Dispneia em gatos: cardíaco versus respiratório: abordagem ao diagnóstico diferencial
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2016-06-29
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A dispneia surge nos gatos como uma emergência médica e estabelecer a sua origem é extremamente importante, principalmente se esta for de origem cardíaca ou respiratória, pois facilmente se confundem. A rápida determinação da sua causa facilita a escolha do tratamento e melhora a recuperação do animal. Assim, o objectivo deste trabalho foi o de abordar o diagnóstico diferencial entre a dispneia de origem cardíaca e respiratória através da identificação das principais características dos dois tipos de dispneia.
Neste trabalho, fez-se uma análise comparativa dos dados obtidos através da história clinica, do exame físico e dos exames complementares de diagnóstico de gatos com dispneia de origem cardíaca (n=3) e respiratória (n=3), observados no Centro Hospitalar Veterinário do Porto, entre Setembro de 2014 a Dezembro de 2014.
A dispneia de origem respiratória ocorreu mais frequentemente devido à presença de asma felina, enquanto a dispneia de origem cardíaca ocorreu secundariamente a insuficiência cardíaca congestiva devido a uma cardiomiopatia hipertrófica. A presença de tosse só foi observada nos gatos com dispneia de origem respiratória. Os animais com suspeita de dispneia de origem respiratória apresentaram dispneia expiratória, enquanto os de origem cardíaca apresentaram dispneia mista. Apenas foram identificados sopros cardíacos nos animais com suspeita de dispneia de origem cardíaca e nestes, as frequências respiratórias no exame físico inicial encontravam-se mais elevadas. No exame radiográfico verificou-se que todos os animais com dispneia de origem cardíaca apresentavam cardiomegalia, com aumento do vertebral heart size (VHS); nos gatos com dispneia respiratória o VHS encontrava-se normal. A ecocardiografia só foi realizada nos animais com suspeita de dispneia de origem cardíaca, tendo permitido o diagnóstico definitivo de cardiomiopatia hipertrófica.
Assim, apesar de a amostra de animais ter sido pequena foram obtidos resultados semelhantes aos descritos na literatura.
Dyspnea appears in cats as an acute emergency and to establish its etiology becomes highly important especially if it is of cardiac or respiratory origin, as they can be easily mixed up. The quick determination of the cause makes the choice of treatment easier and improves the animal's recovery. Thus the aim of this study was to address the differential diagnosis between dyspnea of cardiac and respiratory origin by identifying key characteristics of the two types of dyspnea. In this work there was a comparative analysis of data obtained from the clinical history, physical examination and laboratory test diagnostics in cats with dyspnea of cardiac origin ( n = 3) and respiratory ( n = 3) observed during practical training at Centro Hospitalar Veterinário do Porto between September 2014 and December 2014. Dyspnea of respiratory origin occurred more often due to the presence of feline asthma while dyspnea of cardiac origin was secondary to congestive heart failure due to hypertrophic cardiomyopathy. The presence of cough was observed only in cats with dyspnea of respiratory origin. Animals with suspicion of dyspnea of respiratory origin showed expiratory dyspnea, while the ones with cardiac origin had mixed dyspnoea. Heart murmurs were identified only in animals with suspicion of dyspnea of cardiac origin and in these the respiratory frequencies in the initial physical examination were higher. In the radiographic examination it was found that animals with dyspnea of cardiac origin showed cardiomegaly with increased vertebral heart size (VHS); in cats with respiratory dyspnea VHS was normal. Echocardiography was performed only in animals with suspicion of dyspnea of cardiac origin which allowed a definitive diagnosis of hypertrophic cardiomyopathy. Thus although the number of animals was small were obtained results similar to those described in the literature.
Dyspnea appears in cats as an acute emergency and to establish its etiology becomes highly important especially if it is of cardiac or respiratory origin, as they can be easily mixed up. The quick determination of the cause makes the choice of treatment easier and improves the animal's recovery. Thus the aim of this study was to address the differential diagnosis between dyspnea of cardiac and respiratory origin by identifying key characteristics of the two types of dyspnea. In this work there was a comparative analysis of data obtained from the clinical history, physical examination and laboratory test diagnostics in cats with dyspnea of cardiac origin ( n = 3) and respiratory ( n = 3) observed during practical training at Centro Hospitalar Veterinário do Porto between September 2014 and December 2014. Dyspnea of respiratory origin occurred more often due to the presence of feline asthma while dyspnea of cardiac origin was secondary to congestive heart failure due to hypertrophic cardiomyopathy. The presence of cough was observed only in cats with dyspnea of respiratory origin. Animals with suspicion of dyspnea of respiratory origin showed expiratory dyspnea, while the ones with cardiac origin had mixed dyspnoea. Heart murmurs were identified only in animals with suspicion of dyspnea of cardiac origin and in these the respiratory frequencies in the initial physical examination were higher. In the radiographic examination it was found that animals with dyspnea of cardiac origin showed cardiomegaly with increased vertebral heart size (VHS); in cats with respiratory dyspnea VHS was normal. Echocardiography was performed only in animals with suspicion of dyspnea of cardiac origin which allowed a definitive diagnosis of hypertrophic cardiomyopathy. Thus although the number of animals was small were obtained results similar to those described in the literature.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Doenças do gato , Insuficiência cardíaca , Dispneia paroxística , Diagnóstico diferêncial