咨询描述:咳嗽严重
症状描述:最近咳嗽感觉有痰
患病时长:一年多了,最近比较严重
医院检查:检查两次了
用药情况:没有吃药,只是生理盐水雾化
问题大致一样,细节不同?
徐灿
执业兽医师
你好家长,我已经看到了视频,我需要问一下,有没有拍摄侧位胸片的?他有没有心脏病?还有就是只是用了生理盐水吗?一般来说,会用到抗生素和其他药物的,还有就是发现他的咳嗽有罗音,应该是有痰液,有没有使用化痰的药物呢?我需要知道更多的情况,所以请详述用药。
徐灿
执业兽医师
需要看一下片子,就是侧位胸片,然后生理盐水是没有任何作用的,所以一般来说,在里面会加入药液,我需要了解一下,里面加入了什么药物,还有就是有没有给他用化痰的呢?
都没有用,没有用药物
为保护用户隐私不显示图片/视频
这是医生说的 猫咪咳嗽情况恶化了还是需要考虑一下进一步检查(影像学,气管镜等),毕竟猫咪比较年轻,排查一下咳嗽原因,知道病因去指导治疗会比较好些。
如果确实不考虑进一步的话,这边可以加下雾化药看下治疗效果,但是如果后续中途有想去排查的话,用药会有点影响,需要停药一段时间。
为保护用户隐私不显示图片/视频
徐灿
执业兽医师
有没有更为清晰的X光片子呢?因为这个完全看不清楚,说小的太说小的太严重了,没有什么参考意义,我需要看一下原片。
而且从声音上来看,而且从声音上来判断,他呼吸已经是比较困难的了,考虑到肺部是有痰液的,所以我需要知道一下用药方案,而且他这种情况最好是雾化治疗是最快的。
明天可能才能有原片,我在问医生给了,他应该明天给我。现在都是晚上咳嗽。我想知道是什么原因造成的,能不能治愈呢?我需要怎么做呢?属于哮喘还是支气管炎?
徐灿
执业兽医师
目前来说,我不能完全确定,只能确定的是,它并不是由于支原体,衣原体等感染的,只不过片子太模糊,没有参考价值,所以我不知道它的肺内是什么情况的。所以就无法判定它是否有严重的肺部感染。
而且从声音上来判断,它并不像是哮喘,再有就是所用的药物根本就没有提及,所以说所知道的信息根本就不足,不足以确定原发原因,但是建议是先对症处置,雾化治疗,增加抗生素和激素,还有化痰药物。以应对他的症状,然后做逆向处置排除。
这是检查结果,医生给的建议。那猫咳嗽这种情况能治愈吗?
为保护用户隐私不显示图片/视频
徐灿
执业兽医师
首先就是这个结果是主治医师告知的,我并不能以他这个结果去告知你,因为我并没有核实之前的化验结果,也就是说,这个结论并不是我的意见,所以我不太好以这个方式告诉你。
所以我需要先看一下他之前的X光片,哪怕是以哮喘和慢性呼吸道问题来说,那么也应当增加那么,也应当增加一些激素类药物配合,而并不单纯使用生理盐水。
那加些什么药物一起雾化呢?明天早上再咨询可以吗?明天早上我问医生给原片,谢谢了,先晚安~
徐灿
执业兽医师
方案的话,后续我会告知,但是我不确定他的实际情况,因为化验结果缺失,需要判读之之后才能知道。后续的话,建议肯定是会给的。
只不过我是夜班的医生,所以可能要等到明天下午左右才会回复,或者更晚一些。
这个是DR影片 现在基本都是晚上咳嗽,咳嗽像有痰。2023年8月份左右喝过***,没有作用。现在就只是用生理盐水雾化,没有用药了。
为保护用户隐私不显示图片/视频
徐灿
执业兽医师
如果是这种情况的话,尝试着逆向诊断,在生理盐水里面,加入**霉素,**米松,还有就是*****,然后雾化三天,看一下症状是否会有所缓解,因为从声音来判断,它应该是有痰液,X光的严重程度不高,但是他的症状和声音并不正常。
需要先去检查影像学,气管镜吗?先检查到问题再用药可以吗?,目前它就是晚上咳嗽严重点,白天吃喝拉正常的。
徐灿
执业兽医师
不是的,我建议是你可以按照我告知的方案先给他雾化三天,然后配合着口服,一些激素和抗生素,还有就是促进呼吸,然后看一下状态是否会有好转。
然后我帮你开了个口服的方案,然后像**霉素之类的药物,你得到其他途径去买注射液,比如说兽药店或者是网上之类的。建议逆向诊断,因为气管镜得麻醉。然后建议用药3到5天左右,然后回来复诊。
逆向诊断是什么意思呢?这些药怎么用呢?如果三天还不好转,该去检查什么项目呀
徐灿
执业兽医师
逆向诊断也叫治疗诊断,就是通过症状判断为某一类疾病,或者逆向排除某一类疾病,目前来说,优先考虑就是有肺部的感染问题,还有痰液。所以采取了上面的方案。
你可以点开查看详情,备注的最后一句就是用量,已经有所备注了。
然后建议是口服药物,再加雾化三天,然后看一下症状是否有所缓解,然后回来做复诊,如果说后续没有效果的话,我会告知后续的处置方式。
实际上,逆向诊断也是检查的一种,也叫药物诊断。
徐灿
执业兽医师
如果用了上述方案,三天没效果,做心脏彩超,因为上面的方案绝大部分都是有效的,除非是严重的心脏疾病,或者是反流,而且它还是一个布偶猫,而且发病的时候都是晚上,所以说先按照上面的方案用,后续再考虑其他的,先不要想特别多,想的越多越麻烦,最后越下不了决心。所以说先按照上面的方案用药三天,然后回来复诊。
除了吃这些药,还有雾化用什么药呢?您说的注射液是怎么用呢?
徐灿
执业兽医师
我在上面已经有提到的,就是去买**霉素,**米松,还有就是*****,然后都买注射液,一般的兽用的还是非常好买的。
至于说怎么用,买回来之后可以回来复诊,然后我会告知后续的用量用法,因为我不知道你买的药物是什么规格。所以暂时无法告知具体用量。
徐灿
执业兽医师
可以的,没问题,平台上并没有注射液,因为不允许出售,你可以在平台上买吃的,也可以在其他途径,然后后续的话,按照我所提及的剂量正常的用就行。
好的👌🏻谢谢你,那我先买药,药到了跟您说,后面再用药💊
徐灿
执业兽医师
可以的,没问题,回头回来复诊就行,我一般都是夜班,然后一般晚上九点之后都在,然后回头找我就行,记得买雾化机。一般100多块钱一个,淘宝就有卖的。
徐灿
执业兽医师
感谢您对蘑菇宠医的信任,如果我的回答能够帮助到您,请您在咨询结束后留下5星评论。
后续宠物有其它问题,您可以到“蘑菇宠医”官方微信公众号找到我的医生继续向我提问。
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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