Derrame pleural em gatos : revisão de literatura e descrição de 3 casos clínicos
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2025
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A presente dissertação explora em profundidade o maneio e o diagnóstico do derrame pleural em gatos, combinando uma revisão bibliográfica detalhada com a análise de três casos clínicos representativos, os quais refletem diferentes etiologias e desafios terapêuticos. Foram avaliadas condições associadas à insuficiência cardíaca congestiva (ICC), linfoma mediastínico e peritonite infeciosa felina (PIF), destacando a complexidade no estabelecimento de um diagnóstico diferencial, especialmente devido à inespecificidade dos sinais clínicos iniciais, como dispneia, taquipneia e anorexia. Esses sinais demonstraram a necessidade de exames complementares, incluindo radiografia, ecografia e análises laboratoriais, para a caracterização do fluido pleural em transudato, exsudato ou quilo, e a identificação da causa primária. Nos três casos clínicos analisados, a toracocentese foi determinante como medida emergencial para estabilização respiratória e alívio da pressão intratorácica, enquanto soluções terapêuticas definitivas variaram conforme a patologia de base. No caso da ICC, o uso de diuréticos e o controle de complicações cardíacas foram essenciais, embora tenham revelado a necessidade de inovações terapêuticas para o maneio a longo prazo. O linfoma mediastínico, associado a derrame quiloso, evidenciou a importância de exames tomográficos para o diagnóstico e o potencial de tratamentos combinados, incluindo quimioterapia e intervenções cirúrgicas. A PIF, por sua vez, destacou os desafios relacionados à falta de tratamentos eficazes no cenário nacional, mas também apresentou perspetivas promissoras com o avanço de antivirais como o GS-441524, que pode transformar o maneio desta condição fatal. O estudo concluiu que uma abordagem multidisciplinar, com integração de diagnóstico por imagem, análises laboratoriais e intervenções terapêuticas personalizadas, é indispensável para otimizar os desfechos clínicos. Além disso, reforça-se a importância de avanços na pesquisa e na disponibilização de medicamentos inovadores, como forma de ampliar as opções de tratamento e melhorar a qualidade de vida dos pacientes felinos acometidos por derrame pleural.
This dissertation delves deeply into the management and diagnosis of pleural effusion in cats, combining a comprehensive literature review with the analysis of three representative clinical cases, each reflecting distinct etiologies and therapeutic challenges. Conditions related to congestive heart failure (CHF), mediastinal lymphoma, and feline infectious peritonitis (FIP) were evaluated, highlighting the complexity of establishing a differential diagnosis, particularly due to the non-specific nature of initial clinical signs such as dyspnea, tachypnea, and anorexia. These signs underscored the necessity of complementary tests, including radiography, ultrasound, and laboratory analyses, to characterize pleural fluid in transudate, exudate, or chyle, and identify the primary cause. In all three cases, thoracocentesis was crucial as an emergency measure to stabilize respiratory function and relieve intrathoracic pressure, while definitive therapeutic solutions varied according to the underlying pathology. In CHF, the use of diuretics and the management of cardiac complications were pivotal, though the need for therapeutic innovations for long-term care was evident. Mediastinal lymphoma, associated with chylous effusion, demonstrated the importance of tomographic examinations for diagnosis and the potential of combined treatments, including chemotherapy and surgical interventions. FIP, on the other hand, highlighted challenges related to the lack of effective treatments in the national context but also presented promising perspectives with the advancement of antivirals such as GS-441524, which may revolutionize the management of this fatal condition. The study concludes that a multidisciplinary approach, integrating imaging diagnostics, laboratory analyses, and personalized therapeutic interventions, is indispensable for optimizing clinical outcomes. Furthermore, the importance of advances in research and the availability of innovative drugs is reinforced, as they expand treatment options and improve the quality of life for feline patients suffering from pleural effusion.
This dissertation delves deeply into the management and diagnosis of pleural effusion in cats, combining a comprehensive literature review with the analysis of three representative clinical cases, each reflecting distinct etiologies and therapeutic challenges. Conditions related to congestive heart failure (CHF), mediastinal lymphoma, and feline infectious peritonitis (FIP) were evaluated, highlighting the complexity of establishing a differential diagnosis, particularly due to the non-specific nature of initial clinical signs such as dyspnea, tachypnea, and anorexia. These signs underscored the necessity of complementary tests, including radiography, ultrasound, and laboratory analyses, to characterize pleural fluid in transudate, exudate, or chyle, and identify the primary cause. In all three cases, thoracocentesis was crucial as an emergency measure to stabilize respiratory function and relieve intrathoracic pressure, while definitive therapeutic solutions varied according to the underlying pathology. In CHF, the use of diuretics and the management of cardiac complications were pivotal, though the need for therapeutic innovations for long-term care was evident. Mediastinal lymphoma, associated with chylous effusion, demonstrated the importance of tomographic examinations for diagnosis and the potential of combined treatments, including chemotherapy and surgical interventions. FIP, on the other hand, highlighted challenges related to the lack of effective treatments in the national context but also presented promising perspectives with the advancement of antivirals such as GS-441524, which may revolutionize the management of this fatal condition. The study concludes that a multidisciplinary approach, integrating imaging diagnostics, laboratory analyses, and personalized therapeutic interventions, is indispensable for optimizing clinical outcomes. Furthermore, the importance of advances in research and the availability of innovative drugs is reinforced, as they expand treatment options and improve the quality of life for feline patients suffering from pleural effusion.
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MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA DE EMERGÊNCIA, GATOS, DERRAME PLEURAL, DIAGNÓSTICO DIFERENCIAL, MEIOS DE DIAGNÓSTICO E TERAPÊUTICA, PROMOÇÃO DA QUALIDADE DE VIDA, SAÚDE ANIMAL, CASOS CLÍNICOS, VETERINARY MEDICINE, VETERINARY EMERGENCY MEDICINE, CATS, PLEURAL EFFUSION, DIFFERENTIAL DIAGNOSIS, DIAGNOSTIC PROCEDURES, MEDICAL TESTS, DIAGNOSTIC AND THERAPEUTIC PROCEDURES, PROMOTION OF QUALITY OF LIFE, ANIMAL HEALTH, CASE REPORTS