Avaliação do potencial analgésico do Maropitant em cadelas submetidas à ovariohisterectomia eletiva

Orientadora: Prof. Dra. Fabíola Bono FukushimaDissertação (mestrado) - Universidade Federal do Paraná, Setor de Palotina, Programa de Pós-Graduação em Ciência Animal. Defesa : Curitiba, 23/02/2018Inclui referências : p.53-62Resumo: A dor é uma experiência multifatorial complexa, que resulta em sofrimento e redução da qualidade de vida. Nesse sentido, o estudo de terapias alternativas para o controle da dor ganha destaque. Dessa maneira, o objetivo do presente estudo foi avaliar o efeito analgésico do maropitant e da metadona isolados e em associação em cadelas submetidas à ovariohisterectomia. Os animais (n=24) foram distribuídas em três grupos conforme pré-medicação: META (metadona 0,5 mg/kg IV), MARO (maropitant 1 mg/kg IV) e MEMA (metadona 0,5 mg/kg e maropitant 1 mg/kg IV), seguindo modelo randomizado cego. Realizou-se ovariohisterectomia por cirurgião experiente padronizado como modelo de dor aguda visceral e somática. A anestesia foi induzida e mantida com propofol em infusão contínua. Avaliou-se grau de sedação após pré-medicação, ocorrência de sialorreia, dose de propofol para indução e manutenção, tosse à intubação orotraqueal, variáveis fisiológicas e número de resgates analgésicos, que foi realizado com fentanila (2 mcg/kg) no incremento de 20% da FC, FR ou PAS, mas plano anestésico adequado. As avaliações foram realizadas antes da pré-medicação, 10 minutos após indução, na incisão de pele e musculatura, ligadura dos ovários, corpo uterino e celiorrafia. No pós-operatório os animais foram avaliados durante 24 horas quanto aos parâmetros fisiológicos, dor por meio de escala análoga visual e escala de Glasgow, retorno do apetite e número de resgates analgésicos, que foi realizado com metadona (0,2 mg/kg IV) quando escore ultrapassava 30% do total das escalas. Quanto aos resultados, a mediana do escore de sedação em MARO (2) foi inferior ao META (4,5) e MEMA (6), e houve maior necessidade de propofol para indução (7,43 ± 0,8) e manutenção (0,67 ± 0,11) em MARO. Houve diferença entre os grupos quanto ao número de resgates analgésicos no transoperatório entre MARO (1,12 ± 0,64) e MEMA (0,12 ± 0,35). No pós-operatório não houve diferença significativa na avaliação de dor pelas escalas de VAS e Glasgow. Quanto ao tempo para retorno do apetite em horas e número de resgates no pós-operatório não foram evidenciadas diferenças significativas. Conclui-se que o maropitant isolado possui baixo efeito sedativo e analgésico para o transoperatório, mas melhor efeito quando associado a metadona. No pós-operatório a analgesia do maropitant isolado ou em associação a metadona foi semelhante ao da metadona. Palavras-chave: Maropitant. Analgesia. Dor. OvariohisterectomiaAbstract: Pain is a complex multifactorial experience that results in suffering and reduced quality of life. In this scenario , the study of alternative therapies for pain control is highlighted. Thus, the objective of the present study was to evaluate the analgesic effect of maropitant, methadone , and the association of maropitant and methadone in bitches submitted to ovariohysterectomy. The animals were distributed in three groups according to premedication: META (methadone 0.5 mg/kg IV), MARO (maropitant 1 mg/kg IV), and MEMA (methadone 0.5 mg/kg and maropitant 1 mg/kg IV). The study followed a randomized blind model. Ovariohysterectomy was performed by a standardized experienced surgeon as a model of acute visceral and somatic pain. Anesthesia was induced and maintained with continuous infusion of propofol to effect. Sedation score after premedication, sialorrhea, propofol dose for induction and maintenance, coughing to orotracheal intubation, physiological variables and number of analgesic rescues were evaluated. Intraoperative analgesic rescues were performed with fentanyl (2 mcg/kg) when a 20% increase of HR, RR or SAP was observed in adequate anesthetic plane. The evaluations were performed before premedication, 10 minutes after induction, in the skin and musculature incision, during ligature of the ovaries and uterine body and celiorraphy. In the postoperative period, the animals were evaluated for 24 hours regarding physiological parameters, pain by Visual Analogue Scale and Glasgow scale, return of appetite and number of analgesic rescue, which was performed with methadone (0.2 mg/kg IV ) when the score exceeded 30% of the scales. In relation to the results, the median of sedation score in MARO (2.0) was lower than META (4.5) and MEMA (6), and there was a greater need for propofol to induction (7, 43 ± 0.8) and maintenance (0.67 ± 0.11) in MARO. There was a difference between the groups regarding the number of intraoperative analgesic rescues between MARO (1.12 ± 0.64) and MEMA (0.12 ± 0.35). In the postoperative period, there was no significant difference in pain assessment by VAS and Glasgow scales. Regarding the time to return of appetite in hours and number of rescues in the postoperative period, no significant differences were evidenced. It is concluded that isolated maropitant has a low sedative and analgesic effect for the intraoperative period, but a better effect when associated with methadone. In the postoperative period, analgesia of maropitant alone or in combination with methadone was similar to that of methadone. Key-words: Maropitant. Analgesia. Pain. Ovariohysterectomy

Nonepitheliotropic lymphoma in a dog: case report

Cutaneous lymphoma is an uncommon neoplasm in dogs and Boxer, Shih Tzu, Cocker Spaniel, Basset Hound and Golden Retriever are predisposed breeds. This report describes the case of a 5-year-old mixed-breed female dog presenting ulcerated and fast-growing skin nodules. Initial cytology revealed a poorly differentiated round cell neoplasm. Excision of nodules was performed due to the emergence of new lesions. Histopathological examination was suggestive of histiocytoma. The lesions recurred after one year, and a surgical excision of nodules was performed. An immunohistochemical examination was carried out to refine the diagnosis, revealing positivity for CD3 markers in neoplastic cells and for HLA-DR in neoplastic lymphoid and reactive histiocytic cells; these findings, coupled with the morphological findings, were compatible with nonepitheliotropic cutaneous T-cell lymphoma. Its etiology has not yet been fully elucidated; however, recurrent skin inflammation may be a predisposing factor, which leads to chronic lymphocytic proliferation. Cutaneous lymphoma (CL) causes nonspecific lesions and its classification as epitheliotropic and nonepitheliotropic (NEL) throughout cutaneous signs is difficult, with NEL being the least described form. Animals affected by this form of lymphoma have lymphadenomegaly, firm and multiple nodules that can extend from the dermis to the subcutaneous layer, alopecic and/or ulcerated, often in chest, head and extremities, with rapid progression, which was compatible with the present case. Definitive diagnosis of CL is obtained through histopathology and immunohistochemistry. The aim is to report a case of nonepitheliotropic cutaneous lymphoma in a dog, with emphasis on its clinical, histopathological, and immunohistochemical aspects

Nefrectomia total unilateral em cachorro-do-mato (Cerdocyon thous)

Background: The loss of natural habitats associated with the development of humanity resulted in the need for longer trips and greater interaction with highways by some animal species. Vehicle collision with animals is one of the main factors of pressure over wild animal populations in Brazil; veterinary surgery can play an important role for the recovery of these patients. The lesions commonly seen in animals hit by vehicles may comprise skin lesions, central nervous system injuries, intrathoracic and intra-abdominal complications, among which renal lesions are included. The aim of this work is to report the use of a total nephrectomy technique in a crab-eating fox.Case: A female, adult, 5-kg crab-eating fox (Cerdocyon thous Linnaeus, 1766) was received for emergency care at the Veterinary Hospital of Universidade Federal do Paraná at Palotina. The patient had been struck by a vehicle at a local highway, was unconscious, and exhibited signs of blood loss such as hypothermia, hypotension, and pale mucous membranes. As the clinical evaluation was performed, the patient was stabilized with pain management, correction of hypovolemia and hypothermia, and oxygen therapy. Blood samples were taken in case of the need for preoperative tests. Subsequently, the animal was submitted to the diagnostic imaging section to investigate possible injuries. No chemical restraint was necessary for the procedures. Radiography examination revealed loss of intra-abdominal contrast, which was confirmed to be free fluid on ultrasound examination. Immediately after imaging examination, the animal was taken to the surgical room for exploratory laparotomy. The surgical incision, which was performed over the linea alba, extended from the xiphoid process to the pubis. During surgery, free fluid was confirmed to be diffuse bloody fluid, which was observed in the abdomen; there was absence of lesions in all organs except the right kidney, which revealed clots and lacerations to the capsule, cortex, and medulla, resulting in poor viability of the organ. The condition required removal of the organ, which was performed with the conventional technique described for domestic animals. During the nephrectomy surgical procedure, the patient exhibited severe hypotension with the need of compensatory measures such as intravenous administration of crystalloid and colloid solutions, and vasoactive drugs, which were maintained during the period of surgery. Postoperative care included administration of analgesics and anti-inflammatory drugs for three days, and antibiotics for seven days. Hematological and renal profiles as well as ultrasound examinations were used for monitoring of clinical evolution. The patient was kept in isolation to avoid behavioral stress during hospital stay.Discussion: In this case, the importance of ultrasound diagnosis and viability of the nephrectomy technique were established for the specimen, which was returned to its natural habitat eighteen days after the vehicle collision, after authorization from the local environmental agency. Immediate care of a wild animal that suffers trauma is an important factor to increase success rate for recovery of fauna threatened by vehicle collisions. Early diagnosis associated with the employment of surgical techniques commonly used for domestic animals allow wild-animal clinicians and surgeons to improve viability of threatened populations

Nefrectomia total unilateral em cachorro-do-mato (Cerdocyon thous)

Background: The loss of natural habitats associated with the development of humanity resulted in the need for longer trips and greater interaction with highways by some animal species. Vehicle collision with animals is one of the main factors of pressure over wild animal populations in Brazil; veterinary surgery can play an important role for the recovery of these patients. The lesions commonly seen in animals hit by vehicles may comprise skin lesions, central nervous system injuries, intrathoracic and intra-abdominal complications, among which renal lesions are included. The aim of this work is to report the use of a total nephrectomy technique in a crab-eating fox.Case: A female, adult, 5-kg crab-eating fox (Cerdocyon thous Linnaeus, 1766) was received for emergency care at the Veterinary Hospital of Universidade Federal do Paraná at Palotina. The patient had been struck by a vehicle at a local highway, was unconscious, and exhibited signs of blood loss such as hypothermia, hypotension, and pale mucous membranes. As the clinical evaluation was performed, the patient was stabilized with pain management, correction of hypovolemia and hypothermia, and oxygen therapy. Blood samples were taken in case of the need for preoperative tests. Subsequently, the animal was submitted to the diagnostic imaging section to investigate possible injuries. No chemical restraint was necessary for the procedures. Radiography examination revealed loss of intra-abdominal contrast, which was confirmed to be free fluid on ultrasound examination. Immediately after imaging examination, the animal was taken to the surgical room for exploratory laparotomy. The surgical incision, which was performed over the linea alba, extended from the xiphoid process to the pubis. During surgery, free fluid was confirmed to be diffuse bloody fluid, which was observed in the abdomen; there was absence of lesions in all organs except the right kidney, which revealed clots and lacerations to the capsule, cortex, and medulla, resulting in poor viability of the organ. The condition required removal of the organ, which was performed with the conventional technique described for domestic animals. During the nephrectomy surgical procedure, the patient exhibited severe hypotension with the need of compensatory measures such as intravenous administration of crystalloid and colloid solutions, and vasoactive drugs, which were maintained during the period of surgery. Postoperative care included administration of analgesics and anti-inflammatory drugs for three days, and antibiotics for seven days. Hematological and renal profiles as well as ultrasound examinations were used for monitoring of clinical evolution. The patient was kept in isolation to avoid behavioral stress during hospital stay.Discussion: In this case, the importance of ultrasound diagnosis and viability of the nephrectomy technique were established for the specimen, which was returned to its natural habitat eighteen days after the vehicle collision, after authorization from the local environmental agency. Immediate care of a wild animal that suffers trauma is an important factor to increase success rate for recovery of fauna threatened by vehicle collisions. Early diagnosis associated with the employment of surgical techniques commonly used for domestic animals allow wild-animal clinicians and surgeons to improve viability of threatened populations