咨询描述:您好!陆医生,看了您的执医案例非常好!我家狗狗已15岁了,8年前得过冒出血。2019年时又犯胃炎,断断续续的沒好过。主要症状就是吃多了、吃急了、吃过硬的如肉、鸡肝等多了就呕吐,有时是白沫,有时是白白粘粘的液体,一些时候吐完液体就吐吃的东西了。前段时间给吃了点鸭脖子又开始呕吐到现在一直不好,宠物医院检查x光等,说是十二指肠溃疡(以前诊断胃溃疡),都是一个医院。现在***、*
**、消炎针(不知什么药)、还有护肾的。3天了见效,但没全好,昨晚今早又吐了,不敢给吃东西,吃羊奶和小米粥。麻烦您给诊断一下,出个药方。谢谢了!狗狗太弱了,瘦了的皮包骨,以前可胖了!
回复总结:狗狗吃完东西呕吐白色黏液,可能是十二指肠溃疡引发的。建议给狗狗吃抑制胃酸的分泌的药物、以及保护胃粘膜的药物。同时,配合含有阿莫西林克拉维酸钾的药物,防止胃十二指肠溃疡的感染。最后,给狗狗吃酶制剂,适当补充酶制剂。另外,日常饲养可以配合肠道处方粮。
问题大致一样,细节不同?
陆文健
执业兽医师
根据您提供的信息,狗狗呕吐病程比较长,只要吃食过快、过饱、或者食物硬度大等就会产生呕吐现象 ,我初步判断狗狗胃十二指肠溃疡的可能性比较大(胃十二指肠溃疡常会同时发生)。
但仅仅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、最近一段时间(吃鸭脖子后)出现的呕吐,呕吐物是什么颜色?什么气味?呕吐发生在吃食饮水后大概多长时间?
2、狗狗出现经常性呕吐,有没有出现呕吐物带血的情况?
3、狗狗在存在呕吐的时间,大便怎么样?有没有拉稀现象?有没有大便发黑或者褐色的颜色?
4、您给狗狗的的治疗,除现在打的西咪替丁、爱茂尔、消炎针,还有没有使用其他药物?以前狗狗出现呕吐是怎么治疗的(使用了什么药物)?
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。
陆文健
执业兽医师
麻烦您把上述的问题尽可能详细回答一下。
另外请完善您的狗狗的资料(品种、年龄、体重、公母、有无免疫、有无驱虫),以及您家里有什么药物告诉我。也可以直接申请处方,在申请时填写狗狗的资料。我好给您的狗狗开具处方。
是小土狗,15岁,公狗,有前列腺肥大症状,每年都免疫驱虫。前4年14公斤,这几年因为胃不好,渐瘦到11公斤了。原来可能吃了。近三年因为吃的过饱,猪肝、鸡大腿肉、翅根、啃点骨头,犬精粮(压缩那种的)等等,吃坏了胃。前几年吐白沫、胃液(多是白色),少数时候吐严重了就吐吃的东西,味道有酸、有臭;大便一般时候正常。最近偶尔有拉稀的时候。以前都按胃炎、胃溃疡治疗。这次说发展到十二指肠溃疡。这次一吐就是一、二天,吐完就要水喝。不给就站在水碗处不动,躺一会就起来要喝,实在看不下去了就给一点点喝,喝了吐的更凶。这几天瘦的让我心疼落泪。以前打过庆大霉素、止吐爱茂尔,吃蓓力健、益生菌、健胃消食片、阿莫西林克拉维酸钾片、莫沙必利、奥美拉唑等。前半个月吃鸭脖子后`就出现呕吐,吐的水状白白的、透明的像鼻涕样的液体,吐次数多了就是吃幼犬粮(都是上等的)吐狗粮,整个都吐出来,胃也不儒动,呕吐发生在吃食饮水3、4个小时后,吐完后多数时都禁食禁水,但有时禁不住或是不久给一点点水后马上就吐,吐的还更厉害了!这次打了消炎针(问医生没记住说是N莫西林还是什么)、西咪替丁、爱茂尔外,我自己加了莫沙必利、奥美拉唑片。半月前一开始吐的严重时我给吃了胃复安就好了3天,抢着吃饭了,但又严重了,有6天时间了。这几天没吃东西,多数禁食禁水,然后给喝点羊奶、小米粥汤、吃点营养膏。今早才大便了点,还算正常,颜色偏黑色。不拉稀。大便不带血。家里药都有,买的太多了。麻烦您就开药方告诉我吃多少即可!我狗狗的病和您网上现在挂的病例基本相似,也是十二指肠溃疡。先谢谢了!
对了,陆医生,今早给打静脉注射营养素了,怕脱水,身体也弱的走路都打晃。小便正常!
陆文健
执业兽医师
根据您的描述,您的狗狗应该是胃十二指肠溃疡的可能性是很大。看了您以前和现在医院的诊断为胃十二指肠溃疡,但用药虽然采用了止吐(爱茂尔、胃复安)、抑酸(奥美拉唑)、胃肠动力药物(莫沙必利),另外使用了一些抗生素,但没有完全按照胃十二指肠溃疡进行治疗。
下面我给您的狗狗针对胃十二指肠溃疡开个处方给您参考。
陆文健
执业兽医师
根据狗狗可能的胃十二指肠溃疡的情况,我给它开个处方。处方里面的:
1、奥美拉唑,抑制胃酸的分泌,减轻胃酸对于胃粘膜溃疡的损伤;
2、***,对胃粘膜具有保护作用,这个药物也同时含有阿莫西林克拉维酸钾,防止胃十二指肠溃疡的感染;
3、***复合消化酵素,主要成分是酶制剂,适当补充酶制剂,对于您的老年狗,以及由于抑制胃酸分泌可能带来胃蛋白酶的减少,造成的消化不良。
奥美拉唑您家里应该有,保灵胃溃宁和拜恩复合消化酵素,您可以根据需求自行选择购买。
陆文健
执业兽医师
几点说明和建议:
1、由于狗狗长时间禁食禁水,以及狗狗年龄比较大,严重的营养不良,可以给狗狗给狗狗进行输液是可以的,可以使用生理盐水+5%葡萄糖液,并且加三磷酸腺苷、辅酶A、复合维生素B等营养素;
2、我给您开的药物的喂法很重要,您需要注意一下(奥美拉唑,早餐前30分钟-1个小时服用。保灵胃溃宁第一次早空腹口服,在口服奥美拉唑前1个小时以上服用。第二次可以在晚上吃食前30分钟-1个小时服用)。
3、狗狗胃十二指肠溃疡,这个疾病,尤其对于老年狗狗,治疗难度很大,很容易引起反复,按我上述的治疗方案外,饮食相当重要,一定要给狗狗少吃多餐,并且提供容易消化的食物,最好是糊状的食物。
4、如果您采用我给您的狗狗的治疗方案,建议您每周一次咨询我,我根据狗狗的恢复情况,再给您提供下一步的用药方案。
陆医生,又打扰您了!请问现在和痊愈后可以喂营养膏和微量元素吗?
陆文健
执业兽医师
营养膏和微量元素以及复合维生素不管什么情况下都可以给狗狗补充,是营养性的保健品。但对于治疗胃十二指肠溃疡帮助不大。
主要是狗狗身体太弱了,给他补补能健康一些。现在喂不会对病情恢复有影响吧?谢谢了:
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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