Clinical, Laboratory and Ultrasonographic Findings of Diabetic Dog with Emphysematous Cystitis

Background: Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the accumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detection of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact.                                                                                       Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 hours with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocytosis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the presence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis.                                                                                                   Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog. Emphysematous cystitis is complicated, characterized by the presence of gas in the wall and lumen of the urinary bladder. It is usually reported in patients with diabetes mellitus. The patient presented with a very high glycemic index (376 mg/dL), in addition to having a history of urinary obstruction and presence of bladder stones, which may have acted as predisposing factors for the onset of emphysematous cystitis. In the present case, ultrasonography was the examination of choice. Hyperechoic reverberation-forming lines, identified as gas present in the topography of the urinary bladder, were easily visualized, as described in the literature. For the treatment of this condition, adequate management of the diet and the correct use of antimicrobials are of fundamental importance since the presence of diabetes mellitus in this patient can present serious complications in the future. This report shows the importance of the use of a combination of diagnostic tools to arrive at the correct diagnosis of the patient

Peritonite infecciosa felina- Relato de caso

Feline infectious peritonitis (FIP) is a serious polysystemic viral disease caused by feline infectious peritonitis virus (FIPV), a mutation of feline enteric coronavirus (FECV). Cats aged 3 months to 3 years are reported to be more frequently affected (70% of the animals with the disease presents the age of 1 year). However, the PIF can affect cats of all ages, including older animals. Males and cats of the Persian breeds, Bengals and Ragdols are more prone. It is an invariably fatal immune disease caused by feline infectious peritonitis virus (FIPV). The transmission occurs FECV by oro-faecal route through contact in such a cat with the feces of an infected cat, particularly by mutual us the litter. Although infrequent, can occur transmissão by licking and shared use of containers and drinking fountains. This study aims to report a case of wet FIP in feline patient, from its history to the outcome of your treatment.A peritonite infecciosa felina (PIF) é uma doença viral polissistêmica grave causada pelo vírus da peritonite infecciosa felina (VPIF), uma mutação do coronavirus entérico felino (CVEF). Gatos com idade entre 3 meses a 3 anos são relatados como sendo mais frequentemente acometidos (70% dos animais com a doença apresenta idade inferior a 1 ano). Contudo, a PIF pode acometer gatos de todas as idades, incluindo animais idosos. Machos e felinos das raças Persas, Bengals e Ragdols apresentam predisposição maior. Trata-se de uma doença imunomediada invariavelmente fatal causada pelo virus da peritonite infecciosa felina (VPIF). A transmissão do CVEF ocorre por via oro-fecal através do contato de um gato susceptível com as fezes de um gato infectado, principalmente por us mútuo da liteira. Apesar de infrequente, pode ocorrer transmissão por lambedura e uso compartilhado de vasilhas e bebedouros. Este trabalho tem como objetivo relatar um caso de PIF úmida em paciente felino, desde a sua anamnese até o resultado de seu tratamento.

ASPECTOS ULTRASSONOGRÁFICOS DE HIDRONEFROSE E HIDROURETER EM CADELA

Hydronephrosis is the dilation of the renal collecting system. Advent of ultrasonographic examination allows observe small dilatations in the structures, to carry out precise measurements and the monitoring of the evolution of the alterations. A schnauzer bitch was reffered to the imaging department of VETCLINIC Veterinary Hospital 24 hours. On the ultrasonographic examination, it was possible to visualize the right kidney had an unassembled cortical-medullary relationship, with only the renal capsule and hyperechogenic lines extending to the center (interdiverticular septa) and large. A tubular image located caudally to the right kidney was visualized. The patient was then submitted to exploratory laparotomy where it was possible to verify that the kidney was softened, enlarged, and dilated ureter. Total nephrectomy of the organ was then chosen, where it was then evaluated and incised in a sagittal section, where it was possible to observe a large renal pelvis dilatation and renal tissue atrophy.Hidronefrose é a dilatação do sistema coletor renal. O advento do exame ultrassonográfico permite observar pequenas dilatações nas estruturas, realizar medições precisas e acompanhar a evolução das alterações. Uma cadela schnauzer foi encaminhada ao setor de imagem do Hospital Veterinário VETCLINIC 24 horas. Ao exame ultrassonográfico foi possível visualizar o rim direito com relação córtico-medular desmontada, com apenas a cápsula renal e linhas hiperecogênicas estendendo-se ao centro (septos interdiverticulares) e grandes. Visualizou-se uma imagem tubular localizada caudalmente ao rim direito. A paciente foi então submetida a laparotomia exploratória onde foi possível verificar que o rim estava amolecido, aumentado e com ureter dilatado. Optou-se então por nefrectomia total do órgão, onde foi então avaliado e incisado em corte sagital, onde foi possível observar grande dilatação da pelve renal e atrofia do tecido renal

Clinical, Laboratory and Ultrasonographic Findings of Diabetic Dog with Emphysematous Cystitis

Background: Emphysematous cystitis is a rare inflammatory disease of the lower urinary tract characterized by the accumulation of gas within the wall and lumen of the urinary bladder. The clinical manifestations of emphysematous cystitis resemble those of bacterial cystitis, often hindering the differentiation between the two. In this work, we report a case of emphysematous cystitis in a diabetic dog. The diagnosis of cystitis was followed by ultrasonography for the early detection of emphysematous cystitis, which showed the presence of multifocal and irregular hyperechoic interfaces forming a distal reverberation artifact.                                                                                       Case: A 9-year-old female dog was referred to VETCLINIC Veterinary Hospital 24 hours with a history of urinary incontinence, polydipsia, polyuria, and diabetes mellitus. At first, the blood glucose was measured and found to be 376 mg/dL. Blood count, biochemical measurements of alkaline phosphatase (AF), urea, creatinine, and alanine aminotransferase (AAT), urinalysis, urine culture with antimicrobial susceptibility testing, and abdominal ultrasonography were performed. The hematological exams showed that the serum was lipemic and with hemolysis; the values of AAT, AF, and total plasma proteins were above the reference values; hematocrit was below the normal level; erythrocyte rouleaux and thrombocytosis with platelet aggregates were present. Urinalysis showed the presence of traces of proteins, glucose, and occult blood as well as granular and hyaline cylinders and transitional epithelial cells. In urine culture, growth of the aerobic bacteria Klebsiella pneumoniae was observed, being sensitive to most of the antimicrobials. Ultrasonography showed the presence of gas in the wall of the urinary bladder, besides a discrete thickening of the wall, compatible with the diagnosis of emphysematous cystitis.                                                                                                   Discussion: The first report of emphysematous cystitis in dogs was made in 1926 in a diabetic dog. Emphysematous cystitis is complicated, characterized by the presence of gas in the wall and lumen of the urinary bladder. It is usually reported in patients with diabetes mellitus. The patient presented with a very high glycemic index (376 mg/dL), in addition to having a history of urinary obstruction and presence of bladder stones, which may have acted as predisposing factors for the onset of emphysematous cystitis. In the present case, ultrasonography was the examination of choice. Hyperechoic reverberation-forming lines, identified as gas present in the topography of the urinary bladder, were easily visualized, as described in the literature. For the treatment of this condition, adequate management of the diet and the correct use of antimicrobials are of fundamental importance since the presence of diabetes mellitus in this patient can present serious complications in the future. This report shows the importance of the use of a combination of diagnostic tools to arrive at the correct diagnosis of the patient