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Abstract(s)
A obstrução uretral define-se como uma uropatia obstrutiva, estrutural ou funcional, que impede o fluxo urinário normal do animal. Tanto a doença das vias urinárias inferiores como, em particular, a obstrução uretral, são condições comuns na prática clínica, especialmente em felinos machos. As causas mais comuns de obstrução uretral são a cistite idiopática felina, a urolitíase e os tampões uretrais. O seu tratamento passa pela estabilização inicial do animal, pelo alívio da obstrução, pelo maneio médico e/ou cirúrgico, pela realização de alterações alimentares e pelo enriquecimento ambiental do felino. Apesar da taxa de mortalidade ser baixa, a recorrência de episódios obstrutivos é bastante frequente. O presente estudo retrospetivo teve como objetivos a caracterização de uma amostra populacional de 69 gatos do sexo masculino com obstrução uretral, o relato da sua apresentação clínica, abordagem diagnóstica, tratamento e desfecho clínico; e a avaliação de possíveis fatores de prognóstico que possam estar associados com o aparecimento de recidiva. De acordo com os resultados obtidos, a maioria dos felinos eram castrados (81%), de raça Europeu Comum (88%), estritamente de interior (97%) e sofria o seu primeiro episódio de obstrução uretral (87%) aquando a chegada ao hospital. A moda da idade ao primeiro episódio obstrutivo foi de 2 anos. Os sinais clínicos mais frequentes foram a prostração, o vómito e a hematúria. Relativamente às alterações dos parâmetros laboratoriais, destacam se a azotémia (66%) e a hipercalémia (44%). À urianálise, 94% dos gatos da amostra apresentavam hematúria, 47% cristalúria e 44% piúria. A maioria dos felinos não possuía infeção urinária. O principal achado aos exames imagiológicos foi a presença de urólitos. A causa mais comum de obstrução uretral foi a cistite idiopática (59%). Após estabilização, realizou-se tratamento médico em 56 casos e tratamento cirúrgico em 11 casos. No total, 45% dos felinos experienciaram pelo menos uma recidiva. Destes, 36% foram novamente algaliados na primeira semana e 59% no primeiro mês após hospitalização. Aos 82 dias após o episódio de obstrução, a probabilidade de um felino recidivar foi de 50%. A taxa de mortalidade do presente estudo foi 9%, apesar da causa da maioria das mortes não estar relacionada com a obstrução uretral. O pH urinário foi a única variável avaliada que demonstrou associação com o aparecimento de recidiva (χ² = 4.03, df = 1, P = 0,045)
ABSTRACT - Feline Urethral Obstruction: Retrospective Study and Assessment of Possible Prognostic Factors Associated with Recurrence in Males (2018-2022) - Urethral obstruction is defined as a structural or functional obstructive uropathy that hinders the normal urinary flow of the animal. Both lower urinary tract disease and, in particular, urethral obstruction are common conditions in clinical practice, especially in male cats. The most common causes of urethral obstruction are feline idiopathic cystitis, urolithiasis, and urethral plugs. Treatment involves initial stabilization of the animal, relief of obstruction, medical and/or surgical management, dietary changes, and environmental enrichment for the cat. Despite the low mortality rate, the recurrence of obstructive episodes is quite common. The objectives of the present retrospective study were to characterize a population sample of 69 male cats with urethral obstruction, report their clinical presentation, diagnostic approach, treatment and clinical evolution; and the evaluation of possible prognostic factors that may be associated with the appearance of recurrence. According to the results obtained, the majority of cats were neutered (81%), of the European breed (88%), kept indoors (97%), and suffered their first episode of urethral obstruction (87%) upon arrival at the hospital. The mode of age at the first obstructive episode was 2 years old. The most frequent clinical signs were lethargy, vomiting, and hematuria. Regarding laboratory alterations, notable findings included azotemia (66%) and hyperkalemia (44%). In urinalysis, 94% of the cats in the sample exhibited hematuria, 47% crystalluria, and 44% pyuria. The majority of cats did not have urinary tract infection. The main finding on imaging exams was the presence of uroliths. The most common cause of urethral obstruction was idiopathic cystitis (59%). After stabilization, medical treatment was administered in 56 cases, and surgical treatment was performed in 11 cases. Overall, 45% of the cats experienced at least one episode of recurrent urethral obstruction. Among these, 36% were re-catheterized within the first week, and 59% within the first month after hospitalization. At 82 days post obstructive episode, the probability of a cat experiencing an episode of recurrent urethral obstruction was 50%. The mortality rate in the present study was 9%, although the cause of most deaths was not related to urethral obstruction. Urinary pH was the only evaluated variable that showed an association with recurrent urethral obstruction (χ² = 4.03, df = 1, P = 0,045).
ABSTRACT - Feline Urethral Obstruction: Retrospective Study and Assessment of Possible Prognostic Factors Associated with Recurrence in Males (2018-2022) - Urethral obstruction is defined as a structural or functional obstructive uropathy that hinders the normal urinary flow of the animal. Both lower urinary tract disease and, in particular, urethral obstruction are common conditions in clinical practice, especially in male cats. The most common causes of urethral obstruction are feline idiopathic cystitis, urolithiasis, and urethral plugs. Treatment involves initial stabilization of the animal, relief of obstruction, medical and/or surgical management, dietary changes, and environmental enrichment for the cat. Despite the low mortality rate, the recurrence of obstructive episodes is quite common. The objectives of the present retrospective study were to characterize a population sample of 69 male cats with urethral obstruction, report their clinical presentation, diagnostic approach, treatment and clinical evolution; and the evaluation of possible prognostic factors that may be associated with the appearance of recurrence. According to the results obtained, the majority of cats were neutered (81%), of the European breed (88%), kept indoors (97%), and suffered their first episode of urethral obstruction (87%) upon arrival at the hospital. The mode of age at the first obstructive episode was 2 years old. The most frequent clinical signs were lethargy, vomiting, and hematuria. Regarding laboratory alterations, notable findings included azotemia (66%) and hyperkalemia (44%). In urinalysis, 94% of the cats in the sample exhibited hematuria, 47% crystalluria, and 44% pyuria. The majority of cats did not have urinary tract infection. The main finding on imaging exams was the presence of uroliths. The most common cause of urethral obstruction was idiopathic cystitis (59%). After stabilization, medical treatment was administered in 56 cases, and surgical treatment was performed in 11 cases. Overall, 45% of the cats experienced at least one episode of recurrent urethral obstruction. Among these, 36% were re-catheterized within the first week, and 59% within the first month after hospitalization. At 82 days post obstructive episode, the probability of a cat experiencing an episode of recurrent urethral obstruction was 50%. The mortality rate in the present study was 9%, although the cause of most deaths was not related to urethral obstruction. Urinary pH was the only evaluated variable that showed an association with recurrent urethral obstruction (χ² = 4.03, df = 1, P = 0,045).
Description
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Keywords
Obstrução uretral Trato urinário Gatos Recidiva Prognóstico Urethral obstruction Urinary tract Cats Recurrence Prognosis
Pedagogical Context
Citation
Oliveira CBS. 2024. Obstrução uretral felina : estudo retrospetivo e avaliação de possíveis fatores de prognóstico associados a recidiva em machos (2018-2022) [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa
Publisher
Universidade de Lisboa, Faculdade de Medicina Veterinária