O papel da nutrição no tratamento do cão com doença mixomatosa da válvula mitral
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2018-10-26
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A doença mixomatosa da válvula mitral (DMVM) é a doença cardíaca adquirida mais frequente em cães, sendo responsável por 75% dos casos de doença cardíaca canina. A sua etiologia ainda não está completamente esclarecida mas existe uma componente hereditária envolvida no desenvolvimento desta doença, bem como fatores como o nível de exercício, a obesidade e a dieta do animal. Ocorrem várias alterações histológicas nas válvulas e cordas tendíneas que levam à evolução do quadro clínico do animal. Com essa evolução surgem sinais clínicos relacionados com o agravamento da regurgitação e a deterioração da função cardíaca. O tratamento médico tem como objetivos atrasar a progressão da doença e controlar os sinais clínicos do animal, mantendo a qualidade de vida. Já há muito tempo se sabe que a intervenção nutricional na doença cardíaca é de extrema importância, mas muitas vezes apenas há preocupação com o teor em sódio dos alimentos. Apesar deste ser o nutriente chave no maneio da doença cardíaca, existem outros nutrientes que trazem benefícios à função cardíaca e que devem ser introduzidos na alimentação do cão com DMVM. Neste trabalho foi feita uma revisão bibliográfica acerca da DMVM, seguida da revisão sobre os nutrientes chave no maneio desta doença. Na segunda parte é feita uma aplicação prática a 4 casos clínicos reais acompanhados no Hospital Veterinário do Restelo, em Lisboa. Cada um destes animais encontra-se num estadio da DMVM (B1, B2, C e D) e, por isso, tem necessidades diferentes. Foram feitas duas recomendações de dietas para cada um, uma com alimentos comerciais e outra com alimentos caseiros. Assim, os objetivos deste trabalho foram, em primeiro lugar, rever o conhecimento atual acerca da nutrição na doença cardíaca, em segundo lugar, analisar as dietas atuais e avaliar quão adequadas são a cada animal e, por último, fazer recomendações de novas dietas que seriam mais apropriadas. Em conclusão, a modificação nutricional consoante o estadio da doença cardíaca é de extrema importância e deve ser feita de forma adequada, incluindo a estimativa da energia que o animal necessita e que lhe é fornecida. À medida que a DMVM progride, a alimentação pode tornar-se uma fonte de frustração para o proprietário, para além de poder alterar o prognóstico do animal. Assim, é essencial a escolha da dieta mais adequada a cada indivíduo
Myxomatous mitral valve disease (DMVM) is the most frequent acquired heart disease in dogs, accounting for 75% of cases of canine heart disease. Its etiology is not yet fully understood but there is an inherited component involved in the development of this disease, as well as factors such as exercise level, obesity and the animal's diet. There are several histological changes in the valves and chordae tendineae that lead to the evolution of the clinical condition of the animal. With this evolution, clinical signs appear related to the worsening of regurgitation and deterioration of the cardiac function. The medical treatment aims to delay the progession of the disease and control the clinical signs of the animal, maintaining the quality of life. It has long been known that nutritional intervention in heart disease is of extreme importance, but often there is only concern about the sodium content of food. Although this is the key nutrient in the management of heart disease, there are other nutrients that bring benefits to heart function and that should be introduced into the dog's diet with DMVM. In this work a bibliographic review about the DMVM was made, followed by a review of the key nutrients in the management of this disease. In the second part, a practical application is made to 4 real clinical cases accompanied at the Hospital Veterinário do Restelo, in Lisbon. Each of these animals is in a DMVM stage (B1, B2, C and D) and therefore has different needs. Two dietary recommendations were made for each one, one with commercial foods and another with home-made foods. Thus, the objectives of this work were, firstly, to review current knowledge about nutrition in heart disease, secondly, to analyze the current diets and to evaluate how suitable they are to each animal and finally, to make recommendations of new diets that would be more appropriate. In conclusion, the nutritional modification according to the stage of the heart disease is of extreme importance and must be done properly, including the estimate of the energy that the animal needs and that is supplied to him. As DMVM progresses, diet can become a source of frustration for the owner, as well as altering the animal's prognosis. Thus, it is essential to choose the most appropriate diet for each individual.
Myxomatous mitral valve disease (DMVM) is the most frequent acquired heart disease in dogs, accounting for 75% of cases of canine heart disease. Its etiology is not yet fully understood but there is an inherited component involved in the development of this disease, as well as factors such as exercise level, obesity and the animal's diet. There are several histological changes in the valves and chordae tendineae that lead to the evolution of the clinical condition of the animal. With this evolution, clinical signs appear related to the worsening of regurgitation and deterioration of the cardiac function. The medical treatment aims to delay the progession of the disease and control the clinical signs of the animal, maintaining the quality of life. It has long been known that nutritional intervention in heart disease is of extreme importance, but often there is only concern about the sodium content of food. Although this is the key nutrient in the management of heart disease, there are other nutrients that bring benefits to heart function and that should be introduced into the dog's diet with DMVM. In this work a bibliographic review about the DMVM was made, followed by a review of the key nutrients in the management of this disease. In the second part, a practical application is made to 4 real clinical cases accompanied at the Hospital Veterinário do Restelo, in Lisbon. Each of these animals is in a DMVM stage (B1, B2, C and D) and therefore has different needs. Two dietary recommendations were made for each one, one with commercial foods and another with home-made foods. Thus, the objectives of this work were, firstly, to review current knowledge about nutrition in heart disease, secondly, to analyze the current diets and to evaluate how suitable they are to each animal and finally, to make recommendations of new diets that would be more appropriate. In conclusion, the nutritional modification according to the stage of the heart disease is of extreme importance and must be done properly, including the estimate of the energy that the animal needs and that is supplied to him. As DMVM progresses, diet can become a source of frustration for the owner, as well as altering the animal's prognosis. Thus, it is essential to choose the most appropriate diet for each individual.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária apresentada à Universidade de Trás-os-Montes e Alto Douro
Palavras-chave
cão , doença mixomatosa da válvula mitral , tratamento , nutrição