咨询描述：我们家狗狗之前生病，医生诊断是犬肉芽肿性脑膜脑炎，现在一直在吃***，我想问下长期吃有什么副作用？还有现在两天吃四分之一粒，需要减量吗？
回复总结：针对狗狗嗜酸性肉芽肿，治疗方面可以给狗狗服用含有泼尼松龙成分的药物。但这种药物长期使用肯定有些副作用，主要副作用有：缺钙、骨骼疏松、抵抗力下下降、细菌真菌等病原微生物感染等。如果狗狗服用的剂量是不高的，这种低剂量长时间服用对狗狗影响不是很大。如果狗狗目前精神状态比较稳定的话，可以适当减量，改成3天口服一次1/4片。
问题大致一样，细节不同？
陆文健
执业兽医师
***是一种糖皮质激素类药物，主要成分是泼尼松龙，可以治疗嗜酸性肉芽肿类疾病有效。长期使用肯定有些副作用，但如果确定为嗜酸性肉芽肿只能使用泼尼松龙进行治疗，其他药物效果不明显。
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、狗狗的品种、年龄、体重、公母、有无免疫、有无驱虫？
2、狗狗发生肉芽肿脑膜炎有多长时间了？发病时主要有哪些症状？使用迈可舒效果很明显？
3、狗狗体重？目前迈可舒是怎么使用的？一次口服多少mg？一天口服几次？已经使用了多少天？
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，母，6岁，之前10斤，用药治疗后体重升到了12斤，没有免疫，有驱虫
2.今年四月初发病并送医治疗，发病时一开始抱她的时候她弓背，看起来像是背部或者腹部疼痛，医生诊断为脊髓炎，说先吃镇痛药并回家观察，后来几天内出现走路不稳、偏头、呕吐，流口水等症状，几乎不能走路，核磁检查确诊为脑膜炎，住院治疗，出院后服用迈可舒效果明显，多饮多食多尿
3.差不多出院半个月后开始减量，到现在是每两天吃四分之一颗（5mg)，已经使用了3个月
ps.目前感觉狗有点胖，不知道是不是吃药导致的，还出现了一些皮肤问题
为保护用户隐私不显示图片/视频
陆文健
执业兽医师
我先回答您的问题：
1、***（泼尼松龙）如果长期高剂量使用的话，主要副作用有：导致狗狗钙的流失，也就是可能会引起缺钙，导致骨骼疏松；抵抗力下降，容易导致细菌、真菌等病原微生物感染的疾病；
2、目前您的狗狗（6kg），两天口服1/4片泼尼松龙（5mg），剂量是不高的，这种低剂量长时间服用对狗狗影响不是很大；
3、关于是否减量的问题，如果狗狗目前精神状态比较稳定的话，可以适当减量，改成3天口服一次1/4片；
4、刚刚看了狗狗的皮肤，可能是细菌或者真菌感染的可能，这种情况和口服泼尼松龙也是会有一些关系的。
陆文健
执业兽医师
目前给您的建议是：
1、如果狗狗精神状态比较稳定，的话，可以适当减量，改成3天口服一次1/4片；
2、可以给狗狗补充钙剂，一个月给狗狗服用钙剂7天左右；
3、可以适当给狗狗口服抗生素，比如阿莫西林克拉维钾，防止使用泼尼松龙导致的体抗力低，细菌感染的可能，一周可以使用2-3天；
4、可以给狗狗补充复合维生素，增强狗狗的代谢功能。
下面我给您的狗狗开个处方供您参考。
1.那它这个脑膜炎对寿命的影响大吗？还可以活几年？当时的医生说的是按照国外文献，平均寿命只有一年了
2.请问它的皮肤病需要怎么治疗？涂抹碘伏可以吗，还是需要别的药物？
3.还有肥胖的话，这个是药物导致的吗？当时住院的时候体重降到了9斤，出院后一个月内涨了两三斤，也有控制饮食以及遛狗锻炼，但是效果不明显，目前在12.3-12.5斤之间徘徊
4.遛狗的时候出现呼吸急促、不太跑的动，当时做核磁的时候说炎症影响到了呼吸中枢，导致全麻的时候出现了长时间的呼吸停止，这个有关系吗？还是就是因为肥胖导致的？需要怎么做能让它身体好一点？
陆文健
执业兽医师
1、如果您的狗狗确诊是肉芽肿导致的脑膜炎，使用泼尼松龙治疗是有效的，我的观点是成活几年是可以的，但泼尼松龙可能需要长期服用；
2、狗狗这个皮肤病，目前还不能确定是真菌感染还是细菌感染导致，或者也是有可能长期使用泼尼松龙有关，使用碘伏没有什么效果，建议给狗狗口服复合维生素B，7-14天，观察皮肤的恢复的状况，再来确定是否检测真菌或者细菌后进行针对性治疗；
3、肥胖可能和服这个药物有关，但目前2天使用1/4片剂量，应该副作用不大，也是有可能和狗狗营养补充，健康后增加体重有关；
4、遛狗的时候出现呼吸急促，不喜欢运动，这种情况我是怀疑狗狗心脏功能的问题，尝试使用增强心脏功能的保健类药物，比如***，我在处方中开给您。
陆文健
执业兽医师
根据狗狗由于长期使用泼尼松龙，可能会导致体抗力下降、钙流失的情况，以及心脏功能的问题，下面我给它开个处方。处方里面的：
1、***，抗菌消炎，防止狗狗抵抗力下降导致的细菌感染；
2、*** 葡萄糖酸钙溶液，防止狗狗钙流失，导致骨骼疏松等问题；
3、***复合维生素B溶液，补血生血、保肝解毒、增强食欲和免疫力、增强机体抵抗力；
4、***，可预防和改善各种心血管问题，包括：心力衰竭，血栓梗塞，心律失常，心肌缺血等。
您可以根据需求自行选择购买。
建议处方：
1、***（阿莫西林克拉维酸钾片），50mg×10片/板，一次口服1片，一天2次，连用2-3天，每周服用2天；
2、*** 葡萄糖酸钙溶液，100ml/瓶，一次口服3ml，一天2次，一个月可以使用7-10天左右；
3、***复合维生素B溶液 ，70ml/瓶，一次口服3ml，一天2次，一个月可以使用7-10天左右；
4、*** 宠物营养补充剂，0.5g×30片/盒，一次口服1颗，一天1次，连用30天。
陆文健
执业兽医师
我上面给您开的药物主要是针对狗狗服用药物的辅助用，使用的保健类药物，请用药1 周后复诊，根据您的狗狗恢复的情况再来考虑是否需要调整治疗方案，有问题可随时在线联系。
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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