Efeito do stress associado ao tempo de hospitalização e doença renal crónica no tamanho das glândulas adrenais em gatos
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2022
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A influência que o stress provocado pela hospitalização e presença de doença têm no eixo hipotálamo-hipófise-adrenal (HPA) ainda é pouco conhecido. Estudos sobre o rácio cortisol:creatinina urinário conseguiram correlacionar a influência destes fatores com a libertação de cortisol pelas glândulas adrenais. No entanto, estudos sobre o efeito de doenças crónicas nas medições ecográficas das glândulas adrenais felinas não demonstraram diferenças estatisticamente significativas quando comparadas com as medições obtidas em gatos saudáveis, ainda que as medições em torno das médias, medianas e marginais máximos demonstrassem ser quase sempre superiores.
Pretendeu-se, com o presente trabalho, determinar se o stress induzido por diferentes períodos de hospitalização, assim como o stress induzido pela doença renal crónica (DRC), quando comparada com o stress induzido por enterocolites agudas (ENT), resultam em medições ecográficas diferentes nas glândulas adrenais felinas. Para tal, procedeu-se à examinação ecográfica de 110 gatos doentes (22 com ENT e 27 com DRC), agrupados por diferentes períodos de hospitalização (<1, 1-2 e >2 dias) e mediu-se a altura máxima dorsoventral dos pólos cranial e caudal em ambas as glândulas adrenais.
Os resultados demonstraram que, as médias e medianas de altura máxima dorsoventral dos pólos cranial esquerdo, cranial direito e caudal direito foram maiores nos grupos de hospitalização 1-2 e >2 dias quando comparadas com o grupo de <1 dia de hospitalização e que a média do pólo caudal esquerdo do grupo de hospitalização <1 dia é menor que a média do grupo de >2 dias de hospitalização. Também demonstraram que, no grupo de DRC, os pólos cranial e caudal da glândula adrenal esquerda eram significativamente maiores quando comparados com as medições do grupo com ENT.
Estes resultados sugerem que o stress induzido por diferentes períodos de hospitalização afetam o eixo HPA de forma diferente, assim como o stress provocado pela cronicidade e/ou patofisiologia da DRC afeta o eixo HPA de forma diferente do que em gatos com ENT, traduzindo-se em graus de hiperplasia adrenal diferentes.
Palavras-chave: ecografia; glândulas adrenais; doença renal crónica; enterocolite; hospitalização; eixo hipotálamo-hipófise-adrenal
The influence that the stress caused by hospitalization and the presence of disease have on the hypothalamic-pituitary-adrenal (HPA) axis is still poorly understood. Studies on the urinary cortisol: creatinine ratio were able to correlate the influence of these factors with the release of cortisol by the adrenal glands. However, studies on the effect of chronic diseases on ultrasound measurements of feline adrenal glands have not shown statistically significant differences when compared to measurements obtained in healthy cats, even though measurements around the means, medians, and maximum limits have been shown to be always greater. This dissertation aims to determine whether the stress induced by different periods of hospitalization, as well as the stress induced by chronic kidney disease (CKD), when compared to the stress induced by acute enterocolitis (ENT), results in statistically different ultrasound feline adrenal gland measurements. 110 sick cats (22 with ENT and 27 with CKD), grouped by different periods of hospitalization (<1, 1-2, and >2 days), underwent an ultrasonographic examination and the maximum height of the cranial and caudal poles of both adrenal glands was measured in a sagittal plane. The results showed that the means and medians of the maximum dorsoventral height of the left cranial, right cranial, and right caudal poles were larger in the 1-2 and >2 days hospitalization groups when compared to the <1 day hospitalization group and that the mean of the left caudal pole of the <1 day hospitalization group is smaller than the mean of the >2 days hospitalization group. It also demonstrated that, in the CKD group, the cranial and caudal poles of the left adrenal gland were significantly larger when compared to measurements in the ENT group. These results suggest that the stress induced by different periods of hospitalization affects the HPA axis differently, as well as the stress caused by the chronicity and/or pathophysiology of CKD affects the HPA axis differently than in cats with ENT, translating into different degrees of adrenal hyperplasia. Keywords: adrenal glands; feline; chronic renal disease; enteropathies; ultrasonography; hypothalamic-pituitary-adrenal axis; hospitalization
The influence that the stress caused by hospitalization and the presence of disease have on the hypothalamic-pituitary-adrenal (HPA) axis is still poorly understood. Studies on the urinary cortisol: creatinine ratio were able to correlate the influence of these factors with the release of cortisol by the adrenal glands. However, studies on the effect of chronic diseases on ultrasound measurements of feline adrenal glands have not shown statistically significant differences when compared to measurements obtained in healthy cats, even though measurements around the means, medians, and maximum limits have been shown to be always greater. This dissertation aims to determine whether the stress induced by different periods of hospitalization, as well as the stress induced by chronic kidney disease (CKD), when compared to the stress induced by acute enterocolitis (ENT), results in statistically different ultrasound feline adrenal gland measurements. 110 sick cats (22 with ENT and 27 with CKD), grouped by different periods of hospitalization (<1, 1-2, and >2 days), underwent an ultrasonographic examination and the maximum height of the cranial and caudal poles of both adrenal glands was measured in a sagittal plane. The results showed that the means and medians of the maximum dorsoventral height of the left cranial, right cranial, and right caudal poles were larger in the 1-2 and >2 days hospitalization groups when compared to the <1 day hospitalization group and that the mean of the left caudal pole of the <1 day hospitalization group is smaller than the mean of the >2 days hospitalization group. It also demonstrated that, in the CKD group, the cranial and caudal poles of the left adrenal gland were significantly larger when compared to measurements in the ENT group. These results suggest that the stress induced by different periods of hospitalization affects the HPA axis differently, as well as the stress caused by the chronicity and/or pathophysiology of CKD affects the HPA axis differently than in cats with ENT, translating into different degrees of adrenal hyperplasia. Keywords: adrenal glands; feline; chronic renal disease; enteropathies; ultrasonography; hypothalamic-pituitary-adrenal axis; hospitalization
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Orientação: Ana Santana
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, VETERINARY MEDICINE, VETERINÁRIA, ECOGRAFIA, ULTRASOUND SCAN, GLÂNDULAS SUPRARRENAIS, ADRENAL GLANDS, DOENÇAS RENAIS, KIDNEY DISEASES, DOENÇAS CRÓNICAS, CHRONIC DISEASES, INTERNAMENTOS HOSPITALARES, HOSPITALIZATION, GATOS, CATS, ENTEROCOLITE, ENTEROCOLITIS