蹄葉炎纖維性骨營(yíng)養(yǎng)舟狀骨滑膜囊炎

1、馬外科病蹄病蹄葉炎蹄葉炎 蹄葉炎為蹄皮膜的一種急性無(wú)菌性炎癥，多發(fā)生在兩前蹄或兩后蹄，一蹄或四蹄較少見(jiàn)。 發(fā)病原因發(fā)病原因： 長(zhǎng)期飼喂或過(guò)量飼喂精料或高蛋白飼料過(guò)于單純。 結(jié)癥及腸炎的后期及其它消化機(jī)能障礙進(jìn)。 勞疫過(guò)重或途乘騎，尤其對(duì)久不運(yùn)動(dòng)，偶爾大運(yùn)動(dòng)量者。 護(hù)蹄不當(dāng)者。 What can cause laminitis? Laminitis(蹄葉炎） can be caused by any of the following although in most cases it is caused by a combination of factors rather than just o

2、ne. A carbohydrate (sugar) overload through over-eating of lush grass （味美青草）or excessive quantities of concentrates (the most common cause). Obesity（肥胖）肥胖） is closely associated with laminitis. Metabolic changes in overweight horses are complex and an area of much new research. Such metabolic change

3、s are often referred to as peripheral cushings disease. Cushings Disease（庫(kù)興氏）庫(kù)興氏） is a hormonal disorder caused by a benign tumour of the pituitary gland（垂體）. This is common on older horses and ponies and associated with a long, curly coat even in summer. Trimming （修剪）修剪）or shoeing with an overlong

4、toe can be a contributory factor in triggering （觸發(fā)）laminitis. In many cases the foot is just left to grow too long. Infections, particularly where caused by bacteria, can cause release of endotoxins into the blood stream which may trigger laminitis. A retained placenta（胎衣不下）is a renowned（周知的） cause

5、of laminitis. Stress. During periods of stress the body releases cortisol which can contribute to the development of laminitis in some horses. Concussion injury（震蕩傷）震蕩傷）, predominantly（主要的） in horses with low heels（腳后跟） and flat feet and those repetitively performing work on hard ground. Treatment w

6、ith anti-inflammatory corticosteroids（皮質(zhì)醇類）皮質(zhì)醇類） can trigger laminitis on rare occasions. Obesity increases the risk of laminitis 臨床癥狀： 患病蹄不敢著地，兩前肢發(fā)病時(shí)，后肢伸于腹下，前肢伸于前方，頭揚(yáng)起，兩后肢發(fā)病時(shí)，前肢后踏，頭頸抵垂，后肢關(guān)節(jié)屈曲。站立時(shí)兩肢不能較長(zhǎng)時(shí)間駐立，頻頻換肢，如原地踏步；三肢或四肢同時(shí)發(fā)病，大部分時(shí)間臥地。 患肢指（趾）動(dòng)脈亢進(jìn)，蹄溫升高，同時(shí)眼結(jié)膜充血，嚴(yán)重時(shí)體溫、呼吸、脈搏均加快，肌肉顫抖。還有癥狀較輕的亞急性病例及僅有蹄部輕微

7、升溫輕微痛感的病例。 When laminitis affects the forelimbs, the horse will lean backon its hindquarters（后腿臀部） in an attempt to relive the pain 診斷：診斷：根據(jù)病肢不敢著地負(fù)重，蹄溫高，指（趾）動(dòng)脈亢進(jìn)，嚴(yán)重時(shí)體溫，呼吸，脈搏均增加，結(jié)合有肢體過(guò)度疲勞、長(zhǎng)期飼喂精料或結(jié)癥腸炎的歷史，可以作出確切診斷，并制訂出治療方案。Diagnosis A diagnosis of laminitis can often be made from observable symptoms su

8、ch as: Difficulty walking and marked difficulty when turning. A “stiff” gait. Rocking back onto the heels in order to spare the toe region. Strong “bounding” pulses to the feet indicating increased blood flow and inflammation of the area. A marked reluctance to pick up feet. Another important test i

9、s the use of hoof testers on the sole of the hoof. Usually this will indicate sensitivity in front of the frog(馬蹄叉) in the region of the tip of the pedal bone（足骨）. Percussion (tapping) of the sole or shoe may also demonstrate increased sensitivity.Radiograph (x-rays) may also be necessary to assess

10、the severity of the damage. Radiographs will indicate the position of the pedal bone within the hoof capsule. Tearing of the laminae is often indicated by a radiolucent (black) line between the pedal bone and front hoof wall. Looking at x-rays 治療： 下列幾種療法可順序或挑選應(yīng)用。 1、放血，可頸靜脈放血10002000毫升；或胸堂血或腎堂血400800

11、毫升；或四蹄血，每蹄50100毫升（瘦弱畜不用）。 2、冷卻療法：初期可施行冷腳浴，或用冰敷蹄部，如蹄部有創(chuàng)傷，冷水浴可加防腐劑。 3、藥物療法：下列中西藥物療法可酌選應(yīng)用，也可結(jié)合應(yīng)用。 西藥：25%葡萄糖1000毫升，生理鹽水1000毫升，5%碳酸氫鈉溶液500750毫升，維生素c500毫克，混合一次靜注，每日一次連續(xù)應(yīng)用；同時(shí)肌注地塞米松磷酸鈉注射注液2.55毫克，日一次。 中藥：肢蹄疲勞過(guò)度走傷者用菌陳散，菌陳24克，當(dāng)歸24克，沒(méi)藥18克，甘草、桔梗、柴胡、紅花、青皮、陳皮、紫菀、杏仁（去皮）各15克，共為細(xì)末，開(kāi)水沖調(diào)，侯溫加清油120毫升，同調(diào)灌服。 對(duì)過(guò)食精料及結(jié)腸腸炎繼發(fā)（料

12、傷）用紅花散：紅花、黃藥子、白藥子、青皮、陳皮、厚樸、山楂、甘草各15克，沒(méi)藥、當(dāng)歸各24克，六曲，麥芽各45克（研末后下）枳殼20克，共研末，開(kāi)水沖調(diào)后服。 預(yù)防： 不要長(zhǎng)期及過(guò)食精料，不要長(zhǎng)期單一飼喂高蛋白飼料，同時(shí)注意預(yù)防結(jié)癥、腸炎的發(fā)生，防止肢蹄過(guò)度疲勞及長(zhǎng)期缺乏運(yùn)動(dòng)。 Treatment The first step to be taken is to remove any suspected cause for the laminitis. Removing predisposing causes for laminitis is essential. It usually inv

13、olves bringing the horse or pony in from grass, reducing concentrates(精料), and investigating and treating Cushings or metabolic disease. It some cases it may involve treating a serious underlying infection or restricting work on hard ground. Veterinary attention should be sought to prescribe anti-in

14、flammatory drugs such as bute（保泰松） or finadyne. Other medical treatment may also be used and this may be a drug such as ACP which modifies blood flow. In more severe cases the vet may elect to remove the shoes and support the foot using a foot support system such as Styrofoam（聚苯乙烯泡沫塑料）or Equisoft. T

15、he horse should be confined to a stable on a deep shavings （刨花）bed to provide support to the pedal bone. Prognosis Laminitis is an unpredictable condition and it can sometimes be difficult to make an accurate prognosis. Radiographs enable a more accurate prognosis to be given. In general, the longer

16、 a case goes without improvement, the poorer the prognosis. Mechanism of carbohydrate overload induced laminitis Sugars and starches are normally digested in the small intestine. Excessive quantities cause overspill into the large intestine. The bacterial population in the large intestine cannot dig

17、est simple sugars and carbohydrates but are biased towards digestion of complex carbohydrates. The overspill（過(guò)剩物資）causes an overgrowth of certain alien lactobacilli乳酸桿菌species of bacteria which ferment（發(fā)酵）the sugars instead of digesting them to useable products. This causes an acidosis to develop in

18、 the hind gut（腸） which inhibits the growth and existence of the good digestive bacteria. This drop in pH further favours the growth of abnormal bacteria which produce chemicals that lead to the production of metalloproteinase enzymes in the basement membrane of the hoof. These are responsible for th

19、e detachment（分離） of the laminae（板層）. Hindgut acidosis will manifest （顯示）as sour smelling, loose faeces, development of a crumbly（易碎） white line and poor hoof horn quality. Where laminitic cases cannot be controlled by managemental means alone, hind gut acidosis can be controlled by the use of Founde

20、rguard, a supplement that prevents the overgrowth of undesirable lactobacilli. Probiotics（前生命期的） without the addition of live yeast cultures can be added to the diet to boost the beneficial bacterial numbers to aid effective digestion and to compete with the undesirable bacteria.纖維性骨營(yíng)養(yǎng)不良 本病是成年馬騾由于鈣磷

21、代謝障礙，內(nèi)組織進(jìn)行性脫鈣，骨基質(zhì)逐漸被破壞、吸收，而由增生的結(jié)締組織代替未鈣化的骨樣組織的營(yíng)養(yǎng)不良疾病。馬騾多發(fā)。臨床上以骨骼腫脹為特征。 診斷要點(diǎn)診斷要點(diǎn) 根據(jù)病因調(diào)查。主要由于長(zhǎng)期偏喂含磷多的精料（如麩皮、豆類），或草類搭配不當(dāng)，造成磷多鈣少而致病。 病初，病馬只是呈現(xiàn)不耐使役，容易疲勞出汗，喜臥，四肢常交替出現(xiàn)不明原因的跛行。 中、后期，多數(shù)病馬出現(xiàn)頭骨腫脹變形，下頜骨腫脹增厚，牙齒磨滅不整齊，四肢關(guān)節(jié)腫脹變形。額骨穿刺易刺入而固定全針。病馬異嗜、消化不良。尿液澄清透明，呈酸性反應(yīng)。 防治方法防治方法 調(diào)整日糧內(nèi)鈣磷比例關(guān)系 減少麩皮，補(bǔ)喂南京石粉，使鈣磷比例接近1.2：1。要適當(dāng)運(yùn)動(dòng)

22、，多曬太陽(yáng)。 補(bǔ)充鈣劑 每天內(nèi)服乳酸鈣或碳酸鈣50100g；每天靜注10%氯化鈣溶液100150ml，或10%葡萄糖酸鈣200400ml。為了促進(jìn)鈣鹽吸收，可每隔開(kāi)57天，肌注一次維生素D2(骨化醇)1020ml。為了骨質(zhì)、牙質(zhì)以及細(xì)胞間質(zhì)的形成所必需的物質(zhì)，肌注維生素C35g。 對(duì)癥治療 如拉干小糞球并呈現(xiàn)堿性腸卡他癥狀，則按此癥治療；病馬呈現(xiàn)四肢疼痛或背腰發(fā)硬，可10%水楊酸鈉150200ml，靜脈注射，每天一次，連用34天；或選用鎮(zhèn)跛1020ml，30%安乃1030ml，安痛定注射2050ml，皮下注射。 舟狀骨滑膜囊炎(1NFIAMMATION OF THE NAVICULAR BURSA) 舟狀骨滑膜囊炎常與舟狀骨病并發(fā)。舟狀骨滑膜囊是舟狀竹與指(趾)深屈肌腱之間的滑膜腔，常與蹄關(guān)節(jié)腔相通，發(fā)病時(shí)可互相影響。 舟狀骨滑膜囊炎，馬和牛都可發(fā)生，馬常常是無(wú)敗性的， 牛則多發(fā)化膿性炎癥。 病因病因 無(wú)敗性舟狀骨滑膜囊炎，常由屈腱過(guò)度緊張引起，蹄底挫傷和馬的舟狀骨病也可繼發(fā)本病?；撔灾蹱罟腔つ已祝隈R，常繼發(fā)于蹄底刺傷，致傷過(guò)