Abordagem diagnóstica à doença do trato urinário inferior felino: estudo combinado retrospetivo e prospetivo
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2016
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A Doença do Trato Urinário Inferior Felino (FLUTD) é uma das principais razões, apontada por vários autores a nível mundial, para os proprietários de gatos se deslocarem ao Médico Veterinário. Contudo, em Portugal não existem muitos estudos científicos acerca da etiologia desta doença, estando-se totalmente dependente dos dados da literatura estrangeira. Por conseguinte, o objetivo desta dissertação foi compreender de que forma é feita a abordagem diagnóstica por parte do Médico Veterinário, assim como caraterizar os gatos que apresentaram a doença na região do grande Porto.
Foi recolhida informação médica completa de apenas de 33 gatos que se apresentaram à consulta no Hospital Veterinário do Porto (HVP) com sintomatologia clínica de FLUTD, num período decorrido entre o ano 2010 e 2016, abrangendo um período retrospetivo e prospetivo. A seleção dos mesmos teve por base a realização de Meios Complementares de Diagnóstico (MCD) mínimos necessários que nos permitissem fazer o diagnóstico da etiologia responsável pelos sinais clínicos apresentados. Na ausência de uma causa etiológica, o diagnóstico por exclusão de Cistite Idiopática Felina (FIC) foi realizado, de acordo com o descrito na literatura.
Verificou-se que FIC foi a etiologia predominante, seguida das infeções bacterianas e urolitíase. Relativamente a caraterísticas intrínsecas, foram predominantes o género masculino, a realização orquiectomia/ovariohisterectomia, a raça Europeu Comum e a idade superior a seis anos. Por sua vez, no que concerne a fatores extrínsecos e à história clínica, constatou-se a predominância de animais alimentados exclusivamente com alimento seco e o estilo de vida indoor.
Por fim, constatou-se ainda uma associação estatisticamente significativa entre FIC e a realização de algaliação como parte do tratamento, assim como associações entre diagnóstico com etiologia não FIC e a presença de leucosúria e bacteriúria no sedimento urinário.
Em suma, os resultados obtidos permitem compreender de que forma é feita a abordagem diagnóstica a um animal com sinais FLUTD e, por consequência, perceber de que modo uma maior inclusão de determinados MCD permitiria obter um diagnóstico definitivo, crucial para a adequação da terapêutica a cada paciente e, possivelmente diminuir a recidiva.
The Feline Lower Urinary Tract Disease (FLUTD) is one of the main reasons pointed out by several authors worldwide for owners of cats to go to the veterinarian. However, in Portugal there aren’t many scientific studies about the etiology of this disease, being totally dependent on foreign literature. Therefore, the aim of this work was to understand how is done the diagnostic approach by the veterinarian, as well as characterize the cats with the disease in the greater Porto area. Complete medical information was gathered about only 33 cats presented for consultation at the Veterinary Hospital of Porto (HVP) with clinical symptoms of FLUTD, between the year of 2010 and 2016, covering a retrospective and prospective period. The selection of these was based on the performing of complementary means of diagnostic (MCD) minimum necessary to allow us to diagnose the etiology responsible for the clinical signs presented. In the absence of etiological causes, the diagnosis by exclusion of Feline Idiopathic Cystitis (FIC) was performed, as described on the literature. It was found that FIC was the predominant etiology, followed by bacterial infection and urolithiasis. Regarding intrinsic characteristics, it was predominantly males, animals subjected to orchiectomy/ovariohysterectomy, the breed European shorthair and cats older than six years. In turn, concerning extrinsic factors and clinical history, it was found the predominance of animals fed exclusively with dry food and indoor lifestyle. Finally, there was a statistically significant association between FIC and performing catheterization as part of the treatment, as well as associations between the diagnostic etiology non FIC and the presence of pyuria and bacteriuria in urinary sediment. In short, the results obtained allow us to understand how is done the diagnostic approach to an animal with FLUTD signs and, therefore, understand how the greater inclusion of certain MCD would get a definitive diagnosis, critical to adapt the therapy to each patient and possibly reduce recurrences.
The Feline Lower Urinary Tract Disease (FLUTD) is one of the main reasons pointed out by several authors worldwide for owners of cats to go to the veterinarian. However, in Portugal there aren’t many scientific studies about the etiology of this disease, being totally dependent on foreign literature. Therefore, the aim of this work was to understand how is done the diagnostic approach by the veterinarian, as well as characterize the cats with the disease in the greater Porto area. Complete medical information was gathered about only 33 cats presented for consultation at the Veterinary Hospital of Porto (HVP) with clinical symptoms of FLUTD, between the year of 2010 and 2016, covering a retrospective and prospective period. The selection of these was based on the performing of complementary means of diagnostic (MCD) minimum necessary to allow us to diagnose the etiology responsible for the clinical signs presented. In the absence of etiological causes, the diagnosis by exclusion of Feline Idiopathic Cystitis (FIC) was performed, as described on the literature. It was found that FIC was the predominant etiology, followed by bacterial infection and urolithiasis. Regarding intrinsic characteristics, it was predominantly males, animals subjected to orchiectomy/ovariohysterectomy, the breed European shorthair and cats older than six years. In turn, concerning extrinsic factors and clinical history, it was found the predominance of animals fed exclusively with dry food and indoor lifestyle. Finally, there was a statistically significant association between FIC and performing catheterization as part of the treatment, as well as associations between the diagnostic etiology non FIC and the presence of pyuria and bacteriuria in urinary sediment. In short, the results obtained allow us to understand how is done the diagnostic approach to an animal with FLUTD signs and, therefore, understand how the greater inclusion of certain MCD would get a definitive diagnosis, critical to adapt the therapy to each patient and possibly reduce recurrences.
Descrição
Orientação : Joana Tavares de Oliveira ; co-orientação : Luís Lima Lobo
Palavras-chave
MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, DOENÇAS DO SISTEMA URINÁRIO, GATOS, DIAGNÓSTICOS, DIGESTIVE SYSTEM DISEASES, CATS, DIAGNOSES, VETERINARY MEDICINE, MEDICINA VETERINÁRIA