加拿大奶牛肉牛尿石症.docx

尿石症 UroliThiasisPrepared by: Dr. Terry Hunt•通常发生于阉割牛Disease of castrated males• 膀胱结石-Calculi form in bladder - nidus of bladder cells, minerals and bacteria病因/发病机理Translated by Dr. Fu XiaopingCause & Pathogenesis•通过尿道一平滑结石易通过，但不规则形状结石被卡住后易阻塞尿道Pass into urethra - smooth calculi pass but irregular shaped are trapped and cause urethral obstruction危险因素危险因素危险因素Risk Factors•高精料日粮•草酸盐含量高的植物•饮水少•阉割临床症状3个综合症状1.尿道阻塞High concentrate rations Plants high in oxalates Low water intake CastrationClinical FindingsThree syndromesUrethral obstruction•废食、心跳快 Off feed and elevated heart rate•排尿紧张一尿道有规律波动 Straining to pass urine - urethra pulsating•绞痛/疝痛一踢腹、尾颤、蹬地Colic - feet stamping, kicking at belly and tail twitching• 粉红色尿液排出Maybe dribbling of blood tinged urine• 若完全堵塞，毛干燥 If complete obstruction, dry preputial hair•直肠触诊涨大的膀胱 May palpate enlarged bladder by rectal exam2. 尿道破裂Urethral rupture•动物开始吃食、无绞痛、紧张 Animal begins to eat, no colic and no straining•腹部多水…阴茎周围的腹部区域增大Water belly 一 swelling of ventral abdomen around penis• 腹部水肿，气味如尿 Appears to be ventral edema but smells like urine•腹部脱落Sloughing of ventral skin3. 膀胱破裂Ruptured bladder•临床症状暂时减轻数天 Temporary relief of clinical signs for a few days•尿毒症、消沉、食欲减退 Uremia. depression and anorexia•腹部含有大量尿液一梨形且波动Abdomen fills with urine 一 pear shaped and fluid wave•直检，瘤胃小，腹部大On rectal exam, rumen is small even though abdomen is large•触摸不到膀胱Unable to palpate bladder• 毛干燥Dry preputial hair诊断Diagnosis•依据病史、临床症状Based on history, clinical signs•肿胀程度和腹部滴水 Aspiration of swelling and peritoneal tapDifferential DiagnosisCystitis - bloody urinePyelonephritis - bloody urineAcute intestinal obstruction - colic and distention鉴别诊断•膀胱炎一血尿•肾盂肾炎一血尿•急性肠梗阻一疝痛或膨胀Coccidiosis - strainingSubcutaneous edema•球虫病..•皮下水肿• 充血性心力衰竭一腹水 Congestive heart failure - ascites 实验室和病理学诊断Laboratory and Pathology•加热液体可闻到尿样嗅味 May have to warm up fluid to smell like urine 治疗Treatment1.1.2.尿道阻塞 早期选择屠宰 抗痉挛药•-氨丙嗪 粉碎石头 阴茎手术 尿道破裂 阴茎手术Urethral ObstructionSlaughter is an early optionAntispasmodic drugs - aminopromazine Crush stones at sigmoid flexure of penis Penile AmputationUrethral RupturePenile amputation3.通过腹部切口排出皮下积尿 Drain subcutaneous urine by ventral lacerations 膀胱破裂Ruptured Bladder会阴部尿道手术Perineal Urethrostomy用套管针排出腹部尿液Drain urine from abdomen by trochar 阴茎切除手术 Penile Amputation 麻醉Anesthesia•腰椎膜外麻醉Clip for epidural•第二、三腰椎内3 ml 3 ml into C2 - C3 space皮肤准备Skin Preparation• Clip triple scrub and paint perineal area (midline an area 15 cm * 30 cm)手术Surgery•手术时动物站立Surgery is generally done on the standing animal•在肛门到阴囊基部下方5cm处时皮肤中线做15cm切口Full thickness 15 cm midline skin incision starting 5 cm below the anus to base of scrotum•钝性分离阴茎Bluntly dissect down to penis•抓住阴茎、并将阴茎从切口处拉出 Grasp penis & pull penis out through incision•节扎阴茎海棉体 Ligate Corpus Cavernosum (CC) of penis•切除末梢到节扎处Amputate distal to ligature. 在切 口处固定尿道()Fix urethra in the incision site (suture from skin through CC out skin on other side back through skin, through CC and through skin).•将尿道缝合到切口皮肤边缘Splay urethra suturing to skin edges (urethra is on the dorsal aspect of the penis)•缝合皮肤确保尿不流入切日处Suture skin closed insuring that urine does not run into the incision site预后情况Prognosis•取决于阻塞持续时间、阻塞程度或尿毒症的情况Depends on the duration of obstruction and degree or uremia•尿道表面粗糙化导致阻塞 Granulation of urethra leading to obstruction后遗症•腹膜炎•尿毒症导致死亡•腹部皮肤脱落SequelaePeritonitisUremia resulting in deathSloughing of skin on belly•延期阉割Delay castration•避免日粮中磷酸盐含量过高 Avoid excess phosphorus in ration (Ca:P 2:1) •维持大量饮水(加入盐至日粮的4%),冬天用热处理的水Maintain high water intake (add salt to ration 4%) - heated water in winter•膀胱没能治愈Failure of bladder to heal预防Prevention & Control•饲喂氯化铉，45gm/头天Feed ammonium chloride at rate of 45 gm/head/day to steers•高危地区放牧母畜Pasture females on high-risk pastures。