小動物疾病系統

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犬慢性支氣管炎
作者
潘翊諗、賴政宏、鄭豐邦
中文病名 犬慢性支氣管炎
英文病名 canine chronic bronchitis
疾病描述

 病因:

此病的特色為小氣道內急性炎症反應,若持續咳嗽超過兩個月則開始懷疑是慢性支氣管炎。好發於中年齡犬隻。

多數原因不明,但犬傳染性氣管支氣管炎(博德氏菌)或傳染性病原體感染皆可能繼發本病。另外,灰塵、香菸等刺激物都會使患有慢性支氣管炎更加嚴重。

未經診斷的慢性支氣管炎長期損害呼吸道,導致受感染的支氣管內蓄積黏液和濃汁而擴張。慢性咳嗽也會造成肺泡增大,嚴重者出現肺氣腫。以上兩種疾病為不可逆性的,並逐漸發展成慢性肺病和鬱血性心衰竭。

臨床症狀:

犬隻因激烈運動及興奮而引發咳嗽,於部分病例中可見乾咳,甚至乾嘔或吐出泡沫狀唾液,容易被誤認為嘔吐。

若無其他系統性疾病,患有此病的犬隻食慾及體重皆保持良好。

診斷方法

 1. 藉由病史、理學檢查及臨床症狀將其他可能造成咳嗽的病症排除。患有慢性支氣管炎犬隻的血液學和尿液學檢查多為正常;同時配合胸腔放射線學檢查。

2. 以內視鏡伸檢查氣道內直接觀察黏膜發炎情況,收集檢體並分析。

3. 以氣道沖洗膿樣分泌物並採集檢體。

治療方法

 1. 治療方向主要目的為降低支氣管炎正反應。給予療程約兩週的類固醇治療,若病情逐漸改善,可以每日或隔日低劑量給予。

2. 氣管擴張劑(例如. Theophyllinealbuterol)能幫助呼吸道暢通並降低呼吸疲勞,避免患犬發生喘息和氣道痙攣。

3. 若咳嗽情況加劇,可能為繼發細菌感染,此時適當的給予抗生素是必須的。止咳藥物可有效減緩咳嗽,但僅限短期間給予,因為這類藥物會干擾患犬的免疫力。另外,配合使用袪痰劑以消除膿性分泌物。

4. 氣道沖洗能有效移除管道過多及膿樣內分泌物。

預防控制方法

 1. 移除任何呼吸道刺激物質(例如.灰塵、煙霧等)降低緊迫,避免過度疲勞及興奮。

2. 體重過胖之犬隻應配合減重。

3. 許多犬隻患病後經治療可恢復,但仍需時常調整用藥。

相關圖片 <p>&nbsp;<span style="font-family: 標楷體;">圖一</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此為患有慢性支氣管炎和嚴重支氣管軟化犬隻的右背側內視鏡影像。左側圖氣道看似正常,但完全吸氣時管腔卻完全阻塞</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">(</span><span style="font-family: 標楷體;">右側圖</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">)</span><span style="font-family: 標楷體;">。</span></p>
<p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"><o:p></o:p></span></p>
Close<p>&nbsp;<span style="font-family: 標楷體;">圖一</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此為患有慢性支氣管炎和嚴重支氣管軟化犬隻的右背側內視鏡影像。左側圖氣道看似正常,但完全吸氣時管腔卻完全阻塞</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">(</span><span style="font-family: 標楷體;">右側圖</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">)</span><span style="font-family: 標楷體;">。</span></p>
<p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"><o:p></o:p></span></p>

<p>&nbsp;<span style="font-family: 標楷體;">圖一</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此為患有慢性支氣管炎和嚴重支氣管軟化犬隻的右背側內視鏡影像。左側圖氣道看似正常,但完全吸氣時管腔卻完全阻塞</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">(</span><span style="font-family: 標楷體;">右側圖</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">)</span><span style="font-family: 標楷體;">。</span></p> <p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體"><o:p></o:p></span></p>


<p>&nbsp;<span style="font-family: 標楷體;">圖二</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此圖為犬隻內視鏡氣道影像。第五級氣管塌陷</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">(</span><span style="font-family: 標楷體;">共分五級</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">)</span><span style="font-family: 標楷體;">。</span></p>
<p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"><o:p></o:p></span></p>
Close<p>&nbsp;<span style="font-family: 標楷體;">圖二</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此圖為犬隻內視鏡氣道影像。第五級氣管塌陷</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">(</span><span style="font-family: 標楷體;">共分五級</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">)</span><span style="font-family: 標楷體;">。</span></p>
<p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"><o:p></o:p></span></p>

<p>&nbsp;<span style="font-family: 標楷體;">圖二</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此圖為犬隻內視鏡氣道影像。第五級氣管塌陷</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">(</span><span style="font-family: 標楷體;">共分五級</span><span lang="EN-US" style="font-family: 'Times New Roman', serif;">)</span><span style="font-family: 標楷體;">。</span></p> <p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體"><o:p></o:p></span></p>


<p class="MsoNormal"><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">圖三</span><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"> </span><span style="mso-bidi-font-size:12.0pt;
font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">此圖為犬隻內視鏡氣道影像。左側支氣管至左前肺葉塌陷程度達</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">90%</span><span style="mso-bidi-font-size:12.0pt;
font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">。前後之中膈也都塌陷。</span><span lang="EN-US" style="mso-bidi-font-size:
12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體"><o:p></o:p></span></p>
Close<p class="MsoNormal"><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">圖三</span><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"> </span><span style="mso-bidi-font-size:12.0pt;
font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">此圖為犬隻內視鏡氣道影像。左側支氣管至左前肺葉塌陷程度達</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">90%</span><span style="mso-bidi-font-size:12.0pt;
font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">。前後之中膈也都塌陷。</span><span lang="EN-US" style="mso-bidi-font-size:
12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體"><o:p></o:p></span></p>

<p class="MsoNormal"><span style="mso-bidi-font-size:12.0pt;font-family:標楷體; mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">圖三</span><span style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體"> </span><span style="mso-bidi-font-size:12.0pt; font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">此圖為犬隻內視鏡氣道影像。左側支氣管至左前肺葉塌陷程度達</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">90%</span><span style="mso-bidi-font-size:12.0pt; font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">。前後之中膈也都塌陷。</span><span lang="EN-US" style="mso-bidi-font-size: 12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體"><o:p></o:p></span></p>


<p>&nbsp;<span style="font-family: 標楷體;">圖四</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此圖為犬隻內視鏡支氣管之影像。可見支氣管壁上皮細胞過度增生成結節。</span></p>
<p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"><o:p></o:p></span></p>
Close<p>&nbsp;<span style="font-family: 標楷體;">圖四</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此圖為犬隻內視鏡支氣管之影像。可見支氣管壁上皮細胞過度增生成結節。</span></p>
<p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體"><o:p></o:p></span></p>

<p>&nbsp;<span style="font-family: 標楷體;">圖四</span><span style="font-family: 'Times New Roman', serif;"> </span><span style="font-family: 標楷體;">此圖為犬隻內視鏡支氣管之影像。可見支氣管壁上皮細胞過度增生成結節。</span></p> <p class="MsoNormal"><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體"><o:p></o:p></span></p>


參考文獻

1. Fuentes VL, Johnson LR, Dennis S. Canine tracheobronchial disease. In: Johnson LR, McKiernan BC. Canine and feline cardiorespiratory medicine. 2nd ed. BSAVA, USA, 274-279, 2010.

2. Nelson RW, Couto CG. Disorders of the trachea and bronchi. In: Small animal internal medicine. 5th eds. Elsevier Saunders, USA, 297-304, 2014.

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