Hipertiroidismo felino
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2016-04-19
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Esta dissertação de mestrado tem como objetivo comparar a aplicabilidade e o sucesso terapêutico do tratamento nutricional e do tratamento farmacológico com Metimazol, em gatos hipertiroideus.
O hipertiroidismo felino é uma doença multissistémica que tem suscitado o interesse de investigadores após 1979, ano da primeira referência a esta doença. Tanto a sua etiopatogenia como os factores de risco implicados no seu aparecimento não foram ainda completamente colocados a descoberto, mas dado o aumento da sua prevalência nos últimos anos, crê-se que está relacionada com fatores ambientais ou dietéticos.
Na primeira parte da dissertação procede-se a uma revisão bibliográfica onde se aborda de forma global o tema hipertiroidismo felino, dando-se especial enfoque aos principais meios terapêuticos em uso nesta doença, suas vantagens e desvantagens.
A parte prática desta dissertação centra-se na descrição de quatro casos clínicos de gatos hipertiroideus. Estes casos diferem no tratamento após o diagnóstico. Num caso, o “Blacky”, iniciou-se terapia nutricional com dieta y/d da Hill’s® logo após o diagnóstico, noutro, o “Gaspar”, foi aplicada terapia farmacológica com Metimazol e noutros dois, a “Tininha” e o “Pitágoras”, iniciou-se terapia farmacológica com Metimazol mas, dada a evolução terapêutica dos mesmos, decidiu-se interromper a mesma e iniciar o tratamento nutricional com dieta y/d da Hill’s®.
Cada caso clínico é acompanhado por uma breve discussão individual que incide sobre as decisões diagnósticas, de tratamento e de monitorização propostas pelos colegas médicos veterinários responsáveis pelos casos clínicos. No final, é apresentada uma discussão geral comparativa onde se inclui o cruzamento dos dados dos quatro casos clínicos.
A dificuldade em concluir acerca da eficácia do tratamento nutricional prende-se com a fraca aceitação do alimento comercial por parte do animal e com a falta de comprometimento dos proprietários na sua administração. Por outro lado, o tratamento farmacológico é mais barato que o tratamento nutricional e mostra-se eficaz a longo prazo, mostrando, no entanto, instabilidade na manutenção dos níveis séricos de T4 total e portanto do estado clínico do animal.
This dissertation aims to compare the applicability and the therapeutic success of the nutritional treatment and the pharmacological treatment with Methimazole in cats with hyperthyroidism. Feline hyperthyroidism is a multisystem disease that has raised the interest of researchers after 1979, when the first reference to this disease was made. Both its pathogenesis and risk factors implicated in its onset have not been fully uncovered, but given the increasing prevalence of its occurrence, it is believed that relates to environmental or dietary factors. In the first part of this thesis we present a literature review that comprehensively addresses feline hyperthyroidism with focus on the main therapeutic methods in use for this disease including its advantages and disadvantages. The practical part of this thesis focuses on the description of four clinical cases of hyperthyroid cats. The management of these cases differ since in one case, “Blacky”, the nutritional therapy with y/d from Hill’s® was initiated immediately after diagnosis, in another, “Gaspar”, the therapy was initiated with pharmacological treatment with Metimazol and, in the other two, “Tininha” and “Pitágoras”, drug therapy with Metimazol was started but, because of the therapeutic outcome, it was replaced by the nutritional treatment with y/d from Hill’s®. In each clinical case, there is a brief individual discussion about the diagnostic decisions, treatment and monitoring proposed by the veterinarian responsible for each clinical case. To conclude, there is a general comparative discussion, which includes the intersection of data from the four clinical cases. The difficulty in concluding about the effectiveness of the nutritional treatment relates to the low intake of the commercial food by the animals and to the owner lack of commitment for the food administration. By contrast, pharmacological treatment is cheaper than the nutritional treatment and is effective in the long term treatment, showing, however, instability in the maintenance of serum levels of total T4 and therefore in the stability of the animal’s clinical condition.
This dissertation aims to compare the applicability and the therapeutic success of the nutritional treatment and the pharmacological treatment with Methimazole in cats with hyperthyroidism. Feline hyperthyroidism is a multisystem disease that has raised the interest of researchers after 1979, when the first reference to this disease was made. Both its pathogenesis and risk factors implicated in its onset have not been fully uncovered, but given the increasing prevalence of its occurrence, it is believed that relates to environmental or dietary factors. In the first part of this thesis we present a literature review that comprehensively addresses feline hyperthyroidism with focus on the main therapeutic methods in use for this disease including its advantages and disadvantages. The practical part of this thesis focuses on the description of four clinical cases of hyperthyroid cats. The management of these cases differ since in one case, “Blacky”, the nutritional therapy with y/d from Hill’s® was initiated immediately after diagnosis, in another, “Gaspar”, the therapy was initiated with pharmacological treatment with Metimazol and, in the other two, “Tininha” and “Pitágoras”, drug therapy with Metimazol was started but, because of the therapeutic outcome, it was replaced by the nutritional treatment with y/d from Hill’s®. In each clinical case, there is a brief individual discussion about the diagnostic decisions, treatment and monitoring proposed by the veterinarian responsible for each clinical case. To conclude, there is a general comparative discussion, which includes the intersection of data from the four clinical cases. The difficulty in concluding about the effectiveness of the nutritional treatment relates to the low intake of the commercial food by the animals and to the owner lack of commitment for the food administration. By contrast, pharmacological treatment is cheaper than the nutritional treatment and is effective in the long term treatment, showing, however, instability in the maintenance of serum levels of total T4 and therefore in the stability of the animal’s clinical condition.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Gatos , Doenças do sistema endócrino , Diagnóstico , Terapêutica , Hipertiroidismo