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OFA系列文章~髖關節發育不全的治療選擇 

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OFA系列文章~髖關節發育不全的治療選擇

文章泡泡拔 » 2007-01-24, 12:54

轉載本系列文章請請註明出處:
犬髖關節狗友會(www.dogchd.net)泡泡拔 阮振維譯自www.offa.org

Hip Dysplasia Treatment Options 髖關節發育不全的治療選擇


General Guidelines基本原則

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Once osteoarthritis is present on a radiograph, dysplastic changes are irreversible and usually continue to progress over time.
If a dysplastic dog has secondary arthritis and pain, most owners elect to first treat their dog with medical management. The
key to medical management of arthritis is weight control and exercise management. Studies have shown that up to 76% of
severely dysplastic dogs with arthritis secondary to HD are able to function and live comfortable quality lives with conservative
management.
With weight control, the goal is to prevent the dog from becoming overweight to reduce mechanical stresses applied to the hip
joints. In general terms, the ribs should be easily palpated and there should be an indentation in front of the pelvic wings (waist
line).

一旦在X光上看到退化性關節炎的症狀,退化性的變化將是不可逆,而且會隨著時間持續變化的。如果一隻患有CHD的狗有二次退化性關節炎和疼痛的情形發生,大部分的飼主會選擇用醫療管理來治療他們的狗狗。針對關節炎而實行的醫療管理,其重點在於體重控制和運動管理。研究指出,高達76%患有嚴重CHD,且發生二次退化性關節炎的狗狗,能夠在保守療法下,維持關節的正常功能並且擁有舒服的生活品質。關於體重控制,目標在預防狗狗變得過重,以減少髖關節受到的機械性壓迫。一般對體重控制的定義,是必須能輕易的觸摸到肋骨,並且有腰身。

Controlled exercise is indicated to prevent or relieve the inflammatory process that leads to the pain associated with arthritis. The
amount and difficulty of the activity is determined on a trial and error basis. Exercise should start with short leash walks and be
gradually increased until the dog reaches the desired level of activity. If clinical signs start to reappear, the amount of exercise is
scaled back to a level that will not cause clinical signs. Overall, exercise should fit to an individual dog's maximum intensity level
with the goal to maintain muscle tone and cardiovascular function without causing pain, stiffness, and inflammation to the joint. The
right amount of exercise helps to maintain muscle tone and strength and stabilizes the unstable dysplastic joint. Exercise also improves
joint range of motion which in turn, keeps the dog more comfortable. Swimming, because it is a non-weight bearing exercise, can be
a very useful means of maintaining muscle tone and range of motion without placing concussive forces on the joint.

運動管理的目的是要預防或緩和發炎反應,發炎會引起和退化性關節炎相關的疼痛。運動量和強度的拿捏,必
需經過嘗試和錯誤的過程,才能決定。一開始應該從牽繩控制的短程散步開始,然後逐漸增加份量,直到活動量達到狗狗
需要的程度為止。如果CHD的臨床症狀又開始再度出現,運動量應該再回到前一個等級,讓狗狗不會出現症狀的等級。

總而言之,運動管理應該要合適的達到犬隻個體的最大強度,以達到維持肌肉狀態和心血管功能的目標,並且不能造成關
節的疼痛、僵硬和發炎。正確的運動量可以幫助維持肌肉狀態、強度,並且幫助穩定因發育不全而不穩定的髖關節。運動
也可以改善關節轉動的範圍,讓狗狗能夠感到更舒服。游泳也是一項非常好的選擇,因為它是一項不需承受體重的運動,
游泳對於維持肌肉狀態和增進關節轉動範圍非常有用,而且不會為關節帶來任何衝擊。


Keep the dog in a warm environment. Warmth tends to help control the pain of arthritis from hip dysplasia. As in people, arthritic
pain in dogs tends to be worse in the damp and cold of winter. Providing a well-padded and warm bed will help alleviate some of
the pain associated with osteoarthritis. An egg-crate foam bed for dogs is commercially available. Applying superficial heat in the
form of heating pads may also relieve pain. Care must be taken not to burn the skin especially with an electric heating pad. Heat
works best for chronically inflamed joints from arthritis while cold works better to treat acute (sudden) types of joint injury.

讓狗狗保持在溫暖的環境中,保暖有助於控制CHD引起的關節炎疼痛,和人一樣,冬天的寒冷與濕氣會讓狗狗的
關節炎疼痛變得更嚴重。提供一個有良好襯墊與溫暖的床,將有助於減輕一些關節炎引起的疼痛,市面上可以買到狗狗專用
的蛋型軟墊床,以加熱墊在床的表面增加一些熱度,也可以減輕一些疼痛,不過要注意不要燙傷了皮膚,尤其是使用電毯來
加熱的時候。熱敷對於改善退化性關節炎引起的慢性發炎非常有效,不過對於關節的急性損傷,冰敷才是比較好的方式。



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早上翻了翻CHD精華區,看到一篇在討論某些人不停攻擊保守療法和Amy姐的文章,
其實那些攻擊我好早就看過了,只是今天心血來潮就到OFA網站上找了這篇,花了點時間翻給大家看!
看看OFA怎麼說保守療法,是不是真的不動手術不行? 是不是真的保守療法如此不堪?
是不是整個髖友會都是如此盲目?

其實machi拔也寫過文章了,保守療法是選擇之一,不是唯一! 這才是正確的觀念,該手術就手術,
不必手術就好好作保守療法,沒有哪一個方式才是對的,別就一定是錯的! 一切要看醫生怎麼評估!

哪一個醫生比較好? 我不知道,只是翻譯OFA文章以來,OFA講的每件事情,愛屋都作得很好,
在李醫師和王醫師身上,我看到OFA standard,我相信的是OFA,不是單純因為李醫師,王醫師,Amy姐人很好,
我就盲目支持,很簡單:OFA!

你今天OFA了嗎?

本文翻譯自:http://www.offa.org/hiptreat.html
本文另有討論藥物和手術的部分,翻譯好後會放到泡拔圖書館!

泡拔
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文章: 85
註冊時間: 2006-02-04, 18:01
來自: 花蓮
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