Prevalência de infecção urinária em cães diagnosticados com hiperadrenocorticismo espontâneo

Abstract

Polyuria (PU), low urinary specific gravity and the anti-inflammatory effect caused by the high plasma concentration of glucocorticoids, characteristic of hyperadrenocorticism (HAC), can make it difficult to identify bacteria in the urine and mask clinical manifestations of lower urinary tract infection (ITUI). Thus, it was hypothesized that the use of the ITUI classification proposed by the International Society for Companion Animal Infectious Diseases (ISCAID, 2019) would limit the diagnosis of cystitis in dogs with hyperadrenocorticism. This project aims to verify the prevalence of clinical or subclinical urinary infection in dogs with hyperadrenocorticism belonging to the series of the Endocrinology Service of the Veterinary Hospital of the Federal University of Uberlândia between 2017 and 2020, through the collection of information from medical records of 40 dogs with CAH and creating scenarios for a better analysis of the situation of this group. Considering a screening for ITUI similar to the one proposed by ISCAID (scenario 4), 4% of the animals would be investigated for cystitis and 51% of them would have subclinical bacteriuria. In a screening considering the hypothesis tested in its entirety (scenario 1), 36% of patients would be candidates for bacterial cystitis and 51% would still have subclinical bacteriuria. When PU is no longer included as a potential disturbing sign for the identification of other signs compatible with ITUI considered by ISCAID (scenario 2), dogs with subclinical bacteriuria potential become 85%, leaving only 2% candidates for cystitis. Considering also that the sedimentoscopic visualization of bacteria may be impaired by urinary dilution, when isolated leukocyturia/hematuria (without bacteriuria) were considered as potential indicators of ITUI (scenario 5), 9% of hypercortisolemic canines would be potentially investigated for ITUI (exams of urinary image, culture and antibiogram, etc.) and another 22% would be suspected of subclinical ITU. Therefore, following the ISCAID classification, possibly a considerable number of hypercortisolemic dogs may be underdiagnosed for the presence of ITUI. Given these scenarios, it is concluded that future investigations into the applicability of this classification for this group are necessary, and until then, it is suggested that a less restricted screening method for suspected ITUI, which takes into account that UP may be masking the usual clinical signs of ITUI and that hematuria/leukocyturia are potential indicators of the presence of bacteriuria should still be considered for these patients.