{"id":6195,"date":"2023-07-03T16:15:42","date_gmt":"2023-07-03T19:15:42","guid":{"rendered":"https:\/\/www.ufrgs.br\/lacvet\/?p=6195"},"modified":"2023-11-01T11:16:52","modified_gmt":"2023-11-01T14:16:52","slug":"caso-clinico-176y2","status":"publish","type":"post","link":"https:\/\/www.ufrgs.br\/lacvet\/cc_interativos\/caso-clinico-176y2\/","title":{"rendered":"Caso Cl\u00ednico 176Y2"},"content":{"rendered":"
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Identifica\u00e7\u00e3o<\/strong><\/p>\n\t\t\t

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Esp\u00e9cie: Ovina
Ra\u00e7a: Hampshire Down
Idade: 1 ano
Sexo: Macho
Peso: 105 kg<\/p>\n\n<\/div>\n\t\t<\/div>\n\n

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Anamnese<\/strong><\/p>\n\t\t\t

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No dia 0 o propriet\u00e1rio relatou que o animal foi comprado h\u00e1 15 dias, at\u00e9 ent\u00e3o recebia 4 kg\/dia de ra\u00e7\u00e3o e alfafa. Ap\u00f3s, a quantidade de ra\u00e7\u00e3o foi diminu\u00edda para 1 kg\/dia. O propriet\u00e1rio administrou antimicrobiano, analg\u00e9sico, soro caseiro e suplemento vitam\u00ednico em casa. Foi relatado que o carneiro estava ap\u00e1tico, prostrado e com perda de apetite, apresentando diarreia e urina de colora\u00e7\u00e3o escura. A ingest\u00e3o de \u00e1gua estava normal.<\/p>\n\n<\/div>\n\t\t<\/div>\n\n

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Exame f\u00edsico<\/strong><\/p>\n\t\t\t

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Frequ\u00eancia card\u00edaca: 124 bpm\u2191<\/mark><\/strong><\/mark> (ref.: 70-80)
Frequ\u00eancia respirat\u00f3ria: 32 mpm\u2191<\/mark><\/strong><\/mark> (ref.: 12-20)
Temperatura retal: 39,8 \u00b0C (ref.: 38,5-40,0)
Mucosa ocular hipocorada.<\/p>\n\n<\/div>\n\t\t<\/div>\n\n

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Tratamento e evolu\u00e7\u00e3o<\/strong><\/p>\n\t\t\t

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Dia 17: o animal n\u00e3o estava se alimentando. Foi administrado glicopan e hemolitan (suplementos vitam\u00ednicos). Tamb\u00e9m administrados ibatrim (antimicrobiano) e levamisol (anti-helm\u00edntico), em doses \u00fanicas. Realizada fluidoterapia para aux\u00edlio na fun\u00e7\u00e3o renal.<\/p>\n\n\n\n

Dia 18: mantida a mesma terapia medicamentosa. Realizada prova de compatibilidade para verificar se era vi\u00e1vel a transfus\u00e3o sangu\u00ednea, com objetivo de solucionar o quadro an\u00eamico do paciente. Verifica a incompatibilidade, n\u00e3o foi realizada a transfus\u00e3o.<\/p>\n\n\n\n

Dia 19 ao dia 24: O animal come\u00e7ou a se alimentar, por\u00e9m apresentou fezes pastosas. Permaneceu com glicopan, hemolitan e fluidoterapia.<\/p>\n\n\n\n

Dia 25: fezes com consist\u00eancia normal, o carneiro segue se alimentando. Mantido hemolitan e fluidoterapia.<\/p>\n\n\n\n

Dia 29 ao dia 32: mantida a fluidoterapia, mas interrompida a medica\u00e7\u00e3o restante. Paciente estava se alimentando.<\/p>\n\n\n\n

Dia 33: o carneiro recebeu alta.<\/p>\n\n<\/div>\n\t\t<\/div>\n\n

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Hemograma<\/strong><\/p>\n\t\t\t

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Eritrograma<\/strong><\/td>Dia 1<\/strong><\/strong><\/td><\/tr>
Eritr\u00f3citos (9-15 milh\u00f5es\/\u00b5L)<\/td>4,85\u2193<\/mark><\/strong><\/mark><\/strong><\/mark><\/td><\/tr>
Hemat\u00f3crito (27-45%)<\/td>19\u2193<\/mark><\/strong><\/mark><\/td><\/tr>
Hemoglobina (9-15 g\/dL)<\/td>7,2\u2193<\/mark><\/strong><\/mark><\/td><\/tr>
VCM (28-40 fL)<\/td>39<\/td><\/tr>
CHCM (31-34%)<\/td>38\u2191<\/mark><\/td><\/tr>
Plaquetas<\/strong><\/td>\u00a0<\/td><\/tr>
Quantidade (250-750 \u00d7103<\/sup>\/\u00b5L)<\/td>n.d.*<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Observa\u00e7\u00f5es: *agrega\u00e7\u00e3o plaquet\u00e1ria<\/p>\n\n\n\n

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Leucograma<\/strong><\/td>Dia 1<\/strong><\/td><\/tr>
Leuc\u00f3citos totais (4.000-12.000\/\u00b5L)<\/td>10.447<\/td><\/tr>
Miel\u00f3citos (0\/\u00b5L)<\/td>0<\/td><\/tr>
Metamiel\u00f3citos (0\/\u00b5L)<\/td>0<\/td><\/tr>
Neutr. bast. (0\/\u00b5L)<\/td>0<\/td><\/tr>
Neutr. seg. (699-6.000\/\u00b5L)<\/td>3.865<\/td><\/tr>
Bas\u00f3filos (<300\/\u00b5L)<\/td>0<\/td><\/tr>
Eosin\u00f3filos (<1.000\/\u00b5L)<\/td>209<\/td><\/tr>
Mon\u00f3citos (<750\/\u00b5L)<\/td>0<\/td><\/tr>
Linf\u00f3citos (2.000-9.000\/\u00b5L)<\/td>6.373<\/td><\/tr><\/tbody><\/table><\/figure>\n\n<\/div>\n\t\t<\/div>\n\n
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Bioqu\u00edmica sangu\u00ednea<\/strong><\/p>\n\t\t\t

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<\/td>Dia 1<\/strong><\/strong><\/td>Dia 2<\/strong><\/td>Dia 15<\/strong><\/td>Dia 17<\/strong><\/strong><\/td>Dia 25<\/strong><\/strong><\/td>Dia 29<\/strong><\/strong><\/td>Dia 32<\/strong><\/strong><\/td><\/tr>
Amostra<\/td>plasma<\/td>plasma<\/td>plasma<\/td>plasma<\/td>plasma<\/td>plasma<\/td>plasma<\/td><\/tr>
Hem\u00f3lise<\/td>ausente<\/td>ausente<\/td>ausente<\/td>ausente<\/td>ausente<\/td>ausente<\/td>ausente<\/td><\/tr>
AnticoagulanteA<\/sup><\/td>heparina<\/td>heparina<\/td>heparina<\/td>heparina<\/td>heparina<\/td>heparina<\/td>heparina<\/td><\/tr>
Albumina (26-42 g\/L)<\/td>33<\/td>n.d.<\/td>n.d.<\/td>n.d.<\/td>n.d.<\/td>n.d.<\/td>36<\/td><\/tr>
Fibrinog\u00eanio (1-5 g\/L)<\/td>6\u2191<\/mark><\/mark><\/td>n.d.<\/td>2<\/td>n.d.<\/td>n.d.<\/td>n.d.<\/td>n.d.<\/td><\/tr>
Ureia (17-43 mg\/dL)<\/td>329\u2191<\/mark><\/mark><\/td>429\u2191<\/mark><\/strong><\/mark><\/td>533\u2191<\/mark><\/td>543\u2191<\/mark><\/td>196\u2191<\/mark><\/td>174\u2191<\/mark><\/td>173\u2191<\/mark><\/td><\/tr>
Creatinina (1,2-1,9 mg\/dL)<\/td>6,7\u2191<\/mark><\/td>7,9\u2191<\/mark><\/td>14,5\u2191<\/mark><\/td>13,7\u2191<\/mark><\/td>3,4\u2191<\/mark><\/td>4,1\u2191<\/mark><\/td>3,3\u2191<\/mark><\/td><\/tr>
AST (<280 U\/L)<\/td>1.260\u2191<\/mark><\/td>1.392\u2191<\/mark><\/td>n.d.<\/td>161<\/td>n.d.<\/td>n.d.<\/td>222<\/td><\/tr>
CK (<40 U\/L)<\/td>3.018\u2191<\/mark><\/td>2.341\u2191<\/mark><\/td>n.d.<\/td>104\u2191<\/mark><\/td>n.d.<\/td>n.d.<\/td>313\u2191<\/mark><\/td><\/tr><\/tbody><\/table><\/figure>\n\n<\/div>\n\t\t<\/div>\n\n
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Urin\u00e1lise<\/strong><\/p>\n\t\t\t

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<\/td>Dia 1<\/strong><\/strong><\/td><\/tr>
M\u00e9todo de coletaA<\/sup><\/td>mic<\/td><\/tr>
Sedimento urin\u00e1rioB<\/sup><\/strong><\/td>\u00a0<\/td><\/tr>
C\u00e9lulas epiteliais<\/td>transi\u00e7\u00e3o (aglomerados)\u2191<\/mark><\/td><\/tr>
Cilindros<\/td>ausente<\/td><\/tr>
Hem\u00e1cias<\/td>5<\/td><\/tr>
Leuc\u00f3citos<\/td>5<\/td><\/tr>
Bacteri\u00faria<\/td>leve\u2191<\/mark><\/td><\/tr>
Outros<\/td>\u00a0<\/td><\/tr>
Exame qu\u00edmico<\/strong><\/td>\u00a0<\/td><\/tr>
pH (7,0-8,0)<\/td>8,0<\/td><\/tr>
Corpos cet\u00f4nicosC<\/sup><\/td>ausente<\/td><\/tr>
GlicoseD<\/sup><\/td>ausente<\/td><\/tr>
BilirrubinaE<\/sup><\/td>ausente<\/td><\/tr>
Urobilinog\u00eanio (<1 mg\/dL)<\/td>\u22480,2 mg\/dL<\/td><\/tr>
Prote\u00ednaF<\/sup><\/td>+\u2191<\/mark><\/td><\/tr>
SangueG<\/sup><\/td>+++\u2191<\/mark><\/td><\/tr>
RPCUH<\/sup><\/td>n.d.<\/td><\/tr>
Exame f\u00edsico<\/strong><\/td>\u00a0<\/td><\/tr>
Dens. espec. (1,015-1,045)<\/td>1,012\u2193<\/mark><\/td><\/tr>
Cor<\/td>marrom\u2191<\/mark><\/td><\/tr>
Consist\u00eancia<\/td>fluida<\/td><\/tr>
Aspecto<\/td>turvo\u2191<\/mark><\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

A<\/sup>mic, mic\u00e7\u00e3o natural \u25cf cat, cateteriza\u00e7\u00e3o \u25cf cist, cistocentese \u25cf out, outros (especificar em \u201cObserva\u00e7\u00f5es\u201d)
B<\/sup>N\u00famero m\u00e9dio de elementos por campo de 400 x
C<\/sup>tra\u00e7os, \u22485 mg\/dL \u25cf +, \u224815 mg\/dL \u25cf ++, \u224840 mg\/dL \u25cf +++, \u224880 md\/dL \u25cf ++++, \u2265160 mg\/dL
D<\/sup>tra\u00e7os, \u2248100 mg\/dL \u25cf +, \u2248250 mg\/dL \u25cf ++, \u2248500 mg\/dL \u25cf +++, \u22481000 mg\/dL \u25cf ++++, \u22652000 mg\/dL
E<\/sup>+, leve \u25cf ++, moderada \u25cf +++, alta
F<\/sup>+, \u224830 mg\/dL \u25cf ++, \u2248100 mg\/dL \u25cf +++, \u2248300 mg\/dL \u25cf ++++, \u22652000 mg\/dL
G<\/sup>nh, n\u00e3o hemolisado \u25cf h, hemolisado \u25cf +, leve \u25cf ++, moderada \u25cf +++, alto
H<\/sup>RPCU, rela\u00e7\u00e3o prote\u00edna\/creatinina urin\u00e1ria (na aus\u00eancia de sedimento ativo)
– Caninos: <0,2, n\u00e3o protein\u00farico \u25cf 0,2 a 0,5, protein\u00faria lim\u00edtrofe \u25cf >0,5, protein\u00farico
– Felinos: <0,2, n\u00e3o protein\u00farico \u25cf 0,2 a 0,4, protein\u00faria lim\u00edtrofe \u25cf >0,4, protein\u00farico
– Equinos: <0,93, n\u00e3o protein\u00farico
n.d.: n\u00e3o determinado<\/p>\n\n<\/div>\n\t\t<\/div>\n\n

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Discuss\u00e3o e refer\u00eancias bibliogr\u00e1ficas<\/strong><\/p>\n\t\t\t

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Em breve.<\/p>\n\n<\/div>\n\t\t<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53],"tags":[134,94,151,153,192,84,154,122,177,178,106,181,57,186,184],"class_list":["post-6195","post","type-post","status-publish","format-standard","hentry","category-cc_interativos","tag-anemia","tag-apatia","tag-ast","tag-ck","tag-creatinina","tag-diarreia","tag-fibrinogenio","tag-fluidoterapia","tag-hematuria","tag-hemoglobinuria","tag-hiporexia","tag-isostenuria","tag-ovina","tag-proteinuria","tag-ureia"],"featured_image_src":"","author_info":{"display_name":"SCS","author_link":"https:\/\/www.ufrgs.br\/lacvet\/author\/ceroni\/"},"featured_image_src_square":false,"rbea_author_info":{"display_name":"SCS","author_link":"https:\/\/www.ufrgs.br\/lacvet\/author\/ceroni\/"},"rbea_excerpt_info":null,"category_list":"Casos Cl\u00ednicos Interativos<\/a>","comments_num":"0 comments","_links":{"self":[{"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/posts\/6195","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/comments?post=6195"}],"version-history":[{"count":37,"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/posts\/6195\/revisions"}],"predecessor-version":[{"id":7566,"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/posts\/6195\/revisions\/7566"}],"wp:attachment":[{"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/media?parent=6195"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/categories?post=6195"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ufrgs.br\/lacvet\/wp-json\/wp\/v2\/tags?post=6195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}