咨询描述：您好，我家猫4岁，去年口炎发作后没及时拔牙，牙龈全是红的，现在口炎刚刚做完全口拔牙手术，但是查出来有慢性肾衰，肌酐437，b超查出来左肾有点猕猴桃样的改变，说是可能存在缺血或坏死，白血病病毒阳性，杯状和疱疹病毒也是携带了，暂时还没有出现贫血，术后插了鼻饲管几天，现在可以自主进食且食欲尚可，但自主喝水不多，尿量正常，大便少，还在医院住院观察和输液，想问一下后续出院后的护理上有什么要注意的？比如能吃什么食物，因为我条件有限，可能没法顿顿都喂处方罐，像是一下自制猫饭，注意营养配比的话能不能当主食喂？需不需要吃些降磷的药？还有后续在家的话可以用什么药或者保健品对猫是有帮助的，谢谢！
问题大致一样，细节不同？
于博
执业兽医师
您好如果是饲喂的罐头和输液的话，喝水少也是正常的，只要排尿量正常，不脱水就可以了。
如果只是肌酐尿素氮目前升高，您可以先正常饲喂普通粮，口服降肌酐尿素氮的药物，定期复查指标。罐头少喂就好
如果指标持续生长控制不住或者有蛋白流失，高血磷再饲喂肾脏粮。血磷没异常不需要喂降临药。
1. 我的猫年初时还肯吃点猫粮，后面慢慢不吃了，近半年左右都是喂的湿粮，只有湿粮她还肯吃一点，到术前连湿粮也不怎么肯吃，现在手术完喂点湿粮还能吃一些。想问下现在这种情况吃干粮好还是吃湿粮好？
2. 她术前就是脱水了，在家的时候也是喝水不多，但尿很多。然后现在每天都要补液，如果是回家后饮水量不够脱水了，是不是需要强饲喂水或者自己皮下补液呢？
3. 肌酐尿素氮如果一直降不到正常水平，是不是以后还是会出现高血磷的情况？术前我这边的医生说估计很难回到正常水平。这样的话需要一直服用降肌酐的药物还是要提前开始控制磷的摄入？
4. 大概多久复查一次指标比较合适？
于博
执业兽医师
1.干粮合主食湿粮营养都是一样的，湿粮水分比干粮大。如果从日常讲全口拔牙的宠物还是饲喂干粮比较好，如果喂湿粮残留物会侵入牙龈里。可以饲喂幼猫粮或者小颗粒的猫粮。但是如果它只吃湿粮不吃干粮，还是要以它营养摄入为主，也可以把干粮泡软饲喂看看。
2.猫咪大多天生不爱喝水，所以可以先尝试增加水碗等措施引诱喝水，如果实在不爱喝水饮水量达不到日常所需就需要人工强饲饲喂了。
肾衰的动物一般会有多饮多尿，那时候如果不输液自己在家是需要皮下补液的，但是如果没有脱水多饮多尿就暂时不需要
3.如果是肾衰，肌酐合尿素氮一般是恢复不到正常指标，口服用药和处方粮也是减少废物产生减轻肾脏负担，不是治疗肾脏的，只是协助。减缓发展，所以要一直吃药维持
4.前期建议前两周每周复查一次，如果稳定后面两周一次，，再后面1个月一次
1. 如果出现高血磷的话，一边喂处方粮还要一边吃降磷的药吗？
2. 一般肾衰猫可以用什么药？有没有一些可以增强免疫力的保健品可以推荐？因为她还携带了白血病病毒，用药上是不是要更注意。保健品我也知道不一定真的有用，就是有能力的话还是希望能补点，不知道像****多糖、****这些能不能用
3. 复查的话哪些检查项目是一定要做的？
于博
执业兽医师
1.又降血磷的药物，如果升高就需要口服降磷药
2.稍后给您开个针对它目前的处方肾脏药物，白血病属于病毒病，单纯没有临床表现，就是会影响身体其他疾病的恢复和治愈情况，比如皮肤病，正常猫咪治疗一两周就恢复，它就永远好不了需要终身治疗了，所以平时一定照顾好。可以使用增强免疫力您说的，我个人觉得免疫球蛋白比****多糖更好一些用一种就可以了，没必要全都使用。
3.复查需要复查电解质看一下有没有因为多尿引起的电解质紊乱；血常规看一下有没有贫血，肾衰会引起贫血；生化肾脏指标，尿比重看一下尿浓缩情况，超声看一下肾脏形态。前面每周去复查只查血常规和生化就可以。后面1-2个月时候再都检查一下
于博
执业兽医师
1.**** 一天一次 一次一片 降肌酐降尿素氮
2.**** 一天一袋 兑水拌粮 提高抗病力
3.****维 一天两次 一次一毫升 补血保肝促进食欲
4.**** 一天两次 一次一毫升 保肾
感谢您！还想再问一下：
1. 如果近期复查指标能降下来一些就可以暂时吃普通的猫粮，如果降不下来就得吃处方粮吗？我老担心普通粮含磷高会有影响
2. 我家还有其他猫，是上面这只猫生的崽，现在牙龈也开始有点红，而且掉了几颗牙齿，但不影响进食，目前食欲大小便等各方面还算正常，这样的话需要提前处理一下她的牙的问题吗？是吃药还是拔牙比较好
为保护用户隐私不显示图片/视频
于博
执业兽医师
1.肾病处方粮是低磷高钾，低蛋白的。首先建议您要检测一下尿中有没有蛋白流失，低血钾，高血磷。如果没有情况吃了反而会身体低蛋白，高血钾了。只是肌酐尿素氮高久先用降它们的药物。处方粮要确定有这些情况再使用
2.它有病毒病生的孩子会有感染的情况，再不严重的情况下可以先用口腔喷剂和****维护就好，如果出现严重的口炎影响进食日常生活再拔牙，也不要让它们再接着繁育了。
于博
执业兽医师
不客气非常感谢您对蘑菇宠医的信任。如果我的回答能够帮到您，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。后续宠物有其他问题，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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