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Estudo retrospetivo da litíase urinária em cães e gatos
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A urolitíase está associada, com cada vez maior frequência, ao trato urinário de cães
e gatos. Os cálculos urinários, vulgarmente intitulados de “pedras”, vão-se formando no trato
urinário por acumulação e congregação de cristais existentes na urina (a estruvite e o oxalato
de cálcio são os mais frequentes). A formação destes urólitos está frequentemente
relacionada com a ingestão insuficiente de água, dietas inadequadas (por exemplo, rações
de baixa qualidade) e/ou fatores genéticos. Os urólitos podem ser simples ou podem ter
composição mista ou composta. Alguns cálculos são passíveis de ser dissolvidos através da
mudança do pH urinário (essencialmente por maneio alimentar), enquanto outros não. São
encontrados em qualquer parte do trato urinário e, quando localizados nos rins, o termo
nefrolitíase é mais utilizado por ser mais específico, em detrimento de urolitíase, que é mais
geral. Os urólitos podem, por vezes, originar situações críticas, como um quadro obstrutivo.
Esta é uma urgência médico/cirúrgica e deve ser tratada o mais depressa possível, caso
contrário, pode ter um desfecho fatal. A profilaxia médica baseia-se na diminuição da
saturação urinária dos cristais que formam os cálculos.
O presente estudo retrospetivo analisou os dados clínicos de três gatos (um macho e
duas fêmeas) e duas cadelas com diagnóstico de urolitíase, acompanhados no Hospital
Veterinário de Alvalade. O exame complementar mais realizado foi a radiografia. O sinal
clínico mais frequente foi a prostração, presente em quatro dos cinco casos clínicos. Foram
removidos os cistólitos de três dos animais por cistotomia e foi posteriormente avaliada a
respetiva composição em apenas dois dos casos, sendo um fator limitante para o sucesso do
tratamento. Num dos casos o urólito era composto apenas por um mineral (oxalato de cálcio
mono-hidratado) e no outro a composição era mista (20% de fosfato de cálcio e 80% de
estruvite). Após diagnóstico de litíase, todos os animais fizeram mudança alimentar para uma
ração adequada. O tamanho reduzido da amostra impossibilitou a obtenção de resultados
significativos.
O tratamento pode representar um desafio, pois, muitas vezes, é necessário ajustar
toda a abordagem terapêutica e dietética a cada caso individual, tendo em conta que muitas
vezes existem alterações ou doenças subjacentes (nomeadamente doença renal) e/ou
restrições monetárias. Nesta revisão, foi ainda realçada a importância do papel do detentor
no sucesso do tratamento e a necessidade de uma adesão rigorosa ao protocolo instituído
pelo Médico Veterinário.
ABSTRACT - Urolithiasis is associated, with increasing frequency, to the urinary tract of dogs and cats. Calculi, commonly known as “stones”, are formed in the urinary tract by accumulation and congregation of crystals present in urine (struvite and calcium oxalate are the most frequent). The formation of these uroliths is often related to an insufficient water intake, inadequate diet (e.g. poor-quality rations) and/or genetic factors. Uroliths can be simple or have mixed or compound composition. Some calculi are liable to be dissolved by changing the urinary’s pH (essentially through food management), while others are not. They are found anywhere in the urinary tract and, when located in the kidneys, the term nephrolithiasis is more used as it is more specific, as an alternative to urolithiasis, which is the general term. Uroliths can sometimes lead to critical situations, such as an obstructive condition. This is a medical/surgical emergency and should be treated as soon as possible, otherwise it may have a fatal outcome. Medical prophylaxis is based on decreasing the urine saturation of the crystals that form the calculi. The present retrospective study analyzed the clinical data of three cats (one male and two females) and two female dogs, diagnosed with urolithiasis from Hospital Veterinário de Alvalade. The most performed complementary exam was radiography. The most frequent clinical sign was prostration, present in four of the five clinical cases. The cystoliths of three animals were removed by cystotomy, and the respective composition was subsequently evaluated in only two of the cases, being a limiting factor for the success of the treatment. In one case the urolith was composed of a single mineral (calcium oxalate monohydrate) and in the other the composition was mixed (20% calcium phosphate and 80% struvite). After diagnosing lithiasis, all animals changed their diet to an adequate one. The small sample size proved limiting to obtain significant results. Treatment can be challenging, as it is often necessary to adjust the entire therapeutic and dietary approach to each individual case, taking into account that there are often underlying changes or illness (namely kidney disease) and/or monetary restrictions. In this review, the importance of the tutor’s role in the success of the treatment and the need for strict adherence to the protocol established by the Veterinarian, was also highlighted.
ABSTRACT - Urolithiasis is associated, with increasing frequency, to the urinary tract of dogs and cats. Calculi, commonly known as “stones”, are formed in the urinary tract by accumulation and congregation of crystals present in urine (struvite and calcium oxalate are the most frequent). The formation of these uroliths is often related to an insufficient water intake, inadequate diet (e.g. poor-quality rations) and/or genetic factors. Uroliths can be simple or have mixed or compound composition. Some calculi are liable to be dissolved by changing the urinary’s pH (essentially through food management), while others are not. They are found anywhere in the urinary tract and, when located in the kidneys, the term nephrolithiasis is more used as it is more specific, as an alternative to urolithiasis, which is the general term. Uroliths can sometimes lead to critical situations, such as an obstructive condition. This is a medical/surgical emergency and should be treated as soon as possible, otherwise it may have a fatal outcome. Medical prophylaxis is based on decreasing the urine saturation of the crystals that form the calculi. The present retrospective study analyzed the clinical data of three cats (one male and two females) and two female dogs, diagnosed with urolithiasis from Hospital Veterinário de Alvalade. The most performed complementary exam was radiography. The most frequent clinical sign was prostration, present in four of the five clinical cases. The cystoliths of three animals were removed by cystotomy, and the respective composition was subsequently evaluated in only two of the cases, being a limiting factor for the success of the treatment. In one case the urolith was composed of a single mineral (calcium oxalate monohydrate) and in the other the composition was mixed (20% calcium phosphate and 80% struvite). After diagnosing lithiasis, all animals changed their diet to an adequate one. The small sample size proved limiting to obtain significant results. Treatment can be challenging, as it is often necessary to adjust the entire therapeutic and dietary approach to each individual case, taking into account that there are often underlying changes or illness (namely kidney disease) and/or monetary restrictions. In this review, the importance of the tutor’s role in the success of the treatment and the need for strict adherence to the protocol established by the Veterinarian, was also highlighted.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Nefrolitíase urolitíase urólitos oxalato de cálcio estruvite Nephrolithiasis urolithiasis uroliths calcium oxalate struvite
Contexto Educativo
Citação
Rodrigues MCT 2021. Estudo retrospetivo da litíase urinária em cães e gatos [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária