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Utilização Da Ultrassonografia Pulmonar No Diagnóstico Da Doença Respiratória Bovina
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A doença respiratória bovina (DRB) é uma das patologias com maior impacto económico na produção de bovinos de aptidão leiteira e de engorda. Existem impactos como redução no ganho médio diário, aumento da taxa de mortalidade e morbilidade, impactos económicos nos parâmetros reprodutivos e diminuição da produção de leite na primeira lactação. De forma a reduzir os impactos económicos da DRB, a identificação precoce da forma clínica e subclínica da DRB é crucial. A campo, são frequentemente utilizados métodos tradicionais de diagnóstico, como por exemplo a auscultação pulmonar e a observação dos sinais clínicos (Escala de Wisconsin). Ao longo dos últimos anos, a ultrassonografia pulmonar (USP) tem tido um crescente interesse, não só pela comunidade científica como pelos clínicos. O principal objetivo deste estudo foi reunir e sintetizar a literatura existente, de forma a fornecer aos médicos veterinários, a informação necessária para a implementação da USP nas explorações. Recentemente, a USP tem-se afirmado como um método de diagnóstico prático, rápido, não invasivo e preciso que pode ser utilizado em contexto de campo. Comparativamente aos métodos de diagnóstico habitualmente utilizados, a USP é considerada o método mais sensível (0,85 – 0,94) e específico (0,98-1,0) para a identificação da DRB. A USP poderá ser realizada com as sondas transretais, do tipo lineares e com frequências entre 3,5 a 13 megahertz (MHz). Este tipo de sonda é diariamente utilizado pelos médicos veterinários na realização de diagnósticos de gestação e a avaliação uterina, tornando-se assim mais económica. A área pulmonar a avaliar ainda não está bem definida pela comunidade científica, contudo, sabe-se que a mais afetada em situações de broncopneumonia é a região cranial do lobo pulmonar direito. O lobo pulmonar médio direito e a região caudal do lobo pulmonar direito também são habitualmente afetados. Alguns autores defendem apenas a avaliação do lado direito e outros a avaliação de ambos os lados. Os scores de classificação são maioritariamente qualitativos, podendo ser quantitativos, têm por base a presença de achados ultrassonográficos, como dimensão das consolidações pulmonares e a presença de artefactos em “cauda de cometa”. Este método de diagnóstico é simples e eficaz na deteção da DRB, podendo ser implementado na prática clínica.
Bovine Respiratory Disease (BRD) is one of the pathologies with the greatest economic impact on dairy and beef cattle production. The impacts include reduced average daily gain, increased mortality and morbidity rates, economic impact on reproductive parameters, and decreased milk production during the first lactation. To reduce the economic impacts of BRD, early identification of both the clinical and subclinical forms of the disease is crucial. In the field, traditional diagnostic methods are often used, such as lung auscultation and the observation of clinical signs (Wisconsin Scale). Over the past few years, pulmonary ultrasound (PUS) has gained increasing interest, not only among the scientific community but also among practitioners. The main objective of this study was to compile and synthesize the existing literature to provide veterinarians with the necessary information for the implementation of PUS on farms. Recently, PUS has been established as a practical, fast, non-invasive, and accurate diagnostic method that can be used in the field. Compared to commonly used diagnostic methods, PUS is considered the most sensitive (0.85 – 0.94) and specific (0.98-1.0) method for identifying BRD. PUS can be performed with transrectal probes, of the linear type, with frequencies ranging from 3.5 to 13 megahertz (MHz). This type of probe is routinely used by veterinarians in pregnancy diagnosis and uterine evaluation, making it more cost-effective. The pulmonary area to be assessed is not yet well defined by the scientific community; however, it is known that the cranial region of the right lung lobe is most affected in cases of bronchopneumonia. The middle right lung lobe and the caudal region of the right lung lobe are also commonly affected. Some authors advocate assessing only the right side, while others recommend evaluating both sides. The classification scores are mostly qualitative but can also be quantitative, based on the presence of ultrasonographic findings such as the size of pulmonary consolidations and the presence of “comet-tail” artifacts. This diagnostic method is simple and effective in detecting BRD and can be implemented in clinical practice.
Bovine Respiratory Disease (BRD) is one of the pathologies with the greatest economic impact on dairy and beef cattle production. The impacts include reduced average daily gain, increased mortality and morbidity rates, economic impact on reproductive parameters, and decreased milk production during the first lactation. To reduce the economic impacts of BRD, early identification of both the clinical and subclinical forms of the disease is crucial. In the field, traditional diagnostic methods are often used, such as lung auscultation and the observation of clinical signs (Wisconsin Scale). Over the past few years, pulmonary ultrasound (PUS) has gained increasing interest, not only among the scientific community but also among practitioners. The main objective of this study was to compile and synthesize the existing literature to provide veterinarians with the necessary information for the implementation of PUS on farms. Recently, PUS has been established as a practical, fast, non-invasive, and accurate diagnostic method that can be used in the field. Compared to commonly used diagnostic methods, PUS is considered the most sensitive (0.85 – 0.94) and specific (0.98-1.0) method for identifying BRD. PUS can be performed with transrectal probes, of the linear type, with frequencies ranging from 3.5 to 13 megahertz (MHz). This type of probe is routinely used by veterinarians in pregnancy diagnosis and uterine evaluation, making it more cost-effective. The pulmonary area to be assessed is not yet well defined by the scientific community; however, it is known that the cranial region of the right lung lobe is most affected in cases of bronchopneumonia. The middle right lung lobe and the caudal region of the right lung lobe are also commonly affected. Some authors advocate assessing only the right side, while others recommend evaluating both sides. The classification scores are mostly qualitative but can also be quantitative, based on the presence of ultrasonographic findings such as the size of pulmonary consolidations and the presence of “comet-tail” artifacts. This diagnostic method is simple and effective in detecting BRD and can be implemented in clinical practice.
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Keywords
Doença Respiratória Bovina Ultrassonografia Pulmonar Diagnóstico Bovine Respiratory Disease Pulmonary Ultrasound Diagnosis