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NON-SURGICAL CASTRATION IN MALE DOGS POSSIBILITY, AVAILABILITY AND HUMANITY Suppawiwat Ponglowhapan DVM (Hons), MS, MSc, PhD Department of Obstetrics Gynaecology.

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งานนำเสนอเรื่อง: "NON-SURGICAL CASTRATION IN MALE DOGS POSSIBILITY, AVAILABILITY AND HUMANITY Suppawiwat Ponglowhapan DVM (Hons), MS, MSc, PhD Department of Obstetrics Gynaecology."— ใบสำเนางานนำเสนอ:

1 NON-SURGICAL CASTRATION IN MALE DOGS POSSIBILITY, AVAILABILITY AND HUMANITY Suppawiwat Ponglowhapan DVM (Hons), MS, MSc, PhD Department of Obstetrics Gynaecology and Reproduction, Faculty of Veterinary Sciences Chulalongkorn University

2 Introduction Dr. Patricia N Olson

3  1970’s First awakening to pet over population at animal care & control facilities  “ … hundreds of dogs seems to have been euthanized due to some horrific diseases that was not one we have been taught about in veterinary school !” and “most of them are young and look healthy”. Introduction

4  “ How would the veterinary community respond to a disease that resulted in the death of between 10-25% of all dogs and cats each year? ” a vet student asked.

5 Introduction  In USA, over half of all households own a dog or cat (1:3 in UK,1:4 in BKK)  The human society of the United Stated estimated  8-10 millions dogs and cats enter shelters each year  4.5 millions of them are euthanized

6 Introduction  How many stray dogs in Mexico city? 1962: 460,000 dogs 1974: 900,000 dogs 2006: 3,000,000 dogs

7 Introduction  How many stray dogs in Bangkok? Family dogs580,000523,000- Stray dogs-110,000823,000

8 Introduction

9  In some countries, such as Sweden and Norway, pet overpopulation is not a problem and neutering pets is UNCOMMON.  Pet owners: responsibilities > rights

10 Pet overpopulation YearDog , , ,000 YearCat , , , ,092 82,072,514

11 Pet overpopulation 1. Social problem 2. Hygiene problem 3. Health problem: zoonosis  Texas (1977): stray dogs can produce 94,950 gallons of urine and 38.6 tons of feces per day.

12 Control of pet overpopulation The complexity of pet overpopulation  Human-animal bond  Pet owner responsibility  Animal sterilization/neutering Non purpose-bred dogs must be neutered!

13 Neuter  Neuter (Latin) = Neither (neither masculine or feminine)  adjective = The German word for 'book', 'das Buch', is neuter.  verb = Has your dog been neutered?  Neutering is the removal of an animal's reproductive organ, either all of it or a considerably large part. It is the most drastic surgical procedure with sterilizing purposes. (Wikipedia)reproductive organ sterilizing  Sterilizing (sterilize = to perform a medical operation on someone in order to make them unable to have children)  Female  Female; spaying (removal of the ovaries) OVH ovariectomy / ovariohysterectomy OVH  Male  Male; neutering, castration (removal of the testicles)

14 Castration Surgical VS Non-surgical (Permanent VS temporary)

15 Surgical Castration  Traditional neutering of male dogs  Surgical removal of the testicles of a male animal or human  Removing or inhibiting the function or development of the testes Dog testicles  Spermatozoa  Testosterone

16 Surgical Castration  Spermatozoa  Testosterone Sterility Loss of testosterone- dependent characteristics libido, roaming, urine spraying, aggression, etc.

17 Vasectomy  Cooper (1930) : first experimental vasectomy on a dog  Vasectomy & Castration

18 Vasectomy

19

20 Surgical Castration  Not all owners prefers to have their pets surgically sterilized.  In Brazil (Soto et al., 2005)  56.5% of owners (adopted shelter dogs) against surgical sterilization - Compassion (58.1%) - Unnecessary procedure (11.4%) - Cost (9.5%) - Behavioral change (4.8%)

21 Surgical Castration  In Thailand (Swangchan-uthai et al., 2005)  38.3% against contraception in dogs and/or cats (170/446) - Breeding purpose - Able to confine male dogs - Not necessary to have males neutered - Behavioral and physical change, i.e. obesity - Unsafe procedure - กลัวว่าตัวเองหรือแฟนจะเป็นหมัน... บาป !!!  61.7% prefer to have their pets neutered (276/446) % males, 39.8% females, 46.5% both % orchiectomy, 19.8% vasectomy, 7.7% reversible hormone implant

22 Non-Surgical Castration  No scalpel castration  Chemical castration Expectations for non-surgical castration As effective as gold standard (bilateral orchiectomy) No adverse effects (short-term and long-term) Safe Inexpensive Quick (can be applied to large-scale population) Reversible (?)

23 Non-Surgical Castration Hormonal treatment Progestogens, Androgens, GnRH analogues (agonist/antagonist) Intratesticular/intraepididymal injection Immunocontraception Ultrasound testicular ablation

24 Hormonal treatment

25

26 Steroid hormone (Progestogens, Androgens) Non-steroid hormone (GnRH analogues) Progestogen Androgens GnRH

27 Hormonal treatment Exogenous hormone Down regulation Temporary suppression of fertility

28 Hormonal treatment Steroid Hormone  In early 1930, isolated and determined structure of steriods  In 1937, reported progesterone inhibits ovulation in rabbits  No new products for control of reproduction in the dog and cat have been introduced during the last two decades, other than revised formulations and new brands of progestogens. Non-steroid Hormone  GnRH agonist  Suprelorin  (Deslorelin, Virbac)  Gonazon  implant (Nafarelin, Intervet)

29 Progestogen

30 Clinical use in the bitch Control of oestrus (suppression/prevention) Pseudopregnancy Hypoluteoidism Clinical use in the dog Antisocial behaviour Epilepsy Benign Prostatic Hyperplasia Contraception (+/-) Circum-anal adenoma

31 Progestogen: female Prevention of anoestrus Medroxyprogesterone Perlutex Perlutex mg/kg at 5 mth interval Promone-E Promone-E 50 mg/bitch at 6 mth intervalProligestone Covinan Covinan mg/kg - early proestrus - a series at 3, 4 and 5 mth intervals Side effects : type of hormone, dose, duration of repeated treatment, treatment regimen, stage of oestrus cycle and age of the animal

32 Progestogen: female Side effect Selman et al., 1994 glucose intolerance diabetes mellitus mammary tumors (50%) in treated OVH-bitches Use with Cautions Type of hormone Type of hormone Route of administration Route of administration Dosage Dosage Duration of repeated treatment Duration of repeated treatment Stage of the cycle at initiation of the treatment Stage of the cycle at initiation of the treatment Age of the animal Age of the animal

33 Progestogen: male LH/FSH Spermatogenesis progestogen

34 Progestogen: male England, 1997 ProgestogensDosageRouteDurationResults Megestrol acetate2 mg/kgPO7 dNo change in semen quality Megestrol acetate4 mg/kgPO7 dMinor sperm abnormalities MPA10 mg/kgSC-No change in semen quality MPA20 mg/kgSC-Rapid decline in sperm motility, morphology and output No change in plasma LH concentration was detected as seen in females !!! MPA; medroxyprogesterone acetate Megestrol acetate The male dog appears to differ in the sensitivity of hypothalamo-pituitary response to progestogen feedback

35 Progestogen: male  Not recommended for contraception in the male dog 1. ineffective 2. adverse effects Selman et al., 1994 glucose intolerance diabetes mellitus

36 Androgen AndrogensDosageResultsReferences Mixed testosterone ester5 mg/kgDecline in sperm motility (wk 3-15 post injection) England, 1997 Methyltestosterone50 mg (90 d) Decreased daily sperm output Freshman et al., 1990

37 GnRH analogues  Agonists  Suprelorin  (Deslorelin, Virbac)  Gonazon  implant (Nafarelin, Intervet)  Antagonists  Acyline (Merrion Pharmaceuticals)

38 Deslorelin implant Hypothalamus Anterior pituitary Ovary, Testis GnRH LH, FSH Oestrogen Testosterone

39 Deslorelin implant

40

41 15 d pre-implant 15 d post-implant recovery

42 Deslorelin implant Deslorelin Suprelorin 4.7 mg implant for dogs has been licensed in EU. Indication: For the induction of infertility in healthy, non-castrated, sexually mature male dogs

43 Deslorelin implant Castration 50% in 3 rd week 70% in 9 th week (Barsanti and Finco, 1995)Finasteride 40% in 16 th week (Sirinarumitr et al., 2001)Deslorelin 40% in 4 th week (Ponglowhapan et al., 2010)

44 Deslorelin implant SAMSON Golden retriever 7 years old Urination difficulty BPH Before and 14-day post treatment of Deslorelin implant

45 Deslorelin implant Prostatic volume [(L x W xD)/2.6] (Kamolpatana et al., 2000) Before = 42.0 cm 3 14-d after = 38.5 cm 3

46 Intratesticular injection

47  In 1953  In 1953, Freund et al. Aspermatogenesis in the guinea pig induced by the testicular tissue and adjuvants. J Exp Med. 97: sclerozing/necrotizing agents aspermatogenic orchitistissue sclerosisinfertility  Injection of sclerozing/necrotizing agents into the testes to induce aspermatogenic orchitis and tissue sclerosis resulting in infertility Local inflammatory response Autoimmone response

48 Different Sites of injection Intratesticular injection Intraepididymal injection Vas deferen injection

49 Intratesticular injection  Sclerosing agents o Zinc gluconate (Levy et al., 2008) o 20% hypertonic saline (Emir et al., 2008) o Glycerol (Immegart et al., 2000) o 1.5% chlorhexidine gluconate in 50% DMSO (Pineda et al., 1977) o Calcium chloride (Jana and Samanta, 2007)

50 Intratesticular injection Active ingredientDogs treatedDosage/RouteResultsReferences Zinc arginine2-3.5 yr, n = 10 50mg (0.5mL)/Caudal epididymal injection azoospermia in 90 days post- injection Fahim et al., 1993 Balanced zinc solutionAdults, n = 5Intratesticular injection azoospermia in 4 out of 5 dogs beginning between Day post-injection Tepsumethanon et al., 2005 Zinc gluconate with or without 0.5% DMSO Adults, n= or 26.2mg/ Intratesticular injection azoospermia, oligozoospermia, asthenospermia depending on dosage used and the presence of DMSO Soto et al., 2007 Zinc gluconate neutralized in physiological vehicle 8 mo to 4 yr, n = – 13.1 mg depending on testicular width/ Intratesticular injection Histological changes including degeneration, vacuolation, fewer germ cells, lack of spermatid in atrophic seminiferous tubules Oliverira et al., 2007 Zinc-based solution

51 Neutersol/Esterilsol  FDA approved in 2003

52 Neutersol/Esterilsol Zinc gluconate neutralized by arginine Recommendations 1. Labeled for chemical castration via intratesticular injection in the male dog 2. Age 3-10 months (puppy) 3. Predetermined amount of zinc solution based on scrotal width into each testis 4. Sedation is recommended Range of testicular width (cm)mL per testisMg Zinc

53 Neutersol/Esterilsol Neutersol injection Atrophy of the testis, epididymis, seminiferous tubles and prostate gland Scar tissue formation Prevention of sperm movement from seminiferous to epididymis 3-10 mth old puppies: 99.6% success (223/224)

54 Neutersol/Esterilsol Giant cell Spermatocyte necrosis

55 Surgical castration vs Intratesticular injection Surgical Method Intratesticular Injection เทคนิคและ บุคคลากร ต้องการเทคนิคและอุปกรณ์การผ่าตัด และต้องการสัตวแพทย์ผู้ชำนาญการ ผ่าตัด ไม่ต้องการเทคนิคมาก ใช้ บุคลากรน้อย ไม่จำเป็นต้องมี ทักษะการผ่าตัด การวางยาสลบ ต้องวางยาสลบ (General Anesthesia) ไม่จำเป็นต้องวางยาสลบ แต่ FDA (USA) แนะนำให้ใช้ยาซึม ก่อนการฉีด ความเจ็บปวด สามารถวางแผนระงับความเจ็บปวด ได้อย่างมีประสิทธิภาพ เกิดความเจ็บปวดจากการบวม อักเสบ ภายหลังการฉีด ร้อยละในการ คุมกำเนิด 100%99.6%

56 Surgical castration vs Intratesticular injection Surgical MethodIntratesticular Injection ระยะเวลาที่เริ่มมีผลใน การคุมกำเนิด 7 วัน 60 วัน สำหรับการใช้ Neutersol ลักษณะและจำนวนอสุจิ AzoospermiaOligozoospermia Asthenospermia Azoosspermia ฮอร์โมนไม่สามารถผลิต Testosterone สามารถผลิต Testosterone เนื่องจากยังมี Leydig’s cell เหลืออยู่บางส่วน พฤติกรรมไม่มีพฤติกรรมทางเพศยังมีพฤติกรรมทางเพศ

57 Surgical castration vs Intratesticular injection Surgical Method Intratesticular Injection ร้อยละของปัญหาแทรกซ้อน (Levy et al., 2008) ลักษณะของปัญหาแทรกซ้อน และการแก้ไข แผลแตก : ทำแผล เย็บซ่อม แผลหายเร็ว เนื้อตาย แผลรูเปิด ติดเชื้อรุนแรง : รักษาภาวะติดเชื้อ ผ่าตัดเอาอัณฑะ ออกเย็บตกแต่ง แผลหายช้า ลักษณะภายนอกไม่เห็นอัณฑะที่อยู่ภายในถุงหุ้มอัณฑะในถุงหุ้มมีขนาดเล็กลง และอาจไม่เท่ากัน Identification required* ค่าใช้จ่าย 800 – 2,000 บาทโดยประมาณ ราคาในประเทศไทย 1,651 บาท โดยคิดจาก Neutersol หนึ่งโดสต่อตัว เหรียญ สหรัฐอเมริกา

58 Intratesticular injection Recommendations 1. Information 2. Family dog / stray dog 3. Large scale control population 4. Skill 5. Animal identification 6. National policy Non-surgical castration in male dogs Possibility, availability and humanity

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ดาวน์โหลด ppt NON-SURGICAL CASTRATION IN MALE DOGS POSSIBILITY, AVAILABILITY AND HUMANITY Suppawiwat Ponglowhapan DVM (Hons), MS, MSc, PhD Department of Obstetrics Gynaecology.

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