牠們真的需要打這麼多預防針嗎? （本篇文章請自由轉貼,但請註明出處：大敦寵物醫療中心電子報 特刊2002/10/15） （http://www.dvm.com.tw/epapernew/epaperdetail.asp?eID=352&eNumber=72） 內文批哩啪啦一大堆，我把重點用顏色標記起來了 大家可以選擇著看～ 提前做個結論：目前有的預防針，以正常的飼養方式來看 沒有不用打的預防針... 其中有提及預防針三年打一次的作法，之前忘了在哪裡看到文章 有討論到他的爭議點，如果有人也看過，幫忙從茫茫大海中"翻" 出來大家討論一下吧～ ----------------------------------------------------------------------- 請您一字不漏的看完以下文章,在看完這篇文章前,請勿做任何決定,尤其是曾經 看過我的書”別只給我一根骨頭”的朋友請您一定要注意,因為這是醫學上的修 正,請以下文為依據!!! 從1989年起,全世界的獸醫都開始對於疫苗的施打要求每年補強一次,因為幾乎 所有的學者都認為動物是所謂的被動免疫系統,無法如同人類般產生終身的免疫 但是隨著醫學的進步,一篇篇不利預防注射的文獻紛紛出爐,有更多的學者專家 投入免疫學的研究,1996年發現自體免疫的問題和預防注射有關,尤其是自體免 疫的溶血性貧血(狗),這是一種會嚴重破壞自我的紅血球細胞的一種病,而到了 1998年American Association of Feline Practitioners又發現每年施打疫苗 會增加貓咪纖維肉瘤-fibrosarcoma的機會,所以開始對貓咪的疫苗注射補強時 間延長至三年,再加上事實上有些病毒性疾病在注射疫苗以後甚至於可以達到七 年的效力,所以近兩年來我們都會不禁的問” 我們會不會太常幫牠們打預防針 呢? 2001年九月一日在the Journal of the American Veterinary Medical Association 的文獻中有一篇由American Veterinary Medical Association Executive Board 所公告的”預防注射的原則”在這份文獻中宣佈,對免疫系統的不必要的刺激並 不會增加對疾病的抵抗力,而且反而可能會導致預防注射後引發的可能副作用. 並且要求獸醫們將預防注射分為core及non-core(後面會說明),還有要對每一隻 動物給與牠合適的疫苗注射schedule! 所謂core vaccine就是對於狗貓來說,有 高危險性疾病的疫苗,而non-core則是較低危險性疾病的疫苗, 狗的core vaccine如下: 1. CPV-2(CANINE PARVOVIRUS-2)犬小病毒出血性胃腸炎第二型 2. CDV(CANINE DISTEMPER VIRUS)犬瘟熱病毒 3. CAV-2(CANINE ADENOVIRUS TYPE2 ,INFECTIOUS HEPATITIS) 傳染性肝炎, 由犬腺病毒第二型所控制 4. RV(RABIES VIRUS) 狂犬病病毒 但是幾乎所有的CAV-2在製造時都配著Parainfluenza (PI)副流行性感冒病毒,所 以它雖不是CORE VACCINE,但是卻也被放在CORE VACCINE內, 貓的core vaccine如下: 1. FPV(PANLEUKOPENIA)貓瘟—parvovirus 引起 2. FHV-1(VIRAL RHINOTRACHEITIS)病毒性鼻支氣管炎-herpesvirus type 1引起 3. FCV(FELINE CALICIVIRUS)貓卡利希病毒-calcivirus 引起 4. RV(RABIES VIRUS) 狂犬病病毒 上述的CORE VACCINE是一定要施打的,但是除了幼年期的注射,從第一劑注射開始, 每三到四週打一次,一直打到狗貓滿16週齡為止,之後的第一年要補強一劑,只要有 照這樣的過程執行的犬貓就能達到幼年期完整的防疫,這一劑的補強以後,每三年 要再次補強一次,不可以低於三年.對於已經超過四個月才施打第一次疫苗的犬貓. 則是施打一次以後,隔年再補強一次,然後每三年補強一劑,一樣不可以低於三年! 這些疫苗所產生的抗體力價已被證實可以維持三年以上,所以每三年一次的補強是 絕對足夠的! NON-CORE VACCINE: 以過敏反應來說,死毒的疫苗比活毒疫苗來得容易,而細菌疫苗又比病毒疫苗來的 容易,這也就是為何疫苗容易過敏的原因,因為現有的六合一七合一或字八合一都 有鉤端螺旋體,而這正是死菌疫苗!!所有被歸納在NON-CORE 的疫苗,都不一定要施 打,這些疫苗是否要施打就要依照不同的地區及國度,及所暴露的環境,由獸醫師幫 您決定是否需要施打. 狗的NON-CORE VACCINE有 1. 鉤端螺旋體(leptospirosis) 2. 萊姆病(Lyme Disease)-由Borrelia burgdorferi引起 3. 冠狀病毒腸炎-由Corona virus 引起 4. 博氏桿菌(犬舍咳-) bordetella bronchiseptica引起 5. 梨型虫Giardia 而貓的NOR-CORE VACCINE有 1. 博氏桿菌(犬舍咳)-bordetella bronchiseptica引起 2. FIP(傳染性腹膜炎)-coronavirus 引起 3. FeLV(貓白血病)leukemia virus 引起 4. Chlamydia psittaci 5. 梨形虫Giardia 6. Microsporum canis(感染後會引發貓咪的皮膚病) 以鉤端螺旋體來說,台灣已有不少的病歷報告,而且還會傳染給人類,慎至於會造 成嚴重的腎臟傷害,所以建議您注射,而萊姆病和梨形虫對於整天在沙發上的小型 犬來說是沒有必要的,但是對於會外出感染壁蝨或是接觸到病原的狗狗來說,它也是 需要注射的.而布氏桿菌(犬舍咳)對於常常會去暴露在多數的狗群中或是要參加 dog show或是常常要去住宿的狗來說,就是需要的了!而冠狀病毒腸炎在家犬是比較 嚴重的,它的發生主要和大量的緊迫有關,而外出接觸別的動物就是容易產生stress 的,但是因為目前的台灣,絕大多數的狗狗並沒有很好的社會化行為,所以在鼓勵外 出的情況下,我們仍然建議施打,切勿為了省錢而讓你的狗狗沒有社會化的行為! 而貓咪FIP(傳染性腹膜炎,由)的感染率約1:5000,而疫苗注射二週後的尖峰期也只 有60-80%的保護效果,而研究顯示貓咪在施打這種疫苗時必須是coronavirus free 的狀態而且抗體力價要低於1:100,可是卻有20-40%的貓的抗體力價超過1:100,所以 限制對沒有coronavirus的貓咪族群使用疫苗可降低感染率,而且改變飼養管理方式 會比疫苗注射來得有效!(如增加貓砂盆的數量,降低飼養密度….等等) 而FeLV(貓白血病)是一種致命性的傳染病,而且在自然感染下復元後的貓咪仍然會再 次的感染,也是最容易引發sarcoma的疫苗之一,在台灣,我們建議在有機會接觸病原 危險的幼貓開始注射. Chlamydia psittaci和Microsporum canis在貓咪並不會致命,也不常見,疫苗施打只 能減輕臨床症狀,所以前者除了有懷疑感染此菌的貓咪以外並不建議施打,而後者比 較建議用來治療而非預防!這些non-core疫苗的注射如果需要時,使用頻率和 core vaccine是一樣的 而狂犬病目前因為嚴重的人畜共通及法令的問題,目前仍以各地的法令為依據. 所以現在我們建議的施打方式如下: (犬貓皆同) 六週以上開始注射第一劑,之後每三到四週打一次,一直打到牠滿十六週齡, 一歲四個月時補強一劑,之後每三年補強一劑 若是您的犬貓年齡是超過四個月的,而又沒有確認的疫苗記錄,在檢查沒問題之後, 隔年再補強一劑,之後每三年施打一次! 而施打的種類就請您的醫生給您建議了,要依照每一隻動物的不同狀況給予不同 的建議!! 對於動物醫院的醫生,我們很抱歉,因為這樣的文獻只會減少您的收入,但是這是對 的事情,必須讓飼主知道,我們會在本文的最後提供文獻資料以供閱讀,對於飼主, 雖然您不用每年跑醫院打預防針了,但是如果您沒有遵照上述的方式來打的話, 您的寵物就非常容易發生重大疾病,請一定要遵守幼年的預防注射方式,才能確保牠 們得到足夠的免疫能力!! 對於每一位飼主,雖然您可以三年才去打一次疫苗,但是請您每年一定要回醫院檢查, 最基本的全身健康檢查以及每年兩次的心絲虫篩檢(犬貓皆同),以及每年的洗牙是 更重要的,不要因為可以三年打一次預防針,就真的三年跑一次醫院,這三年,犬貓等 於過了十二年,請您仍然每年定期帶去醫院一趟,我們建議您安排在您生日那一天之 後,這樣比較不會忘記,對於疫苗太常注射所引起的問題如溶血性貧血以及纖維組織 瘤的部份將在下一回開始的大敦電子報中開始介紹,若有興趣的人,到時後請再看看! 大敦寵物醫療中心將從2002年10月15日起,全面改變預防注射的方式, 因為關心,所以用心 文獻資料來源: American Veterinary Medical Association's Council on Biologic and Therapeutic Agents: Canine and feline immunization guidelines. J Am Vet Med Assoc 195:314, 1989. 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Kolar JR, Rude TA: Duration of immunity in cats inoculated with a commercial feline pneumonitis vaccine. Vet Med Small Anim Clin 86:1171-1173, 1981. 56. Wasmoen T, Chu HJ, Chaves L, et al: Demonstration of one year duration of immunity for an inactivated feline Chla- mydia psittaci vaccine. Feline Pract 20:13-16, 1992. 57. Welsh R: Bordetella bronchiseptica infections in cats. J Am Anim Hosp Assoc 32:153-158, 1996. 58. Willoughby K, Dawson S, Jones R, et al: Isolation of B. bronchiseptica from kittens with pneumonia in a breeding cattery. Vet Rec 129:407, 1991. 59. Rojko J, Hardy W Jr.: Feline leukemia virus and other retrovi-ruses. In Sherding R (ed): The Cat. Diseases and Clinical Management, 2nd ed. New York, Churchill Livingstone,1994, pp. 263-432. 60. Haffer KN, Koertje WD, Derr JT, et al: Evaluation of immuno-suppressive effect and efficacy of an improved potency feline leukaemia vaccine. Vaccine 8:12—16, 1990. 61. Tompkins MB, Tompkins WAF, Ogilvie GK: Immunopatho-genesis of feline leukemia virus infections. Companion Anim Pract, July 1998, pp. 15-26. 62. Pedersen NC: An overview of feline enteric coronavirus and infectious peritonitis virus infections. Feline Pract 23:7-20, 1995. 63. Gerher JD, Ingersoll JD, Cast AM, et al: Protection against feline infectious peritonitis by intranasal inoculation of a temperature sensitive FIPV vaccine. Vaccine 8:536-542,1990. 64. Fehr D, Holznagel E, Bolla S, et al: Placebo controlled evaluation of a modified live virus vaccine against infectious perito nitis: Safety and efficacy under field conditions. Vaccine15:1101-1109, 1997. 65. Hill S, Cheney J, Taton-Allen G, et al: Prevalence of enteric zoonoses in cats. J Am Vet Med Assoc 216:687-692, 2000. 66. Greene C, Dressen D: Rabies. In Greene CE (ed): Infectious Diseases of the Dog and Cat, 2nd ed. Philadelphia, WB Saun- ders, 1998, pp. 114-126. 67. Macy DW, Chretin J: Local postvaccinal reactions of a recom-binant rabies vaccine. Vet Forum, August 1999, pp. 44—49. 國外參考網站: http://www.cavaliersonline.com/health/vaccinenew.htm http://www.vmth.ucdavis.edu/vmth/clientinfo/info/vaccinproto.html http://www.inkabijou.co.uk/vaxine.htm http://rrcus.org/assets/html/about/health_genetics/MansfieldVaccine.pdf http://www.vth.colostate.edu/vth/savp2.html -- 我家阿毛的 BLOG 歡迎有空來串門子 http://spaces.msn.com/members/DearAmour/ 不過很久沒去更新了～～ --

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