Nova abordagem clínico-laboratorial de efusões cavitárias caninas

Abstract

Cavitary effusion (CE) is defined as the accumulation of fluid within the peritoneal, pleural or pericardial cavities. They represent a frequent entity in the clinical routine of dogs with prognostic importance usually significant and several etiological associations. Currently, its classification is guided basically by the protein content (TP) and by the total nucleated cell count (TNCC) in the effusion, whereas in human medicine it is performed by means of biochemical parameters of analytical accuracy consistently proven. This study aimed to define a new general classification system for canine CE’s based on biochemical parameters, as well as to construct the epidemiological profile of these cases in a Brazilian socio-geographical context. A total of 433 (304 + 129) consecutive canine CE cases consulted at the Veterinary Hospital of the Federal University of Minas Gerais had their clinical, laboratory and imaging information retrospectively collected and submitted to statistical analysis, including a multiple logistic regression. 60.2% of the animals were females, 27.5% were large-sized, 10.6% were Poodle and 56% were elderly. Considering the underlying etiology, 52.9% of pleural effusions were associated with neoplastic process, 60.1% of peritoneal effusions with severe hypoproteinemia, hypoalbuminemia and/or hepatopathy and 81.8% of pericardial effusions were classified as exudates. The best classical classification range (TP ≥ 2.0 g/dL and TNCC > 5,000 cells/μL) showed an accuracy (73.6%) lower than biochemical parameters, such as ascitic cholesterol (COL-E > 41.2 mg/dL, 88.7%, n=106) and pleural albumin (ALB-E > 0.8 g/dL, 100%, n=112) for the identification of exudates. The best predictive model for any cavity involved the variables glucose, albumin and TNCC (n=66) and showed values of accuracy, sensitivity and specificity for the diagnosis of exudates equals to 94%, 96% and 90%, respectively. The general biochemical classification of canine CAs has a higher diagnostic value compared to the simple classic system and should be implemented in the diagnostic medical routine of canine patients.