咨询描述：猫咪10天前确诊猫传腹，用了***➕**，目前精神状态好转，今天早上有咳嗽，医生建议用**环素，今晚喂了40mg人用**环素，喂完药马上喂了鸡胸肉和猫条，20分钟后猫咪出现拉稀症状，就给它禁食了（但他一直在找食物），4小时后出现呕吐（图片附上）
问题大致一样，细节不同？
徐灿
执业兽医师
你好，家长，对于这种情况来说，能不能把之前的化验结果发给我看一下？我首先需要核实一下他传染性腹膜炎这个事情。
其次就是**环素，对于胃部有刺激，计量方面是每公斤十毫克，一天两次，但是确实有可能会造成呕吐的。
能不能拍摄一段猫咪的视频？我想做一个初步评估。
1⃣️、确诊猫传腹是某天我发现他有腹式呼吸（精神稍微有点差，但是还能吃猫粮）带去了医院拍片发现有胸水，化验报告提示白球比降低，saa100多，所以找药商买了***，目前用药8天，它精神状态有好转（化验结果附上）2⃣️、猫咪吐完以后，母鸡蹲了一会，刚刚在找吃的（4小时前拉肚子以后我就已经把它的猫粮收起来了），现在在睡觉（视频附上）3⃣️，它拉稀发生在刚喂完**环素30分钟内，呕吐发生在喂完**环素4小时。
为保护用户隐私不显示图片/视频
徐灿
执业兽医师
对于这种情况来说，个人认为他的呕吐咳嗽，还是以胸腔内的问题为主导，这种情况个人建议是把**环素，然后替换成***，并且使用一些促进呼吸的药物，能够在一定程度上缓解问题。
也就是说，**环素确实有可能会造成呕吐和腹泻，但是不一定是主要原因，这种情况建议优先排水，然后提供能量持续性治疗。
1⃣️、根据检查结果，猫咪是否为猫传腹？2⃣️、猫咪用***后，呼吸的波浪式起伏明显好转，目前呼吸频率30次/分，暂时没有复查胸片，目前需要利尿吗？ 3⃣️、它确诊传腹已经10天，只有今天出现了腹泻和呕吐，考虑什么原因？ 4⃣️、今晚需要特殊处理吗？ 需要禁食禁水多久？今晚具体需要怎么操作呀？
徐灿
执业兽医师
首先就是他确实是传染性腹膜炎，这个倒是没有太多问题，后续的话，***等药物需要继续使用。
呕吐和腹泻主要考虑药物刺激，这种情况后续可以先断食半天，然后后续持续性使用，看一下是否有缓解。
因为他胸腔之中有腹水，所以需要搭配上一些利尿剂。今天晚上断食，然后后续的话增加一些利尿剂的使用。
1⃣️、它今天早上出现了咳嗽，所以才用**环素，下午和晚上都没有出现了，如果继续咳嗽，后续建议用什么抗生素（它因为传腹已经用了8天的**了）。 2⃣️、禁食禁水，需要补充葡萄糖吗？今晚最后一次进食是7点钟，家里没有葡萄糖，可以明天再用吗？3⃣️、附上目前的呼吸状态，麻烦医生帮忙判断一下，腹式呼吸是否严重，是否腹式呼吸可以反映胸水的情况？是否必须用利尿剂（实在不忍心再给他用太多药物了……但是如果需要的话，就用）
为保护用户隐私不显示图片/视频
徐灿
执业兽医师
目前来说，这个呼吸情况还是比较平稳的，**环素的话，个人建议先不要用了，使用**就可以，适当的你可以加一些激素，还有就是利尿剂，我帮你开了个方案，你可以参考使用。主要是抗炎利尿，用于缓解胸水。
激素不建议使用时间超过两周，利尿剂，等到症状缓解之后，就可以逐渐减量停止了
1⃣️、禁食禁水期间，请问需要补充葡萄糖或者生理盐水吗？
徐灿
执业兽医师
不用停止那么长时间，明天早上再喂就可以了，后续的话正常喂养，作为传染性腹膜炎的猫咪，要保证充足的食物供应，这样的话才能快速的恢复，但是最开始的时候也不应当饱食过度，他已经是治疗的第十天了，所以说正常的，让它摄入能量和食物就行。
1⃣️、他今天吃了**环素以后，30分钟左右出现了腹泻，4小时后出现了呕吐，目前考虑腹泻也是药物刺激导致吗？会不会是肠胃炎？
徐灿
执业兽医师
有肠胃炎的可能性，但是不作为主要考虑，而且**本身也是治疗肠胃炎的，可以做到覆盖治疗，而且由于药物刺激的可能存在。是由于胸水的原因那可能依然存在，所以建议是把抗生素由**代替，并且使用一些激素，和代谢胸水的。
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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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":70,"stock_alarm":10,"spec_data":{"1":{"name":"规格","option":"20mg盒装"}},"cover":null,"thumb":"","sale_count":63,"status":1,"delete_status":0,"created_at":"2021-12-17 14:46:46","updated_at":"2024-03-13 18:34:06"}}}}}}
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