Primeiro relato da mutação nt230(del4) no gene MDR1 em Pastores Alemães no sul do Brasil

The P-glycoprotein (P-gp) is a transmembrane protein encoded by the MDR1 gene that functions as a biological barrier by extruding toxins and xenobiotics out of cells. The MDR1 gene can carry a mutation called nt230(del4), which is a deletion of four base pairs resulting in the formation of a non-functional protein that may predispose to severe toxicosis, as observed in dogs with sensitivity to ivermectin. Several breeds have been described as carriers of the mutation, including German Shepherds (GS). However, the presence of the mutant allele in this breed has not been described in Brazil. This study aimed to determine the genotypic and allelic frequency of the nt230(del4) mutation in the MDR1 gene in GS from Southern Brazil. Blood samples were collected from 79 GS in the state of Rio Grande do Sul and genotype for the MDR1 gene was performed. Seventy-eight (98.7%) dogs were dominant homozygous genotype (wild) and one (1.3%) was heterozygous. This study showed that there is a low frequency (0.6%) of the mutant allele while the frequency of the wild allele is high (99.4%) in this specific population. This is the first report of the presence of the nt230(del4) mutation in the MDR1 gene in GS in Brazil. This information is important for breeders to prevent dissemination of the mutant allele in the national breeding population and international exchange of animals for breeding; for owners and veterinarians to be aware when dispensing and administering medications for GS dogs in Brazil.A Glicoproteína-P é uma proteína transmembrana codificada pelo gene MDR1 que atua como uma barreira fisiológica através da extrusão de toxinas e xenobióticos para fora das células. O gene MDR1 pode carregar uma mutação chamada nt230(del4) que é uma deleção de quatro pares de bases, resultando na formação de uma proteína não-funcional que pode predispor à toxicoses graves, como as observadas em cães sensíveis à ivermectina. Diversas raças de cães foram descritas como portadoras da mutação nt230(del4), incluindo Pastores Alemães (PA). Entretanto, a presença do alelo mutante nessa raça não foi descrita em cães no Brasil. O objetivo desse estudo foi determinar a frequência genotípica e alélica da mutação nt230(del4) em PA no sul do Brasil. Amostras de sangue foram coletadas de 79 PA no estado do Rio Grande do Sul e o genótipo dos cães para o gene MDR1 realizado. Setenta e oito (98.7%) cães foram homozigotos dominantes (selvagem) e um (1.3%) tinha genótipo heterozigoto. A frequência do alelo mutante foi baixa (0.6%), enquanto a frequência do alelo selvagem foi alta (99.4%) nesta população. Este é o primeiro relato da presença desta mutação nt230(del4) no gene MDR1 em PA no Brasil. Esta informação é importante para criadores a fim de prevenir a disseminação do alelo mutante na população de criadores da raça no Brasil e programas internacionais de troca de animais para criação, para tutores e veterinários estarem conscientes quando prescreverem e administrarem medicações para cães PA no Brasil

Adenocarcinoma acinar pulmonar primário em gato : relato de caso

Among the diseases that cause dyspnea in felines, primary pulmonary neoplasia is rare and tends to affect senile cats. This study reports the case of a seven teen year old FeLV infected cat who was diagnosed acinar adenocarcinoma of the lung and kidney metastasis. It presented prostration and anorexia and was hospitalized with dyspnea and pleural effusion. Chest radiography indicated increased radiopacity in the cranial portion of the right hemithorax, compatible with presence of intrathoracic mass and the cytologic analysis of pleural effusion suggested feline infectious peritonitis. The animal died two days after, and the definitive diagnosis was concluded after necropsy and histopathological examination. Pulmonary adenocarcinoma should be included with differential diagnosis of respiratory diseases in cats, especially the elderly.Entre as doenças que causam dispneia em felinos, a neoplasia pulmonar primária é rara e costuma acometer gatos senis. Este trabalho tem por objetivo relatar o caso de um felino, de 17 anos, portador do vírus da leucemia felina, diagnosticado com adenocarcinoma acinar pulmonar primário com metástase no rim e na pleura parietal. O paciente apresentava histórico inespecífico, sendo as principais queixas prostração e anorexia, e foi internado apresentando dispneia e efusão pleural. A radiografia torácica indicou aumento da radiopacidade na porção cranial do hemitórax direito, compatível com presença de neoformação intratorácica. A citologia da efusão foi sugestiva de peritonite infecciosa felina. O animal veio a óbito dois dias após o atendimento inicial e o diagnóstico definitivo foi determinado por meio da necropsia e da avaliação histológica. O adenocarcinoma pulmonar deve ser incluído como diagnóstico diferencial de doenças respiratórias em gatos, principalmente idosos

Megaesophagus Secondary to Feline Dysautonomia (Key-Gaskell Syndrome) in a Cat

Background: Feline dysautonomia is a rare autonomic neuropathy of unknown cause, that has already been reported in Europe, the United States and Brazil. Cats usually show nonspecifc clinical signs that are associated with autonomic dysfunction of the nervous system. The diagnosis is based on the clinical signs and imaging tests, and confrmed by necropsy and histopathological fndings. The prognosis is poor and there is no defnitive treatment. The aim of this report is to describe a case of feline dysautonomia with emphasis in the clinical, diagnostic imaging and histopathological fndings. Feline dysautonomia must always be considered as a differential diagnosis in cases of megaesophagus in cats.Case: A mixed-breed young male cat was evaluated for anorexia, regurgitation, bilateral nasal discharge and dyspnoea for 24 h. The animal was dehydrated and had pale mucous membranes, abdominal distension and keratoconjunctivitis sicca. The neurological examination was normal. Abdominal ultrasound showed a distended bladder and normal intestinal motility. Chest radiography and esophageal contrast study exhibited megaesophagus in the intrathoracic region. Blood work showed mild neutrophilic leukocytosis and the presence of toxic neutrophils. The cat remained hospitalized for supportive care, including fluidtherapy, broad spectrum antibiotics, antiemetic and mucosal protective drugs. Twelve days after the admission, the cat presented prostration, hypoglycemia, hypothermia, hypokalemia and severe leukopenia. Chest radiography revealed increased radiopacity in the right hemithorax, suggesting aspiration pneumonia. The cat died and during necropsy there was marked megaesophagus, with areas of erosion/ulceration of the mucosa, in addition to pulmonary consolidation areas. The histopathological analysis showed an extensive area of ulceration in the esophageal epithelium, in addition to infltration of lymphocytes, macrophages and occasional neutrophils and numerous bacteria, compatible with ulcerative esophagitis. The lung analysis showed severe multifocal thrombosis, multifocal areas of athelectasia, moderate congestion and edema, vegetable material in the bronchi, basophilic myriad bacterial and multifocal necrosis. Hypereosinophilic neurons with pyknotic nuclei, mild cytoplasmic vacuolization, loss of granular appearance of Nissl substance and nuclei shifted to the periphery were observed in the esophageal ganglia. The post mortem diagnosis was megaesophagus and chronic active esophagitis with neuronal degeneration, confrming the diagnosis of feline dysautonomia and aspiration pneumonia.Discussion: This cat was presented with nonspecifc clinical signs, megaesophagus, constipation, keratoconjunctivitis sicca and regurgitation that are commonly observed in cases of feline dysautonomia. However, there were also expiratory dyspnoea, which is less common. Unlike most cases, this cat did not show mydriasis, prolapsed nictitating membranes, reduced pupillary light response or bradycardia. Considering the evolution of its clinical condition, it was suspected that the cat died due to sepsis, possibly as a result of aspiration pneumonia. Since feline dysautonomia is uncommon and requires histopathological analysis for diagnosis confrmation, the prevalence of the disease might be underestimated in our region. In this case, the clinical evaluation, diagnostic imaging, macroscopic and histopathological fndings were consistent with dysautonomia, therefore it is important to consider the disease as a differential diagnosis in cases of megaesophagus in cats, even in the absence of other classical signs of autonomic dysfunction.Keywords: ganglioneuropathy, autonomic neuropathy, neurology, cat

Pênfigo foliáceo em um gato de oito meses de idade: possível reação cutânea adversa a fármacos?

Background: Pemphigus foliaceus is an autoimmune skin disease whose the occurrence in feline clinic is uncommom. The etiology is unknown in most cases. Althought it is a rare condition in cats, pemphigus foliaceus can be induced by drugs. It may affect both adult and old cats with no sexual or racial predilection and diagnosis is based on animal historical, clinical examination and skin histopathology. Moreover, the treatment consists in immunosuppressive-based drugs. This paper describes a pemphigus foliaceus case in an eight-month-old kitten, probably due a cutaneous adverse drug reaction.Case: A 8-month-old, neutered male mongrel cat with crusted lesions located on face was examinated at the Veterinary Hospital. The owners reported that they had adopted the patient two months before the clinical presentation suggesting that this background was unknown. The cat was treated in a local veterinary clinic with antibiotics and anti-inflammatory for rhinotracheitis and herpetic dermatitis on face due to the occurrence of sneezing and crusted pruriginous dermatitis. The kitten presented erosions, purulent exudation and crusts on pinnae, nasal and supra ocular areas, paronychia with purulent exudate and alopecia at distal portion of the tail. Supplementary exams such as skin scraping, cytology and fungal culture were performed to rule out other agents and confirm the diagnosis. The parasitological and fungal examination resulted negative despite the fact that cytological exam showed coccoid bacteria. Complete blood count and biochemical profile showed no alteration and the test for feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) resulted negative. Histological changes were consistent with intra-epidermal pustular subcorneal with acantholysis dermatitis. An immunosuppressive dose of prednisolona was prescribed for 15 days. After this time, the crusted lesions were substituted by alopecia areas. Every 20 days the corticosteroid dose was reduced by half and after 90 days, the patient showed repilation in all regions previously affected during 545 days whithout treatment.Discussion: Pemphigus foliaceus is usually an idiopathic disease but in some cases it may be induced by drugs and infectious or parasitic agents. Previous reports described that animals younger than 1 year-old and older than 17 year-old can be affected. However, the disease occurrence is rare in young cats. The age of onset of symptoms was early considering that the literature describes 5 years of age as an average for the starting of the disease. Pemphigus foliaceus is considered a pustular disease. However, pustule is rarely reported in cats in contrast with crusted lesions which are the most common clinical sign. The body regions affected were the same as reported in the literature with the addition of systemic signs as anorexia and lethargy. Fungal culture and parasitological examination should always be performed in cats with clinical evidence to discharge other agents. Diagnosis is made by skin histopathology in which acantholytic cells are the main characteristic. The importance of the differential diagnosis and skin biopsy regardless of age enabled the diagnosis and therapeutic success. It is suggested that Pemphigus foliaceus was of pharmacodermic etiology because of the age of the patient, a history of administration of unknown antimicrobial medication and the lack of recurrence of clinical manifestations after 545 days of the end of glucocorticoid treatmen

An investigation into the effect of MLSS on the effluent quality and sludge settleability in an aerobic-anoxic sequencing batch reactor (AASBR)

The aim of this study is to enhance the effluent quality and improve the sludge settleability by determining the effects of the mixed liquor suspended solids (MLSS) on the solid’s settling behaviour and the treatment efficiency in an aerobic-anoxic sequencing batch reactor (AASBR). The results obtained from this study revealed that raising the MLSS concentration from 2 to 3 g/l improved the chemical oxygen demand (COD), ammonia-nitrogen (NH3-N) and nitrate-nitrogen NO3-N removal efficiency, and led to an increase in the sludge volume index (SVI) value. Moreover, increasing the MLSS concentration from 3 to 4 g/l did not significantly affect the COD, NH3-N and NO3-N removal rates or the solid’s settling behaviour. However, increasing the MLSS concentration from 4 to 6 g/l significantly reduced the COD and nitrate removal efficiency and the sludge settling rate slowed down. The results proved that the optimal MLSS concentration for COD, NH3-N and NO3-N removal is between 3 and 4 g/l. In this range the removal rates for COD, NH3-N and NO3-N were 93%, 95% and 96% respectively, and the effluent quality was 35 mg/l, 0.43 mg/l and 0.75 mg/l for COD, NH3-N and NO3-N respectively. In addition, a good solid separation occurred during that range with SVI value of 81 ml/g; this finding was supported by a morphological study along with scanning electron microscopy (SEM)

Primary Splenic Torsion Associated with Accessory Spleen in a Dog

Background: Primary splenic torsion occurs when there is a splenic vascular pedicle rotation without association of other diseases, as the Gastric Dilatation Volvulus (GDV). Accessory spleen consists in a splenic tissue fraction independent from main organ, caused by a spleen defect in the embryonic development, most remaining asymptomatic and discovered incidentally. They have their own blood supply, which is usually from a branch of the splenic artery. Present report represents a primary splenic torsion with the accessory spleen finding in a dog.Case: A 7-year-old female mongrel was referred to Veterinary Hospital of Universidade Federal do Rio Grande do Sul, showing pain and firm consistency in the left abdominal region, prostration and inappetence four days before the medical appointment. At the clinical examination, the patient was alert, 7% dehydration, hypocorous mucous membranes, without alteration in lymph nodes, left abdominal pain. Laboratory tests, chest radiographic and abdominal ultrasound was requested. Two images compatible with splenic image were visualized, one with a regular structure without vascularization suggesting splenic torsion and another with homogeneous parenchyma and echogenicity of the normal spleen, with vascularization signal. The animal was referred to the surgical procedure and the anesthetic induction protocol with propofol (6 mg.kg -1) and ketamine hydrochloride (2 mg.kg -1) and maintenance with total intravenous anesthesia with propofol (0.2-0.4 mg.kg -1 / min) and lidocaine (2 mg.kg -1), in a semi-closed loop and spontaneous ventilation. The pre-retro-umbilical incision in the ventral midline was performed, and the exploratory celiotomy was done. During the cavity exploring, a small amount of free fluid and a structure compatible with the spleen were observed. It was noted that the splenic vascular pedicle was twisted around its axis and the gastroesplenic and splenocolic ligaments were also involved. The stomach maintained its position, size and vascularization. Thus, an isolated or primary splenic torsion was characterized. The exploratory laparotomy was recommended, and the total splenectomy was the treatment of choice. The accessory spleen did not demonstrate vascular damage; therefore, was advocated the zeal in handling to preserve your integrity.Discussion:  Isolated splenic torsion is a rare occurrence in dogs. A retrospective study was performed with 60 dogs presenting with non-traumatic hemoperitoneum, in which only three cases presented splenic torsion. Usually, twisting occurs in large or giant breed dogs with deep chest conformation. The etiology of splenic torsion is not well established. Primary splenic torsion is considered emergency surgery, and the prognosis is considered favorable. The literature shows no relation between the presence of the accessory spleen and the occurrence of primary splenic torsion, but both occur due to congenital defects, both of which may be correlated in this case. The accessory spleen is characterized by a defect in the embryonic formation of the splenic tissue and may be associated with other congenital malformations. It can be concluded that in the primary splenic torsion, early surgical treatment is the most indicated. Total splenectomy was considered adequate, and preservation of the accessory spleen was important due to the possibility of some organ functionality

Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis

<p>Abstract</p> <p>Background</p> <p>Health-related quality of life (HRQL) is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF).</p> <p>Methods</p> <p>In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD), n = 98; non-COPD (obesity-hypoventilation syndrome, restrictive disorders, neuromuscular disorders), n = 133) with CHRF and current home mechanical ventilation (HMV), HRQL was assessed by the disease-specific Severe Respiratory Insufficiency (SRI) questionnaire and its prognostic value was prospectively evaluated during a follow-up of 2–4 years, using univariate and multivariate regression analysis.</p> <p>Results</p> <p>HRQL was more impaired in COPD (mean ± SD SRI-summary score (SRI-SS) 52.5 ± 15.6) than non-COPD patients (67.6 ± 16.4; p < 0.001). Overall mortality during 28.9 ± 8.8 months of follow-up was 19.1% (31.6% in COPD, 9.8% in non-COPD). To identify the overall role of SRI, we first evaluated the total study population. SRI-SS and its subdomains (except attendance symptoms and sleep), as well as body mass index (BMI), leukocyte number and spirometric indices were associated with long-term survival (p < 0.01 each). Of these, SRI-SS, leukocytes and forced expiratory volume in 1 s (FEV₁) turned out to be independent predictors (p < 0.05 each). More specifically, in non-COPD patients SRI-SS and most of its subdomains, as well as leukocyte number, were related to survival (p < 0.05), whereas in patients with COPD only BMI and lung function but not SRI were predictive.</p> <p>Conclusion</p> <p>In patients with CHRF and HMV, the disease-specific SRI was an overall predictor of long-term survival in addition to established risk factors. However, the SRI predominantly beared information regarding long-term survival in non-COPD patients, while in COPD patients objective measures of the disease state were superior. This on one hand highlights the significance of HRQL in the long-term course of patients with CHRF, on the other hand it suggests that the predictive value of HRQL depends on the underlying disease.</p

Mortality in COPD patients discharged from hospital: the role of treatment and co-morbidity

BACKGROUND: The aim of this study was to analyse mortality and associated risk factors, with special emphasis on health status, medications and co-morbidity, in patients with chronic obstructive pulmonary disease (COPD) that had been hospitalized for acute exacerbation. METHODS: This prospective study included 416 patients from each of the five Nordic countries that were followed for 24 months. The St. George's Respiratory Questionnaire (SGRQ) was administered. Information on treatment and co-morbidity was obtained. RESULTS: During the follow-up 122 (29.3%) of the 416 patients died. Patients with diabetes had an increased mortality rate [HR = 2.25 (1.28–3.95)]. Other risk factors were advanced age, low FEV(1 )and lower health status. Patients treated with inhaled corticosteroids and/or long-acting beta-2-agonists had a lower risk of death than patients using neither of these types of treatment. CONCLUSION: Mortality was high after COPD admission, with older age, decreased lung function, lower health status and diabetes the most important risk factors. Treatment with inhaled corticosteroids and long-acting bronchodilators may be associated with lower mortality in patients with COPD