酮病和真胃變位

CalvingDiseaseComplex

產(chǎn)后疾病

ketosis&LDA

酮病&真胃變位TalSchcolnikAfimilk,S.A.E.Afikim,Israel以色列阿菲金公司Metabolicdiseases代謝疾病Metabolism新陳代謝

Thewholerangeofbiochemicalprocessesthatoccurwithinalivingorganism.Metabolismconsistsbothofanabolismandcatabolism-buildupandbreakdownofsubstancesinthebody.發(fā)生在機(jī)體內(nèi)生化過(guò)程。分合成代謝和分解代謝即聚集和分解。Superproductivecowsproduces15,000kgmilkin305lactationdays-requiredsupermetabolism.305天生產(chǎn)15,000kg的高產(chǎn)牛需要特別的新陳代謝Milkproductionandreproductionforcedairycowstoconsumeenergyatleast3timesabovetheirenergyneedsformaintenance.

奶牛生產(chǎn)和繁殖消耗的能量至少是維持能量需要的3倍。Ontheedge…極限Feb12postparturiantdiseasecomplex4Calving產(chǎn)犢Conception懷孕Drying-off干奶Puerperium產(chǎn)后配種Dairycowlifecycle奶牛周期循環(huán)DairycowLactation奶牛胎次循環(huán)periparturiantdiseasecomplex,TamirGoshen產(chǎn)犢產(chǎn)后疾病懷孕繁殖管理305天時(shí)干奶365天時(shí)產(chǎn)犢干奶牛管理圍產(chǎn)牛CalvingInterval產(chǎn)犢間隔Calving產(chǎn)犢Calving產(chǎn)犢1stIns.首次輸精RestPeriod始配期SuccessfulIns.有效輸精WastePeriod浪費(fèi)天數(shù)OpenPeriod空懷天數(shù)Dry-Off干奶DryPeriodTransition

Period圍產(chǎn)期Pregnancy懷孕Lactation泌乳期CalvingInterval產(chǎn)犢間隔DairyCow’sLactation奶牛泌乳期Lactationphases胎次階段Terminology專業(yè)術(shù)語(yǔ)Numberofdaysfromcalvingtopregnancy產(chǎn)犢至懷孕的天數(shù)OpenDays空懷天數(shù)Daysuptofirstservice產(chǎn)后至首次輸精天數(shù)RestDays始配天數(shù)Daysbetweenfirstandeffectiveinsemination首次輸精和有效輸精間隔天數(shù)WasteDays浪費(fèi)天數(shù)Periodbetweentwosuccessivecalvingtimes兩次產(chǎn)犢間隔CalvingInterval產(chǎn)犢間隔Term術(shù)語(yǔ)Explanation解釋Lactationscomparison胎次對(duì)比DairyCowLactations泌乳期LactationTransitionperiod

圍產(chǎn)期Managementofthedrycowplaysanimportantroleinthecontrolofmetabolicdisordersnearoratcalvingtime

干奶牛管理在產(chǎn)犢前后牛只新陳代謝起很重要的角色Calvingandatleast6weekslaterarecriticaltimesforthedairycow

產(chǎn)犢及產(chǎn)后6周是奶牛決定整個(gè)胎次的關(guān)鍵期BCSatcalving產(chǎn)犢時(shí)體況評(píng)分Foodconsumption飼料消耗Bodyfatmobilization體脂代謝Thechallengesofthetransitioncow圍產(chǎn)期管理的挑戰(zhàn)Productiondisturbance生產(chǎn)紊亂Immunity免疫ReproductionPerformance繁殖性能Milkproduction奶產(chǎn)量5-12DIMPhysicalExam產(chǎn)后5-12檢查Diagnosis診斷Prognosis預(yù)測(cè)Treat治療Observe觀察Cull淘汰Clinicalexamination臨床檢查

Routineexamination5-12Daysinmilk

(DIM)產(chǎn)后5-12天檢查流程（泌乳天數(shù)<DIM>）

Anamnesis:記憶LactationNo.?胎次數(shù)No.ofcalvesatlastcalving?最后一次產(chǎn)犢胎兒數(shù)Calvesfate?犢?，F(xiàn)狀DaysInMilk?泌乳天數(shù)（DIM）Milkyield?產(chǎn)量Anyproblemsincecalving?是否有產(chǎn)后疾?。縫eriparturiantdiseasecomplex,TamirGoshenDr.TamirGoshen,

Hachaklait,

KoretschoolofVeterinarymedicine,

TheHebrewUniversity,

Jerusalem,Israel.13DifferentialDiagnosis(DD’s):鑒別診斷Ketosis酮病FattyLiver-Fatcowsyndrome脂肪肝-肥胖綜合征DisplacedAbomasum真胃變位Metritis子宮炎R(shí)etainedPlacenta胎衣不下Mastitis乳房炎Laminitis蹄病Traumaticreticulo-pericarditis外傷-心包炎Pyelonephritis腎炎Vagusindigestion消化不良Considerations:注意事項(xiàng)Herd/Individual牛群/個(gè)體Acute/Chronic急性/慢性Interrelations相互關(guān)系Fielddiagnosis/Lab.Sample

現(xiàn)場(chǎng)診斷/實(shí)驗(yàn)室分析CostofRx治療成本Cull淘汰Postpartumexamination產(chǎn)后檢查

Routine5-12DIM產(chǎn)后5-12天規(guī)程14InterrelationsbetweenCalvingDiseases產(chǎn)后疾病間的相互關(guān)系STILL死胎

TWIN雙胎PROMF產(chǎn)褥熱

KET酮病

MET子宮炎

RP胎衣不下

ACID酸中毒LDA真胃變位3.46.82.06.82.450.45.812.0MultifactorialApproach(OdedNir)多因子分析方法15Multivariatelogisticregression多元回歸方程Dr.TamirGoshen,

Hachaklait,

KoretschoolofVeterinarymedicine,

TheHebrewUniversity,

Jerusalem,Israel.發(fā)病原因牧場(chǎng)年份季節(jié)胎衣不下子宮炎真胃變位產(chǎn)褥熱雙胎RiskfactorORp95%CIConstantNA<0.001NAFarm1.02<0.0011.01-1.03Year0.69<0.0010.64-0.75Season0.880.0090.80-0.97Parity1.17<0.0011.08-1.25Retainedplacenta2.60<0.0011.96-3.44Metritis2.91<0.0012.21-3.82LDA51.47<0.00121.5-123.2Milkfever1.510.2070.80-2.88Twinbirth1.470.031.04-2.08LowEnergyIntake能量采食量低FatMobilization脂肪代謝PoorImmuneFunction免疫力低EmptyRumen瘤胃空FattyLiver/Ketosis脂肪肝/酮病Mastitis/Metritis乳房炎/子宮炎DisplacedAbomasum真胃變位ImpairedLiverFunction肝功能損壞Death死亡Neuralketosis酮病Metabolicdisordersofthefreshcow

新產(chǎn)牛代謝紊亂Ketosis酮病Fatcowsyndrome肥胖綜合癥Displacedabomasum真胃變位Retainedplacenta胎衣不下Rumenacidosis瘤胃酸中毒Laminitis蹄病Milkfever產(chǎn)褥熱GrassTetany(tetanushypomagniesemic)低血鎂癥Hypophosphatemia低磷血癥Udderedema水腫Ketosis酮病Ametabolicdisorder,thatresultsfrominadequatedrymatterintakebythedairycowinearlylactation.

代謝紊亂是因?yàn)槊谌樵缙谂Ｖ桓晌镔|(zhì)采食量不足。Whenbloodglucoselevelistoolow,thecowmobilizesbodyreserves,especiallyfat.

當(dāng)體內(nèi)血糖水平過(guò)低，奶牛動(dòng)用身體儲(chǔ)藏尤其是脂肪。Substantialpartofexcessivemobilizedbodyfatconvertedintoketonebodiesintheliverdamaginggluconeogenesis,whichresultsinelevatedketonelevelsintheblood.

大量動(dòng)用體內(nèi)脂肪，轉(zhuǎn)化為酮體，從而影響肝臟對(duì)血糖的代謝，從而造成體內(nèi)酮體累積EtiologyofKetosis酮病病因Toincreasetheirmilkproductionaftercalving,cowshavehighenergyrequirements,whichusuallycannotbemetbyfeedconsumption.Theyare,therefore,athighriskofNEBandtheconsequencebeingketosis.要提高產(chǎn)后牛只產(chǎn)量，產(chǎn)后?？赏ㄟ^(guò)日糧獲取體內(nèi)高能需要。因此能量負(fù)平衡高風(fēng)險(xiǎn)的結(jié)果是酮病的發(fā)生NadavGalon20EnergyCurve能量圖泌乳性能和維持需要能量Mcal/天飼料功能配種時(shí)期體內(nèi)能量酮體-Anorexia厭食-Rumeninactivity瘤胃遲緩-Weightloss體重下降-Lowermilkyield產(chǎn)量下降-Diarrhea腹瀉Centralnervoussystemsymptoms(rare)中樞神經(jīng)系統(tǒng)紊亂

Ketosisclinicalsymptoms酮病臨床綜合癥Pathophysiology病理生理學(xué)negativeenergybalance能量負(fù)平衡Increasedlipolysis增加脂類分解hepaticlipidaccumulation肝臟內(nèi)脂類堆積Impairedgluconeogenesis糖異生受阻Impairedhepaticfattyacidsoxidation,esterificationandlipoproteinsynthesis脂肪酸氧化、酯化及脂蛋白合成受阻，Hypoglycemia,hypoinsulenemia,excessiveketogenesis低血糖癥、酮體合成過(guò)多periparturiantdiseasecomplex,TamirGoshenKetosisintheblood

ofcow

酮病牛只血檢指標(biāo)Ketotic臨床酮病Sub-clinicalketosis隱性酮病Normal正常2852Glucose(mg/dl)葡萄糖>

4.0>1.20.3Ketones(mmol/L)酮體>3.10.3NEFA(mmol/L)游離脂肪酸NadavGalon24DiagnosisofSubclinical&ClinicalKetosis

隱性酮病和臨床酮病的診斷

(7herds1982-84O.Nir-1982-1984年的7個(gè)牛群)

Epidemiology-Incidence&Prevalence

流行性病學(xué)-發(fā)病率&流行性Incidence:

發(fā)病牛群4daysto6weeksaftercalvinginhighproducingcows產(chǎn)后4天-6周高產(chǎn)牛Prevalence:

發(fā)病率RatesofketosisintheIsraeliherd~20%以色列牛群酮病發(fā)病率約20%periparturiantdiseasecomplex,TamirGoshen26Year年份Season季節(jié)Herd-Someherdshighincidenceinheifers

牛群-部分牛群后備牛發(fā)病率較高TotalMixedRations

全混合日糧（TMR）Epidemiology-general

流行病學(xué)-常見(jiàn)

RiskFactors發(fā)病原因periparturiantdiseasecomplex,TamirGoshen27LactationIncidenceRate(LIR)byYear

泌乳期發(fā)病率（LIR）-全年Shpigeletal1996periparturiantdiseasecomplex,TamirGoshen28LIRbySeason

泌乳期發(fā)病率-按季節(jié)Shpigeletal1996periparturiantdiseasecomplex,TamirGoshen11.61712.76.1024681012141618Jan-Mar1-3月Apr-Jun4-6月July-Sept7-9月Oct-Dec10-12月Season季節(jié)LIR(%)泌乳期發(fā)病率29LIRby

Herd泌乳期發(fā)病率-按牛群Shpigeletal1996periparturiantdiseasecomplex,TamirGoshen26.92516.43.72.90510152025303566881055156356Herd牛群LIR(%)30Parity–LactationIncidenceRate(LIR)increaseswithLactationno.(parity)胎次-隨著胎次的增加發(fā)病率也提高High-yielding高產(chǎn)牛Longdryperiod干奶期過(guò)長(zhǎng)ExcessiveBCSatdryofforatcalving干奶/產(chǎn)犢時(shí)體況變化大Uterinedisorders–Twins,RP,Metritis,ect.

子宮扭轉(zhuǎn)-雙胎，胎衣不下，子宮炎等DisplacedAbomasum真胃變位Epidemiology–Individualcow

RiskFactorsperiparturiantdiseasecomplex,TamirGoshenFeb1231LIRbyParity按胎次Shpigeletal1996periparturiantdiseasecomplex,TamirGoshenKetosisandFertility酮病和繁殖率HerdswithEffectsofYieldonFertility*%adverselyaffectedbyNEB

&otherfactors牛群產(chǎn)量對(duì)繁殖的印象牛群存在能量負(fù)平衡或其他原因(148Herds,2007)*OdedNir,2010KetosisandProduction

酮病和產(chǎn)奶量Peak,PersistencyandNegativeEnergyBalance(NEB)1stLactationsCows*(8882cowsin86herds)頭胎牛泌乳峰值，持續(xù)力及能量負(fù)平衡（NEB）-86個(gè)牛群的8882頭牛1%persistency=304.0lbsin305days1%持續(xù)力=305天產(chǎn)量為304L*OdedNir,201034Diagnosisofketosis酮病的診斷TamirGoshenTestingforketonuria酮體的檢測(cè)UrineandMilkTests尿檢和牛奶檢測(cè)periparturiantdiseasecomplex,TamirGoshen35LowmilkproductionPoorappetite低奶量和采食量下降Routinepostpartumexamination5-12days產(chǎn)后5-12天檢查Primaryketosis酮病（僅）VaginalandRectalExamination陰道和直腸檢查RetainedplacentaMetritis,LDA,MF胎衣不下、子宮炎、真胃變位和產(chǎn)褥熱Normal正常Ketonuria酮體>=1.5mmol/LComplicatedketosis酮病綜合征Examinationprotocol檢查規(guī)程periparturiantdiseasecomplex,TamirGoshen36Rabies狂犬病Listeriosis李氏桿菌病CCNBSE-MadCowDisease.瘋牛病Leadpoisoning鉛中毒Grasstetany低血鎂癥Clavicepspaspalipoisoning雀稗麥角菌DifferentialDiagnosisofketosisNervousform

酮病的鑒別診斷

37ClinicalPathology

臨床病理學(xué)Blood:血檢Glucose血糖BHBA羥丁酸Acetoacetate乙酰乙酸NEFA(FFA)游離脂肪酸Liverenzymes肝臟酶Urine:尿檢Acetoacetate乙酰乙酸BHBA羥丁酸Milk:牛奶檢測(cè)Acetoacetate乙酰乙酸BHBA羥丁酸38Problematicherds-allpostparturientcows亞健康牛群-所有產(chǎn)后牛Otherherds:其他牛群 -Sickcows病牛 -Dryfor>70days干奶天數(shù)>70天 -DryoffBCS>=3.75干奶時(shí)體況評(píng)分≥3.75BSCLossinthedryperiod>=0.5

干奶期體況下降超過(guò)0.5分的牛只 -Milkproduction<25/30L 25L<產(chǎn)量<30LWhichcowshouldbetested?

應(yīng)檢測(cè)哪頭牛？periparturiantdiseasecomplex,TamirGoshenNegativeEnergyBalanceatCalving(1)產(chǎn)后能量負(fù)平衡（1）theFamiliarPattern,Herd#1相近的牛只-牛群1Calvingtraits產(chǎn)后指標(biāo)Firstlactation頭胎?！軸econdlactation≥2胎a.Totalcalved總產(chǎn)犢259555i.%withketosis酮病比例40.2(8.3)21.1(14.0)Theroutinetestispartiallyefficient,90/176(51.1%)ofcowswithNEBweremissed檢測(cè)程序明顯有效，51.1%（176頭中的90頭）的能量負(fù)平衡牛只未再出現(xiàn)39OdedNir,2011Calvingtraits產(chǎn)后指標(biāo)Firstlactation頭胎≥Secondlactation≥2胎a.Totalcalved總產(chǎn)犢224712i.%withketosis酮病比例1.4(8.3)4.6(14.0)Theroutinetestisofnovalue121/130(98.8%)ofcowswithNEBweremissed檢測(cè)程序沒(méi)有價(jià)值：98.8%（130頭中的121）沒(méi)有再出現(xiàn)NEBatCalving-“theSmeller”Herd#2產(chǎn)后能量負(fù)平衡-牛群2（牛群較小）40OdedNir,2011≥3胎

二胎

頭胎頭胎

二胎

≥3胎NEBatCalving-theLatePattern(PH)Calvingtraits產(chǎn)后指標(biāo)Firstlactation投胎≥Secondlactation≥2胎a.Totalcalved總產(chǎn)犢8261i.%withketosis酮病比例0.0(8.3)1.7(14.0)Noroutinetest.26/27(96.3%)ofcowswithNEBweremissed沒(méi)有檢測(cè)程序：96.3%（27頭中的26）沒(méi)有再出現(xiàn)41OdedNir,2011DiagnosingKetosis酮病診斷Conventionalmethodsofdiagnosingketosisarenotsatisfactory-afflictedanimalsmaybemissedandhealthycowsmayneedlesslyreceivetreatments.酮病診斷方法不盡人意-牛只痛苦并健康牛只無(wú)需接受治療OdedNir,2010Ketosisinafifarmbyafilab阿菲牧魔盒對(duì)酮病的檢測(cè)

DiagnosisofketosisbyFat/ProteinRatioinMilk

酮病診斷-牛奶中的脂蛋比Ketosisevents酮病事件OdedNir,2010Ketosis–Treatment

酮病-治療Dextroseinfusion(IV):Themostrapidanddirectwayofsupplyingbloodglucose.靜脈注射-最直接最見(jiàn)效的補(bǔ)糖方法Hormonaltreatment(IM):Glucocorticoids(Dexamethasone)激素治療-糖皮質(zhì)激素-地塞米松Oralsugarprecursors:Sodiumpropionateandpropyleneglycolaretwooralsugarprecursors.Theycanbefedordrenchedatarateof250-450grperdayusuallyfollowingglucoseorhormonaltreatment.口服糖：丙酸鈉和丙二醇。每天灌服250-450gr，通常也進(jìn)行靜脈注射葡萄糖或激素輔助治療periparturiantdiseasecomplex,TamirGoshen01/02/202312:5645Treatment治療periparturiantdiseasecomplex,TamirGoshenCostBenefitRatioofKetosisRx

酮病治療成本與價(jià)值比例102損失Loss治療TreatInsFarm牧場(chǎng)Farm牧場(chǎng)NadavGalonKetosis–Prevention

酮病-預(yù)防Avoidover-conditionedcowsinlatelactationanddryperiod.Bodyconditionscoreshouldbe3-3.5atcalving.泌乳末期和干奶期避免體況過(guò)肥。產(chǎn)犢時(shí)體況在3-3.5分Feed2-4kgofgrainpercowduringtheclose-upperiod(3weeksbeforecalving).圍產(chǎn)期（圍產(chǎn)期）飼喂2-4kg谷物Encouragemaximumenergyintakeaftercalvingbyfeedinghighqualityforages.產(chǎn)后飼喂優(yōu)質(zhì)粗飼料以增加牛只能量采食量Feedtotalmixedrationsifpossible.Ifnot,limitgrainintaketo2-4kgperfeeding.如果可能飼喂TMR。沒(méi)有TMR，限制2-4kg谷物采食量Oded

Nir2012Kronfeld,1970Sodiumpropionate丙酸鈉Glycerol甘油PropyleneGlycol丙二醇Radostits,1989Sodiumpropionate丙酸鈉PropyleneGlycol丙二醇Monensin莫能菌素11ICPD,2001Niacin煙酸Glycerol甘油Propyleneglycol丙二醇MerckVetManual,20102010年Merk獸醫(yī)手冊(cè)Niacin煙酸Methionine蛋氨酸Sodium(calcium)propionate丙酸鈉/鈣Rumenprotectedcholine過(guò)瘤胃膽堿PropyleneGlycol丙二醇Ketosis–Prevention酮病預(yù)防49Ketosisinterrelationswithfattyliver

酮病與脂肪肝相關(guān)性Ketosisinruminantsisadiseaseoftheperiparturientperiodcausedbyimpairedmetabolismofcarbohydratesandfatsandisinterrelatedwithfattyliver.反芻動(dòng)物酮病與圍產(chǎn)前期碳水化合物和脂肪代謝紊亂及脂肪肝相關(guān)聯(lián)。Biochemically-thediseasecharacterizedby:生化理性-該疾病特點(diǎn)Ketonemia.酮血癥Ketonuria.酮尿Hypoglycemia.低血糖periparturiantdiseasecomplex,TamirGoshen50FattyLiverSyndrome

脂肪肝綜合癥LipomobilizationsyndromeFattyinfiltrationoftheliverincattle牛只肝臟脂肪外滲Fatcowsyndrome牛只肥胖綜合癥“GooseLiver”肝腫大periparturiantdiseasecomplex,TamirGoshen51Lowmilkproduction產(chǎn)量下降A(chǔ)norexia,Depression,Weakness厭食、消沉、體弱Rumenatony,GITileus-scantmucoid,

便黃且稀

前胃遲緩、腸梗阻-粘液分泌不足、Mildicterus(rarelyvisibleclinically)輕微黃疸-臨床不常見(jiàn)Nervoussigns:staringgaze,holdingheadhigh,muscletremors,coma神經(jīng)緊張：發(fā)呆、仰頭、肌肉痙攣、昏迷Recumbency,death臥地、死亡FattyLiverSyndrome脂肪肝綜合征

ClinicalSigns臨床表現(xiàn)periparturiantdiseasecomplex,TamirGoshen52Hypoglycemia低血糖Ketonemia&Ketonuria酮血、酮尿ElevatedbloodNEFA,Bilirubin,Liverenzymes血液中游離脂肪酸、膽紅素、肝臟酶濃度上Decreasedbloodcholesterol,albumin,TG血液中膽固醇、白蛋白及甘油三酯濃度降低ProlongedBSPclearancetest延長(zhǎng)BSP清除測(cè)試FattyLiverSyndrome脂肪肝綜合征

ClinicalPathology臨床病理學(xué)periparturiantdiseasecomplex,TamirGoshen53FattyLiverSyndrome脂肪肝綜合征

Diagnosis診斷History發(fā)病歷史Clinicalsigns臨床表現(xiàn)Clinicalpathology臨床病理學(xué)Liverbiopsy-theonlyreliablemethodaccuratelyestimatingthedegreeoffattyliver肝臟活體組織-唯一用來(lái)準(zhǔn)確評(píng)估脂肪肝患病程度的方法periparturiantdiseasecomplex,TamirGoshen54Treataccompanyingconditions治療并發(fā)情況Somecowsresponsetotreatment:一些牛只治療效果Parenteralglucoseinfusion補(bǔ)糖Glucocorticoids???糖皮質(zhì)激素BvitaminsVBOralfluidsandelectrolytes口服液體或電解質(zhì)Trans-faunation,Rumenstimulants瘤胃刺激Oralpropyleneglycolorsodiumpropionate口服丙二醇或丙酸鈉Glucagon胰高血糖素

FattyLiverSyndrome脂肪肝綜合征

Treatment治療periparturiantdiseasecomplex,TamirGoshen55

Guarded監(jiān)測(cè)Severecases-poorprognosis極端病例-治療無(wú)效Salvageslaughter屠宰FattyLiverSyndrome脂肪肝綜合征

Prognosis

預(yù)測(cè)periparturiantdiseasecomplex,TamirGoshen56FattyLiverSyndrome脂肪肝綜合征Glucagontreatmentinfattyliver胰高血糖素治療脂肪肝

10mg/dayfor2days2連續(xù)兩天：10mg/天periparturiantdiseasecomplex,TamirGoshen0510152025303540450214Daysaftertreatment治療后天數(shù)%Livertriglycerides肝臟甘油三酯濃度Control對(duì)照組Glucagon注射胰高血糖素57LeftDisplacedAbomasum真胃變位

Definition定義LDAisanentrapmentoftheabomasumbetweentherumenandtheleftabdominalwall真胃變位（LDA）是真胃（皺胃）被瘤胃和腹壁包裹periparturiantdiseasecomplex,TamirGoshen58Etiology-LDA

真胃變位病原學(xué)Notfullyunderstood發(fā)病原因不全被研究出Multifactorial多種原因AprerequisitefordevelopmentofLDAishypomotilityandgaseousdistentionoftheabomasumLDA的一個(gè)發(fā)病原因是腸胃蠕動(dòng)緩慢及皺胃鼓氣TheremightbeanassociationofLDAwith:與LAD可能相關(guān)聯(lián)：Malfunctionsattheleveloftheintrinsicnervoussystem神經(jīng)系統(tǒng)機(jī)能紊亂Impairedcholinergicmuscleresponse膽堿能肌肉反射受損periparturiantdiseasecomplex,TamirGoshen59RiskFactors–LDA致病原因TMRorgrainfeeding TMR/精料Ketosis酮病Retainedplacenta胎衣不下Primarymetritis早期子宮炎Twins雙胎Stillbirth死胎Lowmilkyieldpreviouslactation泌乳早期產(chǎn)量過(guò)低Lowfeedintakebeforeandaftercalving產(chǎn)前和產(chǎn)后采食量過(guò)少periparturiantdiseasecomplex,TamirGoshen60TamirGoshenperiparturiantdiseasecomplex,TamirGoshen-112DA變位牛NORMAL正常牛-2.004.006.008.0010.0012.0014.0016.0018.00DMI(Kg/day)干物質(zhì)采食量（DMI）kg.天Timefromcalving(weeks)產(chǎn)后時(shí)間.-周DMIintakeinnormalandDAcows正常牛只和變位牛只干物質(zhì)采食量對(duì)比61TamirGoshenperiparturiantdiseasecomplex,TamirGoshen-112DANORMAL05522.252.5DMI(%BW/day)DMI-體重%/天Timefromcalving(weeks)產(chǎn)后時(shí)間-周DMIintakeinnormalandDAcows正常牛只和變位牛只干物質(zhì)采食量對(duì)比62Largesize,highproducingadultdairycattle高產(chǎn)牛8-14weekscalvesandin21monthsandolderheifers產(chǎn)后8-14周至泌乳21月及月齡較大的后備牛（新投產(chǎn)）Rareconditioninbeefcattle,andveryrareinsheep's體況差的肉牛，養(yǎng)較少見(jiàn)Approximately90%ofthecasesworldwideareinthefirst6weeksaftercalving全世界90%的病例常見(jiàn)于產(chǎn)后6周Epidemiology-Incidence&Prevalence流行病學(xué)-發(fā)病率及流行性periparturiantdiseasecomplex,TamirGoshen63Incidence-0.2-1.6%inDenmark丹麥-發(fā)病率：0.2-1.6%InIsraeltheincidenceis1%in1stcalfheifersand1.5%incows(bestquartile,2003)以色列頭胎牛發(fā)病率1%，成母牛發(fā)病率1.5%InIsraelmorethen90%oftheDA’saretotheleft在以色列90%的變位是左側(cè)變位periparturiantdiseasecomplex,TamirGoshenEpidemiology-Incidence&Prevalence流行病學(xué)-發(fā)病率及流行性64ClinicalSigns–LDA臨床表現(xiàn)Inappetence,almostanorexia食欲不振，幾近厭食Markeddropinmilkproduction產(chǎn)量下降Varyingdegreeofketosis不同程度酮病Feces-reducedinvolumeandsofterthannormal糞便-量減少且較平時(shí)稀松Decreasedruminalmovements-bothfrequencyandintensity瘤胃遲緩-頻率和強(qiáng)度均減弱periparturiantdiseasecomplex,TamirGoshen65Leftside“ping”incombinedauscultationandpercussion.聽(tīng)診左側(cè)有金屬叩擊聲Insomecases-paroxysmalatrialfibrillationduetothemetabolicalkalosis.一些病例-因代謝性堿中毒，陣發(fā)性心房顫動(dòng)Onrectalexamination-smallemptyrumen,thedisplacedabomasumisrarelypalpated.直腸檢查-瘤胃小且空，皺胃幾乎不可觸摸到Fatcowsmaydevelopseverketosisandfattyliversyndrome.肥胖?？赡馨l(fā)展成急性酮病及脂肪肝綜合征periparturiantdiseasecomplex,TamirGoshenClinicalSigns–LDA臨床表現(xiàn)66

Auscultation&Percussion

聽(tīng)診&叩診periparturiantdiseasecomplex,TamirGoshen67“Ping”location

叩擊聲位置LDA真胃變位periparturiantdiseasecomplex,TamirGoshen68ClinicalPathology臨床病理學(xué)Hemoconcentration-elevatedPCV,Hb&TP血濃縮-血紅蛋白、動(dòng)脈壓力升高，Ketonemia酮血癥Mildmetabolicalkalosis輕度代謝性堿中毒Mildhypochloremia輕度低氯血癥Mildhypokalemia輕度periparturiantdiseasecomplex,TamirGoshen69Paracentesisofthedisplacedabomasum,inthe10or11intercostalspace,inthemiddlethirdoftheabdominalwall:皺胃游離在第10和11肋骨間即腹壁中間1/3處Ph=2Noprotozoa沒(méi)有微生物periparturiantdiseasecomplex,TamirGoshenClinicalPathology臨床病理學(xué)70Diagnosis診斷Clinicalsigns-especiallythetympanicsoundintheleftparalumbarfossa臨床癥狀-在腰椎窩處可明顯聽(tīng)到鼓氣聲音Rectalpalpation-whenpossibletofeelthedisplacedabomasum直腸檢查-可感覺(jué)到變位的皺胃periparturiantdiseasecomplex,TamirGoshen71Treatment治療Conservative-rollingorrunningthecow保守治療-翻轉(zhuǎn)牛只Surgical:手術(shù)Roll&suture翻轉(zhuǎn)&縫合Pennsylvaniamethod–ventralParamedianapproach賓夕法尼亞法-腹中線方法Hanovermethod–rightsideapproachHanover法-右側(cè)法Utrecht