咨询描述:2020年10月左右做子宫蓄脓手术,2021年初大便开始稀软,就诊时确诊胰腺炎,随后用***进行治疗,但效果不明显。2021年5月又去检查,还是胰腺炎,用****治疗,效果还是不明显。后来我就查了文献,怀疑是胰腺外分泌不足,于是每餐补充**,2021年至2022年大便状态稍微稳定,但有时也会软便水样便,出现症状时就给她喂****和***,能够控制住。2023年2-7月大便状态十分稳定,但到了8月初状态特别不好,平均一天大便3-5次,直到10月我给她换了**的低脂处方粮,然后每餐都吃胡萝卜,状态能好一些,但还是不稳定,一天差不多拉3次,早上和中午的都能成型,但晚上就是稀便,严重点就是水样便。这个月初到现在一天平均3-4次,除了早上的粪便能成型,中午和晚上几乎也都是稀便。食欲从发病就特别旺盛。
问题大致一样,细节不同?
曹元钊
执业兽医师
你好,请问这个狗狗的体重目前是不是出现了降低的趋势?有没有做过超声,检查一下肠道情况。从他最近一次的化验结果来说,我觉得这个狗狗其实应该是一个慢性结肠炎或者溃疡性结肠炎的可能性会更高一些,也就是说实际上是肠道有炎症,跟胰腺可能不太搭边
您好,是的,狗狗这几个月体重暴降,从13、14kg左右降到11kg,做了b超,医生说没看见肠道增厚,但是气体特别多,液体特别多,做b超的时候肚子液体一直在来回游荡
曹元钊
执业兽医师
我认为他应该就是一个非常严重的溃疡性结肠炎的可能性会比较高,不应该再把目光放到胰腺上面了。
我觉得你应该针对炎症对症治疗。医生有没有建议提供输液治疗,因为他现在***比较低一点。
医生说***和胆固醇低的原因应该是不吸收,能吸收的话应该会很快增长上去,没有建议我输***。但医生说从血常规看没有特别高的炎症,医生给我两个建议,要么是吃泼尼龙看看效果,要么去看看宠物中兽医,试试中药,我这两天在给她吃中药和艾灸,已经4天左右了,状况没有改善,现在拉的全是水,您用看一下粪便的状况吗?
曹元钊
执业兽医师
您可以把它粪便的情况给我看一下,如果可以的话呢,我想给你建一些药物,你试试看,你可以从哪买都行。
图1、2是周一早上和中午的粪便,晚上也还是水样稀便。图3、4是昨天早上和中午的,下午也是稀便,晚上一点钟还拉了一次稀水便,图5是今天中午吃完饭拉的
为保护用户隐私不显示图片/视频
曹元钊
执业兽医师
我还是觉得这个实际上应该是一个溃疡性结肠炎的可能性会更高一些,也有可能是炎性肠病,不过治疗方法不会有什么区别。
我建议方案如下,第一***,一天一次,每次一片,口服14天。第二***茸一天两次,每次一片,口服14天,第三碱氏***一天两次,每次一片,口服14天。第四益生菌一天两次,每次一袋口服14天益生菌和***隔开两个小时,第五食物改成低敏处方粮。并且要做到少食多餐。
曹元钊
执业兽医师
第1天的时候只准给正常喂食量的1/7,然后慢慢往上加,用5天时间恢复正常饮食量,但是仍然要少食多餐。
她现在一直吃的是**胰腺低脂易消化处方粮,这个粮还要继续吃吗?我知道***龙是激素药,她现在年龄比较大,我怕这个副作用会不会太强了?****铋片之前吃过,吃了没有太大的效果,粪便变成墨绿色,但还是固不住。上周一直吃着****和***片,开始有用,后面就没用了…益生菌的话我们也一直在补,效果感觉也不大….现在就是很纠结这个***龙给她用上会不会副作用太大了….
曹元钊
执业兽医师
我觉得这个低脂处方粮就算了,换成别的吧。试一试低敏处方粮
我认为现在不是说顾忌激素的副作用的时候,而且按照这个剂量使用,短期不会有什么伤害。
****铋只是单纯的去尝试让粪便成型,但是病因没有除去,所以****铋不会有作用,这些药物是要结合使用的。
***也是因为你之前用的别的抗生素用了一段时间,所以换一种。
我觉得不用纠结,我觉得现在是这样的,这个方案是一个基础的治疗,如果不见效果的话,我们还有别的方案,但是得根据他对药物的反应来定。
好的好的,我明白啦,还想问一下就是您觉得如果用中兽医的方法(中药、艾灸)治疗这个疾病可行吗?还有就是她目前食欲特别旺盛,但我们就是每天给她早上25g狗粮和5g鸡胸肉,中午25g狗粮,晚上25g狗粮和5g鸡胸肉,您觉得食物的量上用不用调整?买了低敏粮的话,我应该按多少量给她喂食?您这边建议去输人血***吗?她这个***过低的话,目前会不会有什么危险?因为这两天感觉她早上睡起来的时候手掌脚掌会有点肿,头也会有一点肿。
曹元钊
执业兽医师
中兽医的方法不是不行,但是中兽医有一个很特点,就是它需要一病一方,单纯的去做艾灸,还有一些调理,我觉得见效的可能性并不高。食物的总量并不需要调整,只需要把处方粮换成低敏的就可以。您就按照袋子后面的建议喂食量,然后呢,第1天只给到正常量的1/7,然后慢慢往上加。
他现在的这个肿胀其实就是蛋白低引起的。我觉得***其实可以考虑用一点的,输一点***
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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