咨询描述：我家狗狗昨天吐了一次，里头带一点血丝，但是精神可以，鼻子也是湿的，昨天去医院拍了个DR，医生说胃部没有异物，然后血常规也是正常的。还给开了三粒消炎药和一盒益生菌，一粒消炎药昨天中午医生给我家狗喂了，剩下两粒我还没敢喂
回复总结：狗狗出现呕吐带血的症状，主要病因有：异物损伤食道、胃黏膜损伤、胃十二指肠炎症或者溃疡、胰腺炎、肝脏疾病等。如果狗狗除了呕吐没有其他异常症状，并且吃了大量的薯类，可能是胃十二指肠炎症或者溃疡的可能性比较大，治疗方面建议给狗狗口服宠物专用广谱消炎药，同时配合服用治疗胃溃疡的药物。如果条件允许，建议带狗狗去宠物医院做胃镜检查，然后根据确诊结果对症治疗。
问题大致一样，细节不同？
陆文健
执业兽医师
看了您发来的血常规，没有大的问题，DR片子胃内没有明显的异物。根据您目前提供的信息，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、狗狗品种、年龄、体重、公母、有无免疫、有无驱虫？
2、狗狗昨天呕吐一次，出现血丝，到今天现在为止，还有没有发生过呕吐？呕吐物有没有血丝？
3、狗狗这两天大便怎么样？吃食怎么样？
4、狗狗有没有咳嗽、气喘、多饮多尿等症状？或者狗狗还有其他异常现象？
以上这些情况您仔细回忆后详细的描述给我，对我给狗狗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。
1、泰迪，灰色的，公狗，7岁，4.8公斤，有免疫，近期没有驱虫；
2、到今天为止没有再吐了，只吐了昨天早上那一次；
3、这两天大便正常，成型，昨天早上吐了以后没有再敢喂吃食跟水，只昨天晚上喂了一点点稀粥，它倒是一直想吃零食，但是我没给它吃；
4、咳嗽、气喘、多饮多尿都没有，其他异常现象就是不愿意吃饭跟喝水，其余没有异常情况
陆文健
执业兽医师
狗狗平时一般给它喂那些食物？
不愿意吃饭和喝水这种现象有多长时间了？
以前狗狗有没有偶尔吐黄水的现象？
1、平时早上喂糌粑（是粗粮），然后偶尔喂点宠物零食，晚上是狗粮加各种肉肉（宠物店卖的拌狗粮的），偶尔喂点苹果，削皮后只给果肉部分，然后因为它现在年龄大了牙齿不好，我学着网上的自制狗粮的做法给他做过两次，最近这段时间吃的大部分都是自制狗粮，是红薯紫薯西兰花老南瓜鸡胸肉，蒸熟后和在一起，再加一点糌粑，然后给它喂，是不是因为这个食物它的肠胃有点不耐受导致它胃里东西没消化然后就急性胃炎？
2、就这两天，不愿意吃狗粮，但是看得出来想吃零食，老是盯着零食的方向撒娇
3、有的，感觉我家狗胆不好，喂蛋黄十次理由可能会有一次会吐，就是吃下的东西吐了出来
陆文健
执业兽医师
狗狗呕吐带血，主要病因有：异物损伤食道或者胃黏膜、胃十二指肠炎症或者溃疡、胰腺炎、肝脏疾病等原因导致，目前来看，您的狗狗除吃食喝水少以外，没有其他明显的症状，不太可能是胰腺炎或者肝脏疾病；由于DR拍片食道、胃内没有看到明显的异物，所以异物导致食道和胃粘膜引起出血的原因，基本上也可以排除。目前看了您的描述，您的狗狗吃了大量的薯类（纤维素含量太高）、糍粑（太黏），另外狗狗牙齿不好，偶尔有呕吐，也就是您说的狗胆不好，我的判断狗狗可能是胃十二指肠炎症或者溃疡的可能性比较大，如果要确诊，可能需要做胃镜检查。
目前医院给您狗狗配的药物时***和益生菌，***是抗菌类药物，主要治疗呼吸道、泌尿道、皮肤等感染发炎，对于胃和十二指肠炎症或者溃疡，效果不明显。
目前我给您的建议是：
1、可以尝试治疗胃炎和胃溃疡的药物进行治疗，治疗5天后，观察狗狗吃食情况和呕吐情况；
2、或者您继续观察，如果狗狗呕吐症状变严重的话，再来复诊。
如果您需要使用药物尝试治疗的话，我可以给您的狗狗开个处方，供您参考。
刚才上传的图片中有一个是这边医生开的消炎药，狗狗能吃吗，而且这几天它能吃什么饭，能喝什么，可以喝益生菌吗？
陆文健
执业兽医师
1、照片上的药物时恩诺沙星，狗狗可以吃，但对于狗狗可能帮助不大；
2、可以给狗狗喂益生菌，益生菌主要对于肠道功能有帮助，但喂益生菌的时候，不要和恩诺沙星同时服用；
3、关于狗狗食物问题，我这里给您比较详细说明一下：我给您的建议是狗狗主要还是以狗粮为主，狗狗牙齿不好，可以把狗粮泡软后饲喂。关于自制狗粮，我不建议使用薯类（红薯和紫薯），薯类有对于胃刺激的某些因素；另外不建议喂较多的粗粮类的谷物。
如果自制狗粮，建议使用少量玉米粉或者粳米+碎鸡胸肉+少量碎胡萝卜或者少量碎南瓜+少量西蓝花，少放盐和油，熬成稀饭。
平时适当补充纯酸奶，新鲜的瓶装酸奶最好，对胃肠道的消化功能有帮助。
您的狗狗注意少喂零食，不需要补充蛋黄。
好的，谢谢医生，那我现在可以给他喂饭了吗，喂完饭间隔个半小时可不可以给他喂酸奶，益生菌跟酸奶的功效其实差不多是吧？
陆文健
执业兽医师
根据狗狗可能是胃十二指肠炎症或者溃疡的情况，下面我给它开个处方。处方里面的：
1、保灵西替康 ，治疗应激性溃疡和上消化道出血；
2、保灵胃溃宁，治疗犬猫消化道溃疡（胃、十二指肠为主）。
您可以根据需求自行选择购买。
建议处方：
1、保灵西替康 西咪替丁片，0.1g×24片/盒，一次口服0.5片，一天2次，连用5-7天；
2、保灵胃溃宁（大）硫糖铝片，0.5g×8片×3板/盒，一次口服0.5片。一天2次，连用5-7天。
陆文健
执业兽医师
家长你好！考虑到目前的问诊暂未沟通出结论，我额外赠送你3次追问次数，以顺利完成本次问诊咨询。
陆文健
执业兽医师
1、您可以给狗狗喂饭，这种情况不需要禁食禁水；
2、益生菌和酸奶功能是有相似，但酸奶还有保护胃肠道粘膜的功效；
3、我给您的狗狗开了处方，供您参考，这个处方主要是针对狗狗胃十二指肠炎症或者溃疡进行治疗，您自己考虑需要不需要尝试治疗。
谢谢医生，我现在可以给他喂饭吗，喂完饭半小时以后能不能再喂一点酸奶，另外，酸奶和益生菌的功效是不是差不多？
陆文健
执业兽医师
1、您可以给狗狗喂饭，这种情况不需要禁食禁水；
2、益生菌和酸奶功能是有相似，但酸奶还有保护胃肠道粘膜的功效；
3、我给您的狗狗开了处方，供您参考，这个处方主要是针对狗狗胃十二指肠炎症或者溃疡进行治疗，您自己考虑需要不需要尝试治疗。
陆文健
执业兽医师
感谢您对蘑菇宠医的信任，如果我的回答能够帮助到您，请您在咨询结束后留下5星评论。后续宠物有其它问题，您可以到“蘑菇宠医”官方微信公众号找到我的医生继续向我提问。谢谢您的支持和鼓励，祝您的爱宠早日康复！
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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