咨询描述:猫咪上个月出现呼吸急促腹式呼吸,送去医院做了全身体检,血液、心超、腹超都没有问题,肺部B超显示肺部一部分白色,说是可能肺积液,然后在让它在吸氧舱待了一夜,打利尿针促排尿。第二天下午再次做肺部B超,一点变化没有。接着做了CT,没有积液,这就说明不是肺积液~于是进入胶着,查不出病因。猫胆小,在医院不吃不喝,我接它回家,喂抗生素消炎药,呼吸频次恢复正常。喂了一周停药,停后几天再次呼吸急促,有张嘴怼着地面发出卡卡声,像要吐又吐不出的样子,我不懂它是要咳嗽还是怎么
问题大致一样,细节不同?
王冲
执业兽医师
您好,猫咪家长,根据您以上描述,我初步分析宝贝是有呼吸道感染的问题,呼吸急促可能是肺部有感染,后边出现的对着地面发出咔咔声,这是咳嗽后干呕,麻烦您把化验结果发给我看一下,片子和化验单都发过来。仅仅根据描述还不能做出进一步的判断。我还有几个问题需要向您了解一下,
1. 宝贝多大了?发病多久了?发病之前有没有洗澡或者着凉?您喂药有没有呛到猫咪?
2. 宝贝流眼泪和鼻涕多不多?鼻涕什么颜色?
3. 宝贝咳嗽频繁吗?每次咳嗽都有干呕吗?
4.宝贝现在吃喝欲望,精神状态如何?
5.宝贝生活环境温度有多少度?有没有在早上或者晚上趴窗户台睡觉?
6.您给宝贝测一下体温,用水银温度计,水银头上抹点香油,起到润滑作用,以免插入时对宝贝造成疼痛,然后插到宝贝肛门里2厘米就可以,等2-3分钟后麻烦告诉我温度。
以上这些情况建议您仔细回忆后并尽量详细的描述给我,对我给宝贝目前情况的判断以及制定治疗方案有非常大的帮助,感谢您的配合。另外,把您家爱宠的『年龄、体重』提供一下,待会儿咱们沟通后如果涉及用药建议,方便为宝贝开具处方。(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。)
我这会儿信号不太好,先回答下您的问题,回头再发图片,猫咪是三花玳瑁,5岁,就从2月底开始出现呼吸时胸腔有杂音,立刻找了宠物医生上门来看,她仅从听筒判断是肺炎,给打了消炎针,留了10天消炎药。药吃完没有效果,在3月底出现呼吸急促伴随腹式呼吸,就在4月2号去医院做全面检查了。过年到现在猫咪没有洗澡,不过它在3月暖和后喜欢躺地上,薄地毯。眼泪?好像左眼有一点点,鼻涕的话,大概只在2月见过一次,就一点点黄的,我给它擦了后来再也没看过鼻涕。血液检查是没有炎症的。
现在精神良好,没有以前那么活泼,但是还是黏人的,我白天不在家,晚上回去看它厕所里的排泄物跟以往差不多,应该吃的也正常。
生活的环境就是正常室温,窗台上也铺了薄地毯,然后空调没开。现在暖和,2月份时有点冷,没给它进房间睡,从它不舒服后,都给它睡房里。
体温暂时没法,上次去医院时是高的,因为在医院紧张。
心超,腹超很正常,没有心肌肥大。血液正常,没有炎症。肺部片子我等下发您
王冲
执业兽医师
根据您的描述,推测猫咪出现的腹式呼吸,呼吸频率加快是呼吸道感染引起的,胸腔杂音重,肺炎的可能性最大,这种情况下打利尿针是有作用的,如果只吃消炎药作用不大,需要吃止咳化痰,抗感染的,您家猫咪所处的环境温差可能有点大,一冷一热会刺激呼吸道。
他们检查不出问题时,我提出要不要做个灌洗查一下感染,他们劝我,说猫胆子太小暂时不要再查了,吃药,然后每周去拍肺部B超。 我现在看猫又呼吸急促了,可以确定那个抗生素消炎药不管用,您这边说的抗感染和止咳化痰的药是什么药?我怎么可以最终确定它是呼吸道感染?还有,猫咳嗽是什么样子我不太确定,没见过,反正就是像要吐的姿势,发出咔咔声又没有东西出来
王冲
执业兽医师
咳嗽,就是发出咔咔声,然后再干呕一下。
做肺部b超很难检查肺部和呼吸道感染情况,最好拍片子,拍dr就可以确定,胸腔肺支气管有炎症感染会有一片雾蒙蒙的感觉,拍片子比较直观,抽血做c反应蛋白更能反应感染程度。
您告诉我猫咪体重,我给您推荐用药量和用法
不好意思啊,医生,今天特别特别忙,是这样,我不知道dr是啥,我家猫做了肺部B超和CT 只显示肺部有挺大一片白色 它12斤多 您先给药 其实我很想加您微信 可以语音可以发视频 这样打字好着急
王冲
执业兽医师
猫咪肺部有一大片白色,这是呼吸道感染了,就是肺炎,这种情况会引起呼吸急促,憋气,我给您开点药,您喂喂试试,如果猫咪出现不吃不喝,建议吸氧输液。现在能够正常进食的话,可以先吃药。
平台是可以发视频的,还请您理解,您稍等,我给您开点药
王冲
执业兽医师
根据宝贝的情况,我给它开个处方。处方里面的
1. ****50mg,治疗呼吸道感染,止咳,每天两次,每次一片。
2.****,化痰平喘,每天两次,每次9ml
3.****,利尿,缓解憋气,呼吸困难,每天最多服用两次,每次一片,最多连续用药5天。
您可以根据需求自行选择购买
医生,它如果是肺炎,血液检查为啥却没有炎症?
还有,它上次在医院打利尿针是因为误诊为肺积液,实际上它肺里没有积液,它每天排尿也不少?还需要用利尿的吗?
最后,您开的药里没有消炎的,我这边的消炎药还要继续吗?
王冲
执业兽医师
血液检查血常规和c反应蛋白灵敏度不同,c反应蛋白更敏感,检查更准确,血常规炎症可能就不会很敏感。
肺里边一片白就是有感染,感染高了会出现呼吸急促,憋气,这种情况下需要打利尿针或者喂利尿药。
现在猫咪每天出现呼吸急促或者憋气的话,可以不吃利尿药。
多西环素就是呼吸道抗感染的,这个药不能和速诺或者头孢类消炎药共用,会降低药效,您喂的话可以和多西环素间隔开,间隔6小时喂
医生,这是我第6次提问机会了。一直到现在刚下班,所以回复很不及时,抱歉。我回头看了下当时它的全身体检,里面不止血常规,还有10项生化,还有什么asaa蛋白,但是我真的发不出图片,我试了几次都在那转圈出不来,哪怕信号极好的地方也是发不了图。我想把它各项检查数据以及片子发过去的。唉,我是第一次在网上问诊,不懂。如果是您说的这样,我在这买药是快递吗?多久到?如果它的生化和蛋白检查都没问题,还会是什么?
王冲
执业兽医师
血常规和saa是检测炎症和感染的,如果这两种指标都是正常范围内,很可能是之前用药后指标在正常范围,现在猫咪又开始呼吸急促,有可能又反复了,或者之前没有彻底治愈。现在猫咪正常进食的情况下,您先喂药试试。平台购买药物是发快递,一般3天左右能送到,您也可以根据处方从您附近宠物医院购买。
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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