Ocorrências clínicas presentes em cães em neuroreabilitação funcional
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2023
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Doentes neurológicos, em neuroreabilitação funcional (NRF), podem ser comprometidos com ocorrências clínicas em vários sistemas, prejudicando a sua recuperação. O presente estudo retrospetivo observacional, realizado no Hospital Veterinário da Arrábida (HVA), Centro de Reabilitação Animal da Arrábida (CRAA) e Centro de Reabilitação e Regeneração Animal de Lisboa (CR2AL), entre 1 de Setembro de 2016 e 14 de Dezembro de 2022, inclui 527 cães com patologia neurológica aguda, subaguda ou crónica, classificados pela EFM de 0 a 5, com diversas neurolocalizações e etiologias. O objetivo foi obter a prevalência de ocorrências clínicas durante o período de internamento de doentes de NRF em regime hospitalar, nos centros de referência, determinando medidas preventivas. A prevalência de ocorrências clínicas foi de 79,1%, sendo as mais comuns: bexiga neurogénica (56%) e diarreia aguda (33,6%). O número de ocorrências foi superior (60,4%) em internamentos ≥ 30 dias, maior prevalência na neurolocalização toracolombar (84,9%) e doentes plégicos (92,3%). Verificaram-se fortes significâncias entre as raças braquiocefálicas e presença de dermatites (p ≤ 0,001), a bexiga neurogénica e diarreias em lesões toracolombares (p ≤ 0,001), as incontinências fecal e urinária em doentes toracolombares (p ≤ 0,001) e presença de escaras de decúbito em paraplégicos (p = 0,001). Conclui-se que é necessário considerar neurolocalização, SDP e dias de internamento, para prever possíveis ocorrências e criar regras de maneio para prevenir ou minimizar as mesmas. Palavras-Chave: Ocorrências, Neuroreabilitação funcional, Cães, diarreias, escaras de decúbito
Neurological patients, undergoing functional neurorehabilitation (NRF), may experience clinical occurrences in multiple systems, which can impair recovery. The present observational retrospective study, conducted at HVA, CRAA and CR2AL, between September 1, 2016 and December 14, 2022, included 527 dogs with acute, subacute or chronic neurological diseases, classified by EFM from 0 to 5, with various neurolocalizations and etiologies. The objective was to obtain the prevalence of clinical occurrences during the hospitalization period of NRF patients in the referral centres, to determine preventive measures. The prevalence of clinical occurrences was 79.1%, the most common being: neurogenic bladder (56%) and diarrhoea (33.6%). The number of occurrences was higher (60.4%) in hospitalizations ≥ 30 days, higher prevalence in thoracolumbar neurolocalization (84.9%) and plegic patients (92.3%). There were strong significances between brachiocephalic breeds and presence of dermatitis (p ≤ 0.001), neurogenic bladder and diarrhoea in thoracolumbar lesions (p ≤ 0.001), faecal and urinary incontinence in thoracolumbar patients (p ≤ 0.001) and presence of pressure sores in paraplegics (p = 0.001). We conclude that it is necessary to consider neurolocalization, DPP and days of hospitalization to predict possible occurrences and create management rules to prevent or minimize them. Key words: Occurrences, Functional neurorehabilitation, Dogs, diarrhoea, pressure sores
Neurological patients, undergoing functional neurorehabilitation (NRF), may experience clinical occurrences in multiple systems, which can impair recovery. The present observational retrospective study, conducted at HVA, CRAA and CR2AL, between September 1, 2016 and December 14, 2022, included 527 dogs with acute, subacute or chronic neurological diseases, classified by EFM from 0 to 5, with various neurolocalizations and etiologies. The objective was to obtain the prevalence of clinical occurrences during the hospitalization period of NRF patients in the referral centres, to determine preventive measures. The prevalence of clinical occurrences was 79.1%, the most common being: neurogenic bladder (56%) and diarrhoea (33.6%). The number of occurrences was higher (60.4%) in hospitalizations ≥ 30 days, higher prevalence in thoracolumbar neurolocalization (84.9%) and plegic patients (92.3%). There were strong significances between brachiocephalic breeds and presence of dermatitis (p ≤ 0.001), neurogenic bladder and diarrhoea in thoracolumbar lesions (p ≤ 0.001), faecal and urinary incontinence in thoracolumbar patients (p ≤ 0.001) and presence of pressure sores in paraplegics (p = 0.001). We conclude that it is necessary to consider neurolocalization, DPP and days of hospitalization to predict possible occurrences and create management rules to prevent or minimize them. Key words: Occurrences, Functional neurorehabilitation, Dogs, diarrhoea, pressure sores
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VETERINARY MEDICINE, DOGS, NEUROLOGY, DIARRHOEA, NEUROREHABILITATION, MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, CÃES, NEUROLOGIA, DIARREIA, NEURORREABILITAÇÃO, Mestrado Integrado em Medicina Veterinária