Síndrome de colapso traqueal en el perrofactores predisponentes, parámetros clínicos y respuesta a la terapia inhalada

Abstract

The tracheal collapse (TC) is one of the causes of partial obstruction of the airways more frequent in toy dog breeds. The thoracic radiography is one of the most used proves for staging diagnosis and during various decades its treatment and control has been based on the severity of the clinical signs by means of administration of antitussive drugs, bronchodilators and corticosteroids. At present, there are no prospective studies about the correlation between clinical parameters and radiographic signs, so its relevance in appearance and severity of the clinical chart has been poorly studied. On the other hand, in the existing publications about treatment with inhaled corticosteroids (CI), protocols have not been established, nor does there exist consensus about its use on small animals; as opposed to human medicine where it is the chosen therapeutic method for this type of conditions. The present thesis has been based on achieving two fundamental objectives: a) Correlate clinical and radiographic signs in dogs with tracheal collapse, b) Evaluate efficiency, tolerance and possible adverse effects of fluticasone versus prednisone, by means of a clinical protocol based on a scale of clinical grading, to quantify the clinical signs of dogs with tracheal collapse. For this, we have completed a thorough bibliographic review, analysing and comparing previous studies about the actual techniques and treatments for the CT. On the other hand, we have been able to complete an average length protocol that allows us to evaluate the effects of fluticasone in dogs with TC to detect the possible adverse effects. Once the registers were obtained we proceeded to a statistical study of the data. 165 adult dogs of different sex and different weight from the veterinary clinic 7 Vidas of Alicante and the Veterinary Hospital of Murcia University have been included in the study. Of all the dogs included, 128 dogs were diagnosed radiographically with TC and 57 of them were treated to alleviate the symptoms. While correlating the direct radiographic measurements of the results obtained and their vertebral indices with clinical signs, we saw that there was only negative correlation, between episodes of dyspnoea with the TR-MIN (minimum tracheal diameter)(p=0.010) the same as its index (p=0.018). A negative correlation was also found between a coughing episode with a TR-MIN, TR-TORAX (tracheal diameter of the chest entrance) and their indices. With respect to the tracheal sensibility, we saw that there was a negative correlation with the TR-LAR (tracheal diameter entrance of the larynx), but not with its index, nor with the rest of the clinical signs. While comparing inhaled therapy (TI)(n=39) versus oral therapy (TO)(n=18), higher values in activity in dogs treated with TI were obtained. On the other hand, DS wasn't found while comparing both therapies among: dyspnoea, type of cough, tracheal sensibility and exercise tolerance. As to thirst, it increased in 89,9% of the dogs with TO and 87,5% of them increased their diuresis with TO, versus a 12,5% of the ones treated with TI. And this way, we conclude that the method established by means of radiographic examination together with the clinical grading scale created by our study, allows us the register accurately the quantitative data, being able to establish as clinical protocol in TC and being useful for the further treatment decision. On the other hand, the results of this study show the fluticasone efficiency versus prednisone to control the inflammation of the airways in dogs with TC as well as the decrease of systemic side effects like polyuria/polydipsia.