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Cetoacidose diabética : estudo retrospetivo em cães e gatos
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Resumo(s)
A Cetoacidose Diabética (CAD) é uma complicação grave da Diabetes Mellitus (DM), caracterizada pela tríade de hiperglicémia, acidose metabólica e hipercetonémia (com cetonúria). Resulta da deficiência insulínica, aliada a um excesso de glucagina e outras hormonas diabetogénicas, muitas vezes como resultado da presença de doenças concomitantes.
Na tentativa de apresentar uma proposta de diagnóstico, de monitorização e de um tratamento adequado da CAD, que diminua a taxa de mortalidade desta doença, este estudo teve como objetivos:
- caracterizar uma amostra de 23 canídeos e de 9 felídeos com CAD que se apresentou à consulta no Hospital Escolar da Faculdade de Medicina entre 1/01/2011 e 23/10/2012;
- averiguar a associação da sua apresentação clínica com diversos fatores, como doenças concomitantes, diagnóstico anterior de DM, tempo de internamento e mortalidade;
- apresentar uma proposta de protocolo para o maneio clínico.
A maioria dos animais não tinha diagnóstico prévio de DM. Comparativamente aos cães, os gatos encontravam-se aparentemente numa fase mais avançada da CAD (sinais clínicos, desequilíbrios hidroeletrolíticos e ácido-base mais pronunciados) e, portanto, com maiores repercussões sistémicas. Os cães submetidos a insulinoterapia previamente ao diagnóstico de CAD não manifestaram alterações clínicas e sistémicas tão pronunciadas. A presença de doenças concomitantes foi muito expressiva em ambas as espécies.
A taxa de mortalidade foi de aproximadamente 30% nos cães e de 56% nos gatos, o que demonstra a necessidade de otimizar o maneio clínico dos animais com CAD.
ABSTRACT - Diabetic Ketoacidosis – retrospective study in dogs and cats - Diabetic Ketoacidosis (DKA) is a severe complication of Diabetes Mellitus (DM). It is characterized by the triad of hyperglycemia, metabolic acidosis and ketonemia (with ketonuria). It is the result of an insulin deficiency, together with an increase in glucagon and other contrarregulatory hormones, sometimes as a consequence of concurrent disorders. In order to present a diagnosis, monitoring and an adequate DKA treatment proposal, the aims of this study are: - characterize 23 dogs and 9 cats with DKA who presented consultation on HE-FMV between 1/01/2011 and 23/10/2012; - determine the association of clinical presentation to various factors such as concurrent disorders, previous diagnosis of DM, hospitalization and mortality; - present a proposal of clinical management of DKA Most of the animals had not been diagnosed with DM. Cats seemed to be in a more advanced DKA stage comparatively to dogs. They exhibited worse clinical signs, electrolyte and acid-base imbalances) and, therefore, had larger systemic repercussions. Dogs which were undergoing insulin therapy prior to the diagnosis of DKA did not show as markedly clinical and systemic signs. The presence of concurrent diseases was remarkable. The mortality rate was approximately 30% in dogs and 56% in cats. This reinforces the need to optimize the clinical management of DKA patients.
ABSTRACT - Diabetic Ketoacidosis – retrospective study in dogs and cats - Diabetic Ketoacidosis (DKA) is a severe complication of Diabetes Mellitus (DM). It is characterized by the triad of hyperglycemia, metabolic acidosis and ketonemia (with ketonuria). It is the result of an insulin deficiency, together with an increase in glucagon and other contrarregulatory hormones, sometimes as a consequence of concurrent disorders. In order to present a diagnosis, monitoring and an adequate DKA treatment proposal, the aims of this study are: - characterize 23 dogs and 9 cats with DKA who presented consultation on HE-FMV between 1/01/2011 and 23/10/2012; - determine the association of clinical presentation to various factors such as concurrent disorders, previous diagnosis of DM, hospitalization and mortality; - present a proposal of clinical management of DKA Most of the animals had not been diagnosed with DM. Cats seemed to be in a more advanced DKA stage comparatively to dogs. They exhibited worse clinical signs, electrolyte and acid-base imbalances) and, therefore, had larger systemic repercussions. Dogs which were undergoing insulin therapy prior to the diagnosis of DKA did not show as markedly clinical and systemic signs. The presence of concurrent diseases was remarkable. The mortality rate was approximately 30% in dogs and 56% in cats. This reinforces the need to optimize the clinical management of DKA patients.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cães Gatos Hiperglicémia Cetonúria Glicosúria Cetoacidose diabética Dogs Cats Hyperglycemia Ketonuria Glycosuria Diabetic ketoacidosis
Contexto Educativo
Citação
Filipe, A.I. (2013). Cetoacidose diabética: estudo retrospetivo em cães e gatos. Dissertação de Mestrado. Universidade Técnica de Lisboa, Faculdade de Medicina Veterinária, Lisboa
Editora
Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária