Hipertensão arterial em cães e gatos em ambiente hospitalar
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2020-02-18
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A hipertensão arterial (HA) é uma doença subclínica em que os sinais clínicos surgem apenas numa fase mais avançada, normalmente relacionados com lesões dos órgãos-alvo como os rins, o olho, o cérebro e o coração. A medição da pressão arterial (PA) permite determinar se o animal tem HA e, consequentemente, identificar qual é a causa do aumento dos valores de PA. Uma vez feito o diagnóstico, a decisão de tratar ou não o animal, e a escolha do tratamento anti-hipertensor deve basear-se em vários fatores, nomeadamente na presumível causa primária e na gravidade da HA. Desta forma, o objetivo principal deste trabalho foi determinar quais são as causas mais prováveis do aumento dos valores de PA, em ambiente hospitalar, de forma a perceber quais são os casos que devem ser tratados com fármacos anti-hipertensores.
Neste trabalho foram incluídos 13 cães e 16 gatos que foram internados no hospital VetCentral, entre fevereiro e maio de 2019, e que apresentavam aumento dos valores de PA. Foi obtida a informação do motivo da consulta e realizado um exame físico inicial. Durante o internamento dos animais foram realizadas várias medições da PA pelo método oscilométrico de acordo com o quadro clínico de cada animal.
Na população de cães verificou-se que a maioria dos animais não tinha raça definida (n=8), eram maioritariamente fêmeas (n=9) e com idades superiores a 10 anos (n=8). Na população de gatos a maioria era de raça Europeu comum (n=13), machos (n=11) e a idade estava compreendida, maioritariamente, entre 1 e os 5 anos (n=7). Após a análise da evolução dos valores de PA obtidos durante o internamento dos animais, foi identificada a causa mais provável de HA. Nos cães a causa mais frequente foi a dor (n=12), seguida do stresse (n=1) e da doença renal crónica (DRC) (n=1). No caso dos gatos, verificou-se que em 13 casos o aumento dos valores de PA estava relacionado com a dor, em dois com o stresse e num com a DRC. A HA foi classificada como situacional em todos os animais cujo aumento dos valores de PA estava relacionado com o stresse e a dor (13 cães e 15 gatos), e como HA secundária nos animais com DRC (1 cão e 1 gato).
Neste trabalho, a maioria dos animais em ambiente hospitalar apresentava HA situacional, associda à dor ou ao stresse. Nestes casos, os valores de PA foram controlados com analgésicos e os fatores de stresse foram minimizados. Deste modo, este trabalho realça a importância da identificação da causa do aumento dos valores de PA antes de se iniciar o tratamento com fármacos anti-hipertensores.
Arterial hypertension (HT) is a subclinical disease in which clinical signs arise only at a more advanced stage, usually related to target organ lesions such as the kidneys, the eye, the brain and the heart. Blood pressure (BP) measurement allows determining whether the animal has HT and, consequently, identifying what is the cause of increased BP values. Once the diagnosis has been made, the decision to treat the animal or not, and the choice of antihypertensive treatment should be based on several factors, in particular the presumed primary cause and severity of HT. Thus, the main objective of this work was to determine which causes are the most likely causes of increased BP values, in the hospital environment, in order to understand which cases should be treated with antihypertensive drugs. This study included 13 dogs and 16 cats that were admitted to vetcentral hospital, between February and May 2019, and that presented an increase in BP values. Information on the reason for the consultation was obtained and an initial physical examination was performed. During the hospitalization of the animals, several BP measurements were performed by the oscillometric method according to each clinical case. In the dog population it was found that most animals were not defined breed (n=8), females (n=9) and older than 10 years (n=8). In the cat population, most were common European (n=13), males (n=11) and age was mostly between 1 and 5 years (n=7). After analyzing the evolution of BP values obtained during the hospitalization of the animals, the most likely cause of HT was identified. In dogs the most frequent cause was pain (n=12), followed by stress (n=1) and chronic kidney disease (CKD) (n=1). In the case of cats, it was found that in 13 cases the increase in BP values was related to pain, in two with stress and one with CKD. HT was classified as situational in all animals whose increase in BP values was related to stress and pain (13 dogs and 15 cats), and as secondary HT in animals with CKD (1 dog and 1 cat). In this study, most animals in the hospital environment had situational HT, associated with pain or stress. In these cases, BP values were controlled with analgesics and stress factors were minimized. Thus, this study highlights the importance of identifying the cause of increased BP values before starting treatment with antihypertensive drugs.
Arterial hypertension (HT) is a subclinical disease in which clinical signs arise only at a more advanced stage, usually related to target organ lesions such as the kidneys, the eye, the brain and the heart. Blood pressure (BP) measurement allows determining whether the animal has HT and, consequently, identifying what is the cause of increased BP values. Once the diagnosis has been made, the decision to treat the animal or not, and the choice of antihypertensive treatment should be based on several factors, in particular the presumed primary cause and severity of HT. Thus, the main objective of this work was to determine which causes are the most likely causes of increased BP values, in the hospital environment, in order to understand which cases should be treated with antihypertensive drugs. This study included 13 dogs and 16 cats that were admitted to vetcentral hospital, between February and May 2019, and that presented an increase in BP values. Information on the reason for the consultation was obtained and an initial physical examination was performed. During the hospitalization of the animals, several BP measurements were performed by the oscillometric method according to each clinical case. In the dog population it was found that most animals were not defined breed (n=8), females (n=9) and older than 10 years (n=8). In the cat population, most were common European (n=13), males (n=11) and age was mostly between 1 and 5 years (n=7). After analyzing the evolution of BP values obtained during the hospitalization of the animals, the most likely cause of HT was identified. In dogs the most frequent cause was pain (n=12), followed by stress (n=1) and chronic kidney disease (CKD) (n=1). In the case of cats, it was found that in 13 cases the increase in BP values was related to pain, in two with stress and one with CKD. HT was classified as situational in all animals whose increase in BP values was related to stress and pain (13 dogs and 15 cats), and as secondary HT in animals with CKD (1 dog and 1 cat). In this study, most animals in the hospital environment had situational HT, associated with pain or stress. In these cases, BP values were controlled with analgesics and stress factors were minimized. Thus, this study highlights the importance of identifying the cause of increased BP values before starting treatment with antihypertensive drugs.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cão , Gato , Medição da pressão arterial