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Hipoadrenocorticismo atípico canino
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Abstract(s)
O Hipoadrenocorticismo (HpoAC), ou Doença de Addison (DA) é uma das principais
doenças endócrina de cães. Resulta da incapacidade das glândulas adrenais em produzir
quantidades adequadas de hormonas (mineralocorticoides e/ou glucocorticoides) vitais para a
sobrevivência.
O Hipoadrenocorticismo primário canino é a forma mais comum e decorre da falha ou
incapacidade da glândula adrenal em secretar hormonas esteroides. Em cerca de 95% dos
casos, os animais apresentam simultaneamente défice de glucocorticoides, principalmente
cortisol, e de mineralocorticoides, nomeadamente aldosterona. É considerado o “grande imitador
da medicina interna”, devido à vasta variedade de sinais clínicos não específicos que os animais
podem apresentar e que podem estar associados a outras doenças, tornando o seu diagnóstico
um verdadeiro desafio.
As principias alterações eletrolícas são azotémia, acidose metabólica, hipocloremia,
hipercalemia e hiponatremia. No entanto, em casos mais raros, cerca de 5% a 10% dos cães
com Hipoadrenocorticismo primário não apresentam alterações eletrolíticas, mesmo com a
diminuição ou ausência de síntese de mineralocorticoides.
O diagnóstico presuntivo de hipoadrenocorticismo é realizado com base na história
clínica, nos sinais clínicos e na identificação de anomalias eletrolíticas. Outros meios de
diagnóstico complementares, tais como, a medição da pressão arterial, eletrocardiograma,
ultrassonografia e radiografias são utilizados, no entanto, esta patologia apenas é confirmada
pela realização de um teste endócrino específico, o teste de estimulação com ACTH.
O tipo de tratamento realizado depende do estado clínico do animal e da natureza da
insuficiência, ou seja, glucocorticoide, mineralocorticoide ou ambos. Muitos animais com
insuficiência adrenal primária são apresentados em diferentes fases de uma crise Addisoniana
aguda, exigindo terapia imediata agressiva. Ainda assim, mesmo que o animal apresente um
estado menos crítico necessita igualmente de terapia de suporte.
Hypoadrenocorticism (HpoAC), or Addison's Disease (AD) is a major endocrine disease of dogs. It results from the inability of the adrenal glands to produce adequate amounts of hormones (mineralocorticoids and/or glucocorticoids) vital for survival. Primary canine hypoadrenocorticism is the most common form and results from the failure or inability of the adrenal gland to secrete steroid hormones. Around 95% of the cases, animals have a simultaneous lack of glucocorticoids, mainly cortisol, and mineralocorticoids, specially aldosterone. It´s known as the "great pretender of internal medicine", due to the wide variety of non-specific clinical signs that animals may present and that may be associated to other diseases, making diagnosis a real challenge. The main electrolyte changes are azotemia, metabolic acidosis, hypochloremia, hyperkalemia, and hyponatremia. However, about 5% to 10% of dogs with primary hypoadrenocorticism have no electrolyte changes, even with decreased or the lack of mineralocorticoid synthesis. The primal diagnosis of hypoadrenocorticism is based on the clinical history, clinical signs, and identification of electrolyte abnormalities. Other complementary diagnostic, such as blood pressure, electrocardiogram, ultrasonography and radiographs are also used. However, this pathology is just confirmed by a specific endocrine test, the ACTH test. The treatment depends on the clinical conditional of the animal and the type of the insufficiency, that can be glucocorticoid, mineralocorticoid, or both. Many animals with primary adrenal insufficiency are in different stages of an acute Addisonian crisis, requiring immediately aggressive therapy. Although the animal can be in a less critical condition state he needs a supportive therapy.
Hypoadrenocorticism (HpoAC), or Addison's Disease (AD) is a major endocrine disease of dogs. It results from the inability of the adrenal glands to produce adequate amounts of hormones (mineralocorticoids and/or glucocorticoids) vital for survival. Primary canine hypoadrenocorticism is the most common form and results from the failure or inability of the adrenal gland to secrete steroid hormones. Around 95% of the cases, animals have a simultaneous lack of glucocorticoids, mainly cortisol, and mineralocorticoids, specially aldosterone. It´s known as the "great pretender of internal medicine", due to the wide variety of non-specific clinical signs that animals may present and that may be associated to other diseases, making diagnosis a real challenge. The main electrolyte changes are azotemia, metabolic acidosis, hypochloremia, hyperkalemia, and hyponatremia. However, about 5% to 10% of dogs with primary hypoadrenocorticism have no electrolyte changes, even with decreased or the lack of mineralocorticoid synthesis. The primal diagnosis of hypoadrenocorticism is based on the clinical history, clinical signs, and identification of electrolyte abnormalities. Other complementary diagnostic, such as blood pressure, electrocardiogram, ultrasonography and radiographs are also used. However, this pathology is just confirmed by a specific endocrine test, the ACTH test. The treatment depends on the clinical conditional of the animal and the type of the insufficiency, that can be glucocorticoid, mineralocorticoid, or both. Many animals with primary adrenal insufficiency are in different stages of an acute Addisonian crisis, requiring immediately aggressive therapy. Although the animal can be in a less critical condition state he needs a supportive therapy.
Description
Keywords
Cão Hipoadrenocorticismo canino Atípico Addison Glândula adrenal Glucocorticoides Mineralocorticoides Dog Canine Hypoadrenocorticism Atypical Addison's Adrenal Gland Glucocorticoids Mineralocorticoids;