咨询描述:18号fsAA是78
打了五天的那个针数据还升高了,口炎查过支原体和杯状,没有冠状和艾滋什么的。
考虑拔牙但是现在这个数据是不是不太适合麻醉
那我该考虑检查什么疾病么,这个炎症为什么打了针数据还是升高,我接下来应该怎么治疗?
问题大致一样,细节不同?
徐灿
执业兽医师
你好,家长,这么高的炎症,一般考虑的就是病毒性疾病,但是我需要问一下,你有没有排除传染性腹膜炎呢?如果说艾滋冠状等等都没有,而且仍然是这个数据的话,那么最可能的就是传染性腹膜炎了。
他之前已经使用抗生素了,但是炎症压制不下来,那么就必须考虑是病毒性,有做过生化吗?
我没有打过***,因为湿性传腹是确定没有,干性也B超检查过了,没有问题。如果要确定是不是传腹,只有就是逆推,所以我不确定这有没有必要。
艾滋和冠状没有,但是有杯状和猫支原体感染的那个,就是令我很困惑的一点,是我打了一个礼拜的消炎针,他的炎症数据反而上去了。所以你的建议是让我考虑***逆推么?去确定一下是不是传腹.但如果不是传腹的话,还有没有其他可能呢?(因为我担心打***如果猫咪不是传腹的话,对他会有影响)
徐灿
执业兽医师
请稍等一下,回复这个问题需要比较长的篇幅,所以我需要组织一下。
好的,谢谢 然后我又上传了两个那个体检报告有一份的话,记得看日期,他是两次的体检报告。
为保护用户隐私不显示图片/视频
徐灿
执业兽医师
最开始的描述的时候产生了误解,也就是说,他是有杯状病毒和支原体的对嘛?200多的炎症一般比较指向的就是病毒性疾病,但是第一次询问的时候说的是都查询过,但是没有,所以忽略掉了支原体和杯状病毒。
如果说他确实是有支原体,还有杯状病毒的话,那么有200多的炎症是正常的,而误解之后,因为如果都没有问题,还有200多的炎症,就要去考虑传染性腹膜炎了。但是他的白球比并不符合传染性腹膜炎的一个特征。
总结一下就是,第一次提问,由于描述和理解的一些分歧。所以找不到原因,但是结合后续的描述,就是它已经有杯状了,还有支原体,那么就非常明确了。
对于他高炎症的这个问题,实际上比较好解释,因为它病毒性疾病本身炎症就极高,他是病毒性疾病特征,但是支原体的话,一般就是大环内之类的,或者是***类的,和***类的一些药物去治疗就行。
但是你提到了拔牙的问题,能不能让我看一下他的牙龈?有杯状病毒的话,那么牙龈溃烂是正常,后续的话也不一定需要拔牙,因为杯状病毒会造成粘膜溃烂,尤其是口腔粘膜和舌头,所以说等到他疾病恢复之后就可以了。
用药方面干扰素,和抗生素都是有效的,然后再增加一些口腔喷剂,但是我需要先看一下他的牙龈。
他的牙龈就是现在已经不能碰了,所以可能没有办法拍照,可能是我第一次讲的有点歧义,我的意思是有杯状和支原体,但是没有冠状和艾滋.
然后对于药物的话,我困惑的点,是他本来的指数是78在打了针之后变到了200,所以我感觉干扰素是没有起效果的,你可能需要确认一下,就是时间先后,(就不要默认是低的指数在后面,低的指数是在打针前)所以今天这个结果出来之后,我有一点点震惊
徐灿
执业兽医师
实际上,这个好理解,病毒性疾病会有一个周期,他的炎症会增高也是正常的,一般来说,病毒性疾病的周期是七天,干扰素只是干扰病毒合成,就算是注射,也只是拖延,等七天之后,身体产生抗体了才会慢慢恢复。
对于这种情况来说,个人建议就是先治杯状病毒,干扰素的使用是没问题的,除了化验数值之外,也要了解疾病周期。
这种情况一般首先不考虑拔牙,第一次是因为高炎症不建议手术,第二就是杯状病毒恢复之后,他的牙龈慢慢后续也会恢复,并不是说恢复不了。
治疗方面,首先就是输液,杯状病毒一般患病之后不吃东西,因为口腔疼痛,所以需要输液补充能量和体液,再有就是要使用一些口腔喷剂,缓解口腔溃烂,但是他并发了支原体,所以说抗生素的话一般选择大环内酯类的好一点,或者是***类的林可安类的。
这个是他一开始的时候的照片,那个时候可能比现在的症状稍微轻一点,但是跟现在的情况也差不多,他的牙龈应该已经有露出来了,就是两个牙尖中间的那个洞就是有露出来,我不知道我形容的是否准确,因为我自己是没有看到的.
他的舌头可能也有一点溃烂了(但是拍照拍不出来,因为他现在已经就是完全不配合了)他舌头溃烂是那个医生面诊的时候看到然后跟我讲的,但是他没有仔细跟我讲,所以这一点我不太确定
为保护用户隐私不显示图片/视频
但是他这个杯状已经确诊了一年了,我是一直断断续续的治,然后没治好,所以我才开始考虑拔牙,然后没想到就是打了干扰素以后突然上去了。但你这样解释的话,我可以理解,就是我继续打干扰素
那我就是没有必要去尝试逆推,我就每天先给他喂消炎和杯状的药,然后打干扰素的针,你觉得这样是否可行?
徐灿
执业兽医师
不需要逆向推断,他这个和传染性腹膜炎没关系,后续的话,建议是增加一些激素使用,然后增加一些喷剂,抗生素和干扰素继续使用,这两种药物对于他这种情况非常重要。激素的话是可以使用的,一般使用激素之后就很快有好转,但是一定要记得,如果他总是反复,总是反复,再去考虑拔牙即可。
总体来说就是后续增加口腔喷剂,然后增加激素的使用,并且持续性使用现有方案,一般的正常用一周左右就可以恢复的差不多。但是不能保证后续不会复发。
徐灿
执业兽医师
没事的,但是你一定要记得,使用完上述药物之后,一般的一周之内就会恢复,当然要配合之前的药物,但是如果说,因为激素相对来说,对于他这种情况比较有效。但是总是反复的话,就要切实的考虑拔牙了。
好 就是打****和干扰素,吃配的激素消炎药,加上喷口喷(最后确认下哈哈感谢)
徐灿
执业兽医师
是这样的,****就是消炎药,然后配上干扰素,还有口腔喷剂,一般来说,正常的这么用药的话,一周左右就能恢复,但是一定要记得,如果总是反复,用完激素之后效果明显,但经常反复就要考虑拔牙。
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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