Dr Ryan Chuang 汪喵Talk 莊富成醫師

06/05/2026

AI是否可以取代醫生？寵物主人如何更正確地使用AI

Can AI Replace Your Veterinarian? How Can Pet Owners Use AI Effectively (Scroll down for English Version)
作者：Dr. Ryan Chuang

隨著AI技術日新月異，它能提供的資訊與建議早已達到令人驚訝的境界。就連我自己在臨床上，也常會與AI討論病例、查閱獸醫研究與醫學知識。如果使用得當，AI絕對是大家的好幫手。

然而，最近我常發現許多飼主會諮詢AI關於治療的建議，並因此對我的醫療處置產生疑慮。仔細思考後發現，主人之所以會得到令人不安的資訊，往往是因為提問的方式影響了AI產出的內容。今天想跟大家分享，身為主人應該如何正確使用AI，才不會讓自己陷入不必要的疑惑，進而影響醫療品質。

現在AI的分析推理能力已不同於傳統的網路搜尋，它能根據你提供的資訊、檢查報告與症狀，推測可能的病因並提供治療方案。因此，你提供的細節越豐富，AI給出的結果就越精準。

最近我遇到一位主人焦慮地打給我，因為我開了 Gabapentin 給他的貓咪舒緩牙痛，他在諮詢AI後，質疑藥物的副作用以及是否真的有必要服用。為了讓大家明白「提問」與「答案」的關聯，我分別用兩個方式測試了AI：

A. 較為籠統的提問方式：
提問：「Gabapentin 是什麼藥？有什麼副作用？」
AI的回覆簡述：
Gabapentin 是貓科常用的藥物，用於緩解慢性疼痛或就診前鎮靜。常見副作用包括：嗜睡與鎮靜、共濟失調（走路像喝醉）、流口水或輕微嘔吐。 特別警告：不可使用含木糖醇的人用液體劑型，且長期服用不可突然停藥。

** 如果你看到這樣的回覆，是不是也會感到擔心，覺得這藥物聽起來很可怕？

B. 更為精確、適合的詢問方式：
提問：「我有一隻16歲的貓，體重3.8kg，最近吃完東西都會抓嘴巴。驗血報告全都正常，醫生開了 Gabapentin 25mg 早晚各半顆（12.5mg）止痛，請問適當嗎？劑量安全嗎？」

AI的建議簡述：
針對16歲、3.8kg的老貓，這個做法在臨床上非常常見且安全。
1. 劑量評估： 換算下來約 3.3 mg/kg，低於標準起始劑量3-10 mg/kg。這屬於非常保守且安全的低劑量起步，符合高齡貓「由低開始、緩慢增加」的專業原則。
2. 對症下藥： 抓嘴巴可能與口面部神經痛有關，Gabapentin 對此效果良好。
3. 安全性： 既然血檢正常（特別是腎指數），目前的極小劑量對貓咪負擔很輕。

**看到第二個AI回應後，你是否安心許多了呢？

總結與建議
這篇文章是想讓大家了解，AI是新世代非常有用的工具。若你能提供詳細的數據、客觀的事實描述，再提出你的疑慮，AI給出的建議會遠比你在網路上盲目搜尋得到的碎片資訊更有價值。
然而，最後還是有兩點重要的叮嚀：

1. AI 資訊並非絕對正確： 臨床醫生能實際觀察動物狀態，並透過專業的理學檢查進行全面評估。而AI的判斷完全取決於你輸入的內容，回覆往往較為片面，若資訊不足，極可能產生錯誤判斷。

2. 挑選可靠的AI來源： 許多免費或舊版的AI模型，其資料庫與分析能力有所限制。若想獲得理想的建議，建議選擇更先進、可信度高的AI模型。

或許未來某天AI真的可以取代醫生，但在那天到來之前，與您的主治醫生密切配合、遵守醫療指示，才是對寵物最好的做法。

(內容撰述：Dr. Ryan Chuang。未經許可請勿複製或抄襲，歡迎轉貼分享。)

🏥 預約諮詢
如有任何醫療需求，歡迎聯繫 Paws and Tails Veterinary Hospital：
• 📞 電話： 2832 2836
• 💬 WhatsApp： 9870 5711
• 🌐 網址： www.pawsandtailshk.com
• 📍 地址： 香港上環普仁街 4 號

Can AI Replace Your Veterinarian? How Can Pet Owners Use AI Effectively

As AI technology continues to advance, the information and advice it provides have reached an astonishing level. Even in my own practice, I use AI to discuss clinical cases or review the latest veterinary research and medical knowledge from time to time. AI is indeed an incredible assistant for everyon if you use appropriately .

However, I have recently noticed many owners consulting AI for treatment advice and subsequently feeling doubtful about my recommendation or treatment plan. Upon reflection, I realized that these doubts often stem from how the owner phrases their questions, which directly dictates the quality of the information provided.

Today, I want to share how you, as a pet owner, can use AI correctly so that you don't end up more confused or inadvertently compromise your pet’s quality of care.
Current AI reasoning capabilities are far superior to traditional web searches. It can analyze the specific information, lab reports, and symptoms you provide to infer potential issues and suggest treatment plans. Therefore, the more detailed the information you provide, the more accurate the results will be.

I recently had an owner call me and concerned about the safety and side of gabapentin that I dispensed to her cat for the teeth/mouth pain. To demonstrate the link between the question asked and the answer received, I ran two different queries through the AI:

A. The General Query:
Question: "What is Gabapentin? What are the side effects?"

AI Response Summary: Gabapentin is a drug commonly used in feline medicine for chronic pain or pre-visit sedation. Common side effects include lethargy, sedation, ataxia (walking like they are "drunk"), drooling, or mild vomiting.Special Warning: Do not use human liquid formulations containing Xylitol, and do not stop the medication abruptly after long-term use.

**If you saw this response, wouldn’t you naturally feel worried? The medication sounds quite frightening when presented this way.

B. The Specific (Better) Query:
Question: "I have a 16-year-old cat weighing 3.8kg. Recently, she paws at her mouth after eating. Her blood work is completely normal. My vet prescribed Gabapentin 25mg, half a tablet (12.5mg) twice a day for pain. Is this appropriate? Is the dose safe?"

AI Response Summary: For a 16-year-old, 3.8kg cat, this is a very common and safe clinical approach.
1. Dosage Evaluation: This works out to approximately 3.3mg/kg. The standard starting dose for feline pain is 3–10mg/kg. This is a very conservative and safe starting point, following the professional principle of "start low, go slow" for senior pets.
2. Clinical Correlation: Pawing at the mouth can indicate orofacial neuropathic pain, which Gabapentin treats effectively.
3. Safety: Since the blood work (especially kidney markers) is normal, this tiny dose is very safe for the cat’s system.

**Seeing this second response, do you feel much more at ease?

Summary and Advice
This article is meant to show you that AI is a powerful tool for the new generation. If you can provide detailed data and objective factual descriptions before raising your concerns, the advice AI gives will be far more useful than the fragmented, confusing information found through random web searches.

However, I must leave you with two important reminders:
1. AI Information is Not Infinitely Accurate: A clinical veterinarian can physically examine your pet and observe their actual state. AI's judgment relies entirely on the information you input; if that information is incomplete, the conclusion may be biased or incorrect.

2. Choose Reliable AI Sources: Many free or older AI models have limited databases and reasoning power. For the best advice, choose more advanced, reputable AI models.
Perhaps one day AI might be able to replace doctors, but until that day arrives, working closely with your veterinarian and following their medical instructions remains the best way to care for your pet.

🏥 Appointments & Inquiries
For any medical needs or assistance, please contact Paws and Tails Veterinary Hospital:
• 📞 Phone: 2832 2836
• 💬 WhatsApp: 9870 5711
• 🌐 Website: www.pawsandtailshk.com
• 📍 Address: 4 Po Yan Street, Sheung Wan, Hong Kong

23/04/2026

狗狗變胖、變懶、掉毛？認識「犬甲狀腺機能低下」

與貓咪常見的甲狀腺「亢進」相反，狗狗最常見的是甲狀腺「低下」 (Hypothyroidism)。這種疾病通常發生在中大型犬或步入中老年的狗狗身上，因為發病過程緩慢，很多主人會覺得狗狗只是「變老了」而忽略了求救信號。

1. 什麼是甲狀腺機能低下？
這表示狗狗的甲狀腺無法分泌足夠的甲狀腺素，導致身體的新陳代謝速度變得異常緩慢。
• 成因： 約 95% 的案例是因為甲狀腺萎縮或自體免疫性發炎導致組織被破壞。
• 風險因子： 好發於 4-10 歲 的犬隻。

2. 常見症狀：新陳代謝變慢的警訊
甲狀腺低下的症狀通常是「慢性的」，主人需要細心觀察：
• 體重增加： 即使食量沒有增加，狗狗還是莫名其妙變胖（甚至食慾下降卻變胖）。
• 活力下降： 變得不愛動、昏昏欲睡、容易疲勞，或是變得怕冷（喜歡窩在溫暖處）。
• 皮膚與毛髮問題： 非搔癢性的對稱性掉毛（特別是在軀幹與尾巴，形成「老鼠尾」）、皮膚變黑（色素沉澱）、毛髮乾燥無光澤。
• 悲傷表情 (Tragic Expression)： 因臉部組織增厚，讓狗狗看起來總是很憂鬱。

3. 診斷與治療：一旦確診，效果顯著
如何診斷？
獸醫師通常會結合臨床症狀，透過血液檢查檢測總甲狀腺素 (Total T4)、游離甲狀腺素 (Free T4) 以及促甲狀腺激素 (cTSH)。由於某些藥物或疾病也會干擾數值，有時需要更複雜的檢測來確診。

如何治療？
• 補充甲狀腺素： 這是需要終身服用口服合成甲狀腺素。
• 效果： 治療後，狗狗的活動力通常在 1-2 週內明顯提升，而皮膚與掉毛問題則需要幾個月的時間才會看到好轉。

4. 飼主日常照護重點
• 定期回診： 剛開始治療時，需要頻繁抽血監控血中藥物濃度，以調整到最佳劑量。
• 不要擅自停藥： 這是一種慢性管理疾病，停藥後症狀會迅速復發。
• 觀察副作用： 若藥量過多，狗狗可能出現過動、喝多尿多、喘氣等亢進症狀，需立即告知獸醫師。

(內容撰述：Dr. Ryan Chuang。未經許可請勿複製或抄襲，歡迎轉貼分享。)

🏥 預約諮詢
如有任何醫療需求，歡迎聯繫 Paws and Tails Veterinary Hospital：
• 📞 電話： 2832 2836
• 💬 WhatsApp： 9870 5711
• 🌐 網址： www.pawsandtailshk.com
• 📍 地址： 香港上環普仁街 4 號

17/01/2026

今天要分享一隻乾性腹膜炎的貓貓病例-Colby

Today we are sharing a case of dry FIP in a cat—Colby.

Please scroll down for English version

Colby是一隻一歲半的已絕育公貓，主人於三個月前收養了他，來看診前幾天突然開始精神食慾下降，檢查發現他雙側下巴的淋巴結非常腫大並且發燒，為了進一步診斷，當下立即幫他做了驗血已經腫塊的細針採樣。
驗血發現Colby有輕微的貧血以及輕微的白血球上升，但是其他的器官功能還有蛋白指數都完全正常。

另外也幫他快速的進行了簡單的腹腔超聲波檢查，超聲波並沒有發現有積水，但是腹腔內也有幾顆異常腫大的淋巴結。
下巴腫塊的採樣結果發現有發炎反應的腫大淋巴結，而非淋巴癌。
配合Colby的症狀還有檢查的結果，最有可能的就是乾性的腹膜炎病毒感染，雖然也有可能是其他病毒感染，但是因為Colby沒有其他的症狀，在跟主人討論後決定開始嘗試殺FIP的特效病毒藥。
開始治療2-3天後，Colby 迅速的恢復正常而且食慾非常的好，兩週回診後貧血已經完全正常，而且腫大的淋巴結全都變回正常的大小。

FIP的診斷可以非常複雜，也有很多時候會無法確診，然而透過動物的年紀症狀還有相關的檢查結果，往往可以排除或是強烈懷疑是腹膜炎，當強烈懷疑是腹膜炎的時候，透過給予有效的抗病毒藥，往往會在給藥後一兩天就會有明顯的改善。

我們診所現在使用的病毒藥是英國進口的特效藥。

有需要治療協助的主人歡迎聯絡
Paws and Tails Veterinary Hospital 詢問或預約
☎️28322836
WhatsApp: 98705711
www.pawsandtailshk.com
香港上環普仁街4號

關於貓貓腹膜炎的其他資訊可以參考我以前的另一篇文章。
傳染性腹膜炎FIP的隱憂：https://bit.ly/3m4zFCn

Colby is a 1.5-year-old neutered male cat. His owner adopted him three months ago. A few days before the visit, he suddenly developed lethargy and poor appetite. On exam, both mandibular (under-the-jaw) lymph nodes were markedly enlarged and he had a fever. For further diagnosis, we immediately ran bloodwork and performed a fine-needle aspirate of the swollen node.
Blood tests showed mild anemia and a mild increase in white blood cells, but all other organ function values and protein levels were completely normal.

We also did a quick abdominal ultrasound. There was no fluid accumulation, but several abdominal lymph nodes were abnormally enlarged.
Cytology of the jaw lymph node indicated lymph node enlargement due to inflammation, not lymphoma.
Given Colby’s signs and the test results, the most likely diagnosis was dry formed FIP (feline infectious peritonitis), though other viral infections were possible but less likely as Colby had no other symptoms. After discussing with the owner we decided to start an anti-FIP antiviral, GS441z

Within 2–3 days of treatment, Colby rapidly returned to normal with an excellent appetite. At the two-week recheck, the anemia had fully resolved and all enlarged lymph nodes had returned to normal size.

Diagnosing FIP can be very complex and often cannot be definitively confirmed. However, considering the animal’s age, clinical signs, and test results, we can often rule it out or strongly suspect it. When FIP is strongly suspected, starting an effective antiviral typically leads to noticeable improvement within a day or two.

The antiviral we currently use at our clinic is a special medication imported from the UK.

For more information about FIP in cats, you can refer to another article I wrote previously. https://bit.ly/3m4zFCn

⚠️ If you need veterinary assistance, please contact:
Paws and Tails Veterinary Hospital for inquiries or appointments
☎️ 28322836
WhatsApp: 98705711
www.pawsandtailshk.com
4 Po Yan Street, Sheung Wan

05/12/2025

**關於狗房咳（犬舍咳）（Kennel Cough）的重要資訊**

**Important Information About Kennel Cough**
Scroll down for English version 👇

狗房咳（犬舍咳）是狗主人們常聽到的一種呼吸道疾病，主要由細菌或病毒感染引起。其中最常見的細菌是Bordetella. 近年來，Bordetella的抗藥性增加，使得治療變得更加困難。

有需要治療協助的主人歡迎聯絡
Paws and Tails Veterinary Hospital 詢問或預約
☎️28322836
WhatsApp: 98705711
www.pawsandtailshk.com
香港上環普仁街4號

**傳播方式與症狀**

狗房咳（犬舍咳）一般通過直接接觸或吸入帶有細菌的飛沫傳播，常見症狀包括持續的咳嗽、打噴嚏以及鼻腔分泌物。嚴重時可能引發肺炎、發燒及食慾不振。

**抗藥性問題**

使用正確的抗生素可以有效治療狗房咳（犬舍咳），但由於抗藥性問題日益嚴重，許多犬舍及寵物店會不當使用抗生素，可能導致細菌強化。因此，辨別抗藥性是治療的關鍵。

**如何確定抗藥性**

我們可以通過細菌培養檢測犬隻的感染情況，這樣能確定哪種抗生素有效。近期許多幼犬出現持續咳嗽現象，其常用的抗生素卻無法根治，經過細菌培養後才發現大部分抗生素均顯示抗藥性。

**採樣過程**

對於有咳嗽症狀的幼犬，我們通常會進行利用氣體麻醉的氣管採樣，過程安全迅速，狗狗也會在幾分鐘內甦醒。依賴正確的檢測結果，我們能對症下藥，防止病情惡化。

**及早就醫的重要性**

如果幼犬持續咳嗽，且在服用藥物後無改善，應及時就醫以避免產生更強的抗藥性或造成呼吸道傷害。分享過去的檢測報告顯示，抗藥性問題非常普遍，及早對症治療對於犬隻的康復至關重要。

**抗藥性指標**

- **Resistance（抗藥性）**：該抗生素無法有效殺死細菌。
- **Sensitive（敏感性）**：劑量正確可有效對抗細菌。
- **Intermediate（中介性）**：可能需要更高劑量或再評估療程。

希望這些資訊能幫助狗主人更好地了解狗房咳（犬舍咳），並及時採取適當的治療措施！

Kennel cough is a respiratory disease commonly heard by dog owners, primarily caused by bacterial or viral infections. The most common bacterium is Bordetella. In recent years, the increasing antibiotic resistance of Bordetella has made treatment more challenging.

**Transmission and Symptoms**

Kennel cough is typically transmitted through direct contact or inhalation of droplets containing the bacteria. Common symptoms include persistent coughing, sneezing, and nasal discharge. In severe cases, it may lead to pneumonia, fever, and loss of appetite.

**Antibiotic Resistance Issues**

Using the correct antibiotics can effectively treat kennel cough. However, due to the growing problem of antibiotic resistance, many kennels and pet shops misuse antibiotics, potentially strengthening the bacteria. Therefore, identifying antibiotic resistance is key to effective treatment.

**How to Determine Antibiotic Resistance**

We can test the infection status of dogs through bacterial culture, which helps identify which antibiotics are effective. Recently, many puppies have shown persistent coughing, and commonly used antibiotics have not resolved the issue. Bacterial cultures have revealed that most antibiotics indicated resistance.

**Sampling Process**

For puppies showing coughing symptoms, we typically perform a tracheal sampling. This process is safe and quick, and the dog will wake up within a few minutes. Relying on accurate test results allows us to provide the appropriate medication and prevent worsening conditions.

**Importance of Early Veterinary Care**

If a puppy continues to cough with no improvement after medication, timely veterinary care is crucial to avoid developing stronger antibiotic resistance or causing respiratory harm. Past test reports have shown that antibiotic resistance is quite common, so early, targeted treatment is vital for the puppy's recovery.

**Antibiotic Resistance Indicators**

- **Resistance**: The antibiotic is ineffective at killing the bacteria.
- **Sensitive**: The correct dosage can effectively combat the bacteria.
- **Intermediate**: Higher doses may be needed, or the treatment course requires reevaluation.

I hope this information helps dog owners better understand kennel cough and take appropriate treatment measures in a timely manner!

⚠️ If you need veterinary assistance, please contact:
Paws and Tails Veterinary Hospital for inquiries or appointments
☎️ 28322836
WhatsApp: 98705711
www.pawsandtailshk.com
4 Po Yan Street, Sheung Wan

06/09/2025

看到Sing Sing活潑可愛的樣子真的覺得很開心🥰

21/06/2025

今天要來分享一個雖然少見 但是近年發生比例越來越多的先天遺傳性疾病，多數較常發生在Ragdoll （布偶貓）的一個先天異常疾病-單側子宮發育不全以及同側腎臟發育不全 （Segmental uterine aplasia and ipsilateral renal agenesis）

Today, I'd like to share a rare but increasingly common congenital genetic disorder occurring in recent years, most often found in Ragdoll cats. This condition is known as Segmental Uterine Aplasia and Ipsilateral Renal Agenesis
Scroll down for English version 👇

有需要治療協助的主人歡迎聯絡
Paws and Tails Veterinary Hospital 詢問或預約
☎️28322836
WhatsApp: 98705711
www.pawsandtailshk.com
香港上環普仁街4號

Jojo是一隻兩歲大已絕育的女生布偶貓，主人於一年前領養，當時主人被告知Jojo已經做了絕育，但是幫她做手術的醫生發現他先天只有單側的子宮跟卵巢，自從領養她之後，Jojo開始不斷出現發情的症狀，所以主人於四個月前帶去前一家診所，當時懷疑有可能有卵巢組織殘留，也做了相關荷爾蒙測試證實Jojo體內很有可能有卵巢組織，於是主人決定帶貓貓來找我諮詢意見。

就診當天我立刻幫Jojo進行了腹腔超聲波檢查，發現肚子左側有卵巢組織，同時發現Jojo只有一顆右側腎臟，左側的腎臟先天就沒有發育出來，於是確認了Jojo患有一個Ragdoll常見的發育異常-Segmental uterine aplasia and ipsilateral renal agenesis

別被這個很長的醫學名詞嚇到了，這個先天異常基本上包含了幾個特徵
✅只有單側的子宮：另一側的子宮幾乎沒有發育成形，只有殘存的韌帶或是結締組織
✅只有一顆腎臟，在沒有子宮的那側通常也沒有腎臟
⚠️但是通常仍有兩側的卵巢：為何缺少子宮跟腎臟的那側仍然有卵巢發育的原因不明

當貓貓有這個先天異常時，醫生沒有辦法用一般的絕育方式就同時將兩側的卵巢跟子宮都取出，缺少子宮那一側的卵巢組織需要單獨尋找取出，若有未取出的卵巢在體內，貓貓之後仍然會持續發情。

分享這個病例想讓貓貓主人知道這種先天異常有可能發生，加上近年越來越多自家繁殖或是近親交配的貓貓，使得異常基因的比例越來越高，若醫生發現貓貓只有單側的子宮而只取出單側的組織，如果術中尋找不到另一側的卵巢，之後應該要考慮再用進階的超聲波去協助確認是否真的沒有另一側的卵巢。

⚠️由於卵巢組織很小，如果超聲波畫質不夠好非常有可能會被遺漏，另外醫生也需要有足夠的超聲波經驗才能判斷卵巢組織的結構。

⚠️在術前檢查時可以先請醫生觸摸動物是否有兩側腎臟，若只能摸到一顆腎臟，則非常有可能貓貓患有這個先天異常。

Jojo is a two-year-old spayed female Ragdoll cat. Her owner adopted her a year ago, having been informed that Jojo was already spayed. However, the surgeon discovered Jojo was born with only one side of the uterus and o***y. Since the adoption, Jojo has continually shown signs of being in heat. Four months ago, the owner took Jojo to a clinic suspecting residual ovarian tissue. Hormonal tests suggested the presence of ovarian tissue, so the owner sought my second opinion.

During Jojo’s appointment, I performed an abdominal ultrasound and found ovarian tissue on the left side, along with only one right kidney, as the left kidney didn’t develop. This confirmed that Jojo has a congenital abnormality known as Segmental Uterine Aplasia and Ipsilateral Renal Agenesis.

Don't be intimidated by this long medical term. This congenital anomaly generally includes the following features:
✅ Only one-sided uterus: The other side of the uterus is hardly developed and only remnants of ligaments or connective tissue are present.
✅ Only one kidney: The side lacking a uterus usually also lacks a kidney.
⚠️ However, two-sided ovaries are usually present: The reason for o***y development on the side missing the uterus and kidney is unknown.

When a cat has this condition, the standard spaying procedure cannot remove both ovaries and the uterus simultaneously. The o***y tissue on the side missing the uterus must be separately located and removed; otherwise, the cat will continue to show signs of heat if any ovarian tissue remains.

Sharing this case aims to inform cat owners of such potential congenital anomalies. With more cats being bred or in**ed, these abnormal genes are becoming more prevalent. If a veterinarian discovers a cat with only a one-sided uterus and removes just that, yet cannot locate the other o***y, further advanced ultrasound should be used to confirm the absence of the other o***y.

⚠️ Due to the small size of ovarian tissue, insufficient ultrasound quality might lead to oversight, and sufficient experience is essential for ultrasound interpretation.

⚠️ Before surgery, ask your vet to physically check for two kidneys. If only one can be felt, there's a high chance that the cat has this congenital anomaly.

If you need veterinary assistance, please contact:
Paws and Tails Veterinary Hospital for inquiries or appointments
☎️ 28322836
WhatsApp: 98705711
www.pawsandtailshk.com


#布偶貓
#單側子宮
#單腎
#獸醫推薦

25/05/2025

今天要跟大家分享一個急性腎衰竭伴隨胰臟炎的病例-Bailey

Today I want to share a case of acute kidney failure accompanied by pancreatitis - Bailey.
please scroll down for English version

Bailey是一隻11歲已絕育的母吉娃娃，五月初開始連續三天精神食慾下降，並且吐了兩次，於是去了專科醫院，檢查發現Bailey 腎指數非常高，胰臟炎指數也過高，於是在專科醫院接受住院治療，住院期間接受了腹腔超聲波掃描確認了胰臟明顯發炎，在治療四天後，雖然腎指數稍微有改善，但是仍然很高，而且仍然沒有胃口，所以主人決定帶回家照顧，回家後Bailey狀況持續惡化，於是前來找我諮詢治療建議。來檢查的當天尿素又升高到188mg/dL而肌酸肝也升到4.1mg/dL，胰臟炎指數也從一開始的466U/L升高到1215U/L（正常應該低於200）

在仔細閱讀Bailey的病歷跟詢問主人症狀跟病史後，我幫Bailey的治療做了調整，在新的治療隔天Bailey主動開始吃飯，在兩天後食慾恢復正常，四天後腎指數降超過一半，胰臟炎指數也從1215迅速下降的212，出院五天後胰臟炎指數已經恢復正常178而腎指數也持續下降。

📌為何Bailey之前住院治療這麼久都沒有改善？
關於Bailey的胰臟炎最關鍵的治療其實是抗生素，雖然專科醫院從一開始就有給予抗生素治療，但是由於已經治療超過四天都沒有改善，指數不斷上升，所以我的判斷是因為抗生素無法殺到細菌，在更換了抗生素後隔天Bailey症狀明顯改善。

⚠️並不是所有的胰臟炎都需要抗生素的治療，然而有一大部分腸胃道疾病出現急性的食慾下降或是伴隨嘔吐或是拉肚子的動物，往往是因為惡菌在作怪，若給予正確的抗生素治療，症狀應該會在12-24小時內改善，若沒有明顯改善可能表示有抗藥性或是有其他的問題造成發炎，需要尋找其他可能問題或是調整治療。抗生素的使用需要獸醫師的判斷，切勿自行給予，以避免副作用或是造成抗藥性。

📌為何Bailey之前在專科診所接受靜脈輸液這麼多天，腎指數還是非常高？
在Bailey來看診當天，我們幫她化驗了蛋白尿，而蛋白尿的指數超標，顯示她腎臟內的壓力過高，造成蛋白被擠壓進入尿液，持續的蛋白尿還有腎內的高壓如果沒有接受治療，會對腎臟持續造成傷害，所以當時我讓她開始服用降蛋白尿的藥物，而在配合輸液治療後，腎指數明顯快速的改善。
⚠️蛋白尿的檢驗跟治療在腎衰竭的動物非常重要，若沒有適當治療，腎指數往往不會改善，但是開始治療後需要密切監控腎指數的變化，因為如果給予的劑量不適當，或是動物脫水狀態嚴重，給予降蛋白尿的藥物也可能會造成腎臟傷害，所以需要密切的監控跟追蹤，依動物狀況調整治療跟劑量，通常在開始使用藥物之後3-7天，我會監控腎指數的變化，以判斷蛋白尿的藥物是否可以安全繼續使用。

分享這個病歷除了是讓大家蛋白尿跟腎衰竭的關係，以及使用適當抗生素在某些腸胃道疾病的重要性，另外也要讓大家意識到食慾的進步是判讀許多疾病治療是否有效的重要指標。

⚠️在治療同一種疾病每個醫生的用藥跟治療可以有很多不同的選擇，有時不同的治療都可以達到一樣的效果，但是如果症狀持續沒有改善往往表示治療需要調整，動物才有機會早日痊癒。

有需要治療協助的主人歡迎聯絡
Paws and Tails Veterinary Hospital 詢問或預約
☎️28322836
WhatsApp: 98705711
www.pawsandtailshk.com
香港上環普仁街4號

Bailey is an 11-year-old spayed female Chihuahua. In early May, her activity and appetite decreased for three consecutive days, and she also vomited twice, prompting a visit to a specialist hospital. Tests revealed extremely high kidney indicators and elevated pancreatitis index. Bailey was hospitalized for treatment, and an abdominal ultrasound confirmed pancreatitis. After four days of hospitalization at the specialist hospital, there was slight improvement in her kidney indicators, but she still had no appetite and weak. Her owner decided to take her home to care for her, but Bailey's condition continued to worsen, so they came to me to seek for second opinion. On the day of consultation, her urea level had increased to 188 mg/dL, creatinine to 4.1 mg/dL, and the pancreatic enzyme level had risen from the initial 466 U/L to 1215 U/L (normal is below 200).

After carefully reviewing Bailey’s medical records and discussing symptoms and history with her owner, I adjusted Bailey’s treatment plan. The next day, Bailey started eating on her own, her appetite returned to normal within two days, and four days later, her kidney indicators decreased by more than half. The pancreatic enzyme level quickly dropped from 1215 to 212, and five days after discharge, it normalized, with kidney indicators still decreasing.

📌 Why didn’t Bailey show improvement despite the lengthy hospital treatment? The crucial treatment for Bailey’s pancreatitis was antibiotics. Although antibiotics were administered initially, no improvement was seen after four days, and indicators kept rising. I susoect that the antibiotics couldn’t kill the bacteria. After changing the antibiotics, Bailey's symptoms significantly improved the next day.

⚠️ Not all cases of pancreatitis require antibiotic treatment. However, many acute gastrointestinal issues resulting in appetite loss, vomiting, or diarrhea are caused by harmful bacteria. Correct antibiotic treatment should improve symptoms within 12-24 hours. Lack of improvement might indicate resistance or other issues causing inflammation, needing alternative solutions or adjustments. Antibiotic use should be under a veterinarian’s guidance to avoid side effects or resistance.

📌 Why were Bailey’s kidney indicators still high despite receiving intravenous fluids for days?
On her consultation day, we tested and found high levels of protein in her urine, indicating high pressure in her kidneys. Persistent proteinuria and kidney pressure, if untreated, can continuously harm the kidneys. I prescribed medication to reduce proteinuria, and combined with fluid therapy, Bailey’s kidney indicators improved rapidly.

⚠️ Testing and treating proteinuria in animals with kidney failure is critical. Without proper treatment, kidney indicators often would have little or limited improvement. Close monitoring is necessary after starting treatment, as inappropriate dosing or dehydration could harm the kidneys with treatment. I usually recheck kidney indicators 3-7 days post-medication to ensure safe continued use.

Sharing this case highlights the importance of proteinuria and kidney failure relations, proper antibiotics for some GI conditions, and recognizing appetite improvement as a crucial treatment efficacy indicator.

⚠️ Each doctor may use different medications and treatments for the same disease. Sometimes, different treatments achieve the same results. If symptoms persist, treatment often needs adjustment to enable animals to recover quicker.

If you need veterinary assistance, please contact:
Paws and Tails Veterinary Hospital for inquiries or appointments
☎️ 28322836
WhatsApp: 98705711
www.pawsandtailshk.com

03/05/2025

今天要來分享一個狗狗隱睪的病例-SaiLo

Today, I'm going to share a case dog who has missing testicles - SaiLo.
Please scroll down for English version

SaiLo 是一隻大概五歲的柯基混種犬，因為被狗場遺棄，主人於一兩年前收養他，而因為一開始SaiLo的陰囊扁平摸不到蛋蛋，所以主人認為可能已經絕育，但是因為SaiLo不時會表現出對其他母狗有興趣的行為，所以主人開始懷疑是不是其實SaiLo並沒有絕育，然而之前看過兩家診所，醫生都只含糊的帶過，也沒有提供進一步的檢查意見，主人決定帶狗狗來找我檢查。
跟主人討論後，我立刻幫SaiLo掃了腹腔的超聲波，發現兩顆睪丸都在腹腔內，證實了主人的觀察敏銳，因為體內仍有雄性荷爾蒙才會對母犬產生興趣。
之後幫SaiLo安排了手術取出兩顆在肚子內的睪丸。

雙側腹腔隱睪在狗狗來說相對稍微少見，然而可能因為現在太多狗種繁殖交配而使得基因變異， 也讓隱睪的比例日漸上升，由於這是一個遺傳疾病，患有隱睪的狗狗其實不建議再配種因為生出的小狗非常有可能也會患有隱睪的問題。

如果隱睪不處理會有什麼問題嗎？
睪丸正常位於陰囊內，而陰囊會依照體溫的變化而調整與身體接觸的距離，長期處於溫度較高的環境可能會使睪丸細胞產生變異而形成惡性腫瘤 ，所以有隱睪的狗狗若不早點絕育，睪丸將來非常有可能變成腫瘤而造成問題。

一般如何診斷隱睪？
由於睪丸的結構相對較小，所以除了需要進階的超聲波，操作的醫生也需要經過確實的訓練才有辦法確認睪丸的位置。所以若想診斷隱睪，建議一定要尋求熟練超聲波的醫生。當然進階的影像工具像是電腦斷層(CT scan)一定也可以診斷隱睪的問題，然而一般都需要鎮靜而且費用也會較為昂貴，所以一般超聲波是快速又實惠且不需要鎮靜的檢驗首選方式。

附上術後的照片，因為術前已經透過超聲波確然睪丸位置，所以可以用很小又準確的傷口取出睪丸，也可以迅速的完成手術。

有需要治療協助的主人歡迎聯絡
Paws and Tails Veterinary Hospital 詢問或預約
☎️28322836
WhatsApp: 98705711
www.pawsandtailshk.com
香港上環普仁街4號

SaiLo is a five-year-old Corgi mix. He was adopted by his owner a year or two ago after being abandoned by a dog breeder. Because SaiLo's sc***um felt flat and lacked palpable testicles, the owner assumed he might have been neutered. However, since SaiLo occasionally showed interest in female dogs, the owner became doubtful about his neutered status. Having visited two clinics previously where the issue was vaguely addressed without further examination suggestions, the owner decided to bring SaiLo to me for a check-up.

After discussing with the owner, I immediately performed an abdominal ultrasound and found both testicles in the abdominal cavity, confirming the owner’s keen observation that SaiLo still had male hormones, which explained his interest in female dogs. Later, surgery was scheduled to remove the two intra-abdominal testicles.

Bilateral abdominal cryptorchidism is relatively rare in dogs. However, with the increase in breeding and genetic variations, the incidence rate of cryptorchidism is rising. Since it is a genetic condition, it's not advisable for cryptorchid dogs to breed, as their offspring may also inherit this issue.

Are there any problems if cryptorchidism is not treated?
Normally, testicles are located within the sc***um, which regulates its distance from the body according to temperature changes. Staying long-term in a warmer environment can cause the cells in the testicles to mutate, leading to malignant tumors. Thus, if a cryptorchid dog isn't neutered early, the testicles may eventually develop into tumors, causing serious health problems.

How is cryptorchidism diagnosed?
Because testicular structures are relatively small, advanced ultrasound is needed, and the practitioner must be well-trained to accurately locate the testicles. Therefore, to diagnose cryptorchidism, it's recommended to seek a doctor skilled in ultrasound. Advanced imaging tools like CT scans can also diagnose cryptorchidism, but they often require sedation and are more costly. Therefore, ultrasound is the preferred, quick, and affordable method that doesn’t require sedation.

Attached are postoperative photos. Since the testicle positions were already located via ultrasound, a small and precise incision could be made to remove the testicles, allowing for a quick completion of the surgery.

If you need veterinary assistance, please contact:
Paws and Tails Veterinary Hospital for inquiries or appointments
☎️ 28322836
WhatsApp: 98705711
4 Po Yan Street, Sheung Wan, Hong Kong
www.pawsandtailshk.com

18/04/2025

https://pets.ettoday.net/news/1999171?fbclid=IwZXh0bgNhZW0CMTEAAR4gEj8IJdtdAw67ohRnGgeb0R8Q8wYvJTmuJQSKMtutPLc19TxsJ3qfD1cfjQ_aem_IsmNs4gv38TRexvaI9QunQ&before=1

一開始看到這篇文章的標題覺得很驚訝，因為摘除胰臟不是一個簡單的手術，不是想摘就可以摘，詳細閱讀之後發現其實是胰臟在手術過程中被破壞，附近組織被刮傷，狗狗昏迷失血最後不幸離世。
這樣的事可能發生嗎？
如果醫生學過良好正確的手術方式，這類的奇幻故事當然不可能發生，但是如果是一些‘’蒙古大夫‘’沒有受過正規訓練，胡亂在肚子裡盲目的尋找組織，當然有可能破壞肚子裡的器官，造成傷害甚至死亡。
有些飼主因為沒有獸醫相關知識，會覺得絕育就是小手術，每個醫生都會做，沒有分別，所以找便宜的可以省錢，但是往往拿自己寶貝的動物做賭注。
我其實一直很想讓大家了解到醫療品質的重要性，好的醫療其實有很多隱形的成本，除了有好的藥物、醫療耗材、進階的醫療設備，還有接受過良好訓練並負責的醫護人員跟醫生，才能使得整個醫療的過程跟結果安全又適當。
當然也不表示越貴一定約好，但是羊毛出在羊身上，如果真的太便宜，品質一定會打折扣，也可能犧牲了自己寵物的健康甚至性命。

高雄飼主柯俐伶帶著2歲狗狗「雪糕」去結紮，結果接回家時，發現牠昏迷不醒、肚子傷口也不停在出血。柯俐伶非常緊張，打給醫生詢問狀況，醫生回應「正常現象，不用擔心」。由於媽媽不放心，送去另間醫院才發現雪糕「.....

30/03/2025

最近發佈的貓貓慢性嘔吐文章被非常多人踴躍分享，表示許多主人都發現貓貓可能會有嘔吐的狀況，今天想接著分享一個最近我治療的貓貓-天天，讓大家了解一個常見的腸道疾病-慢性腸炎 IBD(Inflammatory Bowel Disease)

這其實是一個貓貓常見的疾病，然而有時候無法確診，所以有些醫生會請主人觀察而沒有給予治療，也讓有些主人誤以為找不到原因，但是其實貓貓很有可能是患有慢性腸炎（IBD)

天天是一隻8歲已絕育的男生唐貓（短毛家貓），主人於四年前收養他時就發現天天每個月都會嘔吐1-2次，主人帶他去過其他診所做了相關檢查都沒有發現異常，之後開始餵食腸胃處方糧，但是嘔吐的次數沒有改善，通常也只在吃了第一餐之後會吐而其他時間則不會嘔吐，因為食慾都精神沒有問題，所以之前都建議主人繼續觀察，但是今年一月開始天天一個月嘔吐的次數增加到5-6次，於是主人找我諮詢醫療建議。

就診當天幫天天驗了全血還有胰臟炎測試，所有驗血結果都正常，但是因為許多腸胃問題無法靠血液檢查診斷，所以也幫天天掃了全腹腔的超聲波，腹腔超聲波排除了腫瘤，而腸道也沒有明顯增厚，但是因為嘔吐的次數頻繁，表示腸道一定有問題，所以最有可能的疾病就是慢性腸炎IBD，在跟主人討論之後決定開始嘗試慢性腸炎的治療，並更換水解蛋白糧Hypoallergenic diet，在開始治療後，天天就再也沒有出現嘔吐的症狀，而在治療兩週後嘗試將腸道消炎藥減量，但是減量幾天後，天天又開始出現了頻繁的嘔吐，吃回原本劑量後嘔吐馬上又受到控制，所以目前天天持續服用相同的劑量，預計2-3個月持續穩定後會再嘗試減低藥量。

📌我常常聽到一些主人說之前的醫生做了檢查都找不到貓貓嘔吐的原因，所以最後選擇不處理也不治療。
其實貓貓會嘔吐一定是有原因的，首先一定會排除食物的問題，因為有許多主人餵食許多不同的食物還有貓草等刺激了腸胃，或是貓貓真的是敏感腸胃需要吃到水解蛋白糧但是卻沒有試過，若食物的部分真的排除也更換了，接著就要排除其他可能的疾病，如果醫生真的非常有信心都排除了其他的疾病，那通常最有可能的疾病就是慢性腸炎（IBD)了。

📌慢性腸炎會有什麼症狀？
有許多人誤以為貓貓患有IBD就一定會有嘔吐或是拉肚子的症狀，但是其實有許多患有慢性腸炎的貓貓只會有體重減輕或是食慾不好的症狀，所以如果不明原因的變瘦或是不吃飯，如果排除了其他的問題，很多時候都可能是患有了慢性腸炎這個疾病。

📌慢性腸炎應該如何診斷？
當貓貓有上述的症狀而懷疑有慢性腸炎，通常會透過高階的超聲波去評估腹腔的狀況，嚴重慢性腸炎可能會有腸道增厚、腹膜發炎或是淋巴結腫大的異常，但是並非每一隻貓都會有明顯的超聲波變化。
✅先讓大家有個基本概念，貓貓的小腸壁厚度大約在1.5-3.0mm，結構分為四層，透過超聲波去量測其中的分層是否有增厚，這裡指的厚度通常約只有0.3-1.0mm，是非常精細的結構，如果超聲波的畫質不夠好，或是醫生沒有受過超聲波的訓練就可能無法精確測量厚度。

⚠️另外不是所有的慢性腸炎腸道都一定會增厚，若真的要確診是需要手術採樣透過顯微鏡才能觀察到腸道內是否有異常的發炎細胞。
當貓貓的臨床症狀高度懷疑是慢性腸炎，即使超聲波沒有異常，也不能排除這個疾病。
🚨所以一般如果真的懷疑慢性腸炎卻沒有足夠的檢查證據，我仍然會建議使用嘗試性治療
👆如果治療正確，通常3-5天之內一定會有改善，如果治療沒有改善那就可能其實是其他問題被遺漏了。

📌慢性腸炎是否需要長期治療？
由於造成慢性腸炎的原因可能很複雜，除了食物還有可能跟基因、腸道菌叢有關，若症狀出現越久才開始治療有可能需要較長時間，甚至需要長期治療而無法停藥，然而通常症狀穩定後都可以嘗試慢慢減低劑量來觀察症狀是否會復發。

📌慢性腸炎應該如何治療？

要成功治療慢性腸炎分成幾個部分：
1️⃣挑選適當食物：許多病例常常是因為食物種類不適當，在更換適當的食物往往可以改善症狀，甚至不需要使用藥物。
通常獸醫師在治療時會建議的處方食物有三大類：
A. 易消化吸收的腸胃道處方：由於製作過程中將成份適當的分解，降低腸胃道負擔。
B. 高纖維腸道處方糧：有些動物需要較高的纖維以維持腸道健康穩定，若纖維不夠可能會出現腸胃道症狀。
C. 水解蛋白糧：有些動物對於食物成份有嚴重的敏感反應，需要食用食物敏感專用的水解蛋白糧。
⚠️每一隻動物需要哪一類食物需要一一嘗試觀察效果及反應

2️⃣類固醇：由於腸道炎症需要受到控制，類固醇往往是動物能否好轉的關鍵治療，通常一般會選用的類固醇包括以下兩種
A.Prednisolone: 這是一種最常用的全身性的類固醇，效果通常非常好，然而長期使用有可能會有較多副作用，或是在貓貓有特定疾病可能不適合使用。
B. Budesonide: 這是一種主要作用在腸胃道的類固醇，相對於Prednisolone的副作用較少，雖然有些醫生認為這個藥物的效果不理想，但是我個人的使用經驗認為這個藥物對於IBD效果非常好，若劑量使用正確，通常症狀在幾天內都會有明顯改善，而且我目前沒有遇到有明顯副作用的病例。

3️⃣腸道抗生素：在某些病例有時候會需要搭配特定腸胃道的抗生素，常用的包括Metronidazole 或是Tylosin

4️⃣補充維他命B12:許多慢性腸炎的動物都有維他命B12不足的問題，如果沒有透過驗血確認濃度，仍會建議直接補充。

5️⃣補充益生菌：補充良好品質的益生菌種有可能可以令腸道狀況較為穩定。

6️⃣治療脫水及調整電解質：若腸胃道症狀嚴重造成脫水或電解質不平衡需要同時治療。

7️⃣免疫抑制藥物：若對類固醇的治療效果不理想，有時也會考慮搭配免疫抑制藥物去抑制發炎反應。

有需要治療協助的主人歡迎聯絡
Paws and Tails Veterinary Hospital 詢問或預約
☎️28322836
WhatsApp: 98705711
www.pawsandtailshk.com
上環普仁街4號

以上是關於貓貓慢性腸炎的基本資訊，有問題歡迎大家留言詢問。

上述內容由 Dr. Ryan Chuang撰述，未經許可請勿複製或抄襲，但歡迎轉貼分享


#慢性腸炎