Hipotiroidismo canino: revisão de literatura e descrição de 4 casos clínicos
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2022
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A presente dissertação é concretizada na sequência da conclusão do Mestrado
Integrado em Medicina Veterinária da Universidade Lusófona – Centro Universitário de Lisboa
e tem como tema hipotiroidismo canino.
Pretendeu-se com este relatório o desenvolvimento do tema em questão através da
inclusão de uma revisão bibliográfica, seguida da exposição e discussão de 4 casos clínicos.
Para tal, foi incluído na revisão de literatura a anatomia e fisiologia da glândula tiróide,
a etiopatogenia e epidemiologia desta endocrinopatia, a sua apresentação clínica, diagnóstico,
tratamento, monitorização e prognóstico.
Os casos clínicos expostos neste trabalho têm apresentações clínicas distintas, umas
mais e outras menos comuns. Embora na maioria dos casos o diagnóstico tenha sido célere, a
vasta variedade e inespecificidade dos sinais clínicos que os cães podem apresentar pode ser
responsável pela morosa chegada a um diagnóstico definitivo, como se pode verificar num dos
casos apresentados. Os meios complementares de diagnóstico que permitiram identificar a
presença de hipotiroidismo foram os mesmos em todos os casos e são considerados o gold
standard atual para o diagnóstico inicial desta patologia. Apesar da terapia farmacológica
elegida e a dose inicial ter sido a mesma, em 2 casos foi necessário realizar reajustes de dose
ao longo do tratamento. Estes reajustes incluíram quer o aumento, quer a redução da dose.
Embora um dos casos represente uma urgência por hipotiroidismo grave não controlado e como
tal com um prognóstico reservado, todos os casos expostos tiveram uma evolução positiva com
melhoria ou remissão total da sintomatologia apresentada em resposta ao tratamento, sempre
que a dose da terapia farmacológica se encontrava adequada e a compliance dos tutores era
garantida.
Os grandes desafios associados a esta patologia prendem-se com a necessidade de o
clínico estar alerta para toda a sintomatologia que pode estar associada ao hipotiroidismo, por
forma a tornar o processo de diagnóstico mais eficiente e com a importância da existência de
compliance por parte dos tutores, para que seja atingido o sucesso terapêutico.
A natureza hereditária do hipotiroidismo em determinadas raças aumenta o interesse
em desenvolver testes genéticos acessíveis, capazes de identificar animais com maior risco de
desenvolver a patologia.
Palavras-chave: Endocrinopatia; Hipotiroidismo canino; Eixo hipotálamo-hipófisetiróide;
Glândula tiróide; Levotiroxina sódica
The present dissertation is carried out following the conclusion of the Integrated Master´s Degree in Veterinary Medicine of Universidade Lusófona – Centro Universitário de Lisboa and discusses canine hypothyroidism. The aim of this report was to develop the theme, through the inclusion of a bibliographic review, followed by the exposition of 4 clinical cases. To this end, the anatomy and physiology of the thyroid gland, the etiopathogenesis and epidemiology of this endocrinopathy, it´s clinical presentation, diagnosis, treatment, monitoring and prognosis were included in the literature review. The clinical cases exposed in this report have distinct clinical presentations, some of them more and others less common. Although in most cases the diagnosis was fast, the wide variety and lack of specificity of the clinical signs that can be presented by dogs may be responsible for the delay in reaching a definitive diagnosis, as can be seen in one of the presented cases. The complementary means of diagnosis that allowed the identification of hypothyroidism were the same in all cases and are considered the current gold standard for the initial diagnosis of this pathology. Despite the chosen pharmacological therapy and its initial dose being the same, in 2 cases it was necessary to readjust the dose throughout the treatment. These readjustments included both increasing and decreasing the dose. Although one of the cases represent an emergency situation due to uncontrolled severe hypothyroidism, and because of that had a poor prognosis, all the presented cases had a positive evolution with improvement or total remission of the symptoms in response to treatment whenever the dose of the pharmacological therapy was adequate and the compliance of the tutors was guaranteed. One of the major challenges associated with this pathology relate to the need for the clinician to be alert to all the symptoms that may be associated with hypothyroidism. It will turn the diagnostic process more efficient. One should bear in mind that the tutor´s compliance is most important, so that the therapeutic success may be achieved. The hereditary nature of hypothyroidism in certain breeds increases the interest in developing affordable genetic tests capable of identifying animals at greater risk of developing the pathology. Keywords: Endocrinopathy; Canine hypothyroidism; Hypothalamic-pituitary-thyroid axis; Thyroid gland; Levothyroxine sodium
The present dissertation is carried out following the conclusion of the Integrated Master´s Degree in Veterinary Medicine of Universidade Lusófona – Centro Universitário de Lisboa and discusses canine hypothyroidism. The aim of this report was to develop the theme, through the inclusion of a bibliographic review, followed by the exposition of 4 clinical cases. To this end, the anatomy and physiology of the thyroid gland, the etiopathogenesis and epidemiology of this endocrinopathy, it´s clinical presentation, diagnosis, treatment, monitoring and prognosis were included in the literature review. The clinical cases exposed in this report have distinct clinical presentations, some of them more and others less common. Although in most cases the diagnosis was fast, the wide variety and lack of specificity of the clinical signs that can be presented by dogs may be responsible for the delay in reaching a definitive diagnosis, as can be seen in one of the presented cases. The complementary means of diagnosis that allowed the identification of hypothyroidism were the same in all cases and are considered the current gold standard for the initial diagnosis of this pathology. Despite the chosen pharmacological therapy and its initial dose being the same, in 2 cases it was necessary to readjust the dose throughout the treatment. These readjustments included both increasing and decreasing the dose. Although one of the cases represent an emergency situation due to uncontrolled severe hypothyroidism, and because of that had a poor prognosis, all the presented cases had a positive evolution with improvement or total remission of the symptoms in response to treatment whenever the dose of the pharmacological therapy was adequate and the compliance of the tutors was guaranteed. One of the major challenges associated with this pathology relate to the need for the clinician to be alert to all the symptoms that may be associated with hypothyroidism. It will turn the diagnostic process more efficient. One should bear in mind that the tutor´s compliance is most important, so that the therapeutic success may be achieved. The hereditary nature of hypothyroidism in certain breeds increases the interest in developing affordable genetic tests capable of identifying animals at greater risk of developing the pathology. Keywords: Endocrinopathy; Canine hypothyroidism; Hypothalamic-pituitary-thyroid axis; Thyroid gland; Levothyroxine sodium
Descrição
Orientação: Ana Amaral
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, VETERINARY MEDICINE, VETERINÁRIA, CANÍDEOS, CANIDS, CÃES, DOGS, DOENÇAS DO SISTEMA ENDÓCRINO, ENDOCRINE SYSTEM DISEASES, HIPOTIROIDISMO, HYPOTHYROIDISM, TIRÓIDE, THYROID GLAND, REVISÃO BIBLIOGRÁFICA, BIBLIOGRAPHIC REVIEW, CASOS CLÍNICOS, CASE REPORTS