著者

塚野 健志

出版者

公益社団法人 日本獣医師会

雑誌

日本獣医師会雑誌 (ISSN:04466454)

巻号頁・発行日

vol.67, no.9, pp.670-673, 2014-09-20 (Released:2014-10-20)

参考文献数

18

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脱水症を伴わない重度の代謝性アシドーシスに陥った黒毛和種子牛下痢症例に対して,重炭酸ナトリウム液の静脈内投与に加え,断乳処置の併用が代謝性アシドーシス及び糞便スコアの改善に有効であるかを検討した.初診時より24時間の断乳処置を行った群(処置群)では,24時間後で静脈血pH,重炭酸イオン(HCO3-)濃度が有意(P<0.01)に増加,アニオンギャップ(AG)濃度が有意(P<0.01)に減少,糞便スコアは有意(P<0.05)に減少した.初診時より代用乳の哺乳を継続した群(対照群)では,24時間後でpHの有意な増加を認めたが,HCO3-濃度,AG濃度,糞便スコアに有意な差は認められなかった.診療回数は処置群で有意(P<0.05)に短縮した.断乳処置の併用は代謝性アシドーシス及び糞便性状を改善させる傾向にあると考えられた.

著者

塚野 健志

出版者

酪農学園大学

巻号頁・発行日

pp.1-93, 2018-09-30

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The aim of present study was to identify what kind of formulation is appropriate for oral and intravenous nutritional infusion therapy in calves with diarrhea. In chapter 1 discussed the state of fluid therapy for calves with diarrhea in Japan, and noted the necessity of nutrient infusion. In chapter 2, the aim of present survey was to identify risk factors of laboratory findings for mortality in calves with diarrhea. A retrospective analysis was conducted utilizing medical records of 221 diarrheic calves. As a result, hypoglycemia (OR 3.09; 95% CI 1.22-7.87; p=0.02) and failure of respiratory compensation (OR 2.63; 95% CI 1.05-6.62; p=0.04) were the major risk factors associated with a negative outcome in diarrheic calves. Indeed, the addition of glucose to IV fluid solutions is widely used to provide energy, but malnutrition is serious problem in diarrheic calves with hypoglycemia. These results suggest that to consider the next step for nutritional management in diarrheic calves is important. In chapter 3 aimed to confirm necessity of amino acid supply in calves with diarrhea and respiratory diseases. As a result, the blood pH and plasma concentrations of total amino acids (TAA) and branched chain amino acids (BCAA) were significantly and negatively correlated in calves with diarrhea. In other words, acidemia activated the catabolism of protein. Similarly, the calves with Mycoplasma bronchopneumonia, a respiratory disease, were characterized by significantly lower in serum TAA and BCAA. These results indicated that supplying amino acids to diarrheic calves with acidemia and respiratory diseases with hyper inflammation state was important. In chapter 4, oral or intravenous nutrient infusions for diarrheic calves with different pathophysiology features were examined. In section 1, four different compositions of oral electrolyte solutions (OES) were prepared to test how differences in the composition of OES affect dehydration and prevent catabolism. Results of present study demonstrated that OES with high sodium (Na) concentration (100.1 mM) and the ratio of glucose (Glu) and glycine (Gly) to Na was 0.6 : 0.6 : 1.0 has effect of increasing the blood volume. On the other hand, OES with high Glu concentration (116.8 mM) and the ratio of Glu to Gly was 1.0 : 1.0 has catabolism prevention effect. This suggests that it is necessary to use these OES properly. The OES with high Na concentration should be used in the early stages of diarrhea for calves with dehydration and metabolic acidosis, but not in the later stages of exhaustion. The OES with high Glu concentration may beneficial for wasting diarrheic calves with dehydration. In section 2 evaluated the effects of solutions with or without dextrose intravenously administered to diarrheic calves, with beta-hydroxybutyrate (BHBA) concentrations as an index. As a result, the addition of dextrose to intravenous fluid solutions did not affect the correcting dehydration. In addition, catabolism prevention was observed only intravenous infusion of solution with dextrose. These results suggest that a solution with dextrose could be beneficial for wasting diarrheic calves. In section 3 assessed the advantages of dextrose and amino acid mixture solution as parenteral nutrition (PN) therapy for calves with Cryptosporidium parvum (C. parvum) diarrhea. Sixteen diarrheic calves were randomly assigned to receive PN (PPN group, n=8) or only dextrose solution (Dex group, n=8). Plasma diamine oxidase (DAO) activity in the PPN group at the end of infusion (118.3 ± 42.3 IU/mL) was significantly increased compared with that before fluid infusion (81.5 ± 25.8 IU/mL), but there were no significant differences in the Dex group. Increased plasma DAO activity indicated repair of the damaged intestine, as a result, the treatment period for the PPN group was significantly shorter than that for the Dex group. Our results suggested that not only dextrose but dextrose and amino acid mixture solution as PN therapy was recommended in calves with C. parvum diarrhea.The PN therapy has been widely used for humans, but it is not yet standard in large animal medical treatment. The present study demonstrated that the PN therapy could be beneficial for clinical use in calves with diarrhea based on scientific basis. The PN therapy in this study was economical and executable in clinical site. Future studies to examine the prescription of PN infusion solution with an amino acid ratio, lipid, vitamin and trace elements suitable for calf diarrhea are needed.