Obstrução ureteral parcial em gatos : revisão da literatura e relato de 4 casos clínicos
Miniatura indisponível
Data
2020
Título da revista
ISSN da revista
Título do Volume
Editora
Resumo
O presente relatório final de estágio consiste numa apresentação de casos com revisão bibliográfica de Obstrução Ureteral Felina. São apresentados quatro casos clínicos de gatas diagnosticadas com obstrução ureteral parcial unilateral causada por ureterolitíase/ “plugs” ureterais e Doença Renal Crónica concomitante, sujeitas a tratamento médico para a resolução da obstrução.
A Obstrução Ureteral Felina é uma condição bastante desafiante e cada vez mais reconhecida pelos Médicos Veterinários. Os gatos com obstrução ureteral podem apresentar-se com um quadro clínico severo, especialmente se houver disfunção do rim contralateral, que é o caso de pacientes com Doença Renal Crónica.
A incidência de litíase do trato urinário superior tem vindo a aumentar nas últimas décadas e é a principal causa de Obstrução Ureteral Felina. Os pacientes afetados podem apresentar graus variados de Lesão Renal Aguda, distúrbios eletrolíticos e comorbidades, sendo que estas últimas podem complicar o maneio e ser um fator decisivo em relação à opção de tratamento e prognóstico. O Tratamento Médico Desobstrutivo tem como objetivos o aumento da diurese, relaxamento do ureter e promoção da progressão dos ureterólitos. Nos casos em que o tratamento médico não tenha sucesso, estará então indicado o tratamento cirúrgico. Foram descritas várias técnicas cirúrgicas e minimamente invasivas para a resolução de obstruções ureterais em Medicina Veterinária, contudo o debate sobre a abordagem ideal continua.
O tratamento realizado nos casos abordados neste relatório obteve respostas positivas, pois em todos parece ter havido progressão completa do cálculo/ “plug” ureteral. O Tratamento Médico Desobstrutivo pode ser uma boa alternativa a métodos mais invasivos no caso de obstruções ureterais parciais.
This final report consists of a presentation of cases with literature review of Feline Ureteral Obstruction. Four clinical cases of cats diagnosed with unilateral partial ureteral obstruction caused by ureterolithiasis/ ureteral plugs and concomitant chronic renal disease are presented, subject to medical treatment for the resolution of the obstruction. Feline Ureteral Obstruction is a very challenging condition and is increasingly recognized by Veterinarians. Cats with ureteral obstruction may be severely ill, especially if there is contralateral kidney dysfunction, which is the case of patients with Chronic Renal Disease. The incidence of upper urinary tract lithiasis has been increasing in recent decades and it is the main cause of Feline Ureteral Obstruction. Affected patients may have varying degrees of Acute Kidney Injury, electrolyte disturbances and may have comorbidities, which may complicate management and be a decisive factor in relation to treatment option and prognosis. The medical treatment aims at increasing diuresis, relaxing the ureter and promoting the progression of ureteroliths. In cases where the medical treatment is not successful, surgical treatment is indicated. Several surgical and interventional techniques for the resolution of ureteral obstructions in Veterinary Medicine have been described, however the debate about the ideal approach continues. The treatment performed in the cases approached in this report obtained favourable results: in all of them there is evidence of complete progression of the ureterolith/ ureteral plug. The medical treatment can be a good alternative to more invasive methods in the case of partial ureteral obstructions.
This final report consists of a presentation of cases with literature review of Feline Ureteral Obstruction. Four clinical cases of cats diagnosed with unilateral partial ureteral obstruction caused by ureterolithiasis/ ureteral plugs and concomitant chronic renal disease are presented, subject to medical treatment for the resolution of the obstruction. Feline Ureteral Obstruction is a very challenging condition and is increasingly recognized by Veterinarians. Cats with ureteral obstruction may be severely ill, especially if there is contralateral kidney dysfunction, which is the case of patients with Chronic Renal Disease. The incidence of upper urinary tract lithiasis has been increasing in recent decades and it is the main cause of Feline Ureteral Obstruction. Affected patients may have varying degrees of Acute Kidney Injury, electrolyte disturbances and may have comorbidities, which may complicate management and be a decisive factor in relation to treatment option and prognosis. The medical treatment aims at increasing diuresis, relaxing the ureter and promoting the progression of ureteroliths. In cases where the medical treatment is not successful, surgical treatment is indicated. Several surgical and interventional techniques for the resolution of ureteral obstructions in Veterinary Medicine have been described, however the debate about the ideal approach continues. The treatment performed in the cases approached in this report obtained favourable results: in all of them there is evidence of complete progression of the ureterolith/ ureteral plug. The medical treatment can be a good alternative to more invasive methods in the case of partial ureteral obstructions.
Descrição
Orientação: Joana Tavares de Oliveira
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, GATOS, OBSTRUÇÃO URETERAL, DOENÇAS RENAIS, DOENÇAS CRÓNICAS, TRATAMENTOS MÉDICOS, VETERINARY MEDICINE, CATS, URETERAL OBSTRUCTION, KIDNEY DISEASES, CHRONIC DISEASES, MEDICAL TREATMENTS