鳥咪剛喝完水,一滴口水在嘴邊XD
資深院貓"鳥咪"13歲了~最近才摘除乳房腫瘤,本來履步蹣跚叫沒聲音的(只張嘴沒"喵"),術後又年輕了幾歲,叫得出聲音了^^
其實鳥咪前年就因為肥大性心肌病加上慢性腎衰竭發作,後軀輕微癱瘓了一個月,今年又發作之後就一直吃藥到現在><..
不過線也拆了藥也還在吃,她老人家還是精神奕奕的撒嬌,興沖沖的睡一整天~
所以老歸老,只要注意一下,老貓也可以活得很有尊嚴^^
剛睡醒還在呆~
嗯...該散散步還是繼續睡好呢~
鳥咪的心臟超音波檢查...很肥的心臟,唉...
心肌組織TVI成像,可以計算心肌厚度以及協同性,收縮舒張的實時間速度,判斷心臟功能
動態影像看一下
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老狗洗牙前的麻醉前檢查,意外的發現心絲蟲(Dirofilaria immitis)出現在腹腔主動脈內,
正常犬心絲蟲成蟲會出現在右心和肺動脈,就算是被心臟打出去也是往肺動脈的下游去,然後變成肺栓塞,造成咳嗽.
自然發生的主動脈內心絲蟲病例三十年來國內外有報告的僅僅七隻,算是罕見病例.
本病例左右心室壁肥大,肺高壓,左右房室辦閉鎖不全...(上圖為一般的心臟功能測量)
因為蟲體出現的位置特殊,殺蟲計劃須小心執行...
上圖:腹腔主動脈內有一隻心絲蟲("="字號)正被沖往下游
color B-Mode 下的樣子
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十幾歲沒結紮的老母狗,有一天肚子突然大起來,訴痛,精神變差,可是又沒有被公狗配到,到底怎麼了?
經過超音波檢查發現,可憐的狗狗有子宮內膜囊腫性增生加上子宮蓄膿...
這種病只有手術才能根除,不手術的子宮是顆不定時炸彈,一旦發炎擴散狗狗將有生命危險>"<
考慮到狗狗的年紀,為了減少麻醉風險,
我們用心臟超音波檢查心臟的功能發現有嚴重的二尖瓣閉鎖不全,左心房擴大,三尖瓣閉鎖不全,
還有心律不整(心搏徐緩),心跳最慢可以慢到每分鐘38下(上圖箭頭處心跳還有100次/分)...
心搏徐緩發生在手術中的時候有猝死的危險,
即使麻醉醒來也有組織灌流不足的傷害,還是有併發其他老年疾病的風險,
所以趁狗狗年輕力壯的時候操作節育手術,就不用在狗狗年老時面對這樣的困境...
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胸骨旁長軸 LA=左心房 LV=左心室 RA=右心房 RV=右心室 MV=二尖瓣 TV=三尖瓣
即將臨盆的母犬,已經生了兩隻胖嘟嘟的幼犬,
可是因為生產的辛苦,
新生兒未受到媽媽的照顧而夭折了...
所以主人帶來求診,
以超音波檢查確認肚子內的兩隻胎兒還活著(心跳數正常),可是有胎位不正的狀況(尾巴朝向產道)
於是決定實施剖腹產
胸骨旁長軸
心尖四腔室
正在努力舔前腳的小狗^_^
好不容易舔到了~
人醫的小兒心臟超音波可以產前檢查先天性的結構異常,
比如心房中膈缺損,心室中膈缺損等等,
可是獸醫好像沒這習慣,因為種種主觀客觀條件,
大部分小動物的產前檢查停留在算懷幾隻胎兒而已,
真是精準度不同啊,不過我們不願只是被動的等寵物生產時才手忙腳亂,
產前檢查還是必要的~
超音波產檢可以確認預產日(精準到正負兩日的機率有近九成),讓主人可以提早準備,
還可以確認胎兒是否存活,胎位正不正,
更細緻的決定是否剖腹生產,避免漫長的等待造成遺憾.....
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呼吸困難,心臟病的動物尤其是貓咪,
所有的檢查動作(抽血,照X光)往往造成動物極大的緊迫(stress)
緊張過度使呼吸更加困難有休克猝死的危險,
但是非侵入式的超音波檢查可以在氧氣箱內操作,
病患一邊吸氧一邊掃描,將緊迫的影響降至最低...
下圖心基區旁邊(中隔,肺臟區)有高低回音團物
永存性動脈導管是少數幾個可以動手術而且可以痊癒的先天性心臟病,
重要的是 : 1.可動刀的左往右分流
2.沒有其他心臟的先天畸形(不然動刀的考慮更多)
3.病患的身體狀況
本病患為三歲的母狗,發情期超過正常期望值,腹腔掃描發現子宮膨大,腎臟密度異常,腹腔反應性淋巴結,而且
右側卵巢濾泡囊腫(如下圖)
手術可以選擇開胸把shunt綁起來,但是破壞性強,術後照顧辛苦
或是免開胸的把shunt塞住(coil螺絲圈關閉器 or amplazer安普拉茲關閉器),術後恢復快,副作用少.....
有空再寫,還是有人提問再寫.....
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A question frequently asked by clinicians who are treating small animals suspected of having gastrointestinal foreign bodies is whether one imaging test such as survey radiography or ultrasonography is sufficient to make the diagnosis. A study was undertaken to try and answer this question. Survey abdominal radiography and ultrasonography was performed on 16 small animals (11 dogs, five cats) with clinical signs of an obstruction because of a confirmed gastrointestinal foreign body. The majority of the foreign bodies (14/16) were confirmed by surgical removal and were located in the small intestine. A gastric foreign body was retrieved endoscopically and a colonic foreign body was passed in the feces. Radiographically identifiable foreign bodies were evident in nine animals. Small intestinal overdistension was present radiographically in seven animals. Ultrasonography detected a foreign body in all 16 animals. The foreign bodies were identified by their distal acoustic shadowing and variable degrees of surface reflection. An intestinal perforation was detected sonographically but not radiographically. The value of additional sonographic findings including thickening of the gastrointestinal wall and loss of layering, free peritoneal fluid, and lymphadenopathy in these animals is discussed. The findings in this series suggest that in a small animal with a gastrointestinal foreign body, ultrasonography alone could be used to make the diagnosis and may be a more appropriate choice than survey radiography.
跟臨床上的相關是.....未完待續...
At the first week:
At the second week:
Before the mid-term test:
During the mid-term test:
After the mid-term test:
Before the final exam:
Once know the final exam schedule:
7 days before final exam:
6 days before final exam:
5 days before final exam:
4 days before final exam:
3 days before final exam:
2 days before final exam:
1 day before final exam:
A night before final exam:
1 hour before final exam:
During the final exam:
Once walk out from the exam hall:
After the final exam, during the holiday:
脫離學生時代已經很久了，不過看到這圖還是會心一笑～
從這裡看見的～http://blog.pixnet.net/mimibao/post/18855084#trackbacks
感謝善心人士提供原作者自得其乐