(一)出院依慰在飼主手臂 (二)第一次的驗血報告 (三)第二次的驗血報告
(一)出院依慰在飼主手臂
(二)第一次的驗血報告
(三)第二次的驗血報告
96/9/12 00:55:31,6.5kg,vomited with bile for 2 days,hemaurine ,urolithiosis,ememergency for 00:55~02:10
症狀：一歲混種公貓未結紮，嘔吐 黃色膽汁二天，蹲貓盆過久懷疑便秘，嚴重血尿排出，經過觸診膀胱脹大，將尿道結石巧合擠出產生約30豪升血尿於診療台上。
血液檢查：(圖二)
Glucose 192 mg / dl ↑ (55-105)
BUN 128 mg / dl ↑ (16-30)嚴重腎損傷
Serum GOT 50 mU / ml ↑ (10-23)
Serum GPT 85 mU / ml ↑ (10-52)
Creatinine 8.8 mg/dl ↑ (0.5-1.8)嚴重腎損傷
Calcium 8.9 mg / dl Ｎ (8.3-10.1)
處理：因為已將尿道拴子或結石擠出， 省去麻醉導尿同時為飼主節省費用，直接靜脈留置針點滴住院二天觀察。
96/9/12 辦理住院
96/9/12 09:02:12,正常黃色尿液
96/9/12 18:38:31
96/9/12 20:00:47,can eat can,normal urine
開始會進食貓皇冠罐頭(吻仔魚)
96/9/13 08:17:54,normal stool,hemaurine,normal appetite
正常糞便，輕微血尿，食慾正常
96/9/13 15:35:38,out of patient ,might not buy predic food,can eat LP34
血液檢查：(圖三)
BUN 10 mg / dl ↓ (16-30)
Serum GOT 28 mU / ml ↑ (10-23)
Serum GPT 138 mU / ml ↑ (10-52)
Creatinine 1.2 mg/dl Ｎ (0.5-1.8)
二天後第二次血液檢查，腎指數竟然奇蹟似的由8.8降至1.2，也願意吃貓罐頭和尿道結石處方飼料，出院調養(圖一)
(一)第一天精神不佳的注射點滴 (二)第二天抽血前會攻擊飼主和醫師
(三)抽血後狼吞虎嚥貓罐頭
(四)第一次的驗血報告
(五)第二次的驗血報告
96/9/20 22:45:51,4.3kg,distended bladder, urothiosis with uretheter
,depression
anorexia for 2 days ,emergency for 22:45~01:25
症狀：二歲已去勢金吉拉公貓，厭食兩天，精神不佳，不會攻擊飼主和醫師側躺著
血液檢查：(圖四)
HGB 12.3 g / dl__ Ｎ (8-14.5)
Glucose 273 mg / dl ↑ (55-105)
BUN 134 mg / dl ↑ (16-30)嚴重腎損傷
Serum GOT 47 mU / ml ↑ (10-23)
Serum GPT 41 mU / ml Ｎ (10-52)
Creatinine 13.1 mg/dl ↑ (0.5-1.8)嚴重腎損傷
Calcium 7.6 mg / dl ↓ (8.3-10.1)
處理：
因為腎指數高過第四級5.0太多，加上精神沉鬱，使用氣體麻醉導尿術
96/9/21 辦理住院(圖一)
96/9/21 10:05:14,can eat cat can ,can attack anyone ,can urine
96/9/21 10:18:24 尿液檢查：SG
1.030,WBC +,Nitrit ++,Protein
++,Glucose -,Keton -,Urobilinogen
x,Bilirubin -
96/9/21 20:00:54,out of patient ,normal appetite 食慾正常(圖三)
第一天後第二次血液檢查(圖二)，腎指數竟然奇蹟似的由13.1降至2.3，口服腎臟藥物半個月出院調養
血液檢查：(圖五)
Total-Bili 57 mg / dl ↑ (0.2-0.4)
Creatinine 2.3 mg/dl ↑ (0.5-1.8)
討論：
生化血液檢查：請參閱亞東動物醫院服務項目檢驗室
國際腎臟病關心協會的慢性腎臟病的分級系統
|
Stage |
Plasma creatinine µmol/l mg/dl |
Comments |
|
|
Dogs |
Cats |
||
|
1 |
<125 <1.4 |
<140 <1.6 |
Non-azotemic Some other renal abnormality present e.g. inadequate concentrating ability without identifiable non-renal cause; abnormal renal palpation and/or abnormal renal imaging findings; proteinuria of renal origin; abnormal renal biopsy results |
|
2 |
125 - 179 1.4 - 2.0 |
140 - 249 1.6 - 2.8 |
Mild renal azotemia [lower end of the range lies within the reference range for many labs but the insensitivity of creatinine as a screening test means that animals with creatinine values close to the upper limit of normality often have excretory failure] Clinical signs usually mild or absent |
|
3 |
|
|
Moderate
renal
azotaemia |
|
|
|
|
|
|
UPC value |
Substage |
|
|
Dogs |
Cats |
|
|
<0.2 |
<0.2 |
Non-proteinuric (NP) |
|
0.2 to 0.5 |
0.2 to 0.4 |
Borderline proteinuric (BP) |
|
>0.5 |
>0.4 |
Proteinuric (P) |
|
Systolic BP mm Hg |
Diastolic BP mm Hg |
Adaptation when breed- specific reference range is available * |
Substage |
|
<150 |
<95 |
<10 mm Hg above reference range |
Minimal Risk (N) |
|
150 – 159 |
95 - 99 |
10 – 20 mm Hg above reference range |
Low Risk (L) |
|
160 – 179 |
100 - 119 |
20 – 40 mm Hg above reference range |
Moderate Risk (M) |
|
= 180 |
= 120 |
= 40 mm Hg above reference range |
High Risk (H) |
|
No evidence of end organ damage/complications |
No complications (nc) |
||
|
Evidence of end organ damage/complications |
Complications (c) |
||
|
Blood pressure not measured |
Risk not determined (RND) |
||