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Tratamento médico de cólicas em equinos
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Abstract(s)
A cólica em equinos é caracterizada por uma desordem digestiva de natureza multifatorial e complexa, que se manifesta através da dor abdominal aguda, não se traduzindo numa doença (Worku, Wondimagegn, Aklilu, Assefa, & Gizachew, 2017). É considerada uma urgência da prática clínica, uma vez que é a causa de elevadas taxas de morbilidade e mortalidade em equinos (Curtis et al., 2015).
Os equinos são mais predispostos a ter cólicas do que as outras espécies devido a certas caraterísticas anatómicas da espécie: a túnica muscular que funciona como um esfíncter existente entre o esófago e a cárdia e que impede o vómito; o longo mesentério do intestino delgado (ID); o ceco terminar em saco cego; o cólon ascendente livre no abdómen; a diminuição de diâmetro na flexura pélvica (Blikslager, White II, Moore, & Mair, 2017).
Muitos casos de cólica podem solucionar-se de forma espontânea ou através de uma resposta ao tratamento médico, no entanto, existe uma percentagem de casos que exigem intervenção cirúrgica (Curtis et al., 2015). Adicionalmente, algumas lesões gastrointestinais provenientes desta síndrome, podem levar a uma deterioração física rápida do animal podendo mesmo ser fatais. Nestes casos, torna-se fundamental o rápido reconhecimento dos sinais clínicos pelos donos e subsequentemente a assistência do veterinário de ambulatório para que seja realizado um bom diagnóstico (Scantlebury, Perkins, Pinchbeck, Archer, & Christley, 2014). Numa primeira abordagem á cólica o passo primordial é perceber se estamos perante um caso critico ou não (Taylor, Brazil, & Hillyer, 2010). Assim, é imprescindível ter-se em conta a intensidade dos sinais de dor, considerando que um animal em estado de cólica vai estar inquieto, constantemente a deitar-se e a levantar-se, rolar no chão, suar, relinchar, olhar para o flanco, pontapear o abdómen e em casos extremos atirar-se ao chão, tendo em atenção que na generalidade estes sinais são acompanhados de anorexia e depressão (Smith, 2015).
O diagnóstico é habitualmente elaborado através de um procedimento que segue várias etapas, sendo elas uma anamnese inicial, o exame físico completo, palpação retal, entubação nasogástrica, ecografia e, por vezes, recolha de sangue e abdominocentese. A entubação nasogástrica também permite a realização do tratamento em alguns casos, como por exemplo, impactações de areia (Curtis et al., 2015).
O tratamento médico de cólica consiste em atuar no alívio da dor através de aines, opioides, sedativos; de fluidoterapia; uso de laxantes como psílio, óleo mineral, sulfato de magnésio ou combinações destes e anti-helmínticos se houver suspeita de parasitismo (Curtis et al., 2015).
Ainda existe uma grande percentagem de mortalidade associada a episódios de cólica, aspeto que pode dever-se a vários fatores, sendo eles, falta de acompanhamento dos casos, fluidoterapia inadequada para resolver a desidratação ou falha no balanço hidrolítico e perceção tardia dos sinais de cólica por parte dos donos. Nesta sequência, surge a pertinência de melhorar o acompanhamento por parte dos veterinários em colaboração com donos (Worku et al., 2017).
Colic in horses is characterized by a multifactorial and complex digestive disorder that manifests itself through acute abdominal pain and does not translate into disease (Worku et al., 2017). It is considered an urgency of clinical practice, since it is the cause of high rates of morbidity and mortality in horses (Curtis et al., 2015). Equines are more prone to colic than other species due to certain anatomical characteristics of the species: the muscular tunica that functions as a sphincter between the esophagus and cardia and prevents vomiting; the long mesentery of the small intestine; the cecum finishes in a blind sack; the free ascending cólon in the abdomen; the diameter decrease in the pelvic flexure (Blikslager et al., 2017). Many cases of colic can be solved spontaneously or through a response to medical treatment, however, there is a percentage of cases requiring surgical intervention (Curtis et al., 2015). In addition, some gastrointestinal lesions from this syndrome can lead to a rapid physical deterioration of the animal and may even be fatal. In these cases, rapid recognition of clinical signs by the owners and subsequent outpatient veterinarian assistance is essential for a good diagnosis (Scantlebury et al., 2014). In a first approach to colic, the first step is to realize if we are dealing with a critical case or not (Taylor et al., 2010). Thus, it is essential to take into account the intensity of the signs of pain, considering that an animal in colic will be restless, constantly lying down and rising, rolling on the floor, sweating, neighing, looking at the flank, kick the abdomen and in extreme cases throw themselves to the ground, taking into account that in general these signs are accompanied by anorexia and depression (Smith, 2015). Diagnosis is usually performed through a procedure that follows several steps, such as an initial anamnesis, complete physical examination, rectal palpation, nasogastric intubation, echography, and sometimes blood collection and abdominocentesis. Nasogastric intubation also allows the treatment to be performed in some cases, such as sand impaction (Curtis et al., 2015). The medical treatment of colic consists of acting in the relief of pain through aines, opioids, sedatives; of fluid therapy; use of laxatives such as psyllium, mineral oil, magnesium sulfate or combinations thereof and anthelmintics if parasitism is suspected (Curtis et al., 2015). There is still a large percentage of mortality associated with episodes of colic, which may be due to several factors, such as lack of follow-up of cases, inadequate fluid therapy to resolve dehydration or failure of the hydrolytic balance, and late perception of colic signs by the owners. In this sequence, the relevance of improving the follow-up by veterinarians in collaboration with owners arises (Worku et al., 2017).
Colic in horses is characterized by a multifactorial and complex digestive disorder that manifests itself through acute abdominal pain and does not translate into disease (Worku et al., 2017). It is considered an urgency of clinical practice, since it is the cause of high rates of morbidity and mortality in horses (Curtis et al., 2015). Equines are more prone to colic than other species due to certain anatomical characteristics of the species: the muscular tunica that functions as a sphincter between the esophagus and cardia and prevents vomiting; the long mesentery of the small intestine; the cecum finishes in a blind sack; the free ascending cólon in the abdomen; the diameter decrease in the pelvic flexure (Blikslager et al., 2017). Many cases of colic can be solved spontaneously or through a response to medical treatment, however, there is a percentage of cases requiring surgical intervention (Curtis et al., 2015). In addition, some gastrointestinal lesions from this syndrome can lead to a rapid physical deterioration of the animal and may even be fatal. In these cases, rapid recognition of clinical signs by the owners and subsequent outpatient veterinarian assistance is essential for a good diagnosis (Scantlebury et al., 2014). In a first approach to colic, the first step is to realize if we are dealing with a critical case or not (Taylor et al., 2010). Thus, it is essential to take into account the intensity of the signs of pain, considering that an animal in colic will be restless, constantly lying down and rising, rolling on the floor, sweating, neighing, looking at the flank, kick the abdomen and in extreme cases throw themselves to the ground, taking into account that in general these signs are accompanied by anorexia and depression (Smith, 2015). Diagnosis is usually performed through a procedure that follows several steps, such as an initial anamnesis, complete physical examination, rectal palpation, nasogastric intubation, echography, and sometimes blood collection and abdominocentesis. Nasogastric intubation also allows the treatment to be performed in some cases, such as sand impaction (Curtis et al., 2015). The medical treatment of colic consists of acting in the relief of pain through aines, opioids, sedatives; of fluid therapy; use of laxatives such as psyllium, mineral oil, magnesium sulfate or combinations thereof and anthelmintics if parasitism is suspected (Curtis et al., 2015). There is still a large percentage of mortality associated with episodes of colic, which may be due to several factors, such as lack of follow-up of cases, inadequate fluid therapy to resolve dehydration or failure of the hydrolytic balance, and late perception of colic signs by the owners. In this sequence, the relevance of improving the follow-up by veterinarians in collaboration with owners arises (Worku et al., 2017).
Description
Keywords
Cólica Tratamento médico Equinos Gastrointestinal Diagnóstico Colic Medical treatment Equines Gastrointestinal Diagnosis