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Avaliação de fatores de prognóstico em gatos com gengivoestomatite : um estudo retrospetivo
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Resumo(s)
A gengivoestomatite crónica felina (GECF) consiste numa doença imunomediada da mucosa oral dos gatos, de natureza inflamatória crónica e com prevalência variável. É considerado um processo doloroso, com lesões que podem tornar-se muito extensas e cujo tratamento de eleição são as extrações dentárias. O tratamento cirúrgico não garante cura clínica de todos os casos, sendo importante reconhecer fatores que permitam avaliar o prognóstico da resposta ao tratamento instituído. O principal objetivo deste estudo retrospetivo foi identificar fatores que possam ter impacto no prognóstico pós-cirúrgico de gatos com GECF, em particular o tempo decorrido entre o diagnóstico e as extrações dentárias. Foram incluídos na amostra em estudo 82 gatos submetidos a extrações dentárias, tendo sido registadas as seguintes variáveis: sexo, estado reprodutivo, faixa etária, convivência com outros gatos, acesso ao exterior, testagem para Vírus da Imunodeficiência Felina (FIV), Vírus da Leucemia Felina (FeLV), Calicivírus Felino (FCV), tempo decorrido entre o diagnóstico e o procedimento cirúrgico, categorizado em 4 intervalos de tempo distintos, tipo de cirurgia, padrões de lesões e tratamento médico antes da cirurgia (TMAC)). Foram realizados testes estatísticos de forma a estudar associações entre as variáveis recolhidas. Não se verificou associação estatística significativa entre os intervalos de tempo e a resposta à cirurgia, merecendo especial atenção as variáveis FeLV e existência de raízes retidas, cujos animais positivos apresentaram menor chance de melhoria pós-cirúrgica. Este estudo contribuiu com a evidência de que um maior intervalo de tempo entre o diagnóstico e o tratamento cirúrgico não contribui para uma redução da resposta clínica e que um maior tempo de tratamento médico pode não ser relevante para a resposta ao tratamento com extrações dentárias. A identificação e compreensão destes fatores de prognóstico auxilia na prática clínica, ajudando a prever melhor a resposta ao tratamento cirúrgico, e assim a tomar decisões sobre possíveis tratamentos complementares necessários
Feline chronic gingivostomatitis (FCGS) is an imunomediated disease of the oral mucosa in cats, characterized by chronic inflammation and with variable prevalence. It is considered a painful condition, with lesions that can become very extensive, and the gold standard treatment consists of dental extactions. Surgical treatment does not lead to clinical cure of all cases, therefore it is important to recognize factors that allow us to evaluate the prognosis of the treatment response. The main objective of this retrospective study was to identify factors that can impact the postoperative prognosis of cats with FCGS, particularly the elapsed time between diagnosis and dental extractions. This sample included 82 cats subjected to dental extractions, the following variables were recorded: gender, reproductive status, age group, multicat environment, outdoor access, Feline Immunodeficiency Virus (FIV), Feline Leukemia Virus (FeLV) and Feline Calicivirus (FCV), elapsed time between diagnosis and surgery, categorized into four different time intervals, type of surgery, pattern of lesions and medical treatment before surgery. Statistical tests were performed to assess associations between the collected variables. No significant statistical association was found between the time intervals and the response to surgery. The variables FeLV and presence of retained roots deserve special attention, as animals positive to these factors have a lower chance of improvement after surgery. This study provides evidence that a longer time interval between diagnosis and surgical treatment does not contribute to a reduction in clinical response, and that a longer medical treatment prior to surgery may not be relevant to the post-extraction outcome. The identification and comprehension of these prognostic factors is of use in clinical practice, helping to better predict the response to surgical treatment, and thus to make decisions about other complementary treatments
Feline chronic gingivostomatitis (FCGS) is an imunomediated disease of the oral mucosa in cats, characterized by chronic inflammation and with variable prevalence. It is considered a painful condition, with lesions that can become very extensive, and the gold standard treatment consists of dental extactions. Surgical treatment does not lead to clinical cure of all cases, therefore it is important to recognize factors that allow us to evaluate the prognosis of the treatment response. The main objective of this retrospective study was to identify factors that can impact the postoperative prognosis of cats with FCGS, particularly the elapsed time between diagnosis and dental extractions. This sample included 82 cats subjected to dental extractions, the following variables were recorded: gender, reproductive status, age group, multicat environment, outdoor access, Feline Immunodeficiency Virus (FIV), Feline Leukemia Virus (FeLV) and Feline Calicivirus (FCV), elapsed time between diagnosis and surgery, categorized into four different time intervals, type of surgery, pattern of lesions and medical treatment before surgery. Statistical tests were performed to assess associations between the collected variables. No significant statistical association was found between the time intervals and the response to surgery. The variables FeLV and presence of retained roots deserve special attention, as animals positive to these factors have a lower chance of improvement after surgery. This study provides evidence that a longer time interval between diagnosis and surgical treatment does not contribute to a reduction in clinical response, and that a longer medical treatment prior to surgery may not be relevant to the post-extraction outcome. The identification and comprehension of these prognostic factors is of use in clinical practice, helping to better predict the response to surgical treatment, and thus to make decisions about other complementary treatments
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, área científica de Clínica
Palavras-chave
Gengivoestomatite Gato Extração dentária Tratamento Fatores de prognóstico Gingivostomatitis Cat Tooth extraction Treatment Prognostic factors