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非常緊急, 分秒必爭~狗狗腫瘤擴散, 請幫忙, 萬分感激. 

版主: doggydc, Jeff Wang, JLLinVET, 艾咪

非常緊急, 分秒必爭~狗狗腫瘤擴散, 請幫忙, 萬分感激.

文章hil » 2008-08-04, 17:07

1.名字: Cookie
2.年齡: 10 yrs
3.犬種: Miniature Schnauzer
4.性別: Male
5.體重: 7.5 kg
6.病史: (一)在7歲時絕育. (二) 約十個月前小便有血, 服藥後痊癒.
7.發病經過、症狀:
(一) 小狗在半年內逐漸排便變幼及軟, 大便時有黏液, 故服藥杜蟲. 後檢查大便樣本後發現沒有蟲.
(二) 數月前再有血尿. 獸醫肛檢診斷後認為小狗前列線或有膿包, 先用藥確認. 經獸醫處方消炎藥及抗生素後沒有血尿. 故認為不是膿包, 可能是小狗自己的分泌物.
(三) 在上次診症後一星期大便仍有黏液. 血尿情況消失 (或肉眼看不見). 這次覆診肛檢發現前列線腫脹物變小.
(四) 約兩星期後小狗大便有血塊及黏液, 間中尿有少許血. 獸醫肛檢診斷後認為小狗前列線可能有腫瘤. 先再用藥確定.
(五) 小狗用藥一星期後情況稍有改善. 覆診後兩星期小狗再有血尿, 排不到便.經超聲波檢查, 可見前列線有腫塊, 獸醫再處方消炎藥及抗生素
(六) 兩星期後小狗覆診, 獸醫肛檢後認為小狗前列線應為腫瘤並有抗散跡象. 但經X-ray檢查後發覺腫瘤不大應可切除, 故安排即日手術.
8.醫師的診斷:
獸醫開刀後發現腫瘤已擴散至膀胱, 所以獸醫沒有取出任何腫瘤, 只縫合傷口, 給抗生素. 並稱因膀胱不能切除, 獸醫說沒有cure. 又因腫瘤位置, 導致小狗滴尿, 漏尿, 血尿, 排尿不清, 頻密量少及排便困難. 如小狗排不出尿, 便有生命危險.
9.醫師的治療方式:只縫合傷口, 給七天抗生素用量. 小狗在八月二日出院, 將於兩星期後安排拆線.
10.請儘量提供相關檢驗資料、x光片、Video檔:正聯絡診所, 希望盡快能提供.
11.欲詢問醫生之問題:
(一)請問是否有辦法幫助小狗, 是否真的沒有其他治療方式?
(二)有什麼藥物或輔助品可以幫到小狗?
(三)在日常飲食有什麼要注意, 有什麼狗糧處方適合狗狗?
(四)現自行給小狗服用癌症犬雲芝配方(獸醫說是可以的, 但每隻狗反應不同).
請問是否有療效?
(五) 如真的沒辦法, 跟據上述情況, 請估計小狗可以捱多久? 現小狗排尿頻密,半天約五次, 量每次不多, 為沒症狀時的五份三左右. 排便次數亦密, 半天三次, 每次亦量少及幼, 間中有黏液.
(六) 小狗正服抗生素. 每天兩次, 每次一粒. 七天後服完. 如情況再次變差應否再讓獸醫處方抗生素?
hil
 
文章: 7
註冊時間: 2008-08-04, 13:53
性別: 未指定

文章doggydc » 2008-08-05, 01:56

Your doctor is doing his best already.
There are few questions I like to know
First, did your doctor collect some samples for biopsy?
second,is there any 2nd infection in the lesion/tumor ?
third, is your dog neutered(castrated)?
You have to keep the antibiotics longer if the 2nd infection is existing.
Biopsy is for us to know the type of tumor/cancer, so we can try some alterate therapy as chemo or radiation.
I am not familiar with the chinese medicine but I am not agaist it either.
Pain control medicine is useful if your dog shows signs of in pain.
Castration is the first thing has to do for any prostate gland(as primary tumor or cancer) related tumor/cancer, although the tumor or cancer is spreading out to other systems.
doggydc
 
文章: 959
註冊時間: 2004-10-04, 16:25
來自: losangeles
性別: 未指定

文章chien » 2008-08-05, 08:41

譯文如下:

你的醫師已經盡他最大的努力。
接下來,我想要了解幾個問題。
1.你的醫師有幫狗狗做切片檢查嗎?
2.創傷處/腫瘤 是否有二次感染情形?
3.你的狗已經結紮了嗎?

如果二次感染的情形存在的話,抗生素使用的時間必須延長。
切片可以讓我們清楚知道腫瘤/惡性腫瘤的類型,這樣才有辦法嘗試其他的療法,如化療或放射線治療。
我對中藥並不熟悉,但我也不堅持反對使用中藥。
如果你的狗狗有疼痛的跡象,疼痛控制的藥物可讓他舒服些。
雖然腫瘤細胞已經擴散,但是對於前列線相關的腫瘤/惡性腫瘤(原發癌)來說,第一件要做的事是結紮手術。
頭像
chien
 
文章: 749
註冊時間: 2005-12-26, 10:35
來自: 北部
性別: 未指定

文章hil » 2008-08-05, 12:20

醫生你好,

真的很感謝你迅速的回覆及意見. 以下是我的回覆, 希望你能提供更多專業的意見幫助小狗.

1) 你的醫師有幫狗狗做切片檢查嗎?

沒有. 獸醫解釋因腫瘤已擴散, 所以沒有做切片. 只憑經驗(肉眼所見)指出腫瘤多為惡性. 獸醫又解釋如動手術 (切片或切除部份腫瘤)會加速腫瘤擴散, 所以什麼也沒有做, 只取替小狗縫合開刀的傷口. 請問他這樣解釋是正確嗎? 動手術 (切片或切除部份腫瘤) 是否會加速腫瘤擴散?

2) .創傷處/腫瘤 是否有二次感染情形?

因為腫瘤在小狗身體裡面, 在外面看不見, 我不清楚第二次感染的意思是什麼. 但會再詢問獸醫. 而因開刀造成的傷口, 從表面看沒有發炎或感染的跡象.

3) 你的狗已經結紮了嗎?

小狗在七歲時已結紮 (His balls have been cut off). 但仍患上前列線腫瘤. 其實我亦不太清隻狗隻的結紮手術是否只須切除陰囊. 據獸醫說明本想切除小狗的整個前列線及腫瘤, 但因腫瘤已擴散至膀胱, 所以沒有切除任何部份. 現在小狗的前列線仍留在體內.

最後我還希望知道醫生你是否建議再為小狗開刀動手術 (切片或切除部份/ 全部腫瘤)? 是否需要待小狗這次開刀的傷口癒合後才可再動手術?

因現在小狗的精神比開刀以前差是了, 牠好像是很不舒服, 睡不著, 躺在地上時經常轉換姿勢, 不動時亦不閉上眼睛.

Many thanks for your help again! Hope to have your reply swiftly.
hil
 
文章: 7
註冊時間: 2008-08-04, 13:53
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文章doggydc » 2008-08-06, 00:09

By your doctor's description, the cancer is spread out so surgical removal isn't practical. Alternate treatment is the only choices but we need to know the type of cancer(this is why I recommand biopsy).
2nd infection on cancer patient always happys on the cancer growing too fast and there is some necrotic lesion inside the growth.
Please try to contact Oncologist for 2nd opinion.
doggydc
 
文章: 959
註冊時間: 2004-10-04, 16:25
來自: losangeles
性別: 未指定

文章hil » 2008-08-06, 01:21

Dear Doctor,

Really thanks for your quick reply.

I brought my doggie to visit another Vet tonight but found the diagnosis was rather different.

這位獸醫認為小狗有腫瘤或Cancer的可能性較低.

首先獸醫從小狗的X-ray films (was taken on last Friday,1st Aug) 看不見膀胱有腫瘤或異常, 只見到前列線有腫脹, 但腫脹度程不算很大, 未知是否腫瘤. 有可能是發炎.

第二獸醫檢查小狗其他淋巴腺, 未覺有腫脹, 與一般Cancer 徵狀不近似.

但小狗的確在服藥前及停藥後(為消炎藥與抗生素)出現血尿及血便. 現在小狗仍有輕微失禁, 排尿不清, 頻密量少及排便困難. 加上之前的獸醫的確已為小狗開刀, 如他沒有說慌, 看到腫瘤應是肯定?

惟自狗狗手術後, 我一直未能與之前的獸醫直接對話, 只能從他的助手得知診斷及手術結果. 相信他亦沒法提供相片為證.

我真的感到非常困惑, 十分擔心小狗病情會被拖延. 但第二位獸醫是來自自願非牟利診所, 應該會以小狗的健康為先, 故不會存在欺騙.

現在附上剛從第一位獸醫那裡取回的X-ray films (the same ones as mentioned above; I took photos of them and attahced to here), 肴望醫生你能給矛意見.

小狗現時正服用第二個獸醫處方的藥物 (兩星期用量)如下, 稍作觀察. 並安排從新檢驗大小便.

1) Propalin Syrup
2) Clavamox Tab 250mg
3) Glucosamine Sulfate 314mg Cap

對於醫生你的熱心及對小狗無條件給予幫助, 本人真曷無言感激, 昐能得到醫生你的再次回覆. 多謝.
您沒有權限檢視這篇文章所附加的檔案。
hil
 
文章: 7
註冊時間: 2008-08-04, 13:53
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文章doggydc » 2008-08-06, 03:28

so I don't know what can I help you without direct examining your dog and have an accurate diagnosis.
The x-ray quality is very poor and nothing can be seen. For me it is useless.
2nd, cnacer/tumor can't not really seen from xray(plain) if it is inside the bladder.
I even can't see any prostate gland shadow from x-ray.
Lymph node enlargement isn't the guideline for cancer or cancer metastasis.
Find another opinion.
doggydc
 
文章: 959
註冊時間: 2004-10-04, 16:25
來自: losangeles
性別: 未指定

文章hil » 2008-08-07, 02:18

Dear Doctor,

Many thanks for your advice again. It's a pity that I can't bring my dog directly to you due to boundary limit. (I am from HK). But your kindness is much appreciated. I'll continue to seek help from all resources that I can get access to.
hil
 
文章: 7
註冊時間: 2008-08-04, 13:53
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文章hil » 2008-08-08, 00:12

Dear Doctor,

I think I really need your help again. Tonight, I finally obtain the blood test, urine test reports, the ultra-sound image plus 2 photos of my dog’s inner parts during the operation. Still when I talked with the Vet who did the operation for my dog, he claimed that my dog had no cure and the cancer’s spread out.

But when I brought these photos and reports to the 2nd Vet . He said he could not see anything from the photos and the reports indicated my dog’s condition is ok.

It almost makes me crazy that words from the 2 vets are so different. I am now waiting for the updated Urine test of my dog but would prefer to take my dog to another Vet. But before that, would you mind helping me to look at the reports and photos? I would very much appreciate your kindness and suggestion to help my dog again.

Looking forward to hearing from you.

P.S. attached please find the reports and photos.(3 of 6; the rest will be attached in the next post)
您沒有權限檢視這篇文章所附加的檔案。
hil
 
文章: 7
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文章hil » 2008-08-08, 00:30

Dear Doctor,

Attached please find the other 3 of 6 pics.

Thanks for your help.
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hil
 
文章: 7
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文章doggydc » 2008-08-09, 01:38

I only have to say the first dotor has to do the biopsy of the lesion on the bladder.
The ultrasound show some problems inside the prostate gland but not enough for me to say it is tumor or cancer.
he should take some pictures of the prostate gland when he performed the exploratory surgery.
The secon doctor I don't think he has enough inform to judge the problem.
blood test normal can't use to rule out cnacer or tumor.
As I told you, find another opinion. I can't help you any more by not seeing your pet.
doggydc
 
文章: 959
註冊時間: 2004-10-04, 16:25
來自: losangeles
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文章hil » 2008-08-10, 14:32

Dear Doctor,

Many thanks for your help. I'll bring my dog to another Vet very soon and hope that my dog'll be fine.

Thanks again!
hil
 
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註冊時間: 2008-08-04, 13:53
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