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Hepatite crónica canina : estudo retrospetivo de 19 casos clínicos (2011-2022)
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Abstract(s)
RESUMO - A Hepatite Crónica canina (HCC) é considerada a doença hepática primária mais comum nos cães, com uma prevalência de até 12%, representando um relevante fator de morbilidade e mortalidade na prática clínica. Este estudo retrospetivo incluiu cães diagnosticados no Hospital Escolar Veterinário (HEV) entre 2011 e 2022. Foram incluídos todos os canídeos com diagnóstico de HCC confirmado através de biópsia hepática. O objetivo principal foi a caracterização da amostra, dos seus antecedentes clínicos, das alterações clínicas, laboratoriais, imagiológicas e histopatológicas, assim como do desenvolvimento de complicações durante o curso da doença e da gestão terapêutica efetuada. Além disso, teve como objetivo mostrar possíveis tendências raciais e de género em Portugal. O estudo incidiu sobre uma amostra de 19 canídeos com uma idade média de 8,16 anos, onde se observou uma sobrerrepresentação do sexo feminino e dos Labrador retriever. Os sinais clínicos mais relatados incluíram letargia (89,5%) e anorexia (89,5%). No exame físico, icterícia (52,6%) e palpação abdominal dolorosa (52,6%) foram os sinais mais comuns. Nas análises clínicas a ALT (100%) mostrou-se consistentemente elevada, seguida da FAS (94,7%). Os marcadores de função mais frequentemente alterados foram a albumina (57,9%) e a bilirrubina (52,6%). A ecografia foi sugestiva de HCC/cirrose em 47,4% da amostra. Na histopatologia, o infiltrado linfoplasmocitário foi o mais frequente (42,1%) com localização maioritariamente portal/periportal, tal como a fibrose. Oito animais (42,1%) apresentavam cirrose. Durante o curso da doença, surgiram diversas complicações como alterações da coagulação (68,4%), hipertensão portal (31,6%), ascite (31,6%), ulceração gastrointestinal (31,6%) e encefalopatia hepática (26,3%). Quanto à etiologia, a maioria dos casos (89,5%) foi considerado idiopático por falha na deteção da etiologia. Em dois Labrador Retriever foi diagnosticada acumulação primária de cobre. Este estudo retrospetivo permitiu atualizar a epidemiologia da HCC em Portugal e reforçar o caráter inespecífico dos seus sinais clínicos, bem como a importância da biópsia para o diagnóstico e para uma intervenção terapêutica precoce, a fim de retardar a progressão da doença e evitar as suas complicações. Além disso, permitiu obter uma visão aproximada da realidade portuguesa sobre os meios de diagnóstico e a terapêutica disponíveis. As grandes limitações do estudo foram o tamanho da amostra e a sua natureza retrospetiva, que levou a uma falta de padronização da abordagem diagnóstica e terapêutica e impossibilitou a análise do prognóstico
ABSTRACT - CANINE CHRONIC HEPATITIS – A RETROSPECTIVE STUDY OF 19 CLINICAL CASES (2011-2022) - Canine chronic hepatitis (CCH) is considered the most frequent primary hepatic disease in dogs, with a prevalence of up to 12%, representing a relevant cause of morbility and mortality in clinical practice. This retrospective study included dogs diagnosed at Hospital Escolar Veterinário (HEV) between 2011 and 2022. It included all dogs diagnosed with CCH confirmed by hepatic biopsy. The main purpose was the characterization of the population, of their clinical records and their clinical, laboratory, imagiologic and histopathological changes related to the disease, as well as the development of complications and the therapeutic management. Also, it had the purpose of showing racial and gender tendencies in Portugal. This study evaluated a sample of 19 dogs with an average age of 8,16 years and showed an overrepresentation of females and Labrador retriever. The most common clinical signs included lethargy (89,5%) and anorexia (89,5%). At the physical exam, the most frequent findings were icterus (52,6%) and abdominal pain (52,6%). The laboratory analysis showed a consistent increase in ALT (100%) and FAS (94,75%). The most altered function tests were albumin (57,9%) and bilirubin (52,6%). The ultrasound suggested the presence of CCH/cirrhosis in 47,4% of the sample. A lymphoplasmacytic infiltrate was the most frequent finding in histopathology, mainly with portal/periportal location, as fibrosis. Eight dogs presented cirrhosis (42,1%). During the disease, the dogs developed several complications such as coagulation disorders (68,4%), portal hypertension (31,6%), ascites (31,6%), gastrointestinal ulceration (31,6%) and hepatic encephalopathy (26,3%). Most of the cases remained idiopathic (89,5%), as it was not possible to find the etiology of the disease. Two Labrador retriever were diagnosed with primary copper accumulation. This retrospective study allowed the update of the epidemiology of CCH in Portugal and confirmed the unspecific character of clinical signs, as well as the importance of biopsy in the diagnosis and early treatment, delaying the progression of the disease and avoiding the complications. Besides, it allowed the understanding of the portuguese panorama regarding the diagnostic and therapeutic means available. The big limitations of this study were the little sample size and his retrospective nature, leading to a lack of standardization of the diagnostic and therapeutic approach, making impossible the prognostic evaluation
ABSTRACT - CANINE CHRONIC HEPATITIS – A RETROSPECTIVE STUDY OF 19 CLINICAL CASES (2011-2022) - Canine chronic hepatitis (CCH) is considered the most frequent primary hepatic disease in dogs, with a prevalence of up to 12%, representing a relevant cause of morbility and mortality in clinical practice. This retrospective study included dogs diagnosed at Hospital Escolar Veterinário (HEV) between 2011 and 2022. It included all dogs diagnosed with CCH confirmed by hepatic biopsy. The main purpose was the characterization of the population, of their clinical records and their clinical, laboratory, imagiologic and histopathological changes related to the disease, as well as the development of complications and the therapeutic management. Also, it had the purpose of showing racial and gender tendencies in Portugal. This study evaluated a sample of 19 dogs with an average age of 8,16 years and showed an overrepresentation of females and Labrador retriever. The most common clinical signs included lethargy (89,5%) and anorexia (89,5%). At the physical exam, the most frequent findings were icterus (52,6%) and abdominal pain (52,6%). The laboratory analysis showed a consistent increase in ALT (100%) and FAS (94,75%). The most altered function tests were albumin (57,9%) and bilirubin (52,6%). The ultrasound suggested the presence of CCH/cirrhosis in 47,4% of the sample. A lymphoplasmacytic infiltrate was the most frequent finding in histopathology, mainly with portal/periportal location, as fibrosis. Eight dogs presented cirrhosis (42,1%). During the disease, the dogs developed several complications such as coagulation disorders (68,4%), portal hypertension (31,6%), ascites (31,6%), gastrointestinal ulceration (31,6%) and hepatic encephalopathy (26,3%). Most of the cases remained idiopathic (89,5%), as it was not possible to find the etiology of the disease. Two Labrador retriever were diagnosed with primary copper accumulation. This retrospective study allowed the update of the epidemiology of CCH in Portugal and confirmed the unspecific character of clinical signs, as well as the importance of biopsy in the diagnosis and early treatment, delaying the progression of the disease and avoiding the complications. Besides, it allowed the understanding of the portuguese panorama regarding the diagnostic and therapeutic means available. The big limitations of this study were the little sample size and his retrospective nature, leading to a lack of standardization of the diagnostic and therapeutic approach, making impossible the prognostic evaluation
Description
Dissertação de Mestrado Integrado em Medicina Veterinária, na área científica de Clínica
Keywords
Hepatite crónica canina Fígado Idiopático Canine Chronic Hepatitis Liver Idiopathic
Pedagogical Context
Citation
Carramanho ACJS. 2023. Hepatite crónica canina : estudo retrospetivo de 19 casos clínicos (2011-2022) [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa
Publisher
Universidade de Lisboa, Faculdade de Medicina Veterinária