咨询描述：1⃣️猫咪之前脖子上秃了一块但是我们在上海，不能出门问诊，找的网上医生说是真菌感染用了一个星期盐酸特比萘酚软膏和一个星期的皮特芬，现在长出了毛但是毛中还有一点点黑色小颗粒，2⃣️另外今天发现它耳后有一个地方秃了，如图示和脖子之前秃的部位一样，是真菌感染吗？3⃣️还有它的爪子从上个主人接过来它的爪子就是这样了两个月都没好，有涂碘伏。
回复总结：猫咪毛囊炎和猫癣比较相似，毛囊炎的症状起初为小黑点，后转变为脓疱疹，常出现在猫咪下巴以及背部、尾部，猫癣的症状为圆形、不规则形或者全身性的脱毛，伴有皮屑，有些还可能有红斑、丘疹和结痂，可全身性发作。猫咪毛囊炎需要给猫咪口服治疗毛囊炎的抗生素，外抹治疗毛囊炎的药膏，然后每三个月给猫咪做一次体内驱虫，每一个月做一次体外驱虫，可以很好的降低感染毛囊炎的风险。如果是猫藓需要带猫咪去宠物医院进行检查确诊。
问题大致一样，细节不同？
刘文飞
执业兽医师
根据您讲到的详细症状，我初步分析猫咪是皮肤病的症状，但仅仅根据目前信息还不能做出进一步的判断。我还有几个问题需要向您核实一下:
1.您家猫咪快三岁了，体重大概是6千克，脖子用了治疗真菌的药，有好转，其他部位有没有类似的症状，指甲周围有发炎的症状，只用过碘伏，有没有吃过消炎药，图片二所示的地方有没有掉皮屑，皮肤红肿，毛毛里有黑点点，那你多久给猫咪洗一次澡，用的是什么浴液，有没有吹干。
2.您养猫咪大概多长时间了，猫咪平时都吃哪种食物，最近有没有给猫咪换过食物或者吃过什么特殊的东西，骨头之类的坚硬物，导致猫咪出现呕吐的症状，呕吐的是未消化的食物，还是白色粘液，或者黄色粘液，有没有血丝，有没有腹泻的症状;
3.猫咪吃饭，喝水，排便，排尿，玩的状态怎么样
4.猫咪有没有出现咳嗽，打喷嚏，流鼻涕的症状，您正常有没有给猫咪用过什么药;
5.猫咪目前精神状态怎么样，有没有吃东西，喝水，猫咪有没有接种过疫苗，做过体内体外的驱虫。
6.猫咪居住的环境有没有突然降温，猫咪趴在垫子上，还是地板上，家里几只猫咪
以上这些情况您仔细回忆后详细的描述给我，对我给宝贝目前情况做判断以及制定治疗方案有非常大的帮助，感谢您的配合。另外，把您家爱宠的信息补充完整，特别是年龄、体重」，待会儿咱们沟通后如果涉及用药建议，方便为宝贝开具处方。
1.猫咪吃饭睡觉玩耍一切正常，它平时就很调皮上窜下跳，可能是玩的时候受伤的。
我养他从三月到现在，快三个月了，之前的情况不太清楚。
2.⚠️没有口服任何药物。只做一个月一次的驱虫，内服一次在三月份，外用两次分别是3月/4月。我接到家三天后洗了一次澡，大概是3.15，昨天刚刚洗了一次然后吹干了。洗澡的沐浴露我发图给您
3.猫咪之前吃的纯福全期。五月底这个星期在过渡猫粮换成高爷家黑袋装，这个也拍给您了。
4.猫咪之前有过一次吐了的情况，在四月份，吐在沙发上，我早上看到已经干了，网状透明白色的。还有一次小便在客厅，大便在我的卫生间，不是同一天，间隔大概一两个星期。
我家只养了一只猫，但是在一楼，外面有很多流浪猫。
为保护用户隐私不显示图片/视频
1.之前的脖子上患处有过红肿然后长毛的时候结痂蜕小皮屑。
2.猫咪大小便除了那两次不在猫砂盆其余正常，为条状深色。无腹泻无虫卵，它喜欢趴在各种垫子上。
3.前主人说是小时候接种过疫苗，具体情况未知。驱虫有做外用每个月，内服只有三月一次。
4.除了上诉之外偶尔也吃水煮鸡肉和蛋黄
5.有过突然降温，它有时候会打喷嚏的。流鼻涕没有不过它眼角分泌物有点多，我每天用湿巾轻轻擦拭它的眼角。
6现在就是它的耳朵后面又有了，并且伴随抓挠。它脖子没好之前一直带着伊丽莎白圈。并且外用***喷剂一星期➕软膏一星期。
7.有什么其他变化就是它最近更爱睡觉了。
8.伍德氏灯未检测出其他反应，之前的患处也是，没有苹果绿的颜色，弄得我给他用药的时候也心里没什么底。
刘文飞
执业兽医师
您好，猫咪主人，收到您发的图片，结合猫咪的具体症状来看，猫咪图三第一次患病时是什么样样子的，有没有掉皮屑的症状，猫咪目前的症状没有猫癣的症状，像这种脱毛掉毛的症状一般一个月才会长出新的毛毛来（28天是一个毛发的生长周期）猫咪皮肤的症状比较像是毛囊炎的症状，毛囊炎和猫癣比较相似，毛囊炎的症状起初为小黑点，后转变为脓疱疹，常出现在下巴以及背部、尾部，猫癣的症状为圆形、不规则形或者全身性的脱毛，伴有皮屑，有些还可能有红斑、丘疹和结痂。可全身性发作。猫咪毛囊炎需要给猫咪口服治疗毛囊炎的抗生素，外抹治疗毛囊炎的药膏，一般需要给猫咪清淡饮食，然后每三个月给猫咪做一次体内驱虫，每个月做一次体外驱虫，做体外驱虫，清淡饮食可以很好的降低毛病感染毛囊炎的风险。毛囊炎感染周期比较长，一般需要用药一个月左右才会好转，猫咪皮肤的症状就会有所好转。用药期间最好给猫咪带上伊丽莎白圈，再把猫咪的指甲修剪平整，防止猫咪出现抓挠，舔舐的症状，会有利于猫咪皮肤的早日康复。猫咪住的环境需要保持干燥，然后彻底的大消毒，以后每周消一次毒，猫窝拿出去晒晒太阳，有助于杀菌消毒，也可以让猫咪适当的晒晒太阳，不能晒的时间长，晒的时间长了猫咪患部会出现比较痒的症状，您自己照顾完猫咪也需要洗手、消毒，您用的沐浴液没有问题，换完猫粮要是没有出现呕吐腹泻的症状就是正常的，指甲的症状像是猫咪指甲夹伤造成的，需要给猫咪把指甲周围的猫咪清理干净，碘伏消毒，在吃消炎药，治疗毛囊炎的口服药和外用药猫咪就可以用。以上建议您可以参考一下。
好的感谢医生，那可否给开点药？还是我们人用的消炎药它可以吃吗？麻烦开一下药单吧谢谢您。
刘文飞
执业兽医师
根据猫咪的情况，我给它开个处方。处方里面的1.*********，对猫咪脖颈的炎症作用效果比较好，按猫咪的体重用药；2.**凝胶对猫咪皮肤表面消炎抑菌效果比较好，猫咪不能用人用药，人用药对猫咪有风险，猫咪要用宠物专用药
刘文飞
执业兽医师
我这边先开了一周的药，因为猫咪患部症状轻微，您先给猫咪用药观察症状，然后定期做好驱虫，指甲的部分要用药两周，指甲有可能会坏死长出新指甲来
医生建议及处方根据当前病情给出，仅适用于本次问诊
蘑菇宠医处方笺
用法用量需根据患宠的年龄、体重等信息开具，此处方暂不展示
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