共查询到20条相似文献，搜索用时 31 毫秒
1.
Problem-oriented reptile medicine is an explicit, definable process focused on the identification and resolution of a patient's problems. This approach includes gathering case information, clearly defining the problems, making plans to address each problem, and following up with the case over time. Case information and published literature serve as evidence to support clinical decisions and pathophysiological rationale. This article describes the problem-solving process used to diagnose and treat a green iguana (Iguana iguana) that presents with ovostasis. 相似文献
2.
3.
Robert Goggs BVSc DACVECC MRCVS ; Livia Benigni DVM DECVDI MRCVS ; Virginia Luis Fuentes MA VetMB PhD DVC DACVIM DECVIM-CA MRCVS Daniel L. Chan DVM DACVECC DACVN MRCVS 《Journal of Veterinary Emergency and Critical Care》2009,19(1):30-52
Objective – To review the pathophysiology, clinical signs, diagnosis, and treatment of pulmonary thromboembolism (PTE) in small animals. Data Sources – Human and veterinary clinical studies, reviews, texts, and recent research in canine and feline PTE diagnosis and thromboembolic therapeutics. Human Data Synthesis – In humans, clinical probability assessment and point‐of‐care D‐dimer‐based algorithms are widely used. Computed tomography pulmonary angiography is the gold standard for PTE diagnosis in humans. Echocardiography is increasingly used for bedside assessment of affected patients. In low‐risk human patients anticoagulants alone are recommended while patients with cardiogenic shock are treated with thrombolytics followed by anticoagulation. Veterinary Data Synthesis – PTE is associated with numerous predisposing conditions causing hypercoagulability, blood flow stasis, or endothelial injury. Identifying at‐risk patients is key to diagnosis in small animals. Thromboelastography provides a method for identifying hypercoagulable patients. Computed tomography pulmonary angiography may replace selective pulmonary angiography as the imaging technique of choice for PTE diagnosis. PTE therapy consists of supportive treatment combined with appropriate, individualized thromboembolic pharmacotherapy for acute treatment and chronic management. Thrombolytic therapy for PTE remains controversial but may be indicated in hemodynamically unstable acute PTE. Thromboprophylaxis in specific conditions is rational although evidence of efficacy is limited. Prognosis depends upon degree of cardiopulmonary compromise and patient response to therapy. Mortality rates in small animals are unknown. Conclusions – New diagnostic techniques and advances in therapy offer significant potential for improvements in the identification and treatment of PTE in small animals. Further study must be directed to validating new diagnostic modalities and evaluating therapeutic regimes. 相似文献
4.
Martin SW Bonnett B 《The Canadian veterinary journal. La revue veterinaire canadienne》1987,28(6):318-325
Rational clinical practice requires deductive particularization of diagnostic findings, prognoses, and therapeutic responses from groups of animals (herds) to the individual animal (herd) under consideration This process utilizes concepts, skills, and methods of epidemiology, as they relate to the study of the distribution and determinants of health and disease in populations, and casts them in a clinical perspective.
We briefly outline diagnostic strategies and introduce a measure of agreement, called kappa, between clinical diagnoses. This statistic is useful not only as a measure of diagnostic accuracy, but also as a means of quantifying and understanding disagreement between diagnosticians. It is disconcerting to many, clinicians included, that given a general deficit of data on sensitivity and specificity, the level of agreement between many clinical diagnoses is only moderate at best with kappa values of 0.3 to 0.6.
Sensitivity, specificity, pretest odds, and posttest probability of disease are defined and related to the interpretation of clinical findings and ancillary diagnostic test results. An understanding of these features and how they relate to ruling-in or ruling-out a diagnosis, or minimizzing diagnostic errors will greatly enhance the diagnostic accuracy of the practitioner, and reduce the frequency of clinical disagreement. The approach of running multiple tests on every patient is not only wasteful and expensive, it is unlikely to improve the ability of the clinician to establish the correct diagnosis.
We conclude with a discussion of how to decide on the best therapy, a discussion which centers on, and outlines the key features of, the well designed clinical trial. Like a diagnosis, the results from a clinical trial may not always be definitive, nonetheless it is the best available method of gleaning information about treatment efficacy.
相似文献5.
van Galen G Marcillaud Pitel C Saegerman C Patarin F Amory H Baily JD Cassart D Gerber V Hahn C Harris P Keen JA Kirschvink N Lefere L McGorum B Muller JM Picavet MT Piercy RJ Roscher K Serteyn D Unger L van der Kolk JH van Loon G Verwilghen D Westermann CM Votion DM 《Equine veterinary journal》2012,44(5):614-620
Reasons for performing study: Improved understanding of the epidemiology of atypical myopathy (AM) will help to define the environmental factors that permit or support the causal agent(s) to exert toxicity. Objectives: This European survey of AM aimed to describe spatiotemporal distribution, survival, clinical signs, circumstances in which AM develops and its different expressions between countries and over time. Methods: The spatiotemporal distribution, history and clinical features of AM cases reported to the Atypical Myopathy Alert Group from 2006 to 2009 were described. Comparisons of data from the most severely affected countries and from the large outbreaks were made with Fisher's exact and Welch's tests with Bonferroni correction. Results: Of 600 suspected cases, 354 met the diagnostic criteria for confirmed or highly probable AM. The largest outbreaks occurred during the autumns of 2006 and 2009 in Belgium, France and Germany. For the first time, donkeys, zebras and old horses were affected, and clinical signs such as gastrointestinal impaction, diarrhoea, penile prolapse, buccal ulceration and renal dysfunction were observed. Affected horses spent >6 h/day on pastures that almost always contained or were surrounded by trees. The latency period was estimated at up to 4 days. Overall survival rate was 26%. Although differences between countries in affected breeds, body condition, horse management and pasture characteristics were recognised, the common presenting clinical signs and mortality were similar between countries. Conclusions and potential relevance: This study describes new data on case details, history and clinical course of AM that is of preventive, diagnostic and therapeutic value. However, the true impact of the findings of this study on the development of or severity of AM should be tested with case–control studies. 相似文献
6.
Canine brain tumours are becoming established as naturally occurring models of disease to advance diagnostic and therapeutic understanding successfully. The size and structure of the dog's brain, histopathology and molecular characteristics of canine brain tumours, as well as the presence of an intact immune system, all support the potential success of this model. The limited success of current therapeutic regimens such as surgery and radiation for dogs with intracranial tumours means that there can be tremendous mutual benefit from collaboration with our human counterparts resulting in the development of new treatments. The similarities and differences between the canine and human diseases are described in this article, emphasizing both the importance and limitations of canines in brain tumour research. Recent clinical veterinary therapeutic trials are also described to demonstrate the areas of research in which canines have already been utilized and to highlight the important potential benefits of translational research to companion dogs. 相似文献
7.
Denis Wolf Majda Globokar Vrhovec Klaus Failing Christophe Rossier Carlos Hermosilla Nikola Pantchev 《Acta veterinaria Scandinavica》2014,56(1):44
Background
Exotic reptiles have become increasingly common domestic pets worldwide and are well known to be carriers of different parasites including some with zoonotic potential. The need of accurate diagnosis of gastrointestinal endoparasite infections in domestic reptiles is therefore essential, not only for the well-being of captive reptiles but also for the owners. Here, two different approaches for the detection of parasite stages in reptile faeces were compared: a combination of native and iodine stained direct smears together with a flotation technique (CNF) versus the standard SAF-method.Results
A total of 59 different reptile faeces (20 lizards, 22 snakes, 17 tortoises) were coprologically analyzed by the two methods for the presence of endoparasites. Analyzed reptile faecal samples contained a broad spectrum of parasites (total occurence 93.2%, n = 55) including different species of nematodes (55.9%, n = 33), trematodes (15.3%, n = 9), pentastomids (3.4%, n = 2) and protozoans (47.5%, n = 28). Associations between the performances of both methods to detect selected single parasite stages or groups of such were evaluated by Fisher''s exact test and marginal homogeneity was tested by the McNemar test. In 88.1% of all examined samples (n = 52, 95% confidence interval [CI] = 77.1 - 95.1%) the two diagnostic methods rendered differing results, and the McNemar test for paired observations showed highly significant differences of the detection frequency (P < 0.0001).Conclusion
The combination of direct smears/flotation proved superior in the detection of flagellates trophozoites, coccidian oocysts and nematode eggs, especially those of oxyurids. SAF-technique was superior in detecting larval stages and trematode eggs, but this advantage failed to be statistically significant (P = 0.13). Therefore, CNF is the recommended method for routine faecal examination of captive reptiles while the SAF-technique is advisable as additional measure particularly for wild caught animals and individuals which are to be introduced into captive collections. 相似文献8.
Lia Koski Emilio DeBess Hilary E. Rosen Roshan Reporter Thomas Waltz Molly Leeper Jeniffer Concepcion Acevedo Renta Karpí&#x;kov Jacquelyn McCormick Tereza Gelbicova Brenda Morningstar-Shaw Megin Nichols Richard F. Leman 《Zoonoses and public health》2019,66(8):974-977
Reptile contact can result in zoonotic non‐typhoidal salmonellosis. In April 2018, Oregon Public Health Division contacted CDC about a cluster of four Salmonella serovar Fluntern (SF) illnesses in four states (OR, CA, IA, NY); patients reported contact with geckos, a popular reptile pet. PulseNet, the national molecular subtyping network of food‐borne disease surveillance, subsequently identified additional SF clinical isolates. Twelve cases in 11 states were identified; median age was 5 years (range: <1–58 years). Three patients were hospitalized; no deaths were reported. Of those with exposure information (n = 10), all reported reptile exposure; 9 (90%) specified contact with leopard geckos. No common source of geckos was identified from reported purchase locations. Los Angeles County (LAC) health officials isolated SF from one patient's leopard gecko. Five reptile/gecko isolates were identified from the USDA National Veterinary Services Laboratories (NVSL) from 2015 to 2018. Five countries responded to an Epidemic Intelligence Information System post by PulseNet; reptile isolate sequence data were received from Czech Republic. A clinical case from England was identified through the National Center for Biotechnology Information pathogen detection pipeline; the patient did not report contact with leopard geckos. Whole genome sequencing analysis revealed substantial genetic diversity between clinical and animal isolates; however, gecko and clinical isolates from LAC were highly related (1 allele difference). This investigation linking SF illnesses to leopard geckos highlights an important public health risk from pets. A better understanding of how geckos are distributed by the pet industry in the United States could improve traceability to points of origin and mitigate Salmonella transmission at gecko breeders. Earlier NVSL reports of SF isolates from geckos suggest the risk of human SF infection from geckos is not new. This investigation demonstrates a need to educate gecko breeders, retailers and gecko owners about the continued Salmonella infection risk from pet geckos. 相似文献
9.
M. A. Cobb 《The Journal of small animal practice》1992,33(3):113-118
In most cases of dilated cardiomyopathy in the dog (and in man) the aetiology is unknown; these cases are designated idiopathic. Recent advances, particularly in the field of molecular biology, are providing a better understanding of the natural history of the disease and are shedding light on possible primary causes of dilated cardiomyopathy as well as some of the factors which may be responsible for the progressive nature of the disease process. Armed with this information, more specific therapeutic regimes can be developed with the aim of stopping or reversing myocardial damage. The use of skeletal muscle to assist the failing myocardium may offer a practical means of improving a patient's cardiovascular status, particularly in cases where conventional medical therapy is failing to control the progression of the clinical signs. 相似文献
10.
A one-year-old female English Cocker Spaniel dog with idiopathic Horner''s Syndrome is described. The specific clinical signs in this specimen were miosis, ptosis, enophthalmos, and prolapsed nictitans for 2 days following sudden onset. According to history taking, ophthalmic, neurological, and radiological examination, the patient was diagnosed with idiopathic Horner''s syndrome. Manual acupuncture treatment was applied to the dog on local points two times in 2 days. The local acupoints were ST-4 (Di Chang) and GB-1 (Tong Zi Liao). The day after the initial acupuncture treatment, clinical signs related to idiopathic Horner''s syndrome had almost disappeared. The day after the second treatment, specific clinical signs were completely absent. During this period, the dog did not receive any orthodox treatment. Thus, it is suggested that manual acupuncture might be an effective therapy for idiopathic Horner''s syndrome. 相似文献
11.
PRACTICAL RELEVANCE: Feline hypertrophic cardiomyopathy (HCM) is the most common cardiac disease of cats. Treatment of HCM is usually directed at controlling signs of congestive heart failure (CHF), preventing occurrence or recurrence of systemic thromboembolism or delaying/preventing/reversing progression of subclinical disease. STUDY OBJECTIVE AND DESIGN: Despite the laudable goals of therapy, however, little objective evidence supporting therapeutic decisions has been published. We, therefore, hypothesized that cardiologists base their treatment strategies on information other than published clinically relevant science. To gain insight into therapeutic decisions that cardiologists and clinicians with an interest in cardiology (n=99) make for cats with HCM, and on what information they base these decisions, we presented participants with, and asked them to select therapy for, 12 hypothetical scenarios of HCM (± CHF). Responses and justifications for treatment choices were compiled and compared with the results of a comprehensive literature search for published information about treatment of feline HCM. FINDINGS: Evaluation of the therapeutic strategies chosen for these hypothetical cases of HCM suggests that cardiologists or clinicians with a strong interest in cardiology often prescribe treatments knowing that little documented evidence supports their decisions. 相似文献
12.
Kovalik M Thoday KL Evans H van den Broek AH Mellanby RJ 《Veterinary journal (London, England : 1997)》2012,192(2):212-216
The aim of this study was to assess the effects of a standard therapeutic protocol of prednisolone (Pred) on glucose homeostasis in atopic dogs and compare it with previously published data for ciclosporin A (CsA). The central aim of the study was to assess and compare the effects of standard therapeutic protocols of prednisolone (Pred) and ciclosporin A (CsA) on glucose homeostasis in dogs with atopic dermatitis (CAD). Both treatments significantly reduced the physical signs of CAD, as determined by the canine atopic dermatitis extent and severity index version 3 (CADESI-03) and the Edinburgh Pruritus Scale (EPS). Post-treatment plasma glucose concentrations were not significantly different in the two groups, but serum insulin concentrations were significantly higher following Pred therapy (P<0.05). Serum fructosamine concentrations were not significantly different pre- and post-treatment with Pred, although previous studies had shown that CsA treatment increased fructosamine concentrations (P<0.005). The two treatment groups were recruited in a similar timeframe, were numerically matched and there were no differences in CADESI-03 and EPS scores between the CsA and Pred groups either before or after treatment. Thus, both CsA and Pred treatment were associated with mild disturbances in glucose metabolism, but only CsA therapy resulted in a significant increase in fructosamine concentrations. This information may be relevant to clinicians when considering therapeutic options for dogs with atopic dermatitis which already have impaired glucose homeostasis. 相似文献
13.
V. Charlesworth 《Equine Veterinary Education》2018,30(4):192-196
This report describes the clinical, biochemical and histopathological findings of a case of disseminated, primary mycobacterial infection with Mycobacterium bovis in a pony presenting with neurological signs and weight loss. This report revisits tuberculosis as a potential differential diagnosis in horses at a time of relatively strong tuberculosis control in the UK and iterates the importance of post‐mortem examination as a diagnostic tool for clinicians. Key public health questions following exposure to mycobacterial pathogens are also discussed. 相似文献
14.
《Veterinary journal (London, England : 1997)》2015,203(2):211-218
Early diagnosis and prevention of Rhodococcus equi pneumonia in foals represent important goals for equine clinicians. Recent protocols for diagnosis and treatment of Rhodococcosis in foals typically rely on a multimodal approach based on sonographic evidence suggestive of pyogranulomas, sonographic abscess scores and laboratory findings including plasma fibrinogen concentrations, blood biochemistry testing and platelet and leukocyte counts. The aim of this study was to assess the utility of weekly testing of serum amyloid A (SAA) and plasma fibrinogen concentrations in foals to achieve early diagnosis of R. equi pneumonia prior to the onset of clinical signs. This testing was used to simulate a clinically practical screening procedure and compared with thoracic ultrasonography performed in parallel.The present study suggests that SAA does not represent a reliable early marker of Rhodococcosis when plasma concentrations are tested weekly. However, when clinical signs of R. equi pneumonia are present, SAA concentrations may allow clinicians to obtain ‘real-time’ indications concerning both the progress of infection and the effectiveness of therapy. This study raises the possibility that plasma fibrinogen monitoring starting at 1 week of age and repeated on a weekly basis, could serve as a screening test allowing clinicians to identify foals as suspected of R. equi infection. Future investigations regarding both physiological plasma fibrinogen concentrations in foals as well as fibrinogen kinetics in foals affected with R. equi pneumonia, including the establishment of appropriate reference intervals for the test method employed in this study, will be necessary in order to clarify this possibility. 相似文献
15.
Maria Foti Cristina Giacopello Vittorio Fisichella Giuseppe Latella 《Journal of Exotic Pet Medicine》2013,22(3):270-274
Pseudomonas aeruginosa represents an opportunistic pathogen for animals and humans that is often associated with high disease morbidity and, at times, mortality. Captive reptiles have been shown to be reservoirs of P. aeruginosa strains that can be sources of exposure to humans that come in contact with these animals. In this study, the prevalence of P. aeruginosa among subclinical captive reptile species and the antimicrobial sensitivity of bacterial isolates were investigated. Sixty-five oral swabs were collected from captive reptiles belonging to 15 different species in which no overt signs of disease were evident. From this group of animals, 46 (70.8%) isolates were identified as P. aeruginosa. All of the P. aeruginosa strains were shown to have a wide range of antibiotic resistance. At present, there is a paucity of data regarding the prevalence of P. aeruginosa in various reptile species; therefore, continued scientific investigations are indicated to determine the significance of P. aeruginosa infection as it relates to captive reptile species. 相似文献
16.
J. R. Gold 《Equine Veterinary Education》2017,29(3):158-164
17.
《The Journal of Applied Poultry Research》2015,24(2):233-239
Formal systems of inquiry are of limited value when working with rural communities in developing countries. The current research used alternative systems of inquiry and learning that involved applying participatory epidemiology (PE) techniques to collect veterinary information about Newcastle disease (ND) in rural areas. Results indicated that poultry constituted the largest proportion (42.4%) of livestock species kept, and the poultry diseases that local farmers callbingiri, ciwon-sufe,dankanoman-kaji, dangari, andgurdumu are consistent with modern veterinary knowledge of Newcastle disease, respiratory disease, coccidiosis, fowl pox, and ectoparasitism, respectively.Tsuwen zaki (lion's testicle;Cucumuis pustulatus) andgarafuni (balsam pear;Momordica balsamina) are traditional remedies used to prevent Newcastle disease. Local farmers are knowledgeable about common disease that affect their poultry; they have good diagnostic abilities and can recognize clinical signs. There should be improved veterinary outreach to share some of this information via active community participation, and PE should be incorporated into state and national disease surveillance systems. 相似文献
18.
Reptile pain and analgesia is only beginning to be understood in veterinary research and clinical medicine. The diversity of the class Reptilia also makes it difficult to extrapolate analgesic efficacy across species. Many veterinary clinicians argue that the administration of analgesic medication is risky to the patient and may mask behavioral signs of pain, which are considered evolutionarily adaptive for survival. However, veterinarians have an ethical obligation to treat painful conditions in all animals, including reptiles, because effective pain management reduces stress-induced disruption to homeostatic mechanisms and also decreases morbidity and mortality associated with trauma or surgery. Nevertheless, several obstacles limit successful analgesic use, including subjectivity of pain assessment, inadequate knowledge regarding analgesic efficacy across species, pharmacokinetics of analgesic drugs, and the unknown relationship between risks and benefits for this class of drugs. The objective of this review is to provide a current perspective on the practical application of analgesic medication in commonly maintained pet reptile species. 相似文献
19.
An acute outbreak of equine dysautonomia (equine grass sickness) in a group of eight Przewalski's horses (Equus ferus [caballus] przewalskii) 
下载免费PDF全文
下载免费PDF全文 S. J. Girling M. A. Fraser D. Richardson J. Harley J. L. Ireland A. Naylor E. Milne 《Equine Veterinary Education》2017,29(7):358-361
Equine grass sickness (EGS) is a neurodegenerative disease affecting grazing equids of which a single case of the chronic clinical presentation has previously been reported in a Przewalski's horse (Equus ferus [caballus] przewalskii). A group of 8 Przewalski's horses were moved to a new enclosure, recently vacated by a group of 4 Eastern kiang (Equus kiang holdereri) that showed no evidence of disease. After 23 days the first Przewalski's horse showed clinical signs of acute EGS including flank sweating, belly kicking, rapid loss of body condition, cessation of faecal passage, nasogastric reflux and mouthing water. It was subjected to euthanasia within 48 h due to lack of therapeutic response. Within 24 h of this first case developing clinical signs, a further 5 Przewalski's horses showed similar clinical signs of acute EGS and were subjected to euthanasia. Post mortem examinations confirmed acute EGS, with all animals demonstrating typical chromatolysis, cytoplasmic hypereosinophilia, cellular swelling, vacuolation, pyknosis and loss of nuclei in approximately 90% of neurones in the cranial cervical and cranial mesenteric ganglia and myenteric and submucosal plexi of the ileum. Two Przewalski's horses within the group showed no clinical signs of disease. No single pathogen was identified as the causal agent, but the epidemiological pattern of the outbreak was typical for that previously reported for acute EGS in domestic equids. All affected animals and the 2 surviving Przewalski's horses had low antibody titres to Clostridium botulinum type C. This is the first report of acute EGS in a herd of Przewalski's horses. 相似文献
20.
van Galen G Saegerman C Marcillaud Pitel C Patarin F Amory H Baily JD Cassart D Gerber V Hahn C Harris P Keen JA Kirschvink N Lefere L McGorum B Muller JM Picavet MT Piercy RJ Roscher K Serteyn D Unger L van der Kolk JH van Loon G Verwilghen D Westermann CM Votion DM 《Equine veterinary journal》2012,44(5):621-625
Reasons for performing study: Appropriate management of atypical myopathy (AM) requires the establishment of an accurate diagnosis and prognosis. Furthermore, preventive measures to avoid AM need to be refined. Objectives: The aims of the study were as follows: 1) to improve the diagnosis of AM; 2) to identify prognostic predictors; and 3) to refine recommended preventive measures based on indicators of risk factors. Methods: An exploratory analysis of cases in Europe between 2006 and 2009 reported to the Atypical Myopathy Alert Group was conducted. Based on clinical data, reported cases were allocated into 2 groups: confirmed or highly probable AM (AM group; further divided into survivors and nonsurvivors); and cases with a low probability of having AM or with another final diagnosis (non‐AM group). Using Welch's test and odds ratios corrected for multiple comparisons, the AM vs. non‐AM groups were compared to identify indicators for diagnosis and risk factors, and survivors vs. nonsurvivors in the AM group were compared to identify prognostic factors. Sensitivity, specificity and positive and negative predictive values were calculated for specific clinical signs related to final diagnosis and outcome. Results: From 600 reported cases, 354 AM cases (survival rate of 26%) and 69 non‐AM cases were identified, while there were insufficient data to categorise the remainder. Variables valuable for diagnosing AM compared with similar diseases were as follows: presence of dead leaves and wood and/or trees on pastures; sloping pastures; full‐time pasture access; no food supplementation; normal body condition; pigmenturia; normothermia; and congested mucous membranes. Nonsurvival was associated with recumbency, sweating, anorexia, dyspnoea, tachypnoea and/or tachycardia. Survival was associated with remaining standing most of the time, normothermia, normal mucous membranes, defaecation and vitamin and antioxidant therapy. Conclusions and potential relevance: This study refines the list of risk factors for AM. Clinical signs valuable for diagnosis and prognosis have been identified, enabling clinicians to improve management of AM cases. 相似文献