咨询描述：您好王大夫，刚才联系过您那边的医生，我的猫一吐就晕，他说您在这方面比较权威，让我具体问诊情况和后续治疗，请教您。请您回复～感谢～
问题大致一样，细节不同？
王曌
执业兽医师
刚看过你的这个情况了，他现在你要给他把毛先剃光，先减少他体内的这个毛球，然后促进他排毛给他吃益生菌，然后注意他的这个心脑血管的问题
您能不能针对他的情况，一种情况，一个治疗方案，那样告诉我。我理解能力有限，比较混乱。感谢您。首先，猫的生活习惯，饮食习惯和目前症状，根据您的判断，他是不是刚才大夫说的，那三种：1，毛球症2，胆囊问题连带肝脏损伤，3，脑炎或者脑膜炎。然后，您能不能一条一条的说，怎么治疗，怎么检查。我发现这里头只能发五条信息，我不能总问问题。感谢您
王曌
执业兽医师
第1种是这个毛球症的状态，它主要是因为它掉毛的比较多，然后导致毛发在体内淤积，然后排不出去导致的这个呕吐。这个一般的治疗方式就是先给他把毛剃了完了之后给他吃益生菌或者化毛。再就是后期给他喂的时候，以一些容易消化的食物为主。第2个是他肝胆上面的原因，这个你需要给他做B超去看一下他的这个胆囊以及肝脏的情况，因为我听之前你给他喂的肉也比较多，胆囊它主要分泌这个胆汁，胆汁就是消化肉类蛋白的。我看医院给你开的这两个药也没问题，吃上。最后一种就是他这个抽搐晕厥的问题，从生化上看，他这个甘油三酯比较高这个就是常说的这个高血脂。这种从片子上看的话，他身体里边看的没有什么问题，要是像你描述的那样的话，考虑可能是因为这个脑部脑水肿或者说脑膜炎，脑出血然后导致的这个晕厥抽搐，这个你要做检查，要给他拍CT的。如果是你后期要给他输液，一是把这个，血液的粘稠度降下来，二一个是通过这个离子等渗的原理把这个脑子里边的积液给它吸出来，这个就是我前面给他说的，输液的时候要给他输10%的葡萄糖。
我说一下我的理解，你看看有没有不对或者需要补充的：
第一种，毛球症解决方法：
1.他需要常年剃毛，以后得一直保持剃毛的状态，以便减少他吃进去太多的毛排不出来。2.饮食上不能吃太多肉。您建议他的主食吃些什么？他非常挑食，不吃猫粮，有没有方法解决？3.您说的比较好消化的食物都包括啥？请您具体说一下，如果是猫粮，请您告知成分或者牌子？4.针对毛球症，您建议他可以吃的药或者日常保健，请告知牌子，可以让他尽量能多拉出来毛，减少吐出来。
第二种，胆囊以及肝脏的解决办法：
1.因为胆是用来消化肉类的，他平时主要吃肉，所以总用胆囊，所以用多了，对胆囊消耗太大，造成了损伤。由于胆囊出现问题，所以肝脏也就出现了问题，所以生化结果，他的肝指标高。2.之前吃的两种药，可以继续吃。意思是需要长期吃吗？还是再吃多久算一个周期，再去检查？3.针对现在他的胆囊和肝脏情况，他还需要吃哪些牌子的药或者保健品吗？4.是不是为了确认胆囊和肝脏的硬件问题，还是要尽快去做B超？5.另外，到医院，怎么形容这个B超，是叫腹部B超检查吗？
第三种：抽搐晕厥的解决办法：
1.高血脂怎么治疗？平时吃饭，主食吃什么，不能吃什么？需要吃什么牌子的药或保健品？2.是不是只有通过照脑核磁，才能确认是不是脑水肿，脑膜炎或者脑出血的情况？3.如果照了核磁，是脑膜炎，脑水肿或者脑出血，那是不是就可以确定，抽搐晕厥就是脑子的问题影响的了？4.如果确定是脑子的问题引起的抽搐晕厥，他需要吃什么药？到什么情况下要给他输液？5.稀释血液浓度和用离子等渗的原理把脑子里的积水吸出来，这两种解决办法，都是通过输液就能解决的吗？还需要吃什么药？
问题比较多，我尽量写的有条理，给您添麻烦了。还是请您逐条回复，感谢🙏
王曌
执业兽医师
1，给吃主食罐头，或者胃肠道处方罐头。化毛膏是红狗的就可以。益生菌给吃泰淘气的。
2，保肝药可以给他吃一周，那个补血的药需要给他长期吃。保肝药是丹诺士。如果去给他做B超，发现胆汁淤积的话，需要给他吃胆汁酸，对的腹部b超。同时您这个可以给做一下心超，看下心脏有没有问题。
3，给吃低脂肪高蛋白高纤维的粮食。绝育处方粮就可以。鉴于做ct价格比较高，你可以先给按照上边的建议先看有没有缓解，如果没有缓解反而发病频率上升建议给做检查。如果发现他这个出处频率变高，然后你给他可以先去医院，去给他输液做血气。这个口服药一般是抗癫痫的药物，我一会儿把它可能要用到的药物我一会儿把它可能要用到的药物会给你列出我一会儿把他可能要用到的药物会给你列出来，给你开个处方
王曌
执业兽医师
我给他开的有几个东西，一个是处方粮，另外一个是益生菌，还有一个中成药的一个保护消化系统的，就是促进它胆汁分泌这类的。然后再给他开了一个抗癫痫的药物。这些药物需要注意的是益生菌要冰箱冷藏保存，这个抗癫痫的药物给他吃了之后，如果有效果的话，后期可以减少喂的频率。
我总结我的理解：
饮食方面：
吃得多元化一点，以低脂肪高蛋白高纤维为主。满足这些条件的猫粮和罐头都可以，就是不能只吃肉了。
日常保健：
目前我给他吃的是1.甘血维（补血）2.（怡氨泰）猫免疫因子口服液，这两个长期吃对他的病有帮助吗？3.益生菌需要长期吃吗？4.化毛我买的是绿十字的药片，效果可以吗？红狗是药膏，他不吃，喂不进去。
关于您开的药的问题：
1.你开的那个癫痫的药是不是吃上以后，就不能停了，得吃一辈子？还是吃多久？
2.皇家的猫粮，他实在吃不进去。是不是只要是保护肝脏和肠道的猫粮就行？
3.爱迪森健胃片是不是中成药保护消化系统，促进胆汁分泌的？是粉末状还是药片还是胶囊？喂药过程很艰难。需要吃多久？还是长期吃？
4.泰淘气是不是您说的益生菌？是粉末状的吗？
以上我写了三方面，饮食，保健品，您开的药，请您按照这三个方面，分别逐条答复我，感谢
王曌
执业兽医师
1，这个抗癫痫的药就是吃了之后它有效果的话，你这边后期要减少喂药的频率，比如说他以前是一天发作一次给吃了这个之后变成一个礼拜发作一次，你就可以给他一个礼拜吃一次如果说一个月发作一次就可以吃一次后后边先不吃。再观察几个周期。
2，如果说他猫粮吃的不好的话，你这边可以给他去自制粮或者是给他吃主食罐头。
3，这个是片剂的你给他喂这个它有一个调节机体消化的一个作用。吃一周到十天就可以。
4，这个是益生菌它是粉末状的它是一个活菌。所以需要冰箱冷藏保存。
他这个后期饲养的话，主要以这个，保健和饲养为主，能不吃药尽量不吃药。
明白了。目前，我想先要健胃片和益生菌，癫痫的药暂时先不要了，我再观察一阵，如果剃毛，换粮食，吃药都没有缓解，带他去做核磁吧，确定了再吃癫痫的药。
您帮我改一下处方吧，只要两种！
1.如果后期还需要怎么找您问诊和开药？怎么跟您联系？
2.您的医院在哪？在北京吗？医院叫什么名字？
3.处方猫粮，家里还有一只健康的十个月的猫，能一块吃处方粮吗？还是需要各吃各的？
王曌
执业兽医师
您看一下是这两个药吗？这个不一定是要给他做完CT之后再给他吃，这个抗癫痫药，是做CT确诊脑膜炎之后你就需要给他输液治疗了。
1，后期您要再找我的话，您可以买这个问诊包，有优惠的。可以问下客服怎么买。
2，我这边医院在西安呢
3，这边如果那个猫没有什么问题的话，就让他吃正常的商品粮就行了，但是混合着吃也没有问题的
对，是这两种。
1.先要这两种吧，我在这上头直接付款就可以吗？啥时候发货？怎么写地址？
2.我如果保留现在这个聊天截面，回头还能找到您吗？问诊包在哪买？
3.像我的猫这种情况，如果胆囊和肝脏有问题，也有脑膜炎，脑积水或者脑出血。他平时身体痛苦吗？会疼吗？他在抽搐晕厥的时候是什么感觉，他难受吗？
4.请帮我加一下追问次数吧，您回答完我，我再想想还没没有不懂的。感谢🙏
好的，已经付款了。
1.怎么联系客服？微信号或者电话多少？
2.上一条的问题，等待您的回复，感谢🙏
王曌
执业兽医师
这边这边你付完款之后，他们会尽快安排发货的，你这个跟客服联系就可以。
复诊包也可以问客服
他这种大多数会出现的是缺血，一般会出现缺血性的这个抽搐，就是说脑袋里边血液供不上，就跟你这边去长时间蹲在地下，然后突然站起来之后有点头晕，这个也是一样的道理。
明白了，非常感谢您！
我先让他吃一顿时间药，观察一下，希望能尽量不让他吐，照核磁除了贵以外，对他也是伤害，需要全麻。他属于老年猫了，我觉得全麻也挺危险。
之后还需要问诊和买药，我再上来买问诊包。再联系您！
王曌
执业兽医师
可以可以的，他现在就是因为老年，所以说麻醉风险比较多，你要给他做的话看是要镇静还是麻醉，一般如果做CT的可以的，他现在就是因为老年，所以说麻醉风险比较多，你要给他做的话看是要镇静还是麻醉，一般如果做CT的话，猫乖的话可以不用麻醉，不乖的话给他镇静一下
1.如果真做核磁的话，他应该是麻醉了。一直没有对他进行过社会化培训，他出门不行，每次去医院反应非常强烈，回家以后情绪好多天不能平复。所以，先按照您说的，吃药，保健，换粮，剃毛，试试。过一段时间以后，如果还是一吐就晕，那再考虑照不照核磁。
2.近期考虑先带他去照b超吧，腹部和心脏的。排除一下腹部和心脏的器质性病症。
这个步骤是正确的吧？
回头还有不懂的，再找您，感谢王大夫！
王曌
执业兽医师
非常感谢您对蘑菇宠医的信任。如果我的回答能够帮助到您，请您在咨询结束后留下 5 星评价，您的评价是我工作最大的支持，感谢。 后续宠物有其它问题，您可以到“蘑菇宠医”官方微信公众号继续向我提问。
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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