Doença do trato urinário inferior: descrição de casos clínicos
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2021-03-18
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O presente relatório final de estágio do Mestrado Integrado em Medicina Veterinária tem como objetivo a descrição e discussão de casos clínicos de Medicina Interna de animais de companhia, nomeadamente, da subespecialidade de Urologia. O estágio curricular ocorreu em dois centros de atendimento médico-veterinário, no Hospital Veterinário do Baixo Vouga em Águeda, durante cinco meses, e no Wood Street Veterinary Hospital em Londres, durante um mês. De entre a casuística acompanhada, foram selecionados para descrição seis casos clínicos relacionados com as doenças do trato urinário inferior em gatos e cães. O primeiro caso clínico diz respeito a um cão com urolitíase por estruvite e infeção do trato urinário. O tratamento médico iniciado foi interrompido devido ao agravamento dos sinais clínicos, tendo-se avançado para a remoção dos cálculos através de cistotomia. O segundo caso clínico refere-se a um gato com um quadro clínico crónico e inespecífico de doença urinária não responsiva ao tratamento médico de suporte. O diagnóstico final foi de urolitíase por oxalato de cálcio removidos por cistotomia O terceiro caso clínico descrito ilustra uma infeção do trato urinário inferior por Staphylococcus pseudointermedius num gato com disúria. Foi tratado com doxiciclina, no entanto, o animal acabaria por falecer depois de um agravamento dos sinais clínicos. O quarto caso clínico refere-se a um gato com obstrução uretral recorrente. Devido à impossibilidade de algaliar o animal, pelo facto de a uretra apresentar uma estenose grave, foi realizada uma uretrostomia. O quinto caso clínico descreve uma cadela com disúria e distensão da bexiga. A ecografia revelou um espessamento da parede na zona do trígono e a biópsia obtida por laparotomia permitiu confirmar o diagnóstico de carcinoma de células de transição. O sexto caso clínico aborda um gato com distensão da bexiga com material intravesical projetado da superfície da parede compatível com cistite pseudomembranosa. As doenças do trato urinário são um grupo nosológico frequente que compreende um espectro largo de doenças inflamatórias e neoplásicas. A abordagem diagnóstica sistemática, nas suas vertentes clínica, laboratorial e imagiológica, associada à seleção do plano terapêutico e estratégia profilática mais adequados, permitem otimizar o prognóstico, impedir as recidivas e reduzir a morbilidade dos animais de companhia com patologia urinária.
The current report of the curricular internship in Veterinary Medicine aims to describe and discuss clinical cases in the area of Internal Medicine of companion animals, namely the clinical subspecialty of Urology. This internship took place in two different veterinary care centers, the Veterinary Hospital of Baixo Vouga in Águeda, for five months, and the Wood Street Veterinary Hospital in London, for a month. Of the entire series of cases assisted at the two veterinary centers, six clinical cases related to lower urinary tract pathology in cats and dogs were chosen to be described. The first clinical case concerns a dog with struvite urolithiasis and urinary tract infection. The medical treatment was interrupted, due to the worsening of clinical signs, and the uroliths were removed by cystotomy. The second clinical case refers to a cat with a chronic and nonspecific clinical condition of urinary disease not responsive to supportive medical treatment. The final diagnosis was calcium oxalate urolithiasis, further treated by cystotomy. The third clinical case described a lower urinary tract infection by Staphylococcus pseudointermedius in a cat with dysuria. It was treated with doxycycline, however, the animal died after the worsening of clinical signs. The fourth clinical case refers to a cat with recurrent urethral obstruction. Due to the impossibility of inserting a urinary catheter because of urethral stricture, a urethrostomy was performed. The fifth clinical case describes a female dog with dysuria and bladder distention. An ultrasound revealed a thickening of the wall in the zone of the trigone, and the biopsy obtained by laparotomy confirmed the diagnosis of transitional cell carcinoma. The sixth clinical case addresses a cat with bladder distention with intravesical material in continuity with the wall surface, compatible with pseudomembranous cystitis. Urinary tract diseases are a common nosological group which comprises a wide spectrum of inflammatory and neoplastic conditions. The systematic diagnostic approach, in its clinical, laboratory and imaging aspects, associated with the selection of the most appropriate therapeutic plan and prophylactic strategy allows to optimize the prognosis, prevent recurrences and reduce the morbidity of companion animals with urinary pathology.
The current report of the curricular internship in Veterinary Medicine aims to describe and discuss clinical cases in the area of Internal Medicine of companion animals, namely the clinical subspecialty of Urology. This internship took place in two different veterinary care centers, the Veterinary Hospital of Baixo Vouga in Águeda, for five months, and the Wood Street Veterinary Hospital in London, for a month. Of the entire series of cases assisted at the two veterinary centers, six clinical cases related to lower urinary tract pathology in cats and dogs were chosen to be described. The first clinical case concerns a dog with struvite urolithiasis and urinary tract infection. The medical treatment was interrupted, due to the worsening of clinical signs, and the uroliths were removed by cystotomy. The second clinical case refers to a cat with a chronic and nonspecific clinical condition of urinary disease not responsive to supportive medical treatment. The final diagnosis was calcium oxalate urolithiasis, further treated by cystotomy. The third clinical case described a lower urinary tract infection by Staphylococcus pseudointermedius in a cat with dysuria. It was treated with doxycycline, however, the animal died after the worsening of clinical signs. The fourth clinical case refers to a cat with recurrent urethral obstruction. Due to the impossibility of inserting a urinary catheter because of urethral stricture, a urethrostomy was performed. The fifth clinical case describes a female dog with dysuria and bladder distention. An ultrasound revealed a thickening of the wall in the zone of the trigone, and the biopsy obtained by laparotomy confirmed the diagnosis of transitional cell carcinoma. The sixth clinical case addresses a cat with bladder distention with intravesical material in continuity with the wall surface, compatible with pseudomembranous cystitis. Urinary tract diseases are a common nosological group which comprises a wide spectrum of inflammatory and neoplastic conditions. The systematic diagnostic approach, in its clinical, laboratory and imaging aspects, associated with the selection of the most appropriate therapeutic plan and prophylactic strategy allows to optimize the prognosis, prevent recurrences and reduce the morbidity of companion animals with urinary pathology.
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Relatório de Estágio Final Mestrado Integrado em Medicina Veterinária
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cão , gato