咨询描述:狗狗5岁患过肾衰竭,现在10岁,在11月30号发生呕吐,1号带去医院查生化肌酐680,尿素氮40,输了4天水,每天200毫升复查指标没多大变化,听说是输水量不够,又换了一家医院,每天输水400毫升,输了3天,今天复查指标涨到1026,请问这种情况还有救吗,我们还能做什么,几个医生都说没治了
回复总结:针对狗狗肾衰竭呕吐的情况,狗狗现在的肾衰以及疾病程度,治愈的可能性很低。目前能够做的就是考虑进行血液透析,来维持狗狗的寿命。狗狗现在的程度,除了血液透析,实在没有太好的方法了。皮下输液不如静脉输液效果好。另外,可以进行静脉输液营养,来要是替代吃喝食物,补充营养。
问题大致一样,细节不同?
陈奕达
执业兽医师
您好,根据您的描述,以及提供的化验结果来看,1.狗狗现在的肾衰以及疾病程度,说实话,治愈的可能性很低。如果使用概率形容,大概在30-20%。2.以狗狗这种情况,我们能够做的就是考虑进行血液透析,来维持狗狗的寿命。
可是医生说它只有7斤,太小了不适合血透,这种输水都降不下来还能干什么,皮下补液有用吗,它现在精神还是挺好的,也有尿,唯一的症状就是吐,隔一两天就呕吐,导致我不敢喂药喂饭,它就消瘦
陈奕达
执业兽医师
您好,1.狗狗现在的程度,除了血液透析,实在没有太好的方法了。2.皮下输液,还不如静脉输液效果好。3.尿素氮高,也会刺激狗狗出现呕吐症状。这个是没有办法的。4.可以进行静脉输液营养,来要是替代吃喝食物。补充营养。
但是问了几个医院,只有一个医院建议血透,其他的都说回去混日子,今天称重只有6斤4两了,这种还能做血透吗,血透应该是要全麻吧,它受得了吗,会不会挺不住直接死了,有没有啥特效药能管用的
陈奕达
执业兽医师
您好,说实话,达到了狗狗现在的疾病程度,属于药物无力状态,唯一的希望就是透析。如果是人,可以考虑换肾手术,但是小动物暂时没有这个技术。
除了透析,狗狗现在的疾病程度没有特效药。
透析需要麻醉,这个是没有办法的事情。是否能够承受,这个也需要看狗狗当时的状态如何。(麻醉会有一定死亡率)
那你这样说的话,我感觉透析的风险更大,今天查B超,右肾萎缩得都有点看不到了,一公分多,它代谢不了麻药的话岂不是死得更早吗,就这样或许还能拖一段时间,医生都没说继续输水的事情了因为输这么多天不降还涨,就喊我们回家自己给它补液,每天补300毫升,再喂点药过剩下的日子,如果吐了就去医院打止吐针
陈奕达
执业兽医师
您好,1.麻醉可以使用安全一些呼吸麻醉。2.跟您说实话,主治医生的这个说法,是属于比较委婉的建议放弃治疗。因为狗狗现在的疾病程度,单纯用药治疗,效果几乎为零。3.如果实在担心麻醉风险,或者暂时不方便给予狗狗进行透析治疗,那就只能像医生说的那样,给予狗狗进行补液维持。不过个人认为没有太大意义。(建议埋留置针,进行静脉补液。因为皮下补液,效果没有静脉补液好)。
可是之前两个医院,一个医院4天一个医院3天都没效果,不下降反而上升,每天都是10个小时这样陪着它输水,一整天时间都耗在医院,每一天都是六百,一千,人也遭不住钱也遭不住,花了六千多得来的判死刑,所以医生才说要不回家治
陈奕达
执业兽医师
您好,1.如果我们还是想陪伴狗狗一段时间,可以先遵照医嘱,然后在家给予狗狗进行用药治疗一周,之后再进行一下复查,看看后续的指标是否可以逐渐的降低。2.跟您说大实话,可能会稍微直白,不好听一些。不过还是需要跟您实话实说。如果我是狗狗的主治医生,在狗狗现在的疾病程度。只有两个建议:除了建议透析,再有就是建议安乐死,因为再继续保守治疗,对于狗狗现在的疾病问题,帮助不大。白花钱,而且每天给狗狗输液,打针,吃药,狗狗也还是有一些遭罪的。
但是它现在精神比较好,出去玩也是能跑能跳,不忍心去安乐死,尿也能尿出来,感觉还没有到安乐那一步,就除了是它那个呕吐的症状有点老火,基本上打一针止吐的能管个两天,这种情况它大概还能维持多久生命呢
陈奕达
执业兽医师
您好,1.狗狗现在的情况,维持的好,寿命大概在2-12个月,只要身体能够达到一定的代谢,还是可以活一段时间的。2.精神状态好,只能说明狗狗没有那么难受,无法用来完全评估疾病严重程度。因为如果狗狗出现难受状态的情况下,可能下一秒,精神状态就下降了。
陈奕达
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1次追问次数,以顺利完成本次问诊咨询。
陈奕达
执业兽医师
您好,已经收到了您的处方申请,您这边还有什么需要?或者需要开具什么药物?您可以发送过来,我可以一一为您解答。
有不有什么药可以吃的呢,之前搜百度有个人说用人的尿毒清颗粒的有用吗,还有就是补液的用处大不大,每天扎6次,每次50毫升确实也是很受罪,今天补了100我看它走路都有点慢了,不知道是不是补液会疼痛?
陈奕达
执业兽医师
您好,1.口服用药,可以给予狗狗吃一些宠物专用保护肾脏用药。但是效果可能达不到您的预期。2.补液是有很大用处的。3.可以静脉输液,替代皮下注射输液,这样狗狗遭罪的就小了。
陈奕达
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1次追问次数,以顺利完成本次问诊咨询。
陈奕达
执业兽医师
抱歉,我不得不中断一下咱们的沟通。我这边突发紧急手术病例,需要耽搁一段时间给您回复(大概需要20-60分钟),回复不及时,请您见谅🙏🙏🙏,谢谢您的谅解,麻烦您耐心等待一下下。
您可以先给我留言,我会在忙完的第一时间给您回复,🙏 🙏 🙏 🙏 🙏 🙏
稍后我会给您开具一个口服用药,供您采纳参考一下。
(若您需要离开本诊室,稍后可以到官方微信公众号“蘑菇宠医”内找到问诊订单继续和我沟通。)
陈奕达
执业兽医师
您好,这边根据猫咪的情况,我给宝贝开个处方。供您采纳参考一下。(可能达不到您的预期,慎重考虑使用)
处方里面的
1. 肾透,宠物专用保护肾脏用药。
2. 肾康,宠物专用保护肾脏用药。
您可以根据需求自行选择购买。
医生,昨天搜了好多案例,为什么肌酐1500的都有降下去的啊,是因为它们的肾脏没有萎缩只是指标高吗?我们这个萎缩了所以无力回天吗?尿毒清颗粒可不可以喂喂,我看到有人说喂这个有效果的
陈奕达
执业兽医师
您好,肾脏指标降下来,是因为肾脏工作能力能够恢复,而咱们家狗狗已经出现肾脏萎缩,这种程度的问题,能够恢复的概率很低了。只有透析,或者手术更换肾脏才能够有一定几率恢复。如果是宠物专用的药物,可以尝试使用。人类用药建议停止使用,因为人用药是针对人类设计的,并不一定适合给予宠物(动物)使用,效果不一定好,而且可能会有未知性副作用,还请您慎重考虑后采纳使用。
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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