最近食欲不正常，所以去医院检查，第一次8号检查炎症是76 其他检查指标还算正常，今天已经炎症是162.8，B超和DR是说腹部有不明物体
唐潮
执业兽医师
您好家长，从宝贝检查结果来看，首先影像学上X光片上看，左侧肾脏区域增大，有不透明度升高的影响，且体积较大；其次腹部B超上看，肾区边界不清晰，且B超上也可以看到腹腔肿物；其次血常规和C反应蛋白上看，存在高炎症伴有脱水；
结合宝贝的品种和年龄和检查结果来看，腹腔的肿物高度怀疑是腹腔肾区的肿瘤。这种可以对其进行B超引导下穿刺，进行细胞抽吸，然后送检确定肿物性质，判读是良性的还是恶性的。
这边医生建议先做高阶影响CT检查再做下一步治疗方案，您看是否需要，或者目前采取直接穿刺抽取送检还是怎样治疗方案比较合适？
唐潮
执业兽医师
您好家长，CT和穿刺送检各有各的优缺点。在医生可以做B超引导的穿刺的话，那么这个方案是优选的，因为CT是要麻醉的，对于宝贝的这种情况麻醉是存在风险的，而且时间会比较长；虽然B超引导下穿刺也需要一定的麻醉，但是如果宝贝很配合的话也是可以不麻醉的。
所以建议可以和医生沟通，看医生是否可以进行穿刺送检，如果可以那就进行这个操作，然后在确定治疗方案。如果医生无法进行穿刺，那么就只能做CT了，但是CT做了，可能最终还是要采取患处组织送检。所以取组织送检是优选。
一般这种做穿刺送检的费用大概是多少钱？这边医生说如果不做ct没有办法固定肿瘤位置，但是费用太贵如果直接穿刺抽取术前要准备哪些问题，需不需要先消炎治疗，根据您的临床经验金毛这类犬种这种情况的治疗结果一般是什么情况？
唐潮
执业兽医师
您好家长，一般来说穿刺送检费用大概在1000-2000左右，但是不同城市的费用不同。当然，用CT确定位置是可以的，CT确定后，再穿刺送检，但是这个费用就很高了。
至于治疗，从影像上看，高度怀疑是肾脏上的肿瘤，但是无法确定是和性质，所以治疗上很难确定。一般来说，我们会选择开服探查，判断这个肿物是否可以摘除，如果可以摘除的话，可以将摘除的掉的肿物直接送检，但是还是一样，牵扯到麻醉，风险比较大。
手术无法进行的话，就只能口服抗肿瘤的药物，配合化疗药物了，化疗药物的使用，要根据送检结果来确定。
我们没有定期体检的习惯，最近是因为看他一直是食欲不佳，前段时间比较多饮多尿现在已经恢复正常，但是还是不吃东西，所以今天过去复查第一次拍片发现这个问题，如果就是先天出现的肿瘤是否可以考虑膀胱炎和前列腺炎引起的炎症症状影响的食欲？
唐潮
执业兽医师
您好家长，前列腺炎和膀胱炎的炎症是有可能影响食欲。但是从肿物的大小来看，其实宝贝的额食欲问题，和这个腹腔肿物关系更大一些。从B超上看只能说是前列腺肿大和膀胱粘膜增厚，但是考虑宝贝的额年龄，这个更多是因为年龄的问题，主要的还是肾区周围的肿物。这个是关键。
像我家狗狗这个年纪的身体情况，麻醉的风险点主要是在哪里，如果良性肿瘤不切除是否也会像现在这种状态影响到身体健康，良性是否也要治疗，金毛这个品种大概率判断为哪个肿瘤可能性更大，这个情况有没有存在良性肿瘤的可能，恶性的话如果保守按药物治疗可以维持多久？
唐潮
执业兽医师
您好家长，首先麻醉就要确定是否有发生转移，也就是其他地方是否也有类似的肿物，尤其是心肥，这就是风险之处，还有就是麻醉过敏的风险。
其次无论是恶性还是良性，对于这么大的腹腔肿物都是要进行治疗的，无论是手术治疗还是保守治疗，都不可能放任这个肿物变大的，只不过保守治疗可能没有效果，肿物依旧增大。
对于金毛来说，肝肿瘤、淋巴瘤、肾肿瘤、骨肉瘤转移等都容易得，因为金毛是最容易得各种肿瘤得品种。在没有送检得前提下，是无法对其恶性良性做出准确判段得，但是从X光片这个大小来看，恶性得可能性更大。
至于恶性得话，保守治疗能够维持多久，这个不好说，主要看保守治疗后肿物得变化，以及转移得情况。无法确定能够维持多久
大概情况我这边有数了，如果我们考虑决定在家保守治疗的话像它这种情况吃点什么药能维持痛苦少、时间久一点，到什么程度可以送到医院选择安乐
唐潮
执业兽医师
您好家长，如果宝贝选择保守治疗的话，可选的药物，比如抗肿瘤的药物和止疼药。当宝贝体况越来越差，完全没食欲，无法站起来，疼痛无法被止疼药止住的话，那么可以选择安乐的问题。
所考虑的药物如下：
****：抗肿瘤药物，一次口服10粒，一天两次；
****：止疼，一次口服130毫克，一天口服两次，对于已经表现出疼痛的来说，前期需要每天服用，当疼痛控制的不错的时候可以考虑延长口服间隔的时间，以达到用最小剂量的止疼药控制疼痛。
所开局药物供您参考，由于您家宝贝的就医条件不足给出了此次用药建议，该药物的治疗效果以及意外风险无法承担，还请您考虑后采纳。
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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