Abordagem ao diagnóstico de hepatopatias em cães e gatos: comparação entre diagnóstico ecográfico e citológico – Estudo de 45 casos clínicos
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2012
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O presente estudo teve como principal objetivo, verificar a possível relação entre o diagnóstico ecográfico e os resultados diagnósticos obtidos por PAAF em canídeos e felídeos com hepatopatias. No estudo foram avaliados 45 cães e gatos sendo consideradas anamnese, hemograma e bioquímicas séricas, ecografia e PAFF.
Com respeito aos sinais clínicos observou-se que em felídeos foram mais representativos anorexia, vómito e hepatomegália, embora presentes em apenas 20% dos animais. Por outro lado, os canídeos apresentaram mais consistentemente perda de peso e hepatomegália com 40% e 38% respetivamente, sendo também mais suscetíveis à ocorrência de anorexia (36%) e vómito (33%).
As hepatopatias encontradas com maior frequência consistiram no tipo não inflamatório cursando em gatos principalmente com anorexia (50%) e vómito (57%), enquanto que nos cães se registou uma maior ocorrência de perda de peso (40%) e hepatomegália (38%).
Em termos de hepatopatias inflamatórias, nos felídeos os sinais clínicos associados mais frequentes consistiram em coagulopatias e fezes acólicas (52%), enquanto que a distensão abdominal foi o mais representativo nos canídeos (42%).
Com respeito aos achados imagiológicos, nos felídeos a anorexia cursou com colestase, aumento de linfonodos porta e liquido livre abdominal, contrastando com os canídeos que apresentavam principalmente aumento dos linfonodos porta. As formações nodulares/neoformações em felídeos foram associadas a perda de peso, vómito e aumento dos linfonodos porta. Nos canídeos as doenças hepáticas inflamatórias apresentaram uma tendência para imagem ecográfica difusa, por oposição aos felídeos em que este achado foi correlacionado com as patologias não inflamatórias, ambos com hiperecogenicidade.
O presente estudo verificou que em muitas situações um mesmo tipo de imagem ecográfica originou diferentes diagnósticos citológicos, que traduz a importância da implementação rotineira de biópsia hepática para o sucesso na obtenção de diagnóstico definitivo assertivo.
The present study focused in verifying the possible relationship between ultrasound diagnosis and diagnostic results obtained by FNA in dogs and cats with liver disease. The study evaluated 45 dogs and cats and considered medical history, complete blood count, biochemistry profile, and ultrasound-guided fine needle aspirate. With respect to clinical signs observed in cats, anorexia, vomiting, and hepatomegaly, were the most representative although present in only 20% of animals. Moreover, the dogs showed more consistently weight loss and hepatomegaly with 40% and 38% respectively, and seemed to be more susceptible to occurrence of anorexia (36%) and vomiting (33%). The liver diseases diagnosed most frequently consisted in non inflammatory type, presented in cats with clinical anorexia (50%) and vomiting (57%), while in dogs showed a higher rate of weight loss (40%) and hepatomegaly (38% ). In terms of inflammatory type of liver disease, in cats clinical signs associated consisted more frequently in coagulopathies and acholic feces (52%), while abdominal distension was the most representative feature in dogs (42%). With respect to imaging findings in cats with anorexia attended cholestasis, increased portal lymph nodes and free abdominal fluid, contrasting with the dogs that demonstrated essentially portal lymph node enlargement. In cats the occurrence of nodular lesions was most associated with weight loss, vomiting and enlarged portal lymph nodes. In dogs inflammatory liver disease presented an ultrasound image with diffuse pattern, opposed to feline species in which this finding was correlated with non inflammatory diseases, documented in both species with parenchyma hyperechogenicity. This study found that in many situations the same type of ultrasound image originated different cytological diagnosis, which drives the importance of implementing routine liver biopsy for a successful definitive diagnosis achievement.
The present study focused in verifying the possible relationship between ultrasound diagnosis and diagnostic results obtained by FNA in dogs and cats with liver disease. The study evaluated 45 dogs and cats and considered medical history, complete blood count, biochemistry profile, and ultrasound-guided fine needle aspirate. With respect to clinical signs observed in cats, anorexia, vomiting, and hepatomegaly, were the most representative although present in only 20% of animals. Moreover, the dogs showed more consistently weight loss and hepatomegaly with 40% and 38% respectively, and seemed to be more susceptible to occurrence of anorexia (36%) and vomiting (33%). The liver diseases diagnosed most frequently consisted in non inflammatory type, presented in cats with clinical anorexia (50%) and vomiting (57%), while in dogs showed a higher rate of weight loss (40%) and hepatomegaly (38% ). In terms of inflammatory type of liver disease, in cats clinical signs associated consisted more frequently in coagulopathies and acholic feces (52%), while abdominal distension was the most representative feature in dogs (42%). With respect to imaging findings in cats with anorexia attended cholestasis, increased portal lymph nodes and free abdominal fluid, contrasting with the dogs that demonstrated essentially portal lymph node enlargement. In cats the occurrence of nodular lesions was most associated with weight loss, vomiting and enlarged portal lymph nodes. In dogs inflammatory liver disease presented an ultrasound image with diffuse pattern, opposed to feline species in which this finding was correlated with non inflammatory diseases, documented in both species with parenchyma hyperechogenicity. This study found that in many situations the same type of ultrasound image originated different cytological diagnosis, which drives the importance of implementing routine liver biopsy for a successful definitive diagnosis achievement.
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Orientação : Ana Godinho ; co-orientação : Marina Coelho
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MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, DOENÇAS HEPÁTICAS, HEPATIC DISEASES, CANÍDEOS, CANIDS, FELÍDEOS, FELIDS, CÃES, DOGS, GATOS, CATS, ECOGRAFIAS, ULTRASOUND SCANS, CITOLOGIA, CYTOLOGY, CASOS CLÍNICOS, CASE REPORTS, VETERINARY MEDICINE, MEDICINA VETERINÁRIA