咨询描述:你好医生猫咪昨天确诊肥厚性心肌病末期心衰昨天抽胸水200毫升血水 现在医生告诉只能指望美国新药**药物治疗 占时买不到 他在申请试药 您给看看 现在有什么治疗方案 手术做不了了 身体指标都不行下不了手术台
用药情况:利尿**
问题大致一样,细节不同?
赵一强
执业兽医师
您好,您说的那个药应该叫***。前这个药效果还不错,但是他用药以后,可能后期会出现一些不好的反应。前期急救的话还是有比较好的效果的。网上应该可以买得到,你可以搜一搜,找一找。
除此之外,针对宝贝现在这个X光片上面提示的这个情况,我的建议是可以给他把利尿剂先用上。做一下准确的心脏彩超的检查和血压的检测。然后根据它的结果给予对症的利尿剂和降压药处理。
这个东西没有什么手术治疗的方案,全中国现在能做开胸心内的手术的话。不是特别多,也就是最多做做先天的动脉导管未闭手术。所以您可以给宝贝做心脏彩超准确诊断一下,如果确实是这方面的问题,可以调调身体,然后给他尽快安排手术。如果不是这个方面的问题的话,那么我觉得您就还是把方向放在用药上。
那么宝贝目前的状态怎么样呢?
医生 心超做了肥厚性心肌病四期心衰指标900多很严重了 昨天抽完水今天看片子水少了 心超也能看清楚些了 做的传腹检查阳性 现在打***我在网上买的有水性和油性店家肯定的说油性和水性药效一样 水性不疼一些我买的水性可以吗 还有心脏问题您先给个用药方案可以吗 谢谢
为保护用户隐私不显示图片/视频
赵一强
执业兽医师
主人您好,心脏病主要通过心脏彩超检查确诊,然后对症治疗,x光片不能准确诊断心脏病。您上边的那个生化结果,白球比1.2,并不认为他有猫传腹的问题。
个人还是认为是心脏问题,建议您好好做心脏彩超确诊一下。
一般这种情况当下的话,我只能给您建议吃一些利尿剂***片和降压药**。如果需要具体的药物建议的话,麻烦您提供一下宝贝的准确体重。
做这个核酸检测了阳性 心超做了两次确定是肥厚性心肌病四期 猫4.6公斤 这个传腹的***水性和油性药效一样的吧 这个店铺信誉挺好只买***这一种药我买的水性
为保护用户隐私不显示图片/视频
赵一强
执业兽医师
您好,您这个我觉得并不考虑猫传腹,您可以后边再复查生化结果看一下,因为您这个白球比例太高了,我觉得不像。
还是考虑心脏病的因素比较多。您要是方便的话最好把心脏彩超报告单发上来我看一下,如果说当地的医生没有出具的话。我觉得您最好再打听打听,好好做一下心脏彩超。因为这个检查对宝贝的治疗和后续的复查有很大的影响。
那么我先按照4.6公斤把利尿剂和**给您开一下,您先参考看一下吧。
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
{"561304":{"id":561304,"case_id":62403,"user_id":1046848,"to_user_id":2432221,"type":3,"content":"您好,您这个我觉得并不考虑猫传腹,您可以后边再复查生化结果看一下,因为您这个白球比例太高了,我觉得不像。\n还是考虑心脏病的因素比较多。您要是方便的话最好把心脏彩超报告单发上来我看一下,如果说当地的医生没有出具的话。我觉得您最好再打听打听,好好做一下心脏彩超。因为这个检查对宝贝的治疗和后续的复查有很大的影响。\n那么我先按照4.6公斤把利尿剂和**给您开一下,您先参考看一下吧。","media":{"images":{},"videos":{},"business_params":{"prescription_id":156502}},"is_doctor":1,"status":1,"created_at":"2023-10-23 18:08:54","show_rx":true,"rx_info":{"id":156502,"rx_no":2.02310231808515e+24,"user_id":2432221,"doctor_user_id":1046848,"is_independent":0,"case_id":3185142,"pet_info":{"pet_id":410190,"pet_name":"斯芬克斯猫","pet_nickname":"大臭","pet_gender":1,"pet_birth":"1-9","pet_weight":0,"pet_vaccination_status":1,"pet_in_insect_repellent_status":1,"pet_out_insect_repellent_status":0,"pet_age_format":"1岁9个月"},"diagnose":"心脏问题。","signature":"","deadline":null,"status":1,"send_status":1,"use_status":0,"created_at":"2023-10-23 18:08:51","updated_at":"2023-10-23 18:08:54","deleted_at":null,"from_source":"online","template_id":0,"drug_data":{"0":{"id":123247,"prescription_id":156502,"doctor_user_id":1046848,"product_id":720,"product_sku_id":762,"dose":0.5,"dose_unit":"片","use_method":"口服","frequency":"每天2次","days":30,"number":1,"remark":"","created_at":"2023-10-23 18:08:51","updated_at":"2023-10-23 18:08:51","product_info":{"id":720,"hash_id":"R0LPkmpM33g3bVXD","class_ids":{"0":1,"1":2},"category_ids":{"27":186},"is_drugstore":1,"is_prescription":1,"drug_instruction_id":193,"sell_point":"维艾宁呋塞米片","title":"汉维宠仕维艾宁呋塞米片20mg×8片×5板\/盒","recommend_reason":{"0":"治疗心力衰竭,非心源性水肿、急性肾衰和高血压等","1":"心力衰竭治疗不推荐单独长期应用利尿剂,联合匹莫苯丹等临床反应更好"},"baike_guide_text":"","baike_article_hash_id":"","advword":"利尿","spec_data":{"1":{"name":"规格","option_data":{"0":{"name":"20mg盒装"}}}},"cover":"https:\/\/cdn.moguvet.com\/shop\/2022\/11\/507bbb75537f6cdec5d5649cc1ded5ee.jpg","images":{},"attr_data":{},"content":"","supplier_id":1,"transport_id":1,"min_price":148,"max_price":148,"sale_count":76,"tags":"","sort":0,"status":1,"delete_status":0,"created_at":"2021-12-17 14:46:46","updated_at":"2024-11-18 14:56:55","ins":{"id":193,"hash_id":"650KvV4Qn0gWXBEd","class_ids":"[\u00221\u0022,\u00222\u0022]","title":"汉维宠仕维艾宁呋塞米片","common_name":"维艾宁","trade_name":"呋塞米片","en_name":"Furosemide Tablets","brand_name":"汉维宠仕","is_prescription":1,"cover":"\/drug\/2021\/12\/a393976e258b3a2e0a37d7af8e9e820b.jpeg","specification":"20mg×7片×5板\/盒","reference_price":350,"component":"呋塞米","indication":"利尿药。治疗心力衰竭(急性和慢性),非心源性水肿、高钙尿性肾病、急性肾衰竭、高钾血症和高血压。心力衰竭治疗中不推荐单独长期应用利尿剂,因为联合治疗患病动物(例如ACE抑制剂、匹莫苯丹)可得到较好的临床反应。","usage_dosage":"以呋塞米计。内服:犬、猫2.5-5mg\/kg\/次。或遵医嘱。","contraindication":"1.脱水和无尿禁用。\n2.禁用于脱水或高尿酸血症的鸟类。\n3.对于电解质严重损耗、肝衰竭和糖尿病的动物应谨慎使用。","adverse_reaction":"容易发生低血钾症、低氯血症、低钙血症、低镁血症和低钠血症、脱水、多尿\/多饮和肾前性氮血症。严重肺部疾病、低输出量性心力衰竭、肥厚型心肌病、心包或心肌异常、心脏压塞和严重高血压的动物可出现心输出量显著降低。其他不良反应包括耳毒性(尤其在猫)、胃肠道紊乱、白细胞减少症、贫血、虚弱和坐立不安。","attention":"","interaction":"氨基糖苷类药物相关的肾毒性\/耳毒性在同时使用呋塞米时可加强。呋塞米可介导低钾血症,因此增加了地高辛毒性的风险。如果呋塞米和乙酰唑胺、皮质类固醇、噻嗪类药物以及茶碱同时给药可增加低钾血症的风险。因为阿司匹林和呋塞米竞争肾脏的排泄位点,所以二者同时使用会降低排泄,可能需要减少剂量。呋塞米可抑制筒箭毒碱的肌肉松弛效果,但可增强琥珀胆碱的作用。","approval_no":"兽药字(2016)090241179","storage_method":"遮光,密封,在干燥处保存。","validity":"2年","manufacturer":"上海汉维生物医药有限公司","status":1,"created_at":"2021-12-22 18:16:29","updated_at":"2021-12-22 18:16:29"}},"product_sku_info":{"id":762,"product_id":720,"title":"汉维宠仕维艾宁呋塞米片20mg×8片×5板\/盒","advword":null,"price":148,"market_price":198,"cost_price":0,"stock":53,"stock_alarm":10,"spec_data":{"1":{"name":"规格","option":"20mg盒装"}},"cover":null,"thumb":"","sale_count":80,"status":1,"delete_status":0,"cloud_repo_id":0,"cloud_repo_goods_id":"","sort":1,"created_at":"2021-12-17 14:46:46","updated_at":"2024-11-18 14:53:40"}},"1":{"id":123248,"prescription_id":156502,"doctor_user_id":1046848,"product_id":762,"product_sku_id":804,"dose":0.25,"dose_unit":"片","use_method":"口服","frequency":"每天2次","days":30,"number":1,"remark":"","created_at":"2023-10-23 18:08:51","updated_at":"2023-10-23 18:08:51","product_info":{"id":762,"hash_id":"9MqykBxrbKxwb1Or","class_ids":{"0":1},"category_ids":{"6":167},"is_drugstore":1,"is_prescription":1,"drug_instruction_id":85,"sell_point":"贝心舒 盐酸贝那普利咀嚼片","title":"欧博方贝心舒 盐酸贝那普利咀嚼片5mg×28片\/盒","recommend_reason":{"0":"用于治疗犬的充血性心力衰竭"},"baike_guide_text":"","baike_article_hash_id":"","advword":"心力衰竭,盐酸贝那普利","spec_data":{"1":{"name":"规格","option_data":{"0":{"name":"28片盒装"}}}},"cover":"https:\/\/cdn.moguvet.com\/shop\/2021\/12\/b07ec02d2d64e059e64dcd6da4634090.jpeg","images":{},"attr_data":{},"content":"","supplier_id":1,"transport_id":1,"min_price":238,"max_price":238,"sale_count":8,"tags":"","sort":0,"status":1,"delete_status":0,"created_at":"2021-12-20 14:30:35","updated_at":"2024-03-22 10:03:39","ins":{"id":85,"hash_id":"","class_ids":"[\u00221\u0022]","title":"","common_name":"盐酸贝那普利咀嚼片","trade_name":"贝心舒","en_name":"Benazepril Hydrochloride Chewable Tablets","brand_name":"欧博方","is_prescription":1,"cover":"\/drug\/2020\/11\/33b3c442f2129c1af6b64d50dd4ec57b.JPG","specification":"5mg×28片\/盒","reference_price":280,"component":"盐酸贝那普利","indication":"用于治疗犬的充血性心力衰竭。","usage_dosage":"1.以盐酸贝那普利计。内服,犬0.25mg~0.5mg\/kg体重。\n2.在治疗过程中,可根据临床疗效,经兽医的允许在上述剂量上加倍服用。","contraindication":"1.禁用于对血管紧张素转换酶抑制剂过敏的犬。\n2.禁用于妊娠期或泌乳期母犬。\n3.禁用于血压过低、血容量不足(血容量过低)、低钠血症或急性肾功能衰竭的犬。\n4.对于治疗患有严重充血性心力衰竭的犬,须密切监测。\n5.对于患有慢性肾病的犬,建议在治疗期间监测血浆尿素和肌酐水平。\n6.体重不足2.5kg犬的疗效和安全性未明确。","adverse_reaction":"犬对盐酸贝那普利耐受良好。少数犬可能出现呕吐、运动失调、短暂性疲劳等症状。","attention":"","interaction":"通常可与利尿药(呋塞米),地高辛匹莫苯丹以及抗心律病不齐药联合服用,但可能导致低血压,与钾盐或保钾药合用可引起高血压,与非甾体抗炎药合用可降低其疗效。","approval_no":"兽药字153717035","storage_method":"密封,在25度以下的干燥处保存。","validity":"2年","manufacturer":"青岛欧博方医药科技有限公司","status":1,"created_at":"2020-11-09 18:48:59","updated_at":"2020-11-09 18:48:59"}},"product_sku_info":{"id":804,"product_id":762,"title":"欧博方贝心舒 盐酸贝那普利咀嚼片5mg×28片\/盒","advword":null,"price":238,"market_price":360,"cost_price":0,"stock":92,"stock_alarm":10,"spec_data":{"1":{"name":"规格","option":"28片盒装"}},"cover":null,"thumb":"","sale_count":8,"status":1,"delete_status":0,"cloud_repo_id":0,"cloud_repo_goods_id":"","sort":1,"created_at":"2021-12-20 14:30:35","updated_at":"2024-03-21 18:30:55"}}},"drug_data_bak":{"0":{"id":123247,"prescription_id":156502,"doctor_user_id":1046848,"product_id":720,"product_sku_id":762,"dose":0.5,"dose_unit":"片","use_method":"口服","frequency":"每天2次","days":30,"number":1,"remark":"","created_at":"2023-10-23 18:08:51","updated_at":"2023-10-23 18:08:51","product_info":{"id":720,"hash_id":"R0LPkmpM33g3bVXD","class_ids":{"0":1,"1":2},"category_ids":{"27":186},"is_drugstore":1,"is_prescription":1,"drug_instruction_id":193,"sell_point":"维艾宁呋塞米片","title":"汉维宠仕维艾宁呋塞米片20mg×8片×5板\/盒","recommend_reason":{"0":"治疗心力衰竭,非心源性水肿、急性肾衰和高血压等","1":"心力衰竭治疗不推荐单独长期应用利尿剂,联合匹莫苯丹等临床反应更好"},"baike_guide_text":"","baike_article_hash_id":"","advword":"利尿","spec_data":{"1":{"name":"规格","option_data":{"0":{"name":"20mg盒装"}}}},"cover":"https:\/\/cdn.moguvet.com\/shop\/2022\/11\/507bbb75537f6cdec5d5649cc1ded5ee.jpg","images":{},"attr_data":{},"content":"","supplier_id":1,"transport_id":1,"min_price":148,"max_price":148,"sale_count":76,"tags":"","sort":0,"status":1,"delete_status":0,"created_at":"2021-12-17 14:46:46","updated_at":"2024-11-18 14:56:55","ins":{"id":193,"hash_id":"650KvV4Qn0gWXBEd","class_ids":"[\u00221\u0022,\u00222\u0022]","title":"汉维宠仕维艾宁呋塞米片","common_name":"维艾宁","trade_name":"呋塞米片","en_name":"Furosemide Tablets","brand_name":"汉维宠仕","is_prescription":1,"cover":"\/drug\/2021\/12\/a393976e258b3a2e0a37d7af8e9e820b.jpeg","specification":"20mg×7片×5板\/盒","reference_price":350,"component":"呋塞米","indication":"利尿药。治疗心力衰竭(急性和慢性),非心源性水肿、高钙尿性肾病、急性肾衰竭、高钾血症和高血压。心力衰竭治疗中不推荐单独长期应用利尿剂,因为联合治疗患病动物(例如ACE抑制剂、匹莫苯丹)可得到较好的临床反应。","usage_dosage":"以呋塞米计。内服:犬、猫2.5-5mg\/kg\/次。或遵医嘱。","contraindication":"1.脱水和无尿禁用。\n2.禁用于脱水或高尿酸血症的鸟类。\n3.对于电解质严重损耗、肝衰竭和糖尿病的动物应谨慎使用。","adverse_reaction":"容易发生低血钾症、低氯血症、低钙血症、低镁血症和低钠血症、脱水、多尿\/多饮和肾前性氮血症。严重肺部疾病、低输出量性心力衰竭、肥厚型心肌病、心包或心肌异常、心脏压塞和严重高血压的动物可出现心输出量显著降低。其他不良反应包括耳毒性(尤其在猫)、胃肠道紊乱、白细胞减少症、贫血、虚弱和坐立不安。","attention":"","interaction":"氨基糖苷类药物相关的肾毒性\/耳毒性在同时使用呋塞米时可加强。呋塞米可介导低钾血症,因此增加了地高辛毒性的风险。如果呋塞米和乙酰唑胺、皮质类固醇、噻嗪类药物以及茶碱同时给药可增加低钾血症的风险。因为阿司匹林和呋塞米竞争肾脏的排泄位点,所以二者同时使用会降低排泄,可能需要减少剂量。呋塞米可抑制筒箭毒碱的肌肉松弛效果,但可增强琥珀胆碱的作用。","approval_no":"兽药字(2016)090241179","storage_method":"遮光,密封,在干燥处保存。","validity":"2年","manufacturer":"上海汉维生物医药有限公司","status":1,"created_at":"2021-12-22 18:16:29","updated_at":"2021-12-22 18:16:29"}},"product_sku_info":{"id":762,"product_id":720,"title":"汉维宠仕维艾宁呋塞米片20mg×8片×5板\/盒","advword":null,"price":148,"market_price":198,"cost_price":0,"stock":53,"stock_alarm":10,"spec_data":{"1":{"name":"规格","option":"20mg盒装"}},"cover":null,"thumb":"","sale_count":80,"status":1,"delete_status":0,"cloud_repo_id":0,"cloud_repo_goods_id":"","sort":1,"created_at":"2021-12-17 14:46:46","updated_at":"2024-11-18 14:53:40"}},"1":{"id":123248,"prescription_id":156502,"doctor_user_id":1046848,"product_id":762,"product_sku_id":804,"dose":0.25,"dose_unit":"片","use_method":"口服","frequency":"每天2次","days":30,"number":1,"remark":"","created_at":"2023-10-23 18:08:51","updated_at":"2023-10-23 18:08:51","product_info":{"id":762,"hash_id":"9MqykBxrbKxwb1Or","class_ids":{"0":1},"category_ids":{"6":167},"is_drugstore":1,"is_prescription":1,"drug_instruction_id":85,"sell_point":"贝心舒 盐酸贝那普利咀嚼片","title":"欧博方贝心舒 盐酸贝那普利咀嚼片5mg×28片\/盒","recommend_reason":{"0":"用于治疗犬的充血性心力衰竭"},"baike_guide_text":"","baike_article_hash_id":"","advword":"心力衰竭,盐酸贝那普利","spec_data":{"1":{"name":"规格","option_data":{"0":{"name":"28片盒装"}}}},"cover":"https:\/\/cdn.moguvet.com\/shop\/2021\/12\/b07ec02d2d64e059e64dcd6da4634090.jpeg","images":{},"attr_data":{},"content":"","supplier_id":1,"transport_id":1,"min_price":238,"max_price":238,"sale_count":8,"tags":"","sort":0,"status":1,"delete_status":0,"created_at":"2021-12-20 14:30:35","updated_at":"2024-03-22 10:03:39","ins":{"id":85,"hash_id":"","class_ids":"[\u00221\u0022]","title":"","common_name":"盐酸贝那普利咀嚼片","trade_name":"贝心舒","en_name":"Benazepril Hydrochloride Chewable Tablets","brand_name":"欧博方","is_prescription":1,"cover":"\/drug\/2020\/11\/33b3c442f2129c1af6b64d50dd4ec57b.JPG","specification":"5mg×28片\/盒","reference_price":280,"component":"盐酸贝那普利","indication":"用于治疗犬的充血性心力衰竭。","usage_dosage":"1.以盐酸贝那普利计。内服,犬0.25mg~0.5mg\/kg体重。\n2.在治疗过程中,可根据临床疗效,经兽医的允许在上述剂量上加倍服用。","contraindication":"1.禁用于对血管紧张素转换酶抑制剂过敏的犬。\n2.禁用于妊娠期或泌乳期母犬。\n3.禁用于血压过低、血容量不足(血容量过低)、低钠血症或急性肾功能衰竭的犬。\n4.对于治疗患有严重充血性心力衰竭的犬,须密切监测。\n5.对于患有慢性肾病的犬,建议在治疗期间监测血浆尿素和肌酐水平。\n6.体重不足2.5kg犬的疗效和安全性未明确。","adverse_reaction":"犬对盐酸贝那普利耐受良好。少数犬可能出现呕吐、运动失调、短暂性疲劳等症状。","attention":"","interaction":"通常可与利尿药(呋塞米),地高辛匹莫苯丹以及抗心律病不齐药联合服用,但可能导致低血压,与钾盐或保钾药合用可引起高血压,与非甾体抗炎药合用可降低其疗效。","approval_no":"兽药字153717035","storage_method":"密封,在25度以下的干燥处保存。","validity":"2年","manufacturer":"青岛欧博方医药科技有限公司","status":1,"created_at":"2020-11-09 18:48:59","updated_at":"2020-11-09 18:48:59"}},"product_sku_info":{"id":804,"product_id":762,"title":"欧博方贝心舒 盐酸贝那普利咀嚼片5mg×28片\/盒","advword":null,"price":238,"market_price":360,"cost_price":0,"stock":92,"stock_alarm":10,"spec_data":{"1":{"name":"规格","option":"28片盒装"}},"cover":null,"thumb":"","sale_count":8,"status":1,"delete_status":0,"cloud_repo_id":0,"cloud_repo_goods_id":"","sort":1,"created_at":"2021-12-20 14:30:35","updated_at":"2024-03-21 18:30:55"}}}}}}
微信扫一扫
立即问宠医