咨询描述:曹医生您好,上次咨询过你关于狗狗的问题,您给的判断是溃疡性结肠炎或者IBD,但实在由于心里因素,没敢给狗狗用上激素,就找了一个中兽医给开方子,目前喝了有大概四副药,但现在情况还是不行,有几天能看见大便性状和次数的改变,但后面几天又变成纯拉水了。但按您的医嘱,我给她已经换了**低敏粮,也去医院输了两瓶人血***,目前没有肿胀的情况了,就是大便还是稀水状,所以现在还是打算用西医的办法去治疗。想问您几个问题,第一,能不能先不用激素,用抗生素试一试?我看见外网文献推荐的泰农的**菌素,我也给她买上了,这两天就能到,我能不能先用这个试一试,看看能不能控制住。第二,如果**菌素没用的话,人用的醋酸***可以直接给狗吃上吗,因为这个是给她检查的医生建议的,说可以直接吃人用的,一天一次,一次两片,这样可以吗?第三,吃上激素之后是不是意味着以后一直要吃激素?就意味着不能停药了?因为我看长期吃激素对狗的副作用实在太大了,所以一直很担心。毕竟下个月她就15岁了,身体机能肯定不比以前。
图片附上了上次b超的检查报告,您看一下。
感谢您的耐心回答!
问题大致一样,细节不同?
曹元钊
执业兽医师
你好,第一,我实在是不太建议单纯,只用抗生素,因为我始终觉得这个不只是抗细菌的问题同时一定要单纯的去针对炎性,反应进行对症治疗。 所以我还是坚持认为激素在里面的治疗中应该占一个核心地位。
第2人用的醋酸***龙也是可以使用的。只要按照剂量吃就可以了。只不过我们从业的这个法律要求,我们不允许给动物推荐人用药,而且人用药确实也有风险。
第三,吃上激素以后并不是说永远都要吃激素,它是先用上药物对症治疗,之后呢慢慢尝试着去减量,直到达到最低有效量,或者说可能以后能停止,但是现在不行。激素并不是说一定要长期使用的,这个是我们先控制住症状以后再尝试的去减量,或者说那个时候再结合一些中兽医调理。治病的时候急缓之间有讲究的,该上蒙药的时候就得上蒙药,该调理的时候就得调理。
我之前建议的方案仍然不建议说您就是选其中的一种,然后就这么用,我还是建议综合性的治疗,像他现在这种情况,又过去了一些天,我觉得除了激素以外抗生素,然后加上****铋再加上***都是要用的,还有益生菌。
好的好的,那我明白了。那目前我就是按您说的治疗方法进行治疗吧,我买的那个**菌素目前能给她用上吗?***+**菌素+益生菌可以吗?也就是***每天一次,一次2片(10mg),**菌素每天两次,益生菌也是每天补充,***上次您没有开,这个也要用上吗?还有就是我看好多人推荐的L-****对这个疾病也有帮助,这个可以吃上吗?食物上的话用不用进行调整?我现在每天给她吃的都是**的低敏粮,每顿45g左右,一天三顿,这样可以吗?用不用添加点肉什么的?她现在确实太瘦了,食欲也异常的旺盛,每天感觉都吃不饱。平常还需要添加别的营养补充剂吗?比如鱼油,b12,***片这些的…
曹元钊
执业兽医师
准确的说用药应该是**菌素加***龙加益生菌加****铋和***。
普尼斯龙一开始呢,可以按照一天两次,每次一片或者是一天一次,每次两片都行。作为一个初始量,因为这个药物属于激素,我们一开始先用的量呢保守一点之后慢慢再根据反应进行调整。
****铋和***都要给,一天两次,每次一片可以一起吃。 这两个药物基本上没有什么副作用,它也不会吸收进入身体里面也不会增加身体负担,所以是安全的。
他现在的食物暂时不需要调整,还是按照一天三次,每次45克这样给,但是你把所有的药物都用上,以后你要观察它食物的吸收情况,就是说你要观察排便,只要它排便OK。甚至最好的情况,一开始一两天都不排便,那就可以考虑再慢慢的增加喂食量了。像其他的营养的东西暂时都不需要给,因为它重点是不吸收,先先吸收再说。
至于您说****这些是可以的,它也有一定的帮助肠黏膜修复的作用,不过是属于辅助用药。
曹元钊
执业兽医师
我们增加营养物质的前提是它得能吸收,只要能吸收了再慢慢往上加,不吸收你给的越多越不好。
那这些药的用量都是先用14天,14天之后如果稳定的话,激素就可以减量或者停止吗?这些都得14天之后再找您复诊,您再来判断?
曹元钊
执业兽医师
这些用药是的,这些都是先用14天,14天之后如果稳定的话,我可以会考虑减量,但是不会说立刻停止,但是需要复诊需要提供这14天之内它的整体的情况,然后我再来判断。
好的好的明白了,因为激素和**菌素我这边都有,但是碱式盐酸铋片和***片我现在买还得几天,****铋我能不能用小孩的***散先代替,然后***片我也先买人用的代替一下,因为等这些药一起到的话还得几天,我实在有点着急了
益生菌的话我一之前一直给她吃的人用的now foods的25亿益生菌那个,用不用再加上***酵母菌?益生菌和激素还有抗生素要分开时间喂,对吗?
曹元钊
执业兽医师
可以暂时先用别的替代一下,等待药物到达以后,然后去用上,益生菌的话呢,可以使用***酵母菌,人用的那个吃不吃都行。
益生菌和抗生素还有激素要分开,但是抗生素和激素不需要再隔开。
最后问您一下,就是****铋片和***也是一直吃14天吗,如果腹泻缓解了,这两个药用不用停?因为我看副作用会有便秘什么的。谢谢您啦
曹元钊
执业兽医师
初步的计划也是14天,除非这个狗超过四天五天不排便,不然不要停,矫枉就得过正。
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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