Small animal medicine and surgery practice
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2015
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Este relatório descreve quatro casos clínicos a que tive oportunidade de assistir durante o estágio curricular.
A laparoscopia é uma técnica minimamente invasiva com inúmeras aplicações. É considerada uma boa alternativa à cirurgia convencional e um excelente método de
diagnóstico de várias patologias. O menor traumatismo tecidular está associado a uma baixa incidência de complicações intra e pós-operatórias. A principal desvantagem relaciona-se com
o custo elevado do equipamento.
A aspergilose nasal é considerada uma das causas mais comuns de doença nasal
crônica em cães. Os fungos do gênero Aspergillus são patógenos oportunistas que podem
causar uma rinossinusite grave. O processo pode estender-se aos tecidos adjacentes e
pulmões, causando sinais clínicos muito diversos. A aspergilose disseminada, por sua vez, é
geralmente causada por diferentes espécies de Aspergillus. A aspergilose nasal pode ser muito
difícil de diagnosticar e de tratar. É geralmente necessário combinar vários métodos de
diagnóstico para obter um diagnóstico definitivo. Métodos de tratamento incluem técnicas
invasivas e não invasivas e uso de medicamentos antifúngicos sistémicos ou tópicos, por
vezes combinados. O diagnóstico precoce e um tratamento imediato são provavelmente os
aspetos mais importantes para um bom prognóstico. O animal pode responder bem ao
tratamento, mas a condição pode ser recorrente e difícil de curar.
O ibuprofeno é um dos fármacos mais frequentemente envolvidos em intoxicações de
cães e gatos. Embora amplamente utilizado em medicina humana, não é recomendado para
animais de companhia, nos quais tem o potencial de causar perfurações gástricas e
insuficiência renal aguda. Por sua vez, o metaldeído é um pesticida usado para controlar
lesmas e caracóis em jardins e áreas de cultivo e é um dos agentes tóxicos mais comumente
envolvidos em intoxicações de animais de companhia. Este moluscicida tem o potencial de
afetar os principais sistemas orgânicos. Os sinais clínicos mais comuns incluem excitação do
sistema nervoso central, distúrbios gastrointestinais e respiratórios. A morte dos animais
afetados pode ocorrer dentro de algumas horas após a exposição, geralmente como resultado
de uma insuficiência respiratória. Pode também ocorrer uns dias mais tarde devido a uma
insuficiência hepática. O diagnóstico de ambas as intoxicações baseia-se geralmente na
história de exposição ao tóxico e em sinais clínicos compatíveis. Quando a informação
disponível não é suficiente para estabelecer um diagnóstico, diagnósticos diferenciais devem
ser considerados. O prognóstico depende da dose ingerida e do tempo que passa desde a
exposição até que o tratamento é iniciado. A brevidade e agressividade do tratamento de
suporte e a monitorização contínua dos animais são provavelmente mais relevantes para o
prognóstico do que a dose de tóxico ingerida. Como sempre, a melhor forma de tratamento é a
prevenção. Para que isso seja possível é imprescindível que se promova a educação dos
proprietários, uma vez que estes estão frequentemente envolvidos nas intoxicações dos seus
animais. Isto acontece quando o tóxico é colocado/deixado em locais de fácil acesso para os
animais ou até administrado pelos proprietários. Torna-se assim fundamental que os
veterinários informem os seus clientes sobre as substâncias que são potencialmente tóxicas para os seus animais.
This report describes four clinical cases I attended during my undergraduate internship. Laparoscopy is a minimally invasive technique with numerous applications. It is a great alternative to conventional open procedures and widely considered the method of choice to diagnose many conditions and take biopsy samples. The minimal trauma to soft tissues is associated with a lower incidence of intraoperative and postoperative complications. The biggest drawback of this technique is the high costs of the specialized instruments required to perform it. Sino-nasal aspergillosis is one of the most common causes of chronic nasal disease in dogs. Aspergillus spp. are opportunistic pathogens that can cause severe rhinosinusitis. The process can extend to adjacent tissues and to the lungs, causing many different clinical signs. In very severe cases, intracranial signs can arise. Disseminated aspergillosis is also possible but is generally caused by different species of Aspergilli. Sino-nasal aspergillosis can be very difficult to diagnose and to treat. Its diagnosis rely on multiple modalities as hardly any single diagnostic method is foolproof. There are different treatment methods available, including invasive and noninvasive techniques and the use of systemic or topical antifungal drugs, which are sometimes combined. Early detection and treatment are important for the treatment success. The pet may respond well to therapy but the condition may be recurrent and difficult to cure in some cases. Ibuprofen is one of the drugs most commonly involved in dogs and cats poisonings. It is widely used in human medicine with relative safety, however for pets it is not recommended as it can easily cause clinical signs that can lead to gastric perforations and acute renal failure. In turn, metaldehyde is a pesticide mainly used to control slugs and snails in gardens and croplands and is between the toxic agents most commonly involved in pet poisoning episodes. Metaldehyde has the potential to disturb their major body systems. Common clinical signs involve CNS excitation, GI upset and respiratory disturbances. Animals can die within a few hours of exposure, generally as a result of respiratory failure or a few days later due to liver failure. Both toxicosis are generally diagnosed based on history of exposure and compatible clinical signs but differential diagnosis must be considered when the available information is not enough to diagnose. The prognosis depends on the ingested dose and the time passed since exposure until treatment is initiated. Prompt and aggressive symptomatic therapy and supportive care accompanied by continuous monitoring until the patient fully recovers are perhaps more important than the ingested dose for positive outcomes. Besides, the best way of treatment is to prevent it. To do so, proper owner education is the key, as owners are commonly unintentionally involved in their pet poisonings. Ibuprofen can be accidentally ingested or administered by the owner in an attempt to help his sick pet. In turn, metaldehyde is commonly placed on the house premises by the owner and not protected from the pets. Thus, it is crucial that veterinarians alert their clients about potentially toxic substances.
This report describes four clinical cases I attended during my undergraduate internship. Laparoscopy is a minimally invasive technique with numerous applications. It is a great alternative to conventional open procedures and widely considered the method of choice to diagnose many conditions and take biopsy samples. The minimal trauma to soft tissues is associated with a lower incidence of intraoperative and postoperative complications. The biggest drawback of this technique is the high costs of the specialized instruments required to perform it. Sino-nasal aspergillosis is one of the most common causes of chronic nasal disease in dogs. Aspergillus spp. are opportunistic pathogens that can cause severe rhinosinusitis. The process can extend to adjacent tissues and to the lungs, causing many different clinical signs. In very severe cases, intracranial signs can arise. Disseminated aspergillosis is also possible but is generally caused by different species of Aspergilli. Sino-nasal aspergillosis can be very difficult to diagnose and to treat. Its diagnosis rely on multiple modalities as hardly any single diagnostic method is foolproof. There are different treatment methods available, including invasive and noninvasive techniques and the use of systemic or topical antifungal drugs, which are sometimes combined. Early detection and treatment are important for the treatment success. The pet may respond well to therapy but the condition may be recurrent and difficult to cure in some cases. Ibuprofen is one of the drugs most commonly involved in dogs and cats poisonings. It is widely used in human medicine with relative safety, however for pets it is not recommended as it can easily cause clinical signs that can lead to gastric perforations and acute renal failure. In turn, metaldehyde is a pesticide mainly used to control slugs and snails in gardens and croplands and is between the toxic agents most commonly involved in pet poisoning episodes. Metaldehyde has the potential to disturb their major body systems. Common clinical signs involve CNS excitation, GI upset and respiratory disturbances. Animals can die within a few hours of exposure, generally as a result of respiratory failure or a few days later due to liver failure. Both toxicosis are generally diagnosed based on history of exposure and compatible clinical signs but differential diagnosis must be considered when the available information is not enough to diagnose. The prognosis depends on the ingested dose and the time passed since exposure until treatment is initiated. Prompt and aggressive symptomatic therapy and supportive care accompanied by continuous monitoring until the patient fully recovers are perhaps more important than the ingested dose for positive outcomes. Besides, the best way of treatment is to prevent it. To do so, proper owner education is the key, as owners are commonly unintentionally involved in their pet poisonings. Ibuprofen can be accidentally ingested or administered by the owner in an attempt to help his sick pet. In turn, metaldehyde is commonly placed on the house premises by the owner and not protected from the pets. Thus, it is crucial that veterinarians alert their clients about potentially toxic substances.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cavidade nasal , Aspergilose , Infecção , Ibuprofeno , Laparoscopia , Intoxicação por metaldeído