (Administrator)

    【鳥類麴菌感染】

    楓樹珍禽異獸醫院 蔡伊婷醫生

        麴菌 (Aspergillosis)是鳥類最常見的黴菌疾病,和哺乳類相比,鳥類有較高的體溫適合黴菌生長、沒有辦法咳嗽、沒有會咽分隔上下呼吸道、很大面積但卻上皮細胞分佈不發達的呼吸系統和氣囊系統,故比哺乳類容易感染黴菌,其中又以猛禽、海鳥、非洲灰鸚鵡、藍頭亞馬遜鸚鵡、pionus屬鸚鵡感受性更高。

        兩大感染麴菌的危險因子,(1) 為暴露在黴菌濃度高的環境:在不通風、溫暖、潮濕、衛生不佳下容易養成黴菌過量的環境,(2) 宿主免疫力低下:飼養管理不佳、接受tetracycline治療或是接種疫苗、運輸、繁殖、創傷、PBFD感染、重金屬中毒等皆會讓鳥類宿主的免疫力低下而容易感染,另外食物被黴菌污染也可能產生降低宿主免疫力的毒素。

         麴菌主要靠吸入性感染,當黴菌入侵之後開始繁殖,引起組織壞死,形成的黴團塊阻塞呼吸道,並可能沿著薄薄的氣囊膜入侵週邊的組織,或是隨著血液散佈到全身器官。疾病的表現根據宿主的免疫反應、病原的散佈範圍和宿主有沒有存在的疾病可能會局部或是全身感染,但若無治療,往往會漸漸惡化而引發死亡,主要的臨床表徵分為急性和慢性感染兩大類。

        急性感染:暴露於大量黴菌的環境,引起急性的病狀,包括呼吸困難、開口呼吸,食慾下降,可能伴隨急性精神沈鬱、嘔吐、腹水等,通常在7天後死亡,由過度急速,因此解剖常看見鬱血、白色黏液分泌物,看不見肉芽變化。

        慢性感染:由於宿主免疫力低下而感染,可能局部或是全身性,症狀包括食慾下降、疲憊、體重下降、變聲或是失聲、咳嗽、開口呼吸等。黴菌性氣管炎是一個特別情況,在疾病初期沒有任何的呼吸道症狀,主要是聲音的改變。黴菌性氣囊炎、肺炎是臨床上較常見的疾病形態。

        懷疑有麴菌感染的鳥禽其白血球總數很高,20000/ml甚至超過100000/ml,異嗜球左轉、單核球過多和總蛋白過高(球蛋白高,白蛋白低,A/G低下);影像學可以看見氣囊壁增厚、肺炎、腹腔細節看不清楚、氣囊因為被阻塞而過度充氣、出現明顯的團塊等(圖一、圖二),但最準確的方式為病兆採樣,借由組織病理、細胞學或是黴菌培養確診,內窺鏡是一個良好的檢查和採樣的方式(圖三、圖四、圖五)。

        使用全身性藥物投與配合移除團塊是治療黴菌感染的原則,但是有些團塊生長的位置無法移除或是團塊太過廣泛,只使用藥物也是一個方式。常用的抗黴菌藥物有以下:(1) Amphotericin B:在哺乳類有腎毒性,但鳥類半衰期快,所以與哺乳類腎毒性較低,但仍然建議監控腎指數。 (2) Azole類:殺黴菌類藥物,常見的副作用為厭食、嘔吐和肝毒性,在鳥類voriconazole是例外,屬於抑黴菌類,濃度累積緩慢虛數天的時間,治療可能需要幾個月,但組織分佈較itraconazole廣,且對itaconazole易敏感的灰鸚是個選擇。都需要監控肝毒性。此類藥物為口服劑型所以比amphotericin B容易長期使用。

        黴菌的治療一般會需要4-6周或是更長的時間,因此需要與主人有良好的溝通,期間需要監控病情的變化,還需要教育主人的是飼養環境的調整,讓家中的鳥寶健健康康、免疫力完善,才是預防麴菌的不二法門!

    圖一         

    非洲灰鸚鵡因為開口呼吸就診,X光顯現有氣囊炎、肺炎的情況

    圖二

    與圖一同一隻灰鸚鵡,可以看見側照前方體腔,靠近氣管末端出現許多團塊

     

     

    圖三

    A. 體腔內窺鏡發現有許多團塊

    B. 氣囊壁整個發炎變厚且上面佈有血絲

    圖四

    氣管內窺鏡,可隱約見到鳴管後方有一個白色團塊

     

    圖五

    A. 內窺鏡採樣後的細胞抹片,可以看見菌絲的結構

    B. 放大後的菌絲結構


  • 3 Apr 2018 6:58 PM | Rocky Sham (Administrator)

    [病例分享] 母鬆獅蜥卵巢炎診斷與治療

    楓樹珍禽異獸醫院 吳雯鈴醫生

    一隻3歲母鬆獅蜥因食欲、精神不振,並觀察有張口呼吸的情況而就診,就診當天已6天未排便。

    經醫師理學檢查後發現,體態尚可,輕微脫水,正在脫皮且於眼睛及鼻孔周邊有皮屑沾黏,腹圍略膨大,觸診發現於後腹部有異常的團塊,聽診肺音無明顯異常,但口腔內有少許分泌物。鑑別診斷:口炎、下呼吸道感染、生殖系統疾病及肥胖鬆獅蜥常見的脂肪肝。

    與飼主討論後,決定先拍攝x光及超聲波排除部分可能病因。

    X光肺部影像無明顯異常,體腔內有腹水造成腹部下垂,在靠近脂肪墊前方有軟組織不透明度的團塊;進一步以超聲波檢查,顯示肝臟迴音性增強與脂肪迴音性一致,有脂肪肝的可能性,於肝臟及脂肪墊之間有明顯濾泡發育並且伴隨腹水,且濾泡本身回音性不一致,有發炎感染的可能。

    初步判定有卵巢炎並引起腹水,同時開始引發脂肪肝等代謝性問題。建議開腹探查並且移除發炎的卵巢,以免後續引起更嚴重的墜卵性腹膜炎或因濾泡持續發育引起嚴重脂肪肝、肝壞死等不可逆的問題。

    飼主決定於5天後進行開腹探查並且移除發炎的卵巢,檢查體腔內是否有其他狀況,並採樣送細菌培養及抗生素敏感性試驗並決定後續用藥。術前血檢顯示其肝腎功能尚無明顯異常,感染指數為1-2級。

    開腹探查後,確認左側卵巢的濾泡明顯發炎,右側卵巢中央的濾泡有破損並且造成卵黃部分釋出而有較多的腹水積聚,輸卵管無明顯異常,兩側肝葉略黃,尚未發展成嚴重的脂肪肝,體腔內有一塊壞死的脂肪也一併移除。麻醉及手術相當順利,約莫一小時內完成手術。術後病患在半小時內順利甦醒。住院第二天已主動進食,術後第四天出院,術後第12天回診精神食欲排便尿一切正常。

    本病例為母蜥蜴成體最常見的問題之一,若觀察到家中母蜥蜴突然精神食慾變差並伴隨腹圍膨大的情況,建議及早就診檢查。若確認為生殖系統問題,一般建議盡快手術,移除感染發炎的卵巢甚至輸卵管,並且配合醫生術後的照顧建議與治療。

    至於為什麼會建議手術,主要是因為母蜥蜴在性成熟後,每年濾泡都會有季節性發育,甚至在有公蜥蜴存在情況下,會進一步刺激排卵造成後續難產甚至墜卵性腹膜炎等問題存在,是造成許多成體母蜥蜴死亡的主因之一。因此,若無繁殖的需求,飼主們在母蜥蜴性成熟後,可考慮以預防性絕育的方式來避免每年都可能發生的這些問題及相關的併發症。當然,定期的健康檢查,也有助於疾病的早期發現,及早及正確的處理也可避免後續相關的併發症及遺憾。


    圖一、x光DV view,顯示腹腔內疑似有多個軟組織不透明度的團塊分布

    圖二、x光lateral view,肺臟無明顯異常,腹腔下垂疑似有腹水的影像出現,造成腹腔內影像無法清楚辨識

    圖三、超聲波檢查下可見有多個濾泡,並伴隨少量腹水

    圖四、開腹探查後顯示有一壞死脂肪在體腔內,直接移除

    圖五、兩側卵巢比較下,左側卵巢明顯有發炎的情況

    圖六、右側卵巢則於卵巢中央處有輕為破損造成卵黃部分釋出,周邊伴隨較多的積液


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