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Acta sci. vet. (Impr.); 41(supl.1): Pub. 18, 2013. ilus, tab

Artigo em Inglês | VETINDEX | ID: biblio-1372657

Resumo

Background: Perinephric pseudocyst is a rare disease that affects animals and humans. It is characterized by an accumulation of serous fluid around of one or both kidneys, and in cats the manifestation as sub-capsular, containing liquid with transudate characteristics are most frequently observed. The etiology is not well understood yet, but it is known that it is associated with chronic renal injury. While it has no direct relation to race and gender, it shows a higher occurrence in elderly patients above 10 years. According to the scientific literature, surgery is the treatment of choice for this condition. Therefore, the objective of this paper is to report the first case of bilateral perinephric pseudocyst in a young cat in Brazil, treated with palliative maneuver associated with a therapeutic feeding balanced. Case: A 1-year-old Siamese cat, 3 kg, female non-castrated was referred for clinical investigation in the state of Rio de Janeiro, Brazil. It presented a 30 days history of progressive increase of abdominal volume, followed also by weight loss, hyporexia, and apathy. The patient underwent to an abdominal ultrasound, showing a large cyst in both kidneys, suggestive of perinephric pseudocyst. It was found that the surgical therapy would the choice for such alterations; however, the animal owners we do not accepted surgical treatment, were oriented about the risks of recurrence a treatment palliative. Nevertheless, recognizing the risks, they preferred by choose for a minimally invasive treatment. With this clinical challenge, we established a supportive treatment, with fluid therapy and commercial therapeutic feeding. At day of diagnosis of perinephric pseudocyst, which we consider as day 0, blood sample was collected for evaluation hemogram and biochemical serum, tests revealed normochromic normocytic anemia and azotemia. Elapsed 10 days of supportive therapy, the liquid was aseptically drained, being classified as a transudate. It was performed only two collection of perirenal liquid within a interval of 10 days between them. After the second perinephric pseudocyst draining the animal did not return to the veterinary clinic, since the owners had reported, by phone call, the improvement of the animal. The reports were maintained during three months and two years after the diagnostic, with no longer observation of abdominal enlargement. Discussion: The abdominal ultrasound proved to be an effective diagnostic method for the differentiation and confirmation of PNP e the liquid analysis revealed pure transudate. These results are similar to those described by other authors. Laboratory tests showed normocytic normochromic anemia and azotemia. The azotemia may be prerenal, by dehydration, as observed in this report; however, as shown in other studies of conical renal injury, obstruction by calculus can lead to this azotemic condition. Thus, it was possible to observe in this study, corroborating the literature, that the prognosis is related to the degree of renal dysfunction. Since this animal was a young cat, when the dehydration was, corrected along with the percutaneous puncture of liquid, the animal's response was immediate and satisfactory. The levels of urea and creatinine declined, with consequent decrease in accumulation of liquid in cysts. Another fundamental process in the therapeutic care, was the combination of mechanical therapy with therapeutic feeding, providing lower renal overload of minerals and a greater supply of proteins with high digestibility to the animal. It is important to emphasize that it is not recommended to replace the surgery by this protocol, but it is expected with this report demonstrate the importance of this rare disease in our country, highlighting that a palliative maneuver in association with changes in diet are therapies that can be employed with favorable prognosis.

Biblioteca responsável: BR68.1