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Púrpura hemorrágica em égua de criação: estudo de caso clínico
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Abstract(s)
Este caso clínico relata a história de uma égua reprodutora gestante que desenvolveu uma púrpura
hemorrágica após um surto de gurma na sua coudelaria. Esta doença é uma complicação
imunomediada que manifestou-se após o contacto com o Streptococcus equi subsp. equi na
coudelaria. A égua chegou num estado crítico, com dispneia inspiratória, taquicardia, edemas
massivos na face ventral do peito e do abdómen, e presença de petéquias nas mucosas. Após a
realização de um hemograma e de análises bioquímicas do sangue da égua foi elaborada uma lista
de diagnósticos diferenciais e o diagnóstico definitivo foi confirmado com o histórico de gurma que
houve na coudelaria. Para estabilização da égua foi realizada uma traqueostomia à égua. Foi
instituída uma antibioterapia como tratamento etiológico e de suporte face ao risco de
desenvolvimento de uma placentite. Foi necessária ainda uma corticoterapia a base de
dexametasona em doses imunossupressoras para promover a normalização da resposta imunitária
da égua. Foram acrescidos anti-inflamatórios não esteroides (flunixina meglumina e pentoxifilina)
para minimizar a reação inflamatória e trazer analgesia à égua. O tratamento de suporte consistiu em
fluidoterapia, hidroterapia e de marcha a passo. Como tratamento de prevenção do desenvolvimento
de placentite foi também instituída uma terapia à base de altrenogest.
This clinical case reports the story of a pregnant breeding mare who developed a purpura haemorrhagica after an outbreak of strangles in her breeding center. This disease is an immune mediated complication that manifested itself after contact with Streptococcus equi subsp. equi in the stables. The mare arrived in a critical state, with inspiratory dyspnea, tachycardia, massive edemas in the ventral part of the chest and abdomen, and presence of petechiae in the mucous membranes. After a blood count and biochemical analysis of the mare’s blood a list of differential diagnosis was prepared and the definitive diagnosis was confirmed with the history of strangles that occurred in the stables. To stabilize the mare a tracheotomy was performed to the mare. Antibiotic therapy was instituted as an etiological and supportive treatment for the risk of developing placentitis. It was also necessary to use a corticotherapy based on dexamethasone in immunosuppressive doses to promote the normalization of the mare’s immune response. Non-steroidal anti-inflammatories (flunixin meglumine and pentoxifylline) were added to minimize the inflammatory reaction and bring analgesia to the mare. The supportive treatment consisted of fluid therapy, hydrotherapy and march. As a treatment to prevent the development of placentitis, a therapy based on altrenogest was also instituted.
This clinical case reports the story of a pregnant breeding mare who developed a purpura haemorrhagica after an outbreak of strangles in her breeding center. This disease is an immune mediated complication that manifested itself after contact with Streptococcus equi subsp. equi in the stables. The mare arrived in a critical state, with inspiratory dyspnea, tachycardia, massive edemas in the ventral part of the chest and abdomen, and presence of petechiae in the mucous membranes. After a blood count and biochemical analysis of the mare’s blood a list of differential diagnosis was prepared and the definitive diagnosis was confirmed with the history of strangles that occurred in the stables. To stabilize the mare a tracheotomy was performed to the mare. Antibiotic therapy was instituted as an etiological and supportive treatment for the risk of developing placentitis. It was also necessary to use a corticotherapy based on dexamethasone in immunosuppressive doses to promote the normalization of the mare’s immune response. Non-steroidal anti-inflammatories (flunixin meglumine and pentoxifylline) were added to minimize the inflammatory reaction and bring analgesia to the mare. The supportive treatment consisted of fluid therapy, hydrotherapy and march. As a treatment to prevent the development of placentitis, a therapy based on altrenogest was also instituted.
Description
Keywords
Púrpura hemorrágica Gurma Streptococcus equi subsp. equi Gestação avançada Purpura haemorrhagica Strangles Streptococcus equi subsp. equi Advanced gestation.