徐灿
执业兽医师
你好,家长,我需要问一下,是猫咪还是狗狗呢?能不能拍摄一段视频发过来看一下?我需要知道一下他的精神状态,现在有没有做过生化?有没有比较高的炎症?还有就是现在是否有明显的症状,是否有呕吐或者腹痛?是否有拉血的情况?
请补全一下基本信息,并且提交一下化验结果,因为我需要知道更多信息。
布偶猫、快4岁了
第一张是没有输液前的
第一组给他输了血第二组消炎 第三组6542 第四组**** 第五组**** 第六组能量第七组抗体 第八组消炎 小针打了一毫升激素(刺激疗法)复合b **** 晚上这个是****
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食欲不振、腹式呼吸
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徐灿
执业兽医师
我需要问一下,你确定是按照胰腺炎的方针去治疗的吗?因为从生化的结果上来看,不像是胰腺炎,还有没有炎症反应测试和胰腺炎的测试呢?为什么直接确认为胰腺炎呢?
对症治疗一般没有错,但是直接确认为胰腺炎和这个生化指标不太符合。能不能把前后经过说一下,我需要了解一下前后情况。
猫猫现在在宠物医院、医生和我说的是轻微胰腺炎、还有糖尿病、肝肾功能都有些受损、猫猫本来是去治疗皮肤病的、今天医生发信息和我说猫猫情况不好、我去医院他和我说猫猫这两天食欲不好以前能吃3碗猫粮这两天只吃一碗、今天早上他发现猫猫鼻头发白还有些脱水、我送猫猫去的时候它还是有肉今天看到它背上能摸到骨头、大腿上肉也少了很多、毛发都有些毛躁
第一张是上个月拍的、第二张是现在
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徐灿
执业兽医师
对于这种情况来说,首先就是他有没有做过炎症反应测试?还有就是用完上述那些药物之后,是有效果的吗?要优先排除一下感染的问题,因为血糖的改变,除了糖尿病之外,代谢问题也容易引起血糖波动。
血糖确实应该监测,但是个人建议优先排除是否有较强炎症,而且长时间的营养不良或惊吓抑郁等原因,也容易造成毛发枯竭,还有就是要核实还有就是要核实一下,最近一段时间他有没有在发情?一般的胰腺炎会导致淀粉酶升高,但是它的淀粉酶是正常的,还有就是像肌酸激酶的升高,惊吓等原因就会引起,他的目前的主要症状,实际上更倾向于肝脏和血糖的问题,但是不确定是否裹挟着炎症,目前来说,要确认一下是否有较强炎症问题。
它已经绝育了1年多了应该不会发情、也没有营养不良、它21号去住院治疗皮肤病、那时候毛发是好的
猫猫输完液鼻头已经粉回来了、9点半的时间体温只有36.4、打了两针小针10点半的时候36.9、他用的人用耳温器
徐灿
执业兽医师
我需要和你核实一下,也就是说,他一直在住院吗?
从化验结果的单子上来说,它不太像有胰腺炎,更像是有肝脏问题,他有皮肤病的话,皮肤的毛发脱落是正常的,再有就是长时间关押,会有抑郁,而且治疗的这个方案完全是倾向于胰腺炎的方针,所以这一点有点存在疑问。
所以总体这个治疗方案和所表达出来的症状有点对接不上。个人建议是后续增加炎症反应测试,如果说有炎症的话,那么后续就需要使用抗生素继续用药,而且它肝脏指标有异常,一些肝脏问题,或者是长时间营养摄入不良的就会肝脏指标异常或血糖异常,所以总体推荐的方案更倾向于治疗肝脏问题,并且缓解它的压力。
徐灿
执业兽医师
测量猫的体温需要插入肛门之中,人的那种电子的是测不出来的,它测出来的温度是不准确的,因为猫属于被毛动物,一般来说都是要插入肛门之中,最最起码也需要夹在腋下五分钟以上,而且如果真的36度左右,那么基本上属于严重失温,所以这个温度是存疑的。
所以总体是有一定疑问的,它的治疗方针和它的化验结果不太对接,能不能让我看一下猫咪现在的状态,拍一个视频过来。
对、它5月下旬有做过体检、当时各项指标都正常、它是8月21号住院到现在
徐灿
执业兽医师
那就是我对于他是胰腺炎的这个判断有一点疑问,因为从总体的化验结果和症状来说,不像。
第二点就是个人建议增加炎症反应测试,如果说有炎症就用抗生素,后续要增加护肝药物使用,但是从指标上来说,他又没有其他特别严重的问题。血糖的话,倒是可以后续监测一下,因为如果他没有发现任何症状,只是不愿意吃东西和掉毛,再加上他有皮肤病,长期住院,不愿意吃东西和掉毛抑郁,这些都有可能,总体来说,它更像是抑郁或者是肝脏的一些问题引起的状态下降,而并不是胰腺炎,对于现在的治疗方案,我不是特别能认同。
我让人去医院守着猫猫、刚刚猫猫很喘他们去喊医生、现在那个医生又和我说是肺炎、我现在该怎么办
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徐灿
执业兽医师
和他说一下,要一下X光片,因为他之前的治疗方针和生化的结果就很奇怪,和临床症状也不太符。
这样吧,把之前所有的推测和化验结果全部抛弃,重新从头开始判断,那么,没有任何症状,呼吸困难,有掉毛,有皮肤病住院,再加上状态不好,先看一下X光结果。放弃对于他是胰腺炎的推断,优先排除是否肺部感染,那么炎症是肯定存在的了,还有一点肝脏问题,考虑肝脏指标是由于营养供应问题引起的指标异常。
转换成普通话就是,我需要看X光片子,然后重新推断他是什么疾病。因为之前的描述和用药,只是基于之前,建议重新推论。
现在怎么办呀我真的快急死了、
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徐灿
执业兽医师
可以的,大概已经知道了,重新规划方案吧,之前的方案可以废弃了。
首先就是对于他肺部感染问题,还有心脏肥大,后续的话需要使用护心药物,还有就是他肺部感染后需要增加雾化治疗,这个是效果最快的,一般来说,建议使用抗生素,加上一些氨茶碱,还有就是氨溴索,抗生素一般建议泰乐菌素,****,林可霉素等。
然后增加一些护肝肝脏的药物持续性供应营养。记得增加护心的,他的心脏比例有问题,肌酸激酶也升高了,是由于肺部波及心脏引起的。如果你需要的话,我可以帮你开出部分用药,但是雾化这些用药都是注射剂,得到线下的医院去使用。总体来说,之前的方案要废弃。
您帮我开一下处方吧、他那里应该有药的、没有的我想办法去弄来、麻烦了
徐灿
执业兽医师
可以的,我帮你开了一些部分方案,抗生素的话,最好是注射加雾化,这一个在医院用就行,我帮你开的是护心,护肝,还有糖皮质激素,还有就是缓解他的心肺压力,后续你也可以购买后使用,因为他至少也得用药7到14天左右。
主要是因为肺部的位置原因,而且它症状比较厉害,后续记得雾化雾化,对于这种情况效果比较好。
你看一下这些是部分用药,当然也不是唯一方案。
这是现在他给猫猫打的针和现在的体温
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徐灿
执业兽医师
37.6还是有点低,可以和她说一下,现在如果可以的话,增加雾化,主要是以抗生素为主,醋酸泼尼松可以用,然后建议在雾化的里面增加一点肾上腺素,但是最开始的时候要少量,***和***直接加在雾化里面就可以。
徐灿
执业兽医师
对了,我另外需要和你嘱咐一下,我只能大概告诉你方案,但是你尽量不要和主治医师说太多,以避免一些后续可能存在的潜在问题。这个只能说到这。
然后大体的问题已经找到了,建议是先治疗心肺,增加雾化,然后做对症治疗,供应营养,雾化还是比较重要的,然后一定要有一定耐心治疗,时间肯定会特别长,估计得10到15天左右。
徐灿
执业兽医师
如果说呼吸实在困难,那就需要吸氧,现在是晚上,所以说呼吸道系统疾病症状会加重,询问一下,有没有尼可刹米,如果有的话可以少量注射,要是实在实在没有,之前他所提出的方案中,缺少的一个是氨茶碱,是缓解呼吸和心肺压力的,要让他增加。
徐灿
执业兽医师
可以的,后续按部就班治疗吧,这个事情急不得,后续随时关注着,我实际上不是一直在线,后续如果你经常有事情询问我,最好加一个客服微信,遇到紧急情况,可以联系客服,让客服打电话给我,(mgcy003)
然后后续如果有复诊,我不在线,也可以先和客服沟通,然后我再上线就可以。
徐灿
执业兽医师
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星评论。
后续宠物有其它问题,您可以到“蘑菇宠医”官方微信公众号找到我的医生继续向我提问。
谢谢您的支持和鼓励,祝您的爱宠早日康复!
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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