Perineal Hernia in Dogs

Background: Perineal hernia is a serious disease characterized by weakening or atrophy and separation of the muscles and fasciae of the perineal musculature, followed by the caudal displacement of pelvic and abdominal organs to the perineum region. Treatment is invariably surgical and several approaches have been proposed, but complication and recurrence rates remain high. This study aimed to evaluate 120 cases of perineal hernia treated at the Veterinary Hospital of Uberaba (HVU) from 2005 to 2020, addressing the clinical and surgical aspects and the postoperative period, seeking to identify the most relevant factors to improve care and treatment of future patients affected by this disease.Materials, Methods & Results: The medical records of dogs with a definitive diagnosis of perineal hernia were collected. The prevalence of perineal hernia was calculated. Data were obtained regarding sex, being castrated or not, age, body mass, race, clinical signs, affected side, possibility of hernia reduction, treatments used, associated pathologies. Of the 120 cases, only 69 underwent surgery at the HVU and from these cases data were obtained regarding hernia content, surgical techniques, surgical wires used, recurrences and postoperative complications. Fisher's exact test was applied to assess the influence of the type of surgical treatment and surgical thread on the occurrence of complications and recurrences. Perineal hernia was the second most frequently observed hernia. Mixed breed, male, non-neutered and geriatric dogs were the most affected. The most frequently observed clinical signs were related to the digestive and urinary tract, consistent with the most commonly found hernia contents (bladder, prostate and rectum). The simple herniorrhaphy technique was the most used and showed a high number of complications. The second most used technique was the elevation of the internal shutter, which proved to be more efficient than the simple technique. Regardless of the technique used, the association of two or more techniques proved to be more efficient to reduce major complications. The use of the vaginal tunic stood out because it proved to be efficient in the treatment of perineal hernias regardless of whether it is associated with simple herniorrhaphy or obturator elevation. The surgical fixations of abdominal organs (Bladder, Ducto deferente and Colon) proved to be effective, since there were no recurrences or major complications associated with their use and the most used threads for herniorrhaphy were polyamide and catgut. Low recurrence rates were found in patients who received synthetic yarns. The most frequent complications were suture dehiscence and serous secretion.Discussion: Perineal hernia is a very important alteration due to difficulties in treatment, high rates of complications and recurrence, in addition to the large number of affected dogs. Several surgical techniques have already been proposed for the treatment of perineal hernia in dogs and are based on the reconstruction of the perineal musculature through sutures, muscle flaps, biological membranes, synthetic mesh and the reduction of pressure on the perineum through the surgical fixation of organs abdominals such as colon, vas deferens and bladder (in the musculature of the abdominal wall). It is concluded that the perineal hernia affects mainly male, non-neutered and geriatric dogs, being rare in females. Regardless of the techniques used, the association of two or more techniques is more efficient to reduce the rate of recurrences and complications. The autogenous vaginal tunic is a good option for muscle strengthening in perineal herniorraphies. The use of synthetic surgical wires leads to better results in the treatment of perineal hernia when compared to biological wires

Autogenous Osteochondral Graft Associated with IGF-1 in Induced Articular Cartilage Lesion in Rabbits

Background: Articular cartilage has a limited capacity for regeneration and of the various treatments proposed, none have reached appropriate therapeutic effectiveness. This study aimed to evaluate autogenous osteochondral grafts in intact or macerated format, in association with or without insulin-like growth factor type-1 (IGF-1) in the repair of osteochondral defects induced in the femoral trochlear groove of rabbits.Materials, Methods & Results: Seventeen healthy White New Zealand rabbits were selected for this study. The rabbits were female, six months old, and had an average body weight of 4.5 kg. All 34 stifle joints were subjected to autogenous osteochondral grafting in the femoral trochlear groove. The joints were divided into four groups designated as intact osteochondral graft with IGF-1 (INT + IGF), intact osteochondral graft with physiological solution (INT + FIS), macerated osteochondral graft with IGF-1 (MAC + IGF), and macerated osteochondral graft with physiological solution (MAC + FIS). Serial evaluations were performed by orthopedic and radiographic examination. After 6 and 12 weeks postoperatively, the grafted area was subjected to macroscopic, histological, and immunohistochemical analyses. Although no statistically significant differences were found between the groups in relation to clinical, macroscopic, histological, and immunohistochemical aspects, a tendency of IGF-1 to promote tissue repair was evident. In the radiographic evaluation, the articular surface and the recipient site in both groups with IGF-1 showed significantly more effective filling (P ≤ 0.05). Regardless of the group, collagen type 2 production, as assessed by immunohistochemistry, was found to be appropriate on the grafted articular surface.Discussion: In extensive cartilage lesions, the use of intact osteochondral grafts may be infeasible due to donor site morbidity. An alternative is the use of macerated osteochondral grafts, which cover a larger area and act as a support and cellular source in the repair process. Growth factors have been evaluated in association with grafted tissues to aid tissue repair, and IGF-1 is currently prominent. In the radiographic analysis of the present study, when comparing sites subjected to osteochondral grafting, presence of the whole graft evidenced adequate local filling in all groups. However, graft integration was apparently rapid and effective in the INT + IGF and MAC + IGF groups from the sixth and ninth weeks of the procedure, respectively. In the macroscopic evaluation at the twelfth week, graft integration with the original cartilaginous tissue was more evident, especially in both groups treated with IGF-1. It is likely that the property of IGF-1 to increase chondrogenesis in the cartilage repair of articular lesions in vivo may have contributed to these results in radiographic and macroscopic examinations. Histological examination showed no significant difference between groups in the same period of time; however, it was observed that addition of IGF-1 promoted a more evident tissue reaction and cellular activation, potentiating the process of reabsorption and repair in the grafted tissue. Immunohistochemical analysis showed similar immunoreactivity for collagen type 2 in all groups as early as the sixth week. However, a small portion of these tissues cannot be considered true hyaline cartilage due to the absence of some typical features. In summary, addition of IGF-1 to the autogenous osteochondral graft seemed to stimulate reabsorption and replacement processes in the grafted tissue. The grafts showed adequate ability to repair articular cartilage, displaying formation of collagen type 2 similar to that in the original tissue

Autogenous Osteochondral Graft Associated with IGF-1 in Induced Articular Cartilage Lesion in Rabbits

Background: Articular cartilage has a limited capacity for regeneration and of the various treatments proposed, none have reached appropriate therapeutic effectiveness. This study aimed to evaluate autogenous osteochondral grafts in intact or macerated format, in association with or without insulin-like growth factor type-1 (IGF-1) in the repair of osteochondral defects induced in the femoral trochlear groove of rabbits.Materials, Methods & Results: Seventeen healthy White New Zealand rabbits were selected for this study. The rabbits were female, six months old, and had an average body weight of 4.5 kg. All 34 stifle joints were subjected to autogenous osteochondral grafting in the femoral trochlear groove. The joints were divided into four groups designated as intact osteochondral graft with IGF-1 (INT + IGF), intact osteochondral graft with physiological solution (INT + FIS), macerated osteochondral graft with IGF-1 (MAC + IGF), and macerated osteochondral graft with physiological solution (MAC + FIS). Serial evaluations were performed by orthopedic and radiographic examination. After 6 and 12 weeks postoperatively, the grafted area was subjected to macroscopic, histological, and immunohistochemical analyses. Although no statistically significant differences were found between the groups in relation to clinical, macroscopic, histological, and immunohistochemical aspects, a tendency of IGF-1 to promote tissue repair was evident. In the radiographic evaluation, the articular surface and the recipient site in both groups with IGF-1 showed significantly more effective filling (P ≤ 0.05). Regardless of the group, collagen type 2 production, as assessed by immunohistochemistry, was found to be appropriate on the grafted articular surface.Discussion: In extensive cartilage lesions, the use of intact osteochondral grafts may be infeasible due to donor site morbidity. An alternative is the use of macerated osteochondral grafts, which cover a larger area and act as a support and cellular source in the repair process. Growth factors have been evaluated in association with grafted tissues to aid tissue repair, and IGF-1 is currently prominent. In the radiographic analysis of the present study, when comparing sites subjected to osteochondral grafting, presence of the whole graft evidenced adequate local filling in all groups. However, graft integration was apparently rapid and effective in the INT + IGF and MAC + IGF groups from the sixth and ninth weeks of the procedure, respectively. In the macroscopic evaluation at the twelfth week, graft integration with the original cartilaginous tissue was more evident, especially in both groups treated with IGF-1. It is likely that the property of IGF-1 to increase chondrogenesis in the cartilage repair of articular lesions in vivo may have contributed to these results in radiographic and macroscopic examinations. Histological examination showed no significant difference between groups in the same period of time; however, it was observed that addition of IGF-1 promoted a more evident tissue reaction and cellular activation, potentiating the process of reabsorption and repair in the grafted tissue. Immunohistochemical analysis showed similar immunoreactivity for collagen type 2 in all groups as early as the sixth week. However, a small portion of these tissues cannot be considered true hyaline cartilage due to the absence of some typical features. In summary, addition of IGF-1 to the autogenous osteochondral graft seemed to stimulate reabsorption and replacement processes in the grafted tissue. The grafts showed adequate ability to repair articular cartilage, displaying formation of collagen type 2 similar to that in the original tissue

Sensibilidade do teste parasitológico em imprints de baço, medula óssea e linfonodo para o diagnóstico da leishmaniose de acordo com o número de avaliadores

A Leishmaniose Visceral é considerada pela Organização Mundial de Saúde uma das seis endemias prioritárias no mundo, sendo que os cães atuam como reservatórios naturais do parasito. O diagnóstico da enfermidade nos cães é discutido e o propósito do presente trabalho foi de verificar o método parasitológico como meio de diagnóstico da Leishmaniose Visceral Canina utilizando amostras de baço, medula óssea e linfonodo, além de correlacionar com a sintomatologia clínica dos animais e analisar a sensibilidade do diagnóstico parasitológico realizado por um e dois observadores. Foram utilizados 59 cães obtidos pelo Centro de Controle de Zoonoses de Uberlândia - MG. Os animais foram examinados clinicamente antes da eutanásia e classificados em assintomáticos (grupo 1) (n=6), oligossintomáticos (grupo 2) (n=34) e sintomáticos (grupo 3) (n=19). Trinta e três (55,93%) animais foram positivos e destes 20 (60,60%) pertenciam ao grupo 2, 11 (33,33%) ao grupo 3 e 2 (6,06%) ao grupo 1. Em relação aos locais de coleta analisados obteve-se 73 (41,24%) amostras positivas, sendo 28 (38,35%) de medula óssea, 25 (34,24%) de baço e 20 (27,39%) de linfonodo. Quando a leitura foi realizada por um observador obteve-se 13 (22,03%) animais positivos, e com dois observadores este número foi de 33 (55,93%), sendo este aumento na sensibilidade significativo estatisticamente. Não houve diferença estatística entre o número de animais distribuídos entre os grupos com sintomatologia clínica e tampouco quanto ao local puncionado. Recomenda-se a leitura realizada por dois observadores para aumento na sensibilidade do teste parasitológic