咨询描述:症状描述:疑似肝损伤+肠胃炎,昨天吃一整天处方罐头,昨夜大便三次,从软便到拉稀带血,刚呕吐黄水内带血点;从8月开始经常性呕吐,有时一天吐四五次,有时吐一两次,猫粮吃多了吐未消化完的猫粮,罐头吃多了吐水、白沫;食欲饮水正常,只主动吃**肝脏处方粮,并经常感觉很饿,基本间隔两小时就急切要吃,吃完东西会打嗝,肚子经常发出很大的咕噜声;不呕吐时精神状态还可以,有主动活动晒太阳,经常母鸡蹲,大小便基本正常,大便可见包裹黏膜,偶尔有血丝;
患病时长:1月查出肝损伤至今,体重持续减轻,经常性呕吐不止,导致无法正常用药,无法正常饮食吸收营养;
医院检查:1月发现体重减轻,就诊检查:ALT526,确诊肝损伤,因无其他症状医生建议注意饮食调节未给治疗方案;8月开始持续呕吐,体重持续减轻,就诊诊断还是肝损伤:ALT324,SAA112.68,打消炎及止吐针3天输液5天,期间症状减轻,治疗后两天内无呕吐症状,两天后偶尔呕吐,后喂食LD肝脏处方罐头+**肝脏处方粮,服用***,有时可维持两三天正常,然后又突然开始呕吐;10月复查,建议吃****+***,回来有几天正常后又开始呕吐;10月12日再次复查,医生建议该用的止吐药都用过,可能是胃部息肉或毛球,也怀疑甲亢,因当地没有设备不便做检查,建议带去大医院查胃镜等,并再次化验指标:ALT613、AST94、SAA11.44,经与医生沟通还是先止吐保肝,但持续至今仍经常呕吐,治疗效果不佳;
用药情况:9月12日吃****+硫酸***片三天,9月16日吃***,因空腹用药困难,经常吃完后呕吐出来或大便排出,用药断断续续(有效服用时间:10月6-8日3天、10月12-20日9天,共计12天),目前已暂停;10月6-16日吃****+***11天,10月22-26日再吃****+***5天;用药期未吐时间:10月6-9日四天、10月15日-19日五天,共计9天;目前仍然持续呕吐。
问题大致一样,细节不同?
陈奕达
执业兽医师
你好,感谢信任,谢谢。根据现有信息,
1.猫咪现在除了肝脏问题,建议检查一下猫咪是否有胰腺炎问题。如果有胰腺炎,那么猫咪现在很有可能就是三体验的疾病问题。
2.以猫咪现在的疾病程度,别单纯口服用药治疗了,建议考虑进行输液,配合打针治疗。因为猫咪现在的疾病程度,口服用药已经控制不住了。并且可能会有脱水以及低能量问题。
3.猫咪还需要进行一下整个腹部器官彩超检查。进一步综合性诊断。
4.猫咪现在的疾病问题,还是很严重的,需要慎重对待。
5.然后您有什么疑问或者需要,可以一同发送过来,一一为你解答。
1、请问胰腺炎主要症状和检查内容是什么,附图为8月就诊的拍片和B超,烦请查看;2、9月已连续输液打针治疗,主要针对消炎和止吐,目前炎症指数已降低,止吐并未有明显效果,如果再次打针输液,主要针对治疗哪方面呢?3、刚呕吐后又有要吃猫粮的状态,上次喂食是今天18点灌食两管罐头+1/4颗***,目前表现很饿,眼下有什么应急方案,可以给吃猫粮吗?
为保护用户隐私不显示图片/视频
陈奕达
执业兽医师
你好,1.胰腺炎主要症状是呕吐,腹泻,腹痛。需要进一步化验特异性脂肪酶检查。
2.这边需要的是超声完整检查结果(文字以及测量数据),而不是影像图片。因为超声是动态影像,单纯截图,没有任何检测数据,无法建立有效的分析。
3.多管齐下治疗,根据现有信息,主要针对胃肠炎,肝脏损伤,如果有胰腺炎,还要针对胰腺炎治疗用药。
4.现在,需要禁食禁水6-8小时,然后再考虑给予吃喝。如果还是会呕吐,直接去附近急诊宠物医院进行输液,然后禁食禁水36-48小时。
5.稍后根据猫咪现在症状开具一套用药,供你采纳参考一下。
陈奕达
执业兽医师
然后这边根据宝贝的情况,我给宝贝开个应急用药处方。供你采纳参考一下,以备不时之需。(保护肝脏用药正常服用)
药物具体用法用量已经帮你计算妥当,可以点击查看详情按钮,进入处方页面查看。
处方里面的
1. **,宠物专用广谱消炎,可以起到控制消化道炎症效果。
2. ***,提供消化道营养,能够起到促进消化道粘膜恢复,减轻消化道炎症的功效。
3.***,保护胃肠道粘膜用药,有治疗消化道溃疡效果。
4.****,宠物专用**补充剂,减轻胰腺负担。
可以根据需求自行选择购买。
疾病期间,需要注意宝贝不能着凉,饮食不能过于杂乱,最好以猫粮糊糊为主,以少吃多餐为原则喂食。
陈医生您好,今天带猫来医院查了fPL结果为阴性,医生调取了之前的B超,也没有发现有胰腺炎的情况,请问1、目前也未发现腹痛症状,是否可以排除胰腺炎?2、昨晚在禁食6小时后饿的到处找食,喂了泡软的猫粮和猫粮糊糊只舔了几口,少给了一点猫粮后5小时左右又吐了,跟上次呕吐水和血丝症状对比是否还是饮食造成的?3、今天查出血常规各项指标降低,医生建议输液补充***和葡萄糖,加一点消炎药,明天继续再输液观察一下,麻烦您看看针对目前最新情况有什么更好的建议吗?谢谢
为保护用户隐私不显示图片/视频
陈奕达
执业兽医师
你好,可以排除胰腺炎问题了。
呕吐不是食物造成的,跟猫咪患病有关系。建议考虑输液,然后彻底禁食禁水治疗。现在吃喝,可能会刺激猫咪更加严重呕吐。
猫咪贫血并且有白细胞下降问题,经济条件允许情况下,建议排除一下是否有猫艾滋病或者白血病问题。避免出现漏诊情况。
陈奕达
执业兽医师
补充一下,如果条件允许,再排除一次病毒,猫瘟病毒,冠状病毒检查,那就更好了。
1、排除胰腺炎,再化验其他无异常的话,针对目前经常呕吐的情况,是否着重在肝损伤和肠胃炎的治疗上?2、肝损伤用药除了目前的***还可以有什么更对症的药或者辅助的药吗?3、肠胃炎除了您昨天建议的用药,目前吃的****,今天还给吃了点***,是继续吃还是先停药?4、肠胃问题是否需要单独吃些益生菌,吃哪种比较好,家里有****可以给吃吗? 5、今天称体重1.87kg,用药的计量是多少,吃多长的周期比较好?
陈奕达
执业兽医师
你好,1.是的,需要着重肝脏以及胃肠炎用药治疗。
2.可以给予猫咪输液用药,使用宠物专用****,5-10公斤一支。
3.消化道方面用药,以猫咪现在的情况短期内,建议口服用药停止,改成输液治疗。
4.****也暂时停用。
5.如果口服用药,采取上述处方内剂量即可。周期7-21天的时间。具体看猫咪恢复程度。
好的,1、今天的输液单刚拿到,麻烦您看一下,除了****还有什么需要补充的吗?2、针对肝损伤这边医生建议有一个人用的处方药:*****(***),如果能加上会效果比较好,请问您建议可以用吗?3、医生建议也是禁食,但我担心饿太久了,它又很急切的要吃猫粮,这边医生说可以少吃一点,是否可行?4、目前输液还没结束,肚子一直发出滋咕咕的声音,可能是什么原因,严不严重呢?
为保护用户隐私不显示图片/视频
陈奕达
执业兽医师
你好,1.其它用药暂时没有添加了。药物并不是用的越多越好。要适合。
2.没有呕吐的情况下可以给予。如果能够有打针剂型那就更好了。但是建议使用宠物专用的药物,效果更好。
3.喂食,可以考虑在24小时以上,没有呕吐症状情况下进行。
4.咕噜声音是消化道的肠鸣音,属于胃肠炎期间正常出现的症状之一。这个不是什么严重症状。
陈奕达
执业兽医师
不用客气,感谢您的信任以及好评,谢谢。
后续有什么问题,可以随时联系我。
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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