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Estudo retrospetivo sobre gastrotomias no tratamento de sobrecarga gástrica em coelhos
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Resumo(s)
A sobrecarga gástrica é uma consequência de uma das doenças mais frequentes em coelhos, a estase gastrointestinal. Esta pode ser obstrutiva ou não obstrutiva, mas ambas podem causar sobrecarga gástrica pela acumulação de alimento, pêlo e cecotrofos no estômago. Com o decorrer da doença, este conteúdo gástrico, pode desidratar e permanecer retido apesar da utilização da fluidoterapia e terapia farmacológica adequada com analgésicos e procinéticos. Na comunidade científica, existe alguma divergência de opiniões entre os profissionais da área da medicina de animais exóticos sobre como se deve abordar o caso de um coelho com estase gastrointestinal. Esta divergência baseia-se na, presumidamente, difícil recuperação cirúrgica que pode piorar o prognóstico do animal e na taxa de sucesso encontrada no tratamento médico de estase gastrointestinal nestes animais. Este estudo retrospetivo avaliou 15 casos de coelhos diagnosticados com estase gastrointestinal, aos quais foi realizada uma gastrotomia com o objetivo de encontrar e remover um corpo estranho gástrico, ou de esvaziar o estômago, de forma a potenciar a evolução positiva do caso removendo o conteúdo retido, que não permitia o esvaziamento gástrico, facilitando assim a ação farmacológica posterior. Este estudo teve, então, como objetivo avaliar parâmetros como o género, idade, métodos de diagnóstico, sinais clínicos, doenças concomitantes, presença ou não de corpo estranho, influência do tempo passado até à realização da gastrotomia, e verificar a eficiência deste método de tratamento. A avaliação destes casos permitiu concluir que o estado geral destes animais é um fator preponderante para o seu prognóstico já que animais que apresentam sintomatologia mais grave tiveram um pior prognóstico, mesmo quando observados e tratados logo após o início dos sinais clínicos, do que os animais com sintomatologia mais ligeira, mesmo quando decorreu bastante tempo até ao início do tratamento. Este estudo indica também que a realização de uma gastrotomia não aparenta piorar o prognóstico destes animais, e que a sua realização atempada pode inclusive acelerar a recuperação e impedir o desenvolvimento de outras complicações que aumentam a morbilidade e mortalidade destes animais, como as úlceras gástricas e a lipidose hepática.
ABSTRACT - RETROSPECTIVE STUDY OF GASTROTOMIES USED IN THE TREATMENT OF GASTRIC IMPACTION IN LAGOMORPHS - Gastric overload is a consequence of one of the most frequent diseases in lagomorphs, gastrointestinal stasis. This can be obstructive or non obstructive but both cases can cause gastric overload due to the accumulation of food, fur and cecothophs in the stomach. With time, this gastric content can dehydrate and remain impacted despite the institution of the correct fluid therapy and medicines like analgesics and prokinetics. In the scientific community, there are conflicting opinions among exotic pet medicine professionals on how to approach a case of a rabbit with gastrointestinal stasis. This difference of opinions is based on the, presumably, hard surgical recovery that may worsen the animals’ prognosis and on the success rate found with using only medical treatment instead of surgical. This retrospective study examined 15 cases of rabbits that were diagnosed with gastrointestinal stasis and treated with a gastrotomy in order to find and remove a foreign body, or to remove the impacted gastric content that was preventing the stomach from emptying its contents through the pylorus, allowing the medication to work afterwards. The aim of this study was to evaluate parameters such as sex, age, diagnostic methods, clinical signs, concomitant pathologies, presence or absence of a foreign body, influence of the time that passed until the gastrotomies were performed, and to assess the efficacy of this method of treatment. The evaluation of these cases allowed to conclude that the general state of these animals is a determinant factor in its prognosis since the animals that presented with serious symptoms had a worse prognosis, even though they were treated sooner after the symptoms started than those that didn’t present such serious symptoms, but were without treatment for a longer time. This study also indicates that the performance of a gastrotomy doesn’t appear to worsen the prognosis of these animals and that its timely performance can accelerate the recovery and stop the development of other complications like gastric ulcers and hepatic lipidosis that increase morbidity and even mortality.
ABSTRACT - RETROSPECTIVE STUDY OF GASTROTOMIES USED IN THE TREATMENT OF GASTRIC IMPACTION IN LAGOMORPHS - Gastric overload is a consequence of one of the most frequent diseases in lagomorphs, gastrointestinal stasis. This can be obstructive or non obstructive but both cases can cause gastric overload due to the accumulation of food, fur and cecothophs in the stomach. With time, this gastric content can dehydrate and remain impacted despite the institution of the correct fluid therapy and medicines like analgesics and prokinetics. In the scientific community, there are conflicting opinions among exotic pet medicine professionals on how to approach a case of a rabbit with gastrointestinal stasis. This difference of opinions is based on the, presumably, hard surgical recovery that may worsen the animals’ prognosis and on the success rate found with using only medical treatment instead of surgical. This retrospective study examined 15 cases of rabbits that were diagnosed with gastrointestinal stasis and treated with a gastrotomy in order to find and remove a foreign body, or to remove the impacted gastric content that was preventing the stomach from emptying its contents through the pylorus, allowing the medication to work afterwards. The aim of this study was to evaluate parameters such as sex, age, diagnostic methods, clinical signs, concomitant pathologies, presence or absence of a foreign body, influence of the time that passed until the gastrotomies were performed, and to assess the efficacy of this method of treatment. The evaluation of these cases allowed to conclude that the general state of these animals is a determinant factor in its prognosis since the animals that presented with serious symptoms had a worse prognosis, even though they were treated sooner after the symptoms started than those that didn’t present such serious symptoms, but were without treatment for a longer time. This study also indicates that the performance of a gastrotomy doesn’t appear to worsen the prognosis of these animals and that its timely performance can accelerate the recovery and stop the development of other complications like gastric ulcers and hepatic lipidosis that increase morbidity and even mortality.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Coelho cirurgia gastrotomia estase retenção gástrica rabbit surgery gastrotomy stasis impaction
Contexto Educativo
Citação
Rocha PAB 2020. Estudo retrospetivo sobre gastrotomias no tratamento de sobrecarga gástrica em coelhos [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa.
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária