Doença cardíaca no cão - desafios e soluções nutricionais
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2019-01-17
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As doenças cardíacas são cada vez mais comuns no cão, principalmente as doenças adquiridas, em grande parte devido ao aumento da esperança média de vida destes animais. Na maioria das vezes resultam em insuficiência cardíaca (IC), síndrome clínica progressiva e sem cura, cujo objetivo do tratamento crónico consiste na melhoria dos sinais clínicos e prolongamento do tempo de sobrevivência. A nutrição clínica é uma disciplina a ter em conta no maneio da IC, sendo importante para a manutenção de uma boa condição corporal, alívio dos sinais clínicos através do controlo de excessos ou deficiências em nutrientes e pelos potenciais benefícios farmacológicos de certos nutrientes na doença cardíaca, apesar desta área necessitar, ainda, de muita investigação. O objetivo deste trabalho foi realizar uma análise das características das dietas recomendadas na prática clínica para os casos de cães com doença cardíaca em diferentes fases, selecionar os fatores nutricionais chave e identificar onde se podem introduzir alterações para aproximar as recomendações com a informação mais atualizada presente na revisão de literatura realizada neste trabalho. Com este objetivo foram selecionados seis casos clínicos de cães com doença cardíaca que se apresentaram a consulta no Hospital Veterinário do Baixo Vouga, durante o período de cinco meses de estágio curricular. Neste trabalho, inicialmente foi realizada uma revisão de literatura sobre a doença cardíaca, a insuficiência cardíaca, classificação e tratamento farmacológico. Posteriormente, foi realizada uma revisão de literatura sobre a modulação nutricional da doença cardíaca que inclui aspetos como a obesidade, a caquexia cardíaca e os fatores nutricionais chave. Por fim, foi realizada uma avaliação nutricional de cada caso clínico, analisadas as recomendações nutricionais e sugeridas alterações, de forma a que o plano nutricional se aproximasse dos objetivos determinados. O sódio, taurina, L-carnitina, proteína e os ácidos gordos ómega-3 de cadeia longa, revelaram ser os principais nutrientes onde se devem introduzir alterações que vão de encontro aos objetivos. Tendo em conta a importância da manutenção de uma condição corporal ótima nestes animais, também foram sugeridas alterações a nível da ingestão calórica. Em conclusão, é fundamental aliar o tratamento farmacológico ao maneio nutricional, para obter os melhores resultados no tratamento da doença cardíaca
Heart disease is becoming more common in dogs, especially acquired heart disease, largely due to the increased life expectancy of these animals. Most often it results in heart failure (HF), a progressive and without cure clinical syndrome, and the goals of chronic treatment are to improve clinical signs and prolong survival time. Clinical nutrition is a discipline to be taken into account in the management of HF and it is important for the maintenance of an optimal body condition, relief of clinical signs through the control of excesses or deficiencies in nutrients and for the potential pharmacological benefits of certain nutrients in heart disease, although this area still needs further investigation. The aim of this work was to perform an analysis of the characteristics of the diets recommended in the clinical practice for dogs with heart disease in different stages, to select the key nutritional factors and to identify where changes can be introduced to approximate the recommendations with the current information present in the literature review of this work. For this purpose six clinical cases of dogs with heart disease who attended at the Hospital Veterinário do Baixo Vouga during the five-month period of internship were selected. In this work, a literature review was initially carried out on heart disease, heart failure, classification and pharmacological treatment. Subsequently, a literature review on the nutritional modulation of heart disease was carried out, which includes aspects such as obesity, cardiac cachexia and key nutritional factors. Finally, a nutritional assessment of each clinical case was carried out, nutritional recommendations were analyzed and changes were suggested, so that the nutritional plan approached the determined objectives. Sodium, taurine, L-carnitine, protein and long chain omega-3 fatty acids have all been shown to be the main nutrients in which changes must be made to meet the objectives. Given the importance of maintaining an optimal body condition in these animals, changes in caloric intake were also suggested. In conclusion, it is fundamental to combine pharmacological treatment with nutritional management, to obtain the best outcomes in the treatment of heart disease.
Heart disease is becoming more common in dogs, especially acquired heart disease, largely due to the increased life expectancy of these animals. Most often it results in heart failure (HF), a progressive and without cure clinical syndrome, and the goals of chronic treatment are to improve clinical signs and prolong survival time. Clinical nutrition is a discipline to be taken into account in the management of HF and it is important for the maintenance of an optimal body condition, relief of clinical signs through the control of excesses or deficiencies in nutrients and for the potential pharmacological benefits of certain nutrients in heart disease, although this area still needs further investigation. The aim of this work was to perform an analysis of the characteristics of the diets recommended in the clinical practice for dogs with heart disease in different stages, to select the key nutritional factors and to identify where changes can be introduced to approximate the recommendations with the current information present in the literature review of this work. For this purpose six clinical cases of dogs with heart disease who attended at the Hospital Veterinário do Baixo Vouga during the five-month period of internship were selected. In this work, a literature review was initially carried out on heart disease, heart failure, classification and pharmacological treatment. Subsequently, a literature review on the nutritional modulation of heart disease was carried out, which includes aspects such as obesity, cardiac cachexia and key nutritional factors. Finally, a nutritional assessment of each clinical case was carried out, nutritional recommendations were analyzed and changes were suggested, so that the nutritional plan approached the determined objectives. Sodium, taurine, L-carnitine, protein and long chain omega-3 fatty acids have all been shown to be the main nutrients in which changes must be made to meet the objectives. Given the importance of maintaining an optimal body condition in these animals, changes in caloric intake were also suggested. In conclusion, it is fundamental to combine pharmacological treatment with nutritional management, to obtain the best outcomes in the treatment of heart disease.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária apresentada à Universidade de Trás-os-Montes e Alto Douro
Palavras-chave
Doença Cardíaca , Cão , Nutrição Clínica , Tratamento