Medicina interna de animais de companhia: apresentação de casos clínicos
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2022-07-18
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Este relatório de estágio final tem como objetivo a exposição das atividades realizadas
no Hospital Veterinário do Porto (HVP) durante os seis meses de estágio, de setembro de
2020 a março de 2021, assim como a descrição e a discussão de quatro casos clínicos de
diversas áreas de medicina interna de animais de companhia.
Durante o estágio no HVP foi possível acompanhar vários serviços, nomeadamente,
internamento, cirurgia e consultas, permitindo assim o acompanhamento de vários casos
clínicos, desde a anamnese até ao diagnóstico, tratamento e monitorização dos animais. Dos
casos clínicos observados, quatro foram selecionados para serem apresentados e discutidos
neste relatório.
O primeiro caso clínico relata uma hipertensão portal que resultou na formação de
shunts porto-sistémicos adquiridos num cão com 6 meses. O animal apresentou-se com
prostração, vómitos e hiporexia. Com a realização de tomografia computorizada e biópsia
hepática foi possível diagnosticar a presença de hipertensão portal com shunts portosistémicos
adquiridos. Foi implementada uma terapia sintomática e de suporte.
O segundo caso clínico trata-se de uma doença renal crónica, provavelmente
secundária a uma displasia renal, numa cadela Dobermann. Este animal apresentou-se com
anorexia, diarreia e perda de peso. As alterações analíticas eram compatíveis com doença
renal crónica, e com a realização de ecografia abdominal foi possível fazer o diagnóstico
presuntivo de displasia renal. Foi implementado um plano terapêutico de suporte, no entanto
não houve melhoria do estado clínico do animal. O animal foi eutanasiado, após uma semana
de internamento.
O terceiro caso relata um animal com seminoma, sertolinoma, torção testicular e
standstill atrial. Este animal apresentava apenas perda de peso contínua. Durante o exame
físico foram detetados criptorquidismo, sopro cardíaco e bradicardia. Através de
eletrocardiografia foi diagnosticado de standstill atrial. Na ecografia abdominal foi detetada
uma massa testicular. Realizou-se uma orquiectomia bilateral e avaliação histopatológica dos
testículos removidos, tendo sido diagnosticado seminoma, sertolinoma e torção testicular.
Por fim, o quarto caso clínico trata-se de uma cadela com hipotiroidismo e
hipoadrenocorticismo. A queixa inicial da tutora era a relutância ao exercício e a hiporexia. O
hipotiroidismo foi diagnosticado através da avaliação dos níveis séricos de tiroxina e da
hormona estimulante da tiroide. O hipoadrenocorticismo foi diagnosticado através da
realização do teste de estimulação com hormona adrenocorticotrófica. Instituiu-se um plano
terapêutico com fármacos substitutos de tiroxina e cortisol.
Estes quatro casos foram selecionados por abordarem áreas distintas da medicina
interna de animais de companhia permitindo, deste modo, ter uma visão alargada desta
especialidade.
This final report aims to describe the activities carried out at the Hospital Veterinário do Porto (HVP), during the six months of internship, as well as the report and discussion of four clinical cases from various areas within small animal internal medicine. During these six months at the HVP, it was possible to perform rotations divided by the hospital’s services, including hospitalization, surgery and consultations, thus allowing the follow-up of clinical cases. Of all the observed clinical cases, four were chosen to be discussed in this report. The first case discusses portal hypertension, resulting in the formation of acquired portosystemic shunts in a 6-month-old dog. The animal presented with prostration, vomiting and hyporexia. With computed tomography and liver biopsy, it was possible to diagnose the presence of portal hypertension with acquired portosystemic shunts. Symptomatic and supportive therapy was implemented. The second case reports chronic kidney disease, possibly secondary to renal dysplasia, in a Dobermann. This animal presented with anorexia, diarrhea and weight loss. The analytical changes were compatible with chronic kidney disease, and with an abdominal ultrasound it was possible to make a presumptive diagnosis of renal dysplasia. A therapeutic support plan was implemented, however there was no improvement in the animal’s clinical status. She was euthanized after one week of hospitalization. The third case reports a Golden Retriever with seminoma, sertolioma, testicular torsion and atrial standstill. This animal only presented with continuous weight loss. Upon examination, cryptorchidism, cardiac murmur and bradycardia were detected. With electrocardiography he was diagnosed atrial standstill. A testicular mass was also detected through abdominal ultrasound. A bilateral orchiectomy was performed, and histopathological evaluation of the removed testicles allowed the diagnosis of seminoma, sertolioma and testicular torsion. Finally, the fourth case is a dog with hypothyroidism and hypoadrenocorticism. The tutor’s initial complaints were exercise intolerance and hyporexia. Hypothyroidism was diagnosed by measuring serum thyroxine and thyroid stimulating hormone levels. Hypoadrenocorticism was diagnosed by performing the adrenocorticotrophic hormone stimulation test. A therapeutic plan was instituted with substitute drugs for thyroxine and cortisol. These four clinical cases were selected because they address different areas of small animal internal medicine and, thus, allowing a broad view of this specialty.
This final report aims to describe the activities carried out at the Hospital Veterinário do Porto (HVP), during the six months of internship, as well as the report and discussion of four clinical cases from various areas within small animal internal medicine. During these six months at the HVP, it was possible to perform rotations divided by the hospital’s services, including hospitalization, surgery and consultations, thus allowing the follow-up of clinical cases. Of all the observed clinical cases, four were chosen to be discussed in this report. The first case discusses portal hypertension, resulting in the formation of acquired portosystemic shunts in a 6-month-old dog. The animal presented with prostration, vomiting and hyporexia. With computed tomography and liver biopsy, it was possible to diagnose the presence of portal hypertension with acquired portosystemic shunts. Symptomatic and supportive therapy was implemented. The second case reports chronic kidney disease, possibly secondary to renal dysplasia, in a Dobermann. This animal presented with anorexia, diarrhea and weight loss. The analytical changes were compatible with chronic kidney disease, and with an abdominal ultrasound it was possible to make a presumptive diagnosis of renal dysplasia. A therapeutic support plan was implemented, however there was no improvement in the animal’s clinical status. She was euthanized after one week of hospitalization. The third case reports a Golden Retriever with seminoma, sertolioma, testicular torsion and atrial standstill. This animal only presented with continuous weight loss. Upon examination, cryptorchidism, cardiac murmur and bradycardia were detected. With electrocardiography he was diagnosed atrial standstill. A testicular mass was also detected through abdominal ultrasound. A bilateral orchiectomy was performed, and histopathological evaluation of the removed testicles allowed the diagnosis of seminoma, sertolioma and testicular torsion. Finally, the fourth case is a dog with hypothyroidism and hypoadrenocorticism. The tutor’s initial complaints were exercise intolerance and hyporexia. Hypothyroidism was diagnosed by measuring serum thyroxine and thyroid stimulating hormone levels. Hypoadrenocorticism was diagnosed by performing the adrenocorticotrophic hormone stimulation test. A therapeutic plan was instituted with substitute drugs for thyroxine and cortisol. These four clinical cases were selected because they address different areas of small animal internal medicine and, thus, allowing a broad view of this specialty.
Descrição
Mestrado Integrado de Medicina Veterinária
Palavras-chave
Shunts porto-sistémicos extra-hepáticos adquiridos , Displasia renal