Acumputura e moxabustão no tratamento complementar da doença renal crônica em canino: relato de caso

Abstract

The kidneys are essential organs for maintaining the body's homeostasis, with the nephron being the functional unit responsible for the formation of urine and secretion of substances such as erythropoietin. The presence of persistent kidney damage for a minimum period of three months characterizes chronic kidney disease (CKD) and impairs kidney function. Although often considered a disease of older animals, CKD occurs in dogs and cats of all ages, with leishmaniasis being one of the main infectious diseases that contribute to the occurrence of glomerular disease in dogs. Because it is a chronic condition with no possibility of cure, the treatment of CKD has limitations and aims to slow the progression of the disease, improve clinical signs and the patient's quality of life. Acupuncture and moxibustion are Traditional Chinese Medicine (TCM) techniques that stimulate specific points of the body (acupoints), respectively, through the insertion of needles or the heat generated by burning dried Artemisia leaves. Stimulation of specific acupoints related to the renal system can help minimize the effects of dysfunctions caused by CKD, promoting an improvement in the functional conditions of the organism. Based on this, the objective of this study was to report the case of a female dog, mixed breed, with beige fur, approximately 5 years old, weighing 11.1 kg and with a score of 2/5, treated at the Veterinary Hospital of the Federal University of Paraíba (HV-UFPB), with a positive test for leishmaniasis. At the first appointment, a complete blood count indicated mild anemia; biochemical tests showed azotemia and hypoalbuminemia; and abdominal ultrasound showed infectious splenomegaly and signs of chronic nephropathy, suggesting CKD. Based on other complementary tests, the diagnosis of CKD and leishmaniasis were confirmed, with a reserved prognosis, and home treatment was initiated. The patient underwent periodic monitoring, however, over time she presented significant clinical variations, including laboratory alterations such as non-regenerative anemia, azotemia, hyperphosphatemia, hypoproteinemia, hypoalbuminemia, and persistent proteinuria; imaging alterations such as increased echogenicity of the renal cortex, loss of the corticomedullary relationship, and irregular renal capsule; in addition to clinical signs such as polyuria, polydipsia, vomiting, weight loss, ascites, and edema, despite the use of medications such as benazepril. Given the situation, after a renal crisis, the animal was referred to the acupuncture sector. There was a 14-day interval between the first and second acupuncture sessions, after which the sessions were weekly, with some exceptions. In total, 21 sessions were performed. During the sessions, the animal gained weight and improved proteinuria, reaching the borderline value and, consequently, normalization of serum albumin. It is concluded that the use of acupuncture and moxibustion were effective in the treatment of CKD, promoting the reduction of the urinary protein-creatinine ratio, reduction of hypoalbuminemia, weight gain and improvement of the patient's general clinical condition.