Medicina e cirurgia em animais de companhia: Apresentação de casos clínicos
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2022
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O relatório de estágio que se segue é parte integrante da unidade curricular Dissertação, de 6º ano, 1º semestre do curso de Mestrado Integrado em Medicina Veterinária. O estágio curricular, compreendido na referente unidade curricular, teve, no total, uma duração de 14 semanas, sendo que as primeiras 13 semanas de estágio foram realizadas no hospital escolar veterinário da Universidade de Gante, em Gante, Bélgica e a última semana de estágio foi realizada no hospital veterinário da Universidade de Trás-os-Montes e Alto Douro, em Vila Real, Portugal; em ambos acompanhei a clínica de animais de companhia. Em ambos os locais de estágio, tive a oportunidade de assistir e realizar consultas, auxiliar na realização e interpretação de exames complementares de diagnóstico assim como tive a oportunidade de assistir e auxiliar durante procedimentos cirúrgicos. O relatório de estágio que se segue tem como objetivo explanar as atividades médico-veterinárias assistidas e as aptidões práticas desenvolvidas durante o período de estágio supramencionado, e apresentar quatro casos clínicos com resolução cirúrgica que tive oportunidade de acompanhar, durante parte do meu estágio. Dos diferentes casos clínicos com que contactei, dou especial importância a quatro, os quais irão ser descritos no presente relatório de estágio. Todos os casos foram referenciados para o hospital veterinário da Universidade de Gante. Um dos fatores que levou à eleição dos casos clínicos explanados é o pessoal apreço pela área de cirurgia de tecidos moles de animais de companhia. O primeiro caso descrito relata a realização de um shunt ventriculoperitoneal a uma cadela com diagnóstico de hidrocefalia congénita. O animal foi referenciado por apresentar estrabismo lateral bilateralmente, cabeça abaulada, deprimido e com tetraparesia ambulatória. O diagnóstico definitivo foi obtido através de ressonância magnética. Foi realizada cirurgia com a colocação de um shunt ventriculoperitoneal. Após a intervenção cirúrgica, o animal mostrou estar a evoluir favoravelmente, verificando-se melhoria dos sinais clínicos, mas sem cura total. O segundo caso exposto é relativo a uma cadela com ducto arterioso persistente, cujo único sinal clínico foi um som cardíaco contínuo de elevada intensidade detetado à auscultação cardíaca aquando da consulta de primovacinação. O diagnóstico definitivo foi feito por ecocardiografia e o tratamento consistiu na aplicação, por cateterização transarterial, de um dispositivo Amplatz Canine Duct Occluder®. Após o procedimento cirúrgico, o animal recuperou totalmente. O terceiro caso clínico aborda uma gata com urolitíase que apresentava ureterólitos em ambos os ureteres e um cistólito. Os principais sinais clínicos eram hematúria e apatia. O diagnóstico foi feito por ecografia abdominal e foi realizado tratamento cirúrgico recorrendo à técnica de uretetomia e cistotomia, com recurso a instrumentação de microcirurgia, verificando-se que o animal recuperou favoravelmente. Por último, o quarto caso aborda uma cadela intersexo com incontinência urinária. O diagnóstico definitivo foi obtido através da anamnese e exame do estado geral. A incontinência urinária foi resolvida através da colocação de um esfíncter uretral artificial. Contudo, não se verificou melhoria dos sinais clínicos. Este relatório permitiu alargar o conhecimento em três diferentes áreas de especialização de cirurgia de tecidos moles, possibilitando fomentar o raciocínio crítico, de uma forma prática e objetiva, e familiarizar com técnicas cirúrgicas especializadas.
The following report takes part in the curricular unit Dissertation, in the 6th year, 1st semester of the Veterinary Medicine master’s degree. The curricular internship within the same curricular unit had a 14-week duration. In the first 13 weeks, the internship took part in the Veterinary Hospital of the University of Ghent, Belgium, and the last internship week happened at the University of Trás-os-Montes e Alto Douro, in Vila Real, Portugal. In both internships, I had followed the small animal department. In both places I had the opportunity to follow and do some clinical consultations, help with, and interpret diagnostic tool exams as well as to follow and help during surgical procedures. The following report main goal is to bare the activities that I had the opportunity to follow, practical skills acquired during the internship, and to expose four clinical cases with surgical resolution that I had the chance to follow-up at some moment during the internship. Of the multiple clinical cases that I had the chance to encounter, I emphasise four, that will be described in this report. All the four cases were followed in the University of Ghent veterinary hospital. One of the reasons why I have chosen these clinical cases is my special care for soft tissue surgery in small animal practice. The first clinical case is about a ventriculoperitoneal shunt placement on a bitch diagnosed with congenital hydrocephalus. The animal was presented to the veterinary hospital due to bilateral lateral strabismus, dome-shaped skull, abnormal consciousness and ambulatory tetraparesis. The final diagnosis was confirmed by magnetic resonance imaging. A ventriculoperitoneal shunt surgery was performed and, after the surgical intervention, the animal showed some clinical improvement, but not an absence of clinical signs. The second clinical case reported is related to a bitch with persistent ductus arteriosus, and the only clinical sign was a heart murmur detected on the first vaccine consultation. The diagnosis was confirmed by echocardiography, and she was treated with an Amplatz Canine Duct Occluder® device placed by arterial catheterization. There was a full recovery, after the surgical procedure. The third clinical case is about a queen with urolithiasis, ureteroliths in both ureters and a cistolith. The main complaints were haematuria and apathy. The diagnose was made by abdominal ultrasonography and she was treated with ureterotomy and cystotomy. The queen had a good recovery. Lastly, the fourth clinical case is about an intersex bitch with urinary incontinence. The diagnose was made based on the anamnesis, and clinical examination. The treatment of the urinary incontinence was based on an artificial urethral sphincter device placement, however, the animal remained incontinent, with no clinical signs of improvement. The elaboration of this report helped me widen my knowledge on three different soft tissue surgery study areas, allowing me to have a more critical reasoning in a practical and objective way and to get in touch with specialized surgical techniques.
The following report takes part in the curricular unit Dissertation, in the 6th year, 1st semester of the Veterinary Medicine master’s degree. The curricular internship within the same curricular unit had a 14-week duration. In the first 13 weeks, the internship took part in the Veterinary Hospital of the University of Ghent, Belgium, and the last internship week happened at the University of Trás-os-Montes e Alto Douro, in Vila Real, Portugal. In both internships, I had followed the small animal department. In both places I had the opportunity to follow and do some clinical consultations, help with, and interpret diagnostic tool exams as well as to follow and help during surgical procedures. The following report main goal is to bare the activities that I had the opportunity to follow, practical skills acquired during the internship, and to expose four clinical cases with surgical resolution that I had the chance to follow-up at some moment during the internship. Of the multiple clinical cases that I had the chance to encounter, I emphasise four, that will be described in this report. All the four cases were followed in the University of Ghent veterinary hospital. One of the reasons why I have chosen these clinical cases is my special care for soft tissue surgery in small animal practice. The first clinical case is about a ventriculoperitoneal shunt placement on a bitch diagnosed with congenital hydrocephalus. The animal was presented to the veterinary hospital due to bilateral lateral strabismus, dome-shaped skull, abnormal consciousness and ambulatory tetraparesis. The final diagnosis was confirmed by magnetic resonance imaging. A ventriculoperitoneal shunt surgery was performed and, after the surgical intervention, the animal showed some clinical improvement, but not an absence of clinical signs. The second clinical case reported is related to a bitch with persistent ductus arteriosus, and the only clinical sign was a heart murmur detected on the first vaccine consultation. The diagnosis was confirmed by echocardiography, and she was treated with an Amplatz Canine Duct Occluder® device placed by arterial catheterization. There was a full recovery, after the surgical procedure. The third clinical case is about a queen with urolithiasis, ureteroliths in both ureters and a cistolith. The main complaints were haematuria and apathy. The diagnose was made by abdominal ultrasonography and she was treated with ureterotomy and cystotomy. The queen had a good recovery. Lastly, the fourth clinical case is about an intersex bitch with urinary incontinence. The diagnose was made based on the anamnesis, and clinical examination. The treatment of the urinary incontinence was based on an artificial urethral sphincter device placement, however, the animal remained incontinent, with no clinical signs of improvement. The elaboration of this report helped me widen my knowledge on three different soft tissue surgery study areas, allowing me to have a more critical reasoning in a practical and objective way and to get in touch with specialized surgical techniques.
Descrição
Mestrado Integrado em Medicina Veterinária
Palavras-chave
Neurocirúrgica , Cirurgia cardiovascular