Cirurgia de tecidos moles em animais de companhia: apresentação e discussão de casos clínicos
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2024-05-15
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O presente relatório de estágio enquadra-se no âmbito da Unidade Curricular Dissertação do Mestrado Integrado em Medicina Veterinária e tem como fundamento os estágios realizados no Hospital Veterinário Universitário de Coimbra (HVUC), Portugal, com a duração de 3 meses, e no Hospital Veterinário Universitário Rof Codina, em Lugo, Espanha, com a duração de 2 meses e 22 dias. Ambos os estágios, dedicados a animais de companhia, permitiram-me acompanhar e realizar consultas, refletir sobre os possíveis diagnósticos diferenciais, realizar e interpretar exames complementares de diagnóstico, observar e auxiliar em vários procedimentos cirúrgicos, além de auxiliar nos cuidados aos animais durante o internamento. Deste modo, o objetivo deste relatório é detalhar as atividades médico-veterinárias realizadas durante o período de estágio, com foco em quatro casos clínicos acompanhados no Hospital Veterinário Universitário Rof Codina, especificamente na área de cirurgia de tecidos moles. O primeiro caso clínico apresentado é relativo a um cão com duas anomalias primárias do Síndrome Braquicefálico, nomeadamente a estenose das narinas e o palato mole alongado. O animal apresentou-se à consulta, uma vez que apresentava ruídos respiratórios, na qual foram identificadas dificuldades respiratórias, bem como o palato alongado e a estenose das narinas. Estas condições foram abordadas através de procedimentos cirúrgicos, incluindo uma estafilectomia para corrigir o palato mole longo e uma ressecção nasal em cunha bilateral para corrigir a estenose das narinas. O segundo caso clínico respeita a um cão que veio referenciado de outra clínica veterinária com o diagnóstico de hérnia de hiato deslizante. As cirurgias de encerramento do hiato esofágico, esofagopexia e gastropexia fúndica à esquerda foram realizadas com sucesso. O terceiro caso clínico é relativo a um cão que com história clínica de ingestão de um corpo estranho. Realizou-se uma radiografia que confirmou a presença de um corpo estranho no intestino. Foi necessário realizar uma cirurgia de enterotomia para remover o objeto, e durante o procedimento, ao revisar todo o trato gastrointestinal, foi identificado um segundo corpo estranho no estômago, que foi removido através de gastrotomia. Nos dias seguintes de internamento, o animal continuou a vomitar e não tinha apetite. Para esclarecer a situação, foram realizados exames complementares, incluindo uma ultrassonografia e uma gastroscopia. Durante a gastroscopia, foram identificadas ulcerações e esofagite relevantes. O último caso exposto é relativo a um gato que veio referenciado de outra clínica veterinária após uma tentativa sem sucesso de cateterização urinária. O gato apresentava sinais clínicos de estrangúria, hematúria e hiporexia. Foi identificado um cálculo urinário no pénis distal através de radiografia. Para resolução da obstrução, realizou-se uma cirurgia de uretrostomia perineal com o animal posicionado em decúbito dorsal. A seleção destes casos clínicos baseou-se principalmente na necessidade de intervenção cirúrgica, na sua resolução por meio de procedimentos cirúrgicos e no meu profundo interesse nesta área. Trataram-se de casos com histórias clínicas detalhadas que me permitiram aprimorar a habilidade de coleta de informações, diagnóstico e planeamento de tratamento. Com estes casos tive a oportunidade de estudar diversas técnicas cirúrgicas e expandir o meu conhecimento acerca das mesmas.
This internship report falls within the scope of the Dissertation course of the Integrated Master's in Veterinary Medicine and is based on internships carried out at the University Veterinary Hospital of Coimbra (HVUC), Portugal, lasting for 3 months, and at the University Veterinary Hospital Rof Codina, in Lugo, Spain, lasting for 2 months and 22 days. Both internships, dedicated to companion animals, allowed me to attend and conduct consultations, reflect on possible differential diagnoses, perform and interpret complementary diagnostic tests, observe and assist in various surgical procedures, as well as assist in the care of animals during hospitalization. Thus, the objective of this report is to detail the veterinary activities carried out during the internship period, with a focus on four clinical cases observed at the University Veterinary Hospital Rof Codina, specifically in the field of soft tissue surgery. The first clinical case presented is related to a dog with two primary anomalies of Brachycephalic Syndrome, namely stenosis of the nostrils and elongated soft palate. The dog presented for a consultation due to respiratory noises and was found to have breathing difficulties, as well as an elongated palate and narrowed nostrils. These conditions were addressed through surgical procedures, including a staphylectomy to correct the elongated soft palate and bilateral wedge nasal resection to correct nostril stenosis. The second clinical case concerns a dog that was referred from another veterinary clinic with a diagnosis of sliding hiatal hernia. Successful surgeries for hiatal closure, esophagopexia, and left fundic gastropexy were performed. The third clinical case involves a dog with a clinical history of ingesting a foreign body. A radiograph confirmed the presence of a foreign body in the intestine. It was necessary to perform an enterotomy surgery to remove the object, and during the procedure, a second foreign body in the stomach was identified and removed through gastrotomy. In the following days of hospitalization, the dog continued to vomit and had no appetite. To clarify the situation, complementary examinations, including an ultrasound and gastroscopy, were performed. During the gastroscopy, significant ulcerations and esophagitis were identified. The last case presented concerns a cat referred from another veterinary clinic after an unsuccessful attempt at urinary catheterization. The cat exhibited clinical signs of stranguria, hematuria, and hyporexia. A urinary calculus was identified in the distal penis through radiography. To resolve the obstruction, a perineal urethrostomy surgery was performed with the cat positioned in dorsal recumbency. The selection of these clinical cases was primarily based on the need for surgical intervention, their resolution through surgical procedures, and my deep interest in this area. These were cases with detailed medical histories that allowed me to enhance my ability to gather information, diagnose, and plan treatment. With these cases, I had the opportunity to study various surgical techniques and expand my knowledge about them.
This internship report falls within the scope of the Dissertation course of the Integrated Master's in Veterinary Medicine and is based on internships carried out at the University Veterinary Hospital of Coimbra (HVUC), Portugal, lasting for 3 months, and at the University Veterinary Hospital Rof Codina, in Lugo, Spain, lasting for 2 months and 22 days. Both internships, dedicated to companion animals, allowed me to attend and conduct consultations, reflect on possible differential diagnoses, perform and interpret complementary diagnostic tests, observe and assist in various surgical procedures, as well as assist in the care of animals during hospitalization. Thus, the objective of this report is to detail the veterinary activities carried out during the internship period, with a focus on four clinical cases observed at the University Veterinary Hospital Rof Codina, specifically in the field of soft tissue surgery. The first clinical case presented is related to a dog with two primary anomalies of Brachycephalic Syndrome, namely stenosis of the nostrils and elongated soft palate. The dog presented for a consultation due to respiratory noises and was found to have breathing difficulties, as well as an elongated palate and narrowed nostrils. These conditions were addressed through surgical procedures, including a staphylectomy to correct the elongated soft palate and bilateral wedge nasal resection to correct nostril stenosis. The second clinical case concerns a dog that was referred from another veterinary clinic with a diagnosis of sliding hiatal hernia. Successful surgeries for hiatal closure, esophagopexia, and left fundic gastropexy were performed. The third clinical case involves a dog with a clinical history of ingesting a foreign body. A radiograph confirmed the presence of a foreign body in the intestine. It was necessary to perform an enterotomy surgery to remove the object, and during the procedure, a second foreign body in the stomach was identified and removed through gastrotomy. In the following days of hospitalization, the dog continued to vomit and had no appetite. To clarify the situation, complementary examinations, including an ultrasound and gastroscopy, were performed. During the gastroscopy, significant ulcerations and esophagitis were identified. The last case presented concerns a cat referred from another veterinary clinic after an unsuccessful attempt at urinary catheterization. The cat exhibited clinical signs of stranguria, hematuria, and hyporexia. A urinary calculus was identified in the distal penis through radiography. To resolve the obstruction, a perineal urethrostomy surgery was performed with the cat positioned in dorsal recumbency. The selection of these clinical cases was primarily based on the need for surgical intervention, their resolution through surgical procedures, and my deep interest in this area. These were cases with detailed medical histories that allowed me to enhance my ability to gather information, diagnose, and plan treatment. With these cases, I had the opportunity to study various surgical techniques and expand my knowledge about them.
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Síndrome Braquicefálico , Hérnia de Hiato deslizante , Cirurgia Gastrointestinal , Uretrostomia perineal