咨询描述:提问:猫咪肺部是什么问题该如何解决?需要吃什么药?
(猫咪有HCM)
回复总结:猫咪呼吸起来咕噜咕噜的声音,一方面可能有肺部的炎症问题。另外一方面您自己也可以看一下胸腔宝贝的心脏周边是有很多的白团样的一些这种高密度的影像。经常心脏周边的肺是黑色的。说明这种情况还是考虑大概率是一个肺水种。肺水肿的情况下,有可能是需要利尿剂在正常剂量的情况下增加它的用药次数,可能最高次数用到按照每两个小时或者四小时用一次。
问题大致一样,细节不同?
赵一强
执业兽医师
主人您好,单看这个片子的话,高度怀疑宝贝有可能是肺炎或者肺水肿的问题。具体的话要结合一下宝贝目前的症状表现,他是咳嗽?
还是呼吸急促发白或者发紫呢?
如果说宝贝本身有肥厚性心肌病的话,之前是有在吃药吗?把宝贝确诊心脏病的心脏彩超的结果报告单发上来,我看一下。宝贝之前确诊以后用药的内容发上来,我看一下。
那么如果说宝贝是肺炎咳嗽的话,给予对症的消炎药和激素治疗即可。
如果是肺水肿的话,目前表现的是呼吸急促的话。可以高压氧舱吸氧,配合利尿剂。以及针对原发疾病肥厚性心脏病给与对症治疗。
之前做了血常规和查炎症的都正常,猫会偶尔咳嗽 像咳痰一样的感觉 然后呼吸听起来也是有时候呼噜呼噜的。会腹部呼吸。医生说没有肺水肿。前段时间开了一两种速尿片吃但是肉眼看感觉没有什么缓解。但是在更早之前打过几天针缓解了几天然后又变得跟平常一样了。至于心脏现在在喂辅酶Q10。
为保护用户隐私不显示图片/视频
赵一强
执业兽医师
主人你好。因为您这两个心脏彩超的截图看着打的不是太好。您看看当地医生有没有类似于我这样的专业的心脏彩超报单?
一方面宝贝的炎症没有那么说明,宝贝这种情况并不考虑是肺部炎症的问题。另外一方面您自己也可以看一下胸腔宝贝的心脏周边是有很多的白团样的一些这种高密度的影像。经常心脏周边的肺是黑色的。说明这种情况还是考虑大概率是一个肺水种,那么您说宝贝吃利尿剂效果不好。因为肺水肿的情况下,有可能是需要在正常剂量的情况下增加它的用药次数,可能最高次数用到按照每两个小时或者四小时用一次。
所以有可能宝贝吃药的效果不好,是因为用药次数少。
为保护用户隐私不显示图片/视频
这个是单子上的信息 图片的话只有刚刚发的。我刚刚问了检查的医生 他说肺部主要考虑间质性病变。
为保护用户隐私不显示图片/视频
赵一强
执业兽医师
主人您好,按照您的描述。宝贝毕竟才4岁多。这个间质性性病变的说法范围太广了。四岁多了,中老年的肿瘤病变我觉得不太考虑。宝贝的血液检查也没有炎症,那么一些纤维化或者结核性肺炎疾病问题也不考虑。
心脏的检查结果我觉得做的还是不太准确。最好再找专业的宠物医生再做一下。EF97%多有点太高了。
如果按照肺源性疾病引起这种肺密度增高影像处理的话,宝贝这种问题您也可以考虑配合用点激素看看效果。
如果考虑是心源性的话,建议您按照肺水肿给与利尿剂治疗。配合一些心脏方面的药物,比如说ACEi抑制剂等。
好的感谢您的建议!想请问一下如何判断是肺源性还是心源性呢?
赵一强
执业兽医师
主人你好,大部分都是心源性的。最主要的确诊手段就是心脏彩超。虽然您给宝贝之前做的这个心脏彩超的结果不是太准确。但是确诊心源性的肺水肿。就是心脏彩超。
赵一强
执业兽医师
主人您好。可以的。利尿剂暂定一天喂4次,6小时一次,如果后面呼吸缓解可以改为一天两次。。除了利尿剂先给您开一个激素类药物。两种药物配合使用,看一下效果。
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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