Avaliação renal de cães naturalmente infectados por Leishmania sp. e tratados com miltefosina: aspectos ultrassonográficos Modo B e Doppler

Abstract

Canine visceral leishmaniasis (CVL) is a disease that affects dogs, with a wide range of clinical signs and various alterations in the abdominal organs, with the kidneys being the most affected. In order to properly stage the disease and make the best therapeutic choice, renal assessment should be carried out using ultrasound, biochemical tests and blood pressure profiles. The aim of this study was to compare renal aspects using B-mode ultrasound and vascular Doppler, biochemical tests, urinalysis and blood pressure in Leishmania sp. positive dogs treated with miltefosine at different stages of treatment. To this end, 38 dogs over the age of one year were used, distributed as follows: 12 healthy dogs (G1), 26 dogs naturally infected with Leishmania sp., of which 12 were positive and not treated with miltefosine (G2) and 14 were treated with miltefosine (G3). Evaluations were carried out twice, 30 days apart, where a complete blood count, urea (U) and creatinine (C) levels were taken. Urine was collected by cystocentesis for urinalysis and urinary protein/creatinine ratio (UPCR). Blood pressure was measured using vascular Doppler. The Doppler resistivity index (RI) of the renal arteries was obtained at the same time as the B- mode ultrasound assessments. After the laboratory tests, serum U levels were observed with an average value of 39.7 mg/dL, with no statistical difference between the groups. Serum C levels averaged 0.92 mg/dL, with a statistical difference between G1 and G2. The average blood pressure values were 118 to 144 mmg, with G2 having the lowest measurement (135 to 140 mmg) and a statistical difference between the other groups. After urinalysis, urine density ranged from 1024 to 1030, with no statistical difference between the groups. With the RPCU, values ranging from 0.3 to 2.2 were obtained, with the highest value in G3. In Doppler velocimetry, systolic velocity (SV) values ranged from 42.4 to 60.2 cm/s for the right kidney and 45.97 to 60.1 cm/s for the left. Diastolic velocity (DV) ranged from 14.5 to 21.3 in the right kidney and 15.8 to 19.8 in the left. Resistivity index (RI) measurements ranged from 0.66 to 0.68 for the right kidney and 0.65 to 0.68 for the left, with no statistical difference between the groups. Even with some ultrasound and hemodynamic changes, the urea and creatinine values were within the normal range for the species. The IR averages showed no difference between the treated and untreated animals. The positive animals not treated with miltefosine had higher blood pressure values than the negative and treated animals. The patients treated with miltefosine were proteinuric with reference values higher than normal.