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Enteropatias crónicas em carnívoros domésticos : estudo de uma série de casos
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As enteropatias crónicas representam um grupo heterogéneo de doenças caracterizadas por sinais clínicos gastrointestinais persistentes, dividindo-se em enteropatias responsivas à dieta e à modulação da microbiota intestinal, enteropatias responsivas a imunossupressores e enteropatias não responsivas. O presente estudo descreve uma série de casos de canídeos e felídeos com enteropatias crónicas, com diagnóstico histopatológico e avaliação do tratamento instituído. A doença inflamatória intestinal/enteropatia responsiva a imunossupressores em canídeos e felídeos é de etiologia multifatorial e ainda não muito bem compreendida. A microbiota intestinal e dieta, o sistema imunitário e fatores genéticos são os três grandes tópicos nos quais se pensa residir a origem da doença inflamatória intestinal. A forma mais comum desta patologia é a enterite linfoplasmocítica e os sinais clínicos são inespecíficos (émese, diarreia, hiporexia, perda de peso, dor/desconforto abdominal). O diagnóstico, frequentemente de exclusão, necessita de confirmação por histopatologia. Em casos mais graves, esta enteropatia pode ser acompanhada de uma síndrome com perda de proteína. O tratamento envolve uma combinação de fármacos imunossupressores e modificação alimentar com recurso a dieta hipoalergénica para modulação da resposta imunitária. Como terapêutica sintomática podem ser utilizados pré-, pró- e simbióticos, para reversão da disbiose, e anti-éméticos e protetores gástricos. No entanto, em casos não responsivos à abordagem convencional ou de forma a reduzir o uso de corticoterapia, podem ser abordadas técnicas como o transplante de microbiota fecal ou o uso de células estaminais. Neste estudo retrospetivo foi caracterizada uma amostra de 15 animais, 11 canídeos e 4 felídeos, de raças e idades diversas, diagnosticados com enteropatias crónicas. Os sinais clínicos mais comuns foram émese nos felídeos e émese e hiporexia nos canídeos e todos os casos foram responsivos ao tratamento instituído. Todos os animais foram sujeitos a endoscopia alta e biopsia. A análise histopatológica revelou, em todos os casos, enteropatia do tipo linfoplasmocitíco e a pesquisa de Helicobacter spp. foi positiva em dois casos
Chronic enteropathies represent a heterogeneous group of diseases characterized by persistent gastrointestinal clinical signs, divided into enteropathies responsive to diet and gut microbiota modulation and enteropathies responsive to immunosuppressants. This study describes a case series of canine and feline chronic enteropathies, with histopathological diagnosis and evaluation of the treatment implemented. Inflammatory bowel disease/ Immunosuppressant-responsive enteropathy in canines and felines is of multifactorial etiology that is still not fully understood. The intestinal microbiota and diet, the immune system, and genetic factors are considered the three main contributors to the development of this disease. The most common form is lymphoplasmacytic enteritis, and the clinical signs are nonspecific (vomiting, diarrhea, hyporexia, weight loss, abdominal pain/discomfort). Diagnosis is often one of exclusion and requires histopathological confirmation. In more severe cases, the enteropathy may be associated with a protein-losing syndrome. Treatment involves a combination of immunosuppressive drugs and dietary modification using a hypoallergenic diet to modulate the immune response. Symptomatic therapy may include prebiotics, probiotics, and synbiotics to reverse dysbiosis, as well as antiemetics and gastric protectants. In cases unresponsive to conventional therapy, or to reduce corticosteroid use, alternatives such as fecal microbiota transplantation or the use of stem cells may be considered. In this retrospective study, a sample of 15 animals, 11 canines and 4 felines of various breeds and ages, diagnosed with chronic enteropaties was characterized. The most common clinical signs were vomiting in felines, and vomiting and hyporexia in canines and all cases responded to the instituted treatment. All animals underwent upper gastrointestinal endoscopy and biopsy. Histopathological analysis revealed lymphoplasmacytic enteritis in all cases and Helicobacter spp. was detected in two cases
Chronic enteropathies represent a heterogeneous group of diseases characterized by persistent gastrointestinal clinical signs, divided into enteropathies responsive to diet and gut microbiota modulation and enteropathies responsive to immunosuppressants. This study describes a case series of canine and feline chronic enteropathies, with histopathological diagnosis and evaluation of the treatment implemented. Inflammatory bowel disease/ Immunosuppressant-responsive enteropathy in canines and felines is of multifactorial etiology that is still not fully understood. The intestinal microbiota and diet, the immune system, and genetic factors are considered the three main contributors to the development of this disease. The most common form is lymphoplasmacytic enteritis, and the clinical signs are nonspecific (vomiting, diarrhea, hyporexia, weight loss, abdominal pain/discomfort). Diagnosis is often one of exclusion and requires histopathological confirmation. In more severe cases, the enteropathy may be associated with a protein-losing syndrome. Treatment involves a combination of immunosuppressive drugs and dietary modification using a hypoallergenic diet to modulate the immune response. Symptomatic therapy may include prebiotics, probiotics, and synbiotics to reverse dysbiosis, as well as antiemetics and gastric protectants. In cases unresponsive to conventional therapy, or to reduce corticosteroid use, alternatives such as fecal microbiota transplantation or the use of stem cells may be considered. In this retrospective study, a sample of 15 animals, 11 canines and 4 felines of various breeds and ages, diagnosed with chronic enteropaties was characterized. The most common clinical signs were vomiting in felines, and vomiting and hyporexia in canines and all cases responded to the instituted treatment. All animals underwent upper gastrointestinal endoscopy and biopsy. Histopathological analysis revealed lymphoplasmacytic enteritis in all cases and Helicobacter spp. was detected in two cases
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Palavras-chave
Enteropatias crónicas Disbiose Enterite linfoplasmocítica Terapêutica imunossupressora Endoscopia alta Doença inflamatória intestinal Chronic enteropathies Dysbiosis Lymphoplasmacytic immunosuppressive therapy Upper endoscopy Inflammatory bowel disease