❞ كتاب Fallibility of faecal consistency as a criterion of success in the evaluation of oral fluid therapy for calf diarrhoea ❝

Fallibility of faecal consistency as a criterion of success in the evaluation of oral fluid therapy for calf diarrhoea

Fallibility of faecal consistency as a criterion of success in the evaluation of oral fluid therapy for calf diarrhoea من كتب طب بيطرى


The
primary
object
of
oral
rehydration
therapy
(ORT)
in
the
treatment
of
diar-
rhoea
is
to
correct
the
fluid
and
electrolyte
depletion
and
the
acid-base
disturb-
ances,
allowing
the
patient's
natural
defences
to
overcome
the
cause
of
the
diar-
rhoea
and
to
restore optimal
conditions
for the
normal
gut
flora
(Michell,
1983,
1994).
Specifically,
the
aim
is
to
treat
the
patient
rather
than
the
faeces
(Ludan,

76
BRITISH
VETERINARY.JOURaN.AL,
152,
1
1988;
Avery
&
Snyder,
1990).
The
most
important
single
objective
is
to
restore
plasma
volume
and
reduce
the
danger
of
circulatory
shock.
In
human
medicine,
from
the
earliest
days
of
ORT,
there
have
been
problems
with
resistance
from
patients
(or
their
mothers)
if
the
faeces
failed
to
improve,
or
if
faecal
loss
even
increased,
in
the
early
stages
of
therapy
(Carpenter,
1987;
Naylor,
1990;
Ribeiro
&
Lifshitz,
1991).
Indeed,
rehydration
may
increase
the
patient's
ability
to
produce
fluid
faeces
as
well
as
restoring
circulating
volume.
It
required
persistent
education
by
health
workers
to
persuade
mothers
that
this
did
not
matter
provided
the
child's
condition
was
improving.
Naturally,
it
implies
that
utilization
of
the
oral
rehydration
solution
(ORS)
is
less
than
perfect,
but
the
per-
fect
ORS
is
yet
to
emerge
in
either
human
or
veterinary
medicine.
In
veterinary
medicine,
the
analogous
problem
is
obviously
important:
faced
with
a
tardy
improvement
in
faecal
appearance,
the
farmer
oz"
the
veterinarian
may
well
conclude
that
they
should
t
o
,
something
different.
Worse,
the
European
Commission
(EC)
sets
particular
store
by
clinical
criteria,
notably
improvement
of
faecal
consistency
(as
reflected
in
faecal
score
(FS)),
in
judging
the
suitably
of
new
oral
rehydration
products
for
registration
(EC,
1999).
Yet
we
have
shown
that
clinical
criteria,
including
faecal
consistency,
are
hopelessly
insensitive
as
a
basis
for
comparing
the
efficacy
of
different
ORSs
(Michell
et
al.,
1999).
We
therefore
thought
it
important
to
examine
the
particular
question
'Does
improvement
of
faecal
appearance,
offer
even
a
crude
guide
to
the
effectiveness
of
an
ORS
in
restoring
plasma
volume?'.
We
thought
it
important
to
use
mainstrealn,
conven-
tional
ORT
rather
than
novel
solutions
to
answer
it,
hence
our
choice
of
the
two
most
widely
used
veterinary
oral
rehydration
products
in
the
UK
for
our
treat-
ment.
The
focus
of
the
study,
however,
is
not
the
effectiveness
of
the
products
but
the
prognostic
value
of
faecal
improvement
in
gauging
the
success
of
oral
rehy-
dration
therapy.
METHODS
General
Our
methods
have
been
published
in
detail
(Michell
et
aL,
199 . المزيد..