咨询描述：你好，我家猫咪前天绝育第四天，晚上尿血，早晨一直扒拉猫砂但是没有尿或者只尿一点点。昨天带去医院做b超检查，发现膀胱内有少量结晶和絮状物。血常规和生化没事。医生打了止痛针，利尿针，开了修复膀胱黏膜的药。并让继续打针。我想听听您的看法，针还需要继续打吗？猫现在这个情况和他突然加了干粮有关系吗？他现在这个毛病算是膀胱炎吗？
问题大致一样，细节不同？
曹元钊
执业兽医师
您所提供的信息，我可以认为这个猫基本上应该就是膀胱炎没有错，但是他们做了一个膀胱超声但他，好像没有做尿检，我不太清楚它里面到底是以细菌为主还是结晶为主，还是所谓自发性膀胱炎。
如果是我的话呢，他现在生化是正常的，也就是说还没有发生完全的尿路，梗阻并且没有导致肾后性肾衰竭，如果是我，我会在家口服药物，口服抗生素止疼药，然后修复膀胱粘膜药，然后如果但凡有开始食欲下降，呕吐，或者说真正两天或者说超过一天都没有见到什么排尿，就必须得考虑导尿。
我认为这个跟换食物其实关系不大，但是跟应激有关。
当时由于膀胱没有尿液，所以没有取尿做检查。您的意见就是可以不去打针，但是需要在家口服药物对吗？他没有做尿液检查，但是血检的白细胞也是正常的，也依旧需要口服抗生素吗？另外我看到说利尿剂不要轻易给猫使用，我的猫这种情况，是不是也不要用利尿针？他产生的絮状物，可以通过口服这些药排出吗？他的黏膜是不是也不能自行修复？
曹元钊
执业兽医师
我的建议是不去打针，但是要口服药。我不建议使用利尿剂，我觉得这是一种很危险的行为。
白细胞就是说血中的白细胞是正常，不代表说没有膀胱炎，因为膀胱炎呢，很可能是一个局部发生的炎症，它不一定会反映在血液的指标中，这就是为什么说我很倾向于做一个尿检，看看有没有尿中的白细胞细菌等等。
它所产生的絮状物，如果一切都运气非常好，接下来排尿顺畅，那么理论上来讲，起码有70%~80%能慢慢一点点的排出去的。病人有部分可能不能必然有部分可能不能尿出去，但是必然有部分可能不能尿出去，除非什么，除非他排尿顺畅，这一历史连续性超过至少3~5个月。如果说吃完药以后，它只有半个月排尿顺畅之后又复发，那这个絮状物是不可能完全排出去的。
理论上来讲，膀胱黏膜修复药只是一个辅助用药，它在所有治疗里面，它提供的效果不超过5%~10%，但是呢，如果主人条件可以的话，还是会建议有比没有好。
那么其实他现在不是尿闭，就是一个膀胱炎对吗？您建议口服的那些药，具体都是些什么呢？我想按照您说的这些药来先让猫服用，请您也告诉我服用次数 剂量以及时间。另外，我要如何观察他好了没有？因为他昨天打了针以后，我发现他其实尿的很多了，我没有一个准确的概念。如果在吃药过程中，猫还是尿血，我要不要干预。另外，在吃药过程中，他出现了哪些除了呕吐以外的症状，我就需要带他去医院了？还有，您说利尿针是一个很危险的行为，但是他昨天打了这个针，我要注意哪方面？
曹元钊
执业兽医师
是的我认为这个猫现在实质上是个膀胱炎。
关于具体的用药的话，我其实建议您在用户端申请开药，我提供方案给你，这个方案不收费，您的根据需要选择购买，重点重点是我必须要知道这个猫的体重。
如果这个猫一天上2~3次以上的厕所，但是不要超过5次，每一次蹲下去的时间不要超过35秒到45秒，同时每一次猫砂盆的团块大概至少要有一个2/3以上鸡蛋大小。另外排完尿之后，用一张很柔软的纸巾稍微擦拭一下阴茎部位，最好不要有过多的尿液残留。满足以上基本上是可以痊愈，当然对您观察来说有一点困难，重点就是排尿时间和单次排尿量。
在吃药过程中不满5~7天，猫尿血暂时不用管，如果精神食欲比较好，不用管。但是如果精神食欲变差就需要处理，如果超过7天还有尿血就需要处理（需要去医院），同时如果连续1~2天，他都没有可能肉眼可见的成团的尿块就必须处理。
泌尿针目前来说如果这个阴猫排尿多了其实我认为相对来说不风险就不是很高了这个风险在于胆利尿针
利尿剂目前来说，如果这个猫排尿多了，其实我认为相对来说风险就不是很高了（但是只限于目前），这个风险在于达利尿针，它只是让膀胱，有很多尿液增加膀胱的压力，然后让他就说白了，增加压力以后强行把这个尿液给冲出去。万一他万一他卡住了，尤其里面还有絮状物，万一他卡住了，再把膀胱充满很多尿液，那不是很危险吗？
猫体重8.4-8.5斤。体重最近其实一直一点点下降，是不是和他这个膀胱炎也有关系呢？您的意思是打了利尿针以后，猫只要能排尿，就说明是安全的了对吗？医院的医生建议猫以后都吃处方粮了，但是我担心处方粮成分不好，能不能以后喂他普通的湿粮罐头就好了？或者您建议饮食上要怎么调整吗？他这个膀胱炎是不是出现时间不会很久，我担心他做绝育之前就已经有问题了，但是没做相关检查才导致他这样。
我申请了开药，但是体重那里貌似不能保留小数点，会影响吗？猫现在是4.2公斤。
曹元钊
执业兽医师
我的意思是猫打完利尿针以后呢，理论上来说它的持续时间不会超过24小时，也就是说现在已经是安全了，但是如果你再打每一次打都是一次冒险。
除非医生做过尿检，查明结晶的类型，它是一个磷酸镁结晶这一类的结晶，同时这个猫的结晶量必须非常大，这种情况才有必要去吃处方量，如果不是的话，那么你给他多喝水，其实会更安全。
普通的湿粮罐头能够促进饮水量，这是一个好处，弊端就是有的猫胃肠道不太好容易腹泻，就比较个体化，所以还是要后续观察一下，你可以先试着给一点观察反应
我个人建议先把普通的湿粮罐头和普通的粮食混到一起，再加点水诱使它多喝水，然后呢，家里的换成一个自动饮水器。
如果顺利的话，膀胱炎能够在5~7天之内控制住，但是有的时候很难去根。
曹元钊
执业兽医师
这个体重轻度的浮动不会影响到剂量的，我建议方案如下：
**呢，作为抗生素一天两次每次一片。用十天
****每次0.4毫升每天一次，连用7天，首次加倍就是第1天给0.8毫升，这个属于非甾体抗炎药。
****这个是以防万一的，要防止美洛昔康所引发的胃肠道副作用，一天两次每次半片，连用7天。
***是修复膀胱粘膜的药物。
收到，谢谢您。另外还想问一下，他那个膀胱黏膜，修复的程度也是有限的吧？那后面猫膀胱黏膜会不会越来越薄了？另外我在他吃药过程中，可以继续追问您吗？
曹元钊
执业兽医师
不会的，这个你放心，恰恰相反，膀胱壁随着炎症的发展，反而会越来越厚，但是这个变厚的过程会导致膀胱收缩能力出现问题。这个膀胱黏膜修复药物呢，修复能力是有限的，它毕竟只是个辅助用药。这个膀胱黏膜修复药物呢，修复能力是有限的，它毕竟只是个辅助用药。
您在吃药过程中可以继续追问我或者说寻求复诊，这个都没有问题的。
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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