Avaliação da resposta ao tratamento conservador em 55 cães com diagnóstico presuntivo de doença do disco intervertebral toracolombar : estudo retrospetivo
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2025
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A doença do disco intervertebral é uma patologia que acomete cães com frequência. Apesar da descompressão cirúrgica já ter sido comprovada como terapêutica confiável, muitas vezes ela não é uma opção viável, o que tem cada vez mais levantado a necessidade de estudos que auxiliem a estabelecer a eficácia do tratamento conservador. Pretendeu-se, com o presente trabalho retrospetivo identificar cães que receberam o diagnóstico presuntivo de doença do disco intervertebral toracolombar e que foram submetidos ao maneio clínico. O estudo procurou avaliar os desfechos desse tratamento e verificar as possíveis variáveis associadas ao resultado do mesmo. Para tal, procedeu-se a recolha de dados a partir dos prontuários de pacientes com disfunção neurológica sugestivas de acometimento do segmento medular toracolombar, atendidos na clínica Referência Veterinária, Portugal, entre 2022 e 2024. No total, foram avaliados 215 prontuários, dos quais 55 atenderam aos critérios de inclusão no estudo. O grau de disfunção neurológica dos pacientes foi classificado de acordo com uma escala numérica, na qual zero indicava ausência de sinais clínicos e cinco correspondia a paraplegia sem nocicepção. Foram analisadas variáveis como raça e se pertencia a raça condrodistrófica, idade, sexo, estado reprodutivo, terapias adjuvantes, controlo da dor e da inflamação, repouso e duração dos sinais clínicos, para verificar a sua influência na evolução dos pacientes. 83% dos pacientes estavam ambulatórios na avaliação inicial. Sucesso no tratamento foi observado em 78,2% dos cães, 18,2% dos casos apresentaram recidiva, enquanto 3,6% tiveram insucesso. As raças condrodistróficas foram responsáveis pela maioria dos casos, sendo que a mais comum foi a Buldogue Francês. Um tempo prolongado com sinais clínicos antes da avaliação neurológica e ajuste no tratamento, teve associação negativa com o sucesso no tratamento dos pacientes. O uso de anti-inflamatório apresentou associação significativa com um maior tempo de duração dos sinais clínicos antes da consulta. Concluiu-se que o maneio conservador foi eficaz para tratar cães com doença do disco intervertebral toracolombar. As variáveis analisadas não apresentaram associação significativa com o sucesso no tratamento, não podendo ser consideradas como fatores prognósticos. Os resultados sugeriram que muitos cães não necessitam obrigatoriamente do tratamento cirúrgico para se recuperar e mesmo em casos nos quais há indicação, mas não havendo a possibilidade de realização de exames de imagem e descompressão cirúrgica, o tratamento conservador se apresenta como uma alternativa válida, devendo ser considerado.
Intervertebral disc disease is a condition that frequently affects dogs. Although surgical decompression has already been proven as a reliable therapeutic option, sometimes it is not a viable option, which has increasingly raised the need for studies to help establish the effectiveness of conservative treatment. The present retrospective study aimed to identify dogs diagnosed with presumptive thoracolumbar intervertebral disc disease who were treated with clinical management. The study sought to evaluate the outcomes of this treatment and examine the possible variables associated with these outcomes. To this end, data was collected from the medical records of patients with neurological dysfunctions suggestive of involvement of the thoracolumbar spinal segment, seen at the clinic Referência Veterinária, Portugal, between 2022 and 2024. A total of 215 medical records were reviewed, of which 55 met the inclusion criteria for the study. The degree of neurological dysfunction in the patients was classified using a numerical scale, where grade zero was assigned to those without clinical signs and grade five was assigned to those with paraplegia without nociception. Variables such as breed and whether they belonged to the chondrodystrophic breeds, age, sex, reproductive status, adjuvant therapies, pain and inflammation control, rest, and duration of clinical signs were analyzed to determine their influence on patient outcomes. At the initial assessment, 83% of the patients were ambulatory. Treatment success was observed in 78,2% of the dogs, 18,2% had a recurrence, while 3,6% had treatment failure. Chondrodystrophic breeds accounted for the majority of cases, with the French Bulldog being the most frequently observed breed. The prolonged duration of clinical signs before the neurological evaluation and treatment adjustment was negatively associated with treatment success. The use of anti-inflammatory medication was significantly associated with a longer duration of clinical signs before consultation. It was concluded that conservative management was effective in treating dogs with thoracolumbar intervertebral disc disease. The analyzed variables were not significantly associated with treatment success and could not be considered as prognostic factors. The results suggested that many dogs do not necessarily require surgical treatment to recover, and even in cases where surgery is indicated but imaging exams and surgical decompression are not possible, conservative treatment is a valid alternative and should be considered.
Intervertebral disc disease is a condition that frequently affects dogs. Although surgical decompression has already been proven as a reliable therapeutic option, sometimes it is not a viable option, which has increasingly raised the need for studies to help establish the effectiveness of conservative treatment. The present retrospective study aimed to identify dogs diagnosed with presumptive thoracolumbar intervertebral disc disease who were treated with clinical management. The study sought to evaluate the outcomes of this treatment and examine the possible variables associated with these outcomes. To this end, data was collected from the medical records of patients with neurological dysfunctions suggestive of involvement of the thoracolumbar spinal segment, seen at the clinic Referência Veterinária, Portugal, between 2022 and 2024. A total of 215 medical records were reviewed, of which 55 met the inclusion criteria for the study. The degree of neurological dysfunction in the patients was classified using a numerical scale, where grade zero was assigned to those without clinical signs and grade five was assigned to those with paraplegia without nociception. Variables such as breed and whether they belonged to the chondrodystrophic breeds, age, sex, reproductive status, adjuvant therapies, pain and inflammation control, rest, and duration of clinical signs were analyzed to determine their influence on patient outcomes. At the initial assessment, 83% of the patients were ambulatory. Treatment success was observed in 78,2% of the dogs, 18,2% had a recurrence, while 3,6% had treatment failure. Chondrodystrophic breeds accounted for the majority of cases, with the French Bulldog being the most frequently observed breed. The prolonged duration of clinical signs before the neurological evaluation and treatment adjustment was negatively associated with treatment success. The use of anti-inflammatory medication was significantly associated with a longer duration of clinical signs before consultation. It was concluded that conservative management was effective in treating dogs with thoracolumbar intervertebral disc disease. The analyzed variables were not significantly associated with treatment success and could not be considered as prognostic factors. The results suggested that many dogs do not necessarily require surgical treatment to recover, and even in cases where surgery is indicated but imaging exams and surgical decompression are not possible, conservative treatment is a valid alternative and should be considered.
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MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, HÉRNIA DISCAL, CANÍDEOS, CÃES, VETERINARY MEDICINE, SLIPPED DISC, CANIDS, DOGS