Estadiamento e sub-estadiamento da doença renal cronica em gatos
Miniatura indisponível
Ficheiros
Data
2017
Autores
Título da revista
ISSN da revista
Título do Volume
Editora
Resumo
A Doença Renal Crónica (DRC) é a doença do sistema renal mais comummente
diagnosticada em gatos e mais especificamente nos de idade avançada. É caraterizada por
presentar uma evolução progressiva e irreversível, com níveis de morbilidade e mortalidade
elevados.
O presente estudo prospetivo foi desenvolvido no Hospital veterinário Arco do Cego
(HVAC), no período de Março de 2014 até Outubro de 2014 e abrangeu uma amostra de 33
gatos com diagnóstico de Doença Renal Crónica apresentados à consulta ou internados no
HVAC. Os objetivos consistiram em caraterizar clinicamente os gatos com DRC, e em
especial os estadios clínicos de todos os pacientes e sub- estadiamento de 16 (48%) dos
gatos, segundo as diretrizes apresentadas pela International Renal Interest Society (IRIS).
Deste modo foi possível: identificar os sinais clínicos e sintomas mais comuns na
apresentação da doença, avaliar parâmetros clínicos, bioquímicos e urinários abrangidos no
estadiamento e sub- estadiamento da DRC, caraterizar os diversos estadios da doença de
acordo com as caraterísticas individuais dos gatos da série e determinar a existência de
relação estre valores de creatinina com os parâmetros ureia (BUN), hematócrito (Htc),
fósforo e densidade urinária (DU).
Foi possível verificar que os animais geriátricos foram os mais afetados. Os sinais
clínicos observados com maior frequência nos pacientes foram desidratação e má condição
corporal, enquanto que anorexia parcial, vómitos, letargia, perda de peso e polidipsia foram
os sintomas mais comummente referidos pelos os tutores dos gatos presentes a consulta.
Relativamente ao estadiamento da doença 12% dos gatos estava no estadio I, 49% no
estadio II, 27% no estadio III e 12% no estadio IV. Com base na presença e gravidade da
proteinúria 50% dos gatos foram classificados como não proteinúricos, 15% como
proteinúricos no limite e 35% como proteinúricos. No sub-estadiamento com base na
pressão arterial 50% dos pacientes apresentavam risco mínimo, 19% risco baixo e 31%
risco moderado, não estando presente lesões em órgãos-alvo em nenhum dos casos. Foi
possível aferir um efeito significativo do estadiamento e dos valores de creatinina nos
parâmetros BUN, DU, fósforo e hematócrito.
O presente estudo permitiu compreender algumas limitações na prática clinica que
influenciam o diagnóstico precoce da doença que são associadas aos exames
complementares necessários ao estadiamento e sub-estadiamento bem como ao
comportamento dos tutores dos gatos que na grande maioria apenas apresentam os
animais a consulta quando estes já apresentam sinais de doença.
Chronic Kidney Disease (CKD) is the most commonly kidney disease diagnosed in cats and more specifically in the elderly. It is characterized by progressive and irreversible evolution, with high levels of morbidity and mortality. The present prospective study was carried out at Arco do Cego Veterinary Hospital from March 2014 to October 2014 and included a sample of 33 cats diagnosed with CKD submitted to consultation or hospitalized at HVAC. The objectives were to clinically characterize cats with CKD, and in particular the clinical stages of all patients and substaging of 16 (48%) of the cats, according to the guidelines presented by the International Renal Interest Society (IRIS). This way, it was possible to identify the most common clinical signs and symptoms displayed by the disease, to evaluate clinical, biochemical and urinary parameters covered in the staging and sub-staging of CKD, to characterize the different stages of the disease according to the individual characteristics of the cats in the series and to determine the existence of a relation between creatinine values with urea (BUN), hematocrit (Hct), phosphorus and urinary density (DU). It was possible to verify that the geriatric animals were the most affected. The most frequently clinical signs observed in the patients were dehydration and poor body condition, while partial anorexia, vomiting, lethargy, weight loss and polydipsia were the most common symptoms reported by the tutors of the cats present at the visit. In regards to the staging of the disease 12% of the cats were in stage I, 49% in stage II, 27% in stage III and 12% in stage IV. Based on the presence and severity of proteinuria, 50% of the cats were classified as non-proteinuric, 15% as proteinuric at the limit and 35% as proteinuric. In sub-staging based on blood pressure, 50% of patients had minimal risk, 19% had low risk and 31% had moderate risk, no target organ damage was found in any of the cases. It was possible to observe a significant effect of staging and creatinine values on the BUN, DU, phosphorus and hematocrit parameters. The present study allowed to understand some limitations in the clinical practice that influence the early diagnosis of the disease that are associated to the complementary tests necessary for staging and sub-stage, as well as the behaviour of the tutors of the cats that in the great majority only present the animals to the consultation when they already present signs of illness.
Chronic Kidney Disease (CKD) is the most commonly kidney disease diagnosed in cats and more specifically in the elderly. It is characterized by progressive and irreversible evolution, with high levels of morbidity and mortality. The present prospective study was carried out at Arco do Cego Veterinary Hospital from March 2014 to October 2014 and included a sample of 33 cats diagnosed with CKD submitted to consultation or hospitalized at HVAC. The objectives were to clinically characterize cats with CKD, and in particular the clinical stages of all patients and substaging of 16 (48%) of the cats, according to the guidelines presented by the International Renal Interest Society (IRIS). This way, it was possible to identify the most common clinical signs and symptoms displayed by the disease, to evaluate clinical, biochemical and urinary parameters covered in the staging and sub-staging of CKD, to characterize the different stages of the disease according to the individual characteristics of the cats in the series and to determine the existence of a relation between creatinine values with urea (BUN), hematocrit (Hct), phosphorus and urinary density (DU). It was possible to verify that the geriatric animals were the most affected. The most frequently clinical signs observed in the patients were dehydration and poor body condition, while partial anorexia, vomiting, lethargy, weight loss and polydipsia were the most common symptoms reported by the tutors of the cats present at the visit. In regards to the staging of the disease 12% of the cats were in stage I, 49% in stage II, 27% in stage III and 12% in stage IV. Based on the presence and severity of proteinuria, 50% of the cats were classified as non-proteinuric, 15% as proteinuric at the limit and 35% as proteinuric. In sub-staging based on blood pressure, 50% of patients had minimal risk, 19% had low risk and 31% had moderate risk, no target organ damage was found in any of the cases. It was possible to observe a significant effect of staging and creatinine values on the BUN, DU, phosphorus and hematocrit parameters. The present study allowed to understand some limitations in the clinical practice that influence the early diagnosis of the disease that are associated to the complementary tests necessary for staging and sub-stage, as well as the behaviour of the tutors of the cats that in the great majority only present the animals to the consultation when they already present signs of illness.
Descrição
Orientação : Joana T. de Oliveira ; co-orientação : Sónia Campos
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, INTERNATIONAL RENAL INTEREST SOCIETY, VETERINÁRIA, GATOS, DOENÇAS RENAIS, DOENÇAS CRÓNICAS, ESTADIAMENTO, VETERINARY MEDICINE, CATS, RENAL DISEASES, STAGE, INTERNATIONAL RENAL INTEREST SOCIETY