The role of iatrogenic disease of cattle in admission to veterinary hospital

G. Sala, A. Boccardo, Eleonora Coppoletta, A. Belloli, D. Pravettoni
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Abstract

Iatrogenic diseases are due to negligence or malpractice (Pezza et al .,2008). In human medicine, these conditions are widely described (Weingart et al ., 2000), mostly for insurance issues related to hospitalization, while in veterinary medicine are reported only occasional case reports. 4155 clinical records related to cattle admitted to the Clinic for Ruminants and Swine of the University of Milan between 2005 and 2017 were analyzed. Clinical cases that required admission because of an iatrogenic related disease were selected for this study. For case selection, 3 experienced veterinarians examined the clinical records, cross-compared the selection and pick 114 cases (2,7%). The iatrogenic diseases were primarily caused by farmers (93%) than veterinary practitioner (7%). Iatrogenic diseases were caused mostly by erroneous administration of drugs (47,4%), excessive traction at birth (17,5%), improper milk or colostrum administration, frequently performed by oroesophageal tubing (16,7%) or by forced administration using a nipple bottle (12,3%). As verified by our study, farmers often performs medical, nursing and zootechnical procedures without adequate competences and sometimes choose medical treatment for sick animals without professional consultation of veterinarians.The veterinarian rule is fundamental in farmer education. Clinicians, especially in some professional branches as neonatology, should be more responsible of their assignments, avoiding delegation of specific procedures to unskilled staff. The importance of communication in improving management and health in dairy farms has been recently demonstrated (Jansen and Lam, 2012; Jansen et al ., 2010). Effective communication has a key role in dairy herd health and communication strategies are required to support diseases control programs (Lievaart et al ., 2008). More attention to iatrogenic issue may have a positive impact on animal and public health. Moreover, a decrease of unnecessary and injurious drug administration may result in a reduction of treatment costs and in prevention of antibiotic resistance.
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牛医源性疾病在兽医医院住院中的作用
医源性疾病是由于疏忽或医疗事故造成的(Pezza等人,2008年)。在人类医学中,这些情况被广泛描述(Weingart et al ., 2000),主要用于与住院有关的保险问题,而在兽医学中,仅偶尔报道病例报告。分析了2005年至2017年米兰大学反刍动物和猪诊所收治的4155例与牛有关的临床记录。本研究选择因医源性相关疾病而需要住院的临床病例。病例选择方面,3名经验丰富的兽医检查临床记录,交叉比对选择,选择114例(2.7%)。医源性疾病以农民(93%)为主,兽医(7%)居多。医源性疾病的主要原因是错误给药(47.4%),出生时过度牵引(17.5%),不正确的乳或初乳给药,经常通过口食管管(16.7%)或强行使用奶瓶给药(12.3%)。我们的研究证实,农民经常在没有足够能力的情况下进行医疗、护理和动物技术程序,有时在没有兽医专业咨询的情况下选择对病畜的治疗。兽医规则是农民教育的基础。临床医生,特别是在一些专业分支,如新生儿科,应该对他们的任务更负责任,避免将特定程序委托给不熟练的工作人员。最近已经证明了沟通在改善奶牛场管理和健康方面的重要性(Jansen和Lam, 2012;Jansen et al ., 2010)。有效的沟通在奶牛群健康中起着关键作用,需要沟通策略来支持疾病控制计划(Lievaart等人,2008)。对医源性问题的更多关注可能对动物和公众健康产生积极影响。此外,减少不必要和有害的药物管理可能导致治疗费用的降低和抗生素耐药性的预防。
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