繼續翻譯異位性皮膚炎之四,

有興趣的朋友可以在下面的連結看到貓之異位性皮膚炎之一, 之二, 之三的資訊:

之一: http://littlevet.pixnet.net/blog/post/27452484

之二: http://littlevet.pixnet.net/blog/post/27454702

之三: http://littlevet.pixnet.net/blog/post/27455712

 

 

 

以下文章翻譯自Dr. Jon (以下會貼上原始連結以及原文)

現今有兩個比較主要治療異位性皮膚炎的方式: 藥物治療以及免疫治療.

最理想治療大部分中等程度到嚴重的異位性皮膚炎的方式就是合併兩種治療方式.

藥物治療可以緩解異位性皮膚炎的症狀, 但是並不是治療過敏本身的問題.

大部分有異位性皮膚炎的貓咪都很年輕, 且需要很多年的治療. 治療的部分可能會包含著下列一個或多個方式:

1. 抗組織胺: 抗組織胺的藥物不像在人有效, 抗組織胺只能幫助約25-30%的異位性皮膚炎的貓咪.

但是通常可以在一開始的時候試試看, 因為它不像其他類固醇的藥物有比較多的副作用. 有些貓咪對於某些抗組織胺的效果比其他的好,

所以你的獸醫可能會試試看2-3種不同類型的抗組織胺看看, 再知道你的貓貓是不是對於抗組織胺有反應.

2. 脂肪酸補充也有可能可以減緩因免疫反應造成的搔癢症. 有一些脂肪酸像是魚油,

可以幫助改變細胞膜的化學組成進而改變免疫反應產生的化學物質. 就像抗組織胺一樣,

這些產品並不能改變所有異位性皮膚炎的貓咪, 但是這些藥物卻十分安全. 有些貓對於抗組織胺可能沒什麼明顯的反應,

但是如果搭配著脂肪酸一起服用就會有可能有效果.

3. 二次性的細菌性感染也很常出現在有異位性皮膚炎的貓咪身上.

因此, 有異位性皮膚炎的貓咪有時候是會需要抗生素來治療膿皮症的. 皮膚的酵母菌感染也有可能需要一併治療.

4. 洗毛精治療對於控制搔癢症也可能有效果. 像是有些洗毛精是含有燕麥成分的,

此種洗毛精有對於皮膚有緩和以及保濕的效果, 所以也會被用於比較乾燥的皮膚.

有些含有燕麥的洗毛精甚至含有局部麻醉或是局部類固醇的效果, 因此他們是非常安全且對於搔癢症是有幫助的!!

5. 當以上的方式都沒辦法達到治療的效果之後, 類固醇可能就得被使用了.

這種藥物對於有異位性皮膚炎的動物非常有效果. 但是這種藥卻有副作用, 所以沒辦法被長期使用.

所以如果沒有小心使用的話, 貓咪可能會承受很嚴重的副作用. 這些副作用比較常見的有喝水的量變多, 排尿的量增多, 增加食慾, 最後會變胖.

也會有免疫抑制的問題進而達到二次性感染的問題. 類固醇也會對胃有刺激性, 也會對肝臟有不好的影響, 甚至對於正常的腎上腺會有抑制的現象.

短效口服類固醇是比長效施打型的類固醇要來的安全的, 因為口服的很快就會被身體所排泄掉, 而長效施打型的類固醇則只能用在很難餵藥的貓身上.

6. 免疫治療在理論上是最理想的治療異位性皮膚炎的方式. 這種方式被建議在沒辦法安全及有效的控制異位性皮膚炎症狀的貓身上.

免疫治療的真正機制還尚未明朗, 但是為了就是讓免疫系統對於過敏原不要反應這麼大. 這種治療方式對於60-80%的異位性皮膚炎貓咪都有效果.

現今有特定的過敏原萃取物已經可以用來測試. 一開始, 會把小量的萃取物, 頻繁的, 且逐量增加的打進貓咪的身上.

因為頻繁的注射過敏原萃取物, 你的獸醫通常會教你要怎麼在家裡施打. 一旦過敏原累積到一定的量之後,

每次施打的間隔就會漸漸增長. 這種方式改善的速度比較緩慢, 可能會花3-6個月才會有明顯的改善.

此時, 抗組織胺, 脂肪酸, 以及有緩和皮膚效果的洗毛精就可以合併使用.



原文以及連結:
http://www.petplace.com/cats/atopy-in-cats/page4.aspx

Two primary forms of treatment for atopy are available: drug treatment and immunotherapy. The ideal treatment for most moderately and severely affected animals is some combination of both types of treatment. Drug therapy relieves the symptoms of atopy but does nothing to treat the underlying allergy itself. Most cats with atopy are young and may require years of therapy. Treatments for atopy may include one or more of the following:

  • Antihistamines are much less helpful in atopic cats than they are in humans. Antihistamines help only 25 to 30 percent of atopic cats, but often are tried first because they have fewer adverse effects than do the cortisone-like drugs (i.e., corticosteroids). Some animals respond better to one antihistamine than to others, and your veterinarian may try 2 or 3 different types of antihistamines before concluding that they are not helpful in a given cat.

  • Fatty acid supplements may relieve itchiness (i.e., pruritus) by modulating the immune response. Certain fatty acids such as eicosapentanoic acid (found in fish oil) help change the chemical composition of cell membranes and ultimately the types of chemical mediators (i.e., prostaglandins) produced during the allergic response, resulting in a milder response. Like antihistamines, these products are not helpful in all affected animals, but they are very safe. Some cats that do not respond well to antihistamines may respond to a combination of antihistamines and fatty acids.

  • Secondary bacterial infections are common in cats with allergic skin disease. Therefore, cats with atopy occasionally need antibiotics to treat complicating pyoderma. Yeast infections of the skin and ear also have to be treated occasionally.

  • Shampoo therapy may be very helpful in managing itchiness (i.e., pruritus) caused by atopy. Shampoos that contain colloidal oatmeal are soothing and moisturizing, and can be used frequently without drying the skin. Some oatmeal-based shampoos contain topical anesthetics or topical corticosteroids that are very safe and further help reduce itchiness (i.e., pruritus).

  • When the above treatments are no longer effective, corticosteroids such as prednisone may be used. This class of drugs is very effective in atopic animals. Unfortunately, however, these drugs have many potential adverse effects that restrict their long-term use. Cats can experience severe adverse effects if corticosteroids are not used carefully. Examples of the adverse effects of corticosteroids include increased water consumption (polydipsia) and urinations (polyuria), increased appetite and food intake (polyphagia) leading to obesity, suppression of the immune system leading potentially to secondary infections, irritation of the stomach, alterations in liver function tests, and suppression of normal adrenal gland activity.

    Short-acting, orally-administered corticosteroids are safer than long-acting injectable corticosteroids because the former can be cleared rapidly from the animal's body in the event of adverse effects. Long-acting injectable corticosteroids should be reserved for use in cats that resist administration of oral medications.

  • Immunotherapy (hyposensitization, desensitization, allergy shots) theoretically is the ideal form of treatment for atopy, and is recommended for cats that cannot be managed safely and effectively with symptomatic therapy. The exact mechanism by which immunotherapy works is not well understood, but the goal is to induce tolerance by the immune system to allergens to which the animal is sensitive. This technique is effective in 60 to 80 percent of atopic cats.

    An extract of the allergens selected by allergy testing is prepared. Initially, a small amount is injected frequently (every 1 to 2 days) and the dosage gradually increased. Due to the frequency of injections, your veterinarian usually will show you how to administer the injections at home. Once the cumulative dose reaches a certain level, the injection interval is slowly increased until injections are given every 2 to 3 weeks. The interval may then be maintained for a relatively long period of time. Improvement is gradual and your cat may not benefit markedly for the first 3 to 6 months of immunotherapy. Antihistamines, fatty acid supplements and soothing shampoos may be used while immunologic tolerance develops.
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