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預防注射

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,

狗的核心疫苗如下:
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,

貓的核心疫苗如下:
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

上述的核心疫苗是一定要施打的,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!

非核心疫苗:
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.
狗的非核心疫苗有
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
1. 博氏桿菌(犬舍咳-) bordetella bronchiseptica引起
4. 梨型虫Giardia

而貓的非核心疫苗有
2. 博氏桿菌(犬舍咳)-bordetella bronchiseptica引起
3. FIP(傳染性腹膜炎)-coronavirus 引起
4. FeLV(貓白血病)leukemia virus 引起
5. Chlamydia psittaci
6. 梨形虫Giardia
7. 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,甚至於會造成嚴重的腎臟傷害,您可以依照所處的環境以及飼養及生活習慣來做決定,必竟非核心疫苗的效力往往不到一年,即使每年施打也一樣有空窗期。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

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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

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