A Retrospective Study of Small Animal Poisoning at the Veterinary Medical Teaching Hospital from South Region of Brazil

Background: Poisoning cases are a challenge for the veterinary practitioner, since many agents can be involved. The incomplete patient history associated with advanced poisoning stage often leads to death. Since lacking information is common, it is essential to be aware of principal poisoning agents and their associated symptomatology. The aim of this study is to describe the major agents involved in small animal poisoning, the causative agent, poisoning route, time to search veterinary care, clinical signs and ancillary tests of canine and feline patients treated at the Veterinary Medical Teaching Hospital from January 2010 to June 2016.Materials, Methods & Results: Forty-four medical records with poisoning history were found and reviewed, but only 30 medical records had complete data to be evaluated. There were 24 dogs and 6 cats, 17 female and 13 male. Six females were spayed. Poisoning agent identification was possible in 29 cases and was food, molluscicide, cleaning product, ornamental plants, medication, rodenticide and antiparasitic drugs. Fourteen poisonings were caused by the owner and 16 were accidental. There was a higher poisoning incidence in dogs than cats. Most of the patients were young and unneutered/unspayed.Discussion: In this study there was a higher poisoning prevalence in dogs than cats, as occurred in other studies published in Europe, Belgium, France, Greece, Italy, Spain, Austria and other Brazilian regions. Most of the patients were young, which is in agreement with previous studies in which young animals were more affected. Domestic antiparasitic drugs were the most common poisoning agents (33%), as reported in studies from France and Spain. In southern Brazil, the most common poisoning agent was medication, whereas in southeast Brazil, organophosphates were the most prevalent poisoning agent. Considering this, the geographic localisation seems to influence the poisoning agent. It is known that many owners give unprescribed medication to their pets and this also happened in this study, as 46% of the poisoning cases were caused by the owner. The most common clinical signs were gastrointestinal (76%, emesis and anorexia) and neurological (63%, depression). This is in agreement with another study that showed a high number of patients poisoned by medications leading to severe gastrointestinal clinical signs. Despite a history of eating spiced food, our food-poisoned patient did not show clinical signs compatible with pepper poisoning. In fact, clinical signs were more compatible with salt or onion and garlic poisoning, but there was no history to support that our patient had eaten these foods. The patient who ate fern and busy Lizzie (Impatiens walleriana) did not show clinical signs compatible with these agents but showed gastrointestinal clinical signs that could have occurred due to plant indigestion. This fact emphasises the need for more studies in this area. One dog with rodenticide poisoning presented with normal blood test results, but the blood sample was collected a few hours after exposure. This can occur after brodifacoum poisoning, which has a longer half-life than warfarin. In brodifacoum poisoning cases, clinical signs can appear days after exposure. In one dog, it was not possible to indentify the poisoning agent and this specific patient case exemplifies the challenge to diagnose the exact poisoning agent and concomitant diseases when the history is incomplete. This retrospective study shows the heterogeneity of the causative agents and the associated symptomatology, which highlights the need for further studies in this area. In this study, antiparasitic drugs were the most common poisoning agents, especially pyrethroids. Dogs were more affected than cats. Most of the patients were young and unneutered/unsprayed, indicating these characteristics could be a risk factor in this study

AVALIAÇÃO RADIOGRÁFICA DA DISPLASIA COXOFEMORAL EM CÃES

The hip joint is composed of two osteoarticular structures: the acetabular cavity and the femur. Dysplasia is one of the most frequent orthopedic diseases in this region and mainly affects large dogs. It is characterized by joint laxity, abnormal hip formation and degenerative joint disease. It presents high heritability and environmental factors contribute to phenotypic expression and the severity of the disorder. Claudication, pain, and reduced range of motion of the joint are the main clinical signs, however, the clinical presentation can be variable. Pelvic radiography and clinical evaluation are the main methods to diagnose the disease. Countless radiographic techniques can be used in the diagnosis. The ventrodorsal projection of the hip with extended hind limbs is used by the Orthopedic Foundation for Animals (OFA), Fédération Cynologique Internationale (FCI) and British Veterinary Association/Kennel Club (BVA/KC). However, the Pennsylvania Hip Improvement Program (PennHIP), Dorsolateral Subluxation Score (DLS), Flückiger Subluxation Index and Dorsal Acetabular Kidney methods use other projections and evaluate joint laxity in order to diagnose this condition early. The aim of this work is to describe the main radiographic methodologies used for the evaluation and diagnosis of hip dysplasia in dogs, as well as their advantages, disadvantages, and limitations of each technique.A articulação coxofemoral é composta por duas estruturas osteoarticulares: a cavidade acetabular e o fêmur. A displasia é uma das doenças ortopédicas mais frequentes desta região e acomete, principalmente, cães de grande porte. A displasia é uma das doenças ortopédicas mais frequentes dessa região e acomete, principalmente, animais de grande porte. É caracterizada por frouxidão articular, formação anormal do quadril e doença articular degenerativa. Apresenta alta herdabilidade e os fatores ambientais contribuem para a expressão fenotípica e a gravidade do distúrbio. Claudicação, dor e redução na amplitude do movimento da articulação são os principais sinais clínicos, no entanto, a apresentação clínica pode ser variável. A radiografia pélvica e a avaliação clínica são os principais métodos para se diagnosticar a doença. Inúmeras técnicas radiográficas podem ser utilizadas no diagnóstico. A projeção ventrodorsal do quadril com os membros posteriores estendidos é usada pela Orthopedic Foundation for Animals (OFA), Fédération Cynologique Internationale (FCI) e British Veterinary Association/Kennel Club (BVA/KC). Contudo, os métodos Pennsylvania Hip Improvement Program (PennHIP), Dorsolateral Subluxation Score (DLS), Flückiger Subluxation Index e Dorsal Acetabular Rim utilizam outras projeções e avaliam a frouxidão articular com intuito de diagnóstico precoce desta afecção. Objetivou-se com este artigo descrever as principais metodologias radiográficas utilizadas para avaliação e diagnóstico da displasia coxofemoral em cães, bem como suas vantagens, desvantagens e limitações de cada técnica

Postioplastia modificada para a redução de fimose em cães

A fimose em cães é uma afecção pouco freqüente em clínicas e hospitais veterinários. Porém, provoca muito desconforto ao animal afetado. Ela pode ser de origem adquirida, gerada por trauma, congênita ou por neoplasia, gerando inabilidade de exposição do pênis em relação ao prepúcio, causando postite, impossibilidade de copular, retenção de urina e dor. A complicação mais comum da fimose é a balanopostite, sendo que proprietário relata a dificuldade de micção e até mesmo disúria. O tratamento da fimose depende da sua origem, podendo ser clínico ou cirúrgico. O tratamento clínico baseia-se em medicações e compressas locais mornas, enquanto que para o tratamento cirúrgico indica-se a postioplastia. O objetivo do trabalho é demonstrar que a postioplastia modificada é de simples execução e traz menores problemas pós-operatórios. As cirurgias foram realizadas em dois cães de raças distintas, atendidos no Hospital de Clínicas Veterinárias do Rio Grande do sul (HCV-UFRGS). A técnica cirúrgica aqui descrita é uma modificação de duas técnicas já relatadas, proporcionando uma solução fácil e eficaz para o problema. Os resultados alcançados foram excelentes, comprovando a eficácia da cirurgia

Plate-Rod Osteosynthesis in Dogs and Cats

Background: Most fractures are caused by traumatic processes due to car accidents, but they can also occur due to bullets, fights and falls. Surgical stabilization is often necessary and shows high rates of bone healing when its basic concepts are followed. The objective of this study is to report cases of shaft fracture in long bones stabilized with intramedullary pin and plate (IMPP) in order to evaluate pre- and postoperative clinical and radiographic signs, correlating the ideal surgical technique described on recent studies with complications resulting from the surgical procedure.Cases: This study includes patients undergoing osteosynthesis with intramedullary pin and plate from January 2015 to December 2016 at the Veterinary Medical Teaching Hospital of UFRGS. During this period, 13 animals (five cats and eight dogs) with long bone fractures were treated with the abovementioned association. Information on breed, age, sex, etiology of the fracture, affected bone, clinical signs, osteosynthesis technique, clinical progress, fracture healing, and postoperative complications was collected for the study. Late postoperative recovery was evaluated by telephone contact with owners. The mean age was 5.4 years (3 months - 15 years) and body weight 17.66 kg (3 - 28.4 kg). The fractures were due to being hit by a vehicle (5), bites (1), accident with a toy (1), and unknown (6).Discussion:  All cases included in this study were in the femur, humerus or tibia. Fractures in the radius are also frequent in small animal traumatology, but in this case the use of an intramedullary pin is not recommended. All animals had diaphyseal fractures, which is an important prerequisite for IMPP stabilization. The IMPP association is mainly indicated in cases of comminuted fractures, when it is anatomically impossible to reduce fracture fragments, as occurred with nine patients in this study. The plate did not break of fail in any of the cases, as the association of an intramedullary pin with the plate significantly reduces tension on the plate, increasing bending strength up to ten times. One of the animals presented severe postoperative pain and could not adequately lean on the operated limb. Orthopedic and neurological evaluation led to the conclusion that the long pin in the region of the subtrochanteric fossa could be injuring the sciatic nerve and the animal was reoperated to cut the pin shorter. Pain stopped and after seven months the animal could lean on the limb and move normally, being proprioceptive and showing no pain on palpation and manipulation. The pin used in the IMPP technique should fill 30 to 40% of the diameter of the intramedullary canal at its narrowest portion. Of the 13 patients included in this study, six received pins within the recommended diameter, one received a pin larger than recommended, and five received pins smaller than recommended. The mean diameter of the pin related to the diameter of the medullary canal was 32.3% (19% - 54.8%). The bone healing rate described for IMPP is high (98%), three patients returned for this study reevaluation and all of them presented visible radiographic bone healing. We concluded that osteosynthesis associated with the use of intramedullary pin and plate resulted in adequate stabilization of fractures in the femur, tibia and humerus, allowing fast functional recovery with low complication rates

Craniectomia descompressiva em raposa (Cerdocyon thous Linnaeus, 1766)

 O presente trabalho apresenta relato de craniectomia descompressiva em raposa (Cerdocyon thous), macho, jovem, após diagnóstico de trauma cranioencefálico. O paciente foi graduado pela escala de Glasgow modificada como grave (grau 7), e por não ter apresentado melhora durante as primeiras quatro horas de tratamento, optou-se então pelo procedimento cirúrgico de craniectomia descompressiva com o intuito de diminuir a pressão intracraniana para prevenção e controle de danos do sistema nervoso. O paciente apresentou melhoras progressivas, após 60 dias obteve alta. A sequela observada nesse caso foi de déficit visual do olho direito, retornando com a movimentação e resposta ao ambiente. Após alta médica o paciente foi encaminhado a zoológico, mostrou interação com outros indivíduos da mesma espécie e reproduziu com uma fêmea do mesmo recinto

Substituição do ligamento redondo por membrana biológica e pino transarticular na redução de luxação coxofemoral bilateral em cães

A luxação coxofemoral é a mais freqüente nos pequenos animais, sendo geralmente causada por trauma, levando a ruptura do ligamento redondo e da cápsula articular. O exame clínico identifica o tipo de luxação e a severidade da lesão, sendo de fundamental importância também para a avaliação sistêmica do animal traumatizado. O diagnóstico definitivo é realizado através de radiografia simples, que ajuda a direcionar o tratamento. Este trabalho tem o objetivo de relatar a redução de luxação coxofemoral bilateral com ruptura de cápsula e ligamento redondo de um cão. Para tanto, esse ligamento foi substituído por um “flap” de fáscia lata autógena no membro esquerdo e fixada a articulação com pino transarticular no membro direito, na premissa tentativa de redução. Com a reluxação do membro esquerdo, o “flap” de fáscia lata autógena foi substituído por centro frênico eqüino conservado em glicerina 98%. O centro frênico permitiu o uso funcional do membro 15 dias após a cirurgia, enquanto o pino transarticular em apenas 40 dias de pós-operatório. Sugere-se que o centro frênico eqüino conservado possa ser uma alternativa viável na redução de luxação coxofemoral

MIELOGRAFIA EM CÃES

Spinal cord diseases can cause pain and urinary incontinence. All these clinical signs can interfere in a significant way in life quality of ill patients. The clinical localization of the neurological lesions as well as the characteristic of the diseases course are of extreme importance in the elaboration of the possible differential diagnoses. In order to define the diagnosis and treatment, additional tests are necessary. Advanced imaging exams such as computed tomography (CT) and magnetic resonance imaging (MRI) stand out as complementary possibilities. These image modalities aren´t easily accessible in Brazil and other developing countries and are restricted to big cities. Considering this, more traditional image techniques such as myelography are still useful in spinal cord diseases diagnosis and treatment in places where CT and or MRI are inaccessible. Myelography requires general anesthesia and the spinal tap area must be clipped and surgically prepared. The spinal tap can be done in subarachnoid lumbar space or cisterna magna. Liquor fluence, twitching the tail or limbs are signs that the needle is in the subarachnoid space and myelography contrast can be administrated. There are four myelography patterns: normal, extradural, intradural-extramedullary and intramedullary) and these patterners can occur in different diseases etiologies. Subdural contrast administration can cause many side effects, the most studied is myelography induced seizures.Doenças na medula espinhal causam dor, dificuldade ambulatorial e incontinência urinária, interferindo de forma significativa na qualidade de vida dos animais. A localização clínica das lesões neurológicas, bem como a característica do curso das doenças são de extrema importância na elaboração dos possíveis diagnósticos diferenciais. Para se definir o diagnóstico e tratamento, são necessários exames complementares. Atualmente destacam-se os exames de imagem avançados como tomografia computadorizada (TC) e a ressonância magnética (RM) como possibilidades complementares. Estes exames, entretanto, são pouco disponíveis no Brasil e outros países em desenvolvimento ou estão restritos aos grandes centros urbanos. Desta maneira, técnicas que exijam menor tecnologia e estão mais disponíveis, como mielografia, ainda têm papel fundamental no diagnóstico e planejamento cirúrgico de afecções medulares em locais nos quais a TC e RM são inacessíveis. Para a realização da mielografia o paciente deve ser submetido à anestesia geral e a punção deve ser feita em condições estéreis em cisterna magna ou em região lombar. O fluir do liquor, o animal movimentar a cauda ou membros, são indícios de que o bisel da agulha está no espaço subaracnóideo e o contraste deve ser administrado. Existem quatro tipos de padrão mielográfico (normal, extradural, intradural-extramedular e intramedular) e cada padrão pode estar relacionado a diferentes tipos de afecção. A administração do contraste no espaço subaracnóideo pode causar inúmeros efeitos adversos, sendo o mais estudado a ocorrência de convulsões após mielografia

Leveling osteotomy of the tibial plateau at an inverted angle in a dog

One dog, Golden Retriever, 5 months old, was seen complaining of lameness and pain in the left pelvic limb. Avulsion of the tibial crest was diagnosed by radiographic means, which was corrected with a tension band. The absence of postoperative radiographic monitoring and the non-removal of the apparatus led to the early closure of the cranial tibial physis with continuous flow growth, resulting in pain, functional loss of the limb after one year and at a 13.2º tibial plateau angle negative. The biomechanical alteration of the limb was corrected using the inverted TPLO technique, converting the angle of the tibial plateau to 5.3 positive, without a rockback evidenced in 30, 60, 90 days up to four months after the operation. The objective of this case report is to describe the surgical correction with the inverted TPLO technique in a case of angle of the negative tibial plateau secondary to not removing the tension band applied in avulsion of the growing tibial crest. After 120 days, the dog was presented fully recovery and weight-bearing without any complication

Plate-Rod Osteosynthesis in Dogs and Cats

Background: Most fractures are caused by traumatic processes due to car accidents, but they can also occur due to bullets, fights and falls. Surgical stabilization is often necessary and shows high rates of bone healing when its basic concepts are followed. The objective of this study is to report cases of shaft fracture in long bones stabilized with intramedullary pin and plate (IMPP) in order to evaluate pre- and postoperative clinical and radiographic signs, correlating the ideal surgical technique described on recent studies with complications resulting from the surgical procedure.Cases: This study includes patients undergoing osteosynthesis with intramedullary pin and plate from January 2015 to December 2016 at the Veterinary Medical Teaching Hospital of UFRGS. During this period, 13 animals (five cats and eight dogs) with long bone fractures were treated with the abovementioned association. Information on breed, age, sex, etiology of the fracture, affected bone, clinical signs, osteosynthesis technique, clinical progress, fracture healing, and postoperative complications was collected for the study. Late postoperative recovery was evaluated by telephone contact with owners. The mean age was 5.4 years (3 months - 15 years) and body weight 17.66 kg (3 - 28.4 kg). The fractures were due to being hit by a vehicle (5), bites (1), accident with a toy (1), and unknown (6).Discussion:  All cases included in this study were in the femur, humerus or tibia. Fractures in the radius are also frequent in small animal traumatology, but in this case the use of an intramedullary pin is not recommended. All animals had diaphyseal fractures, which is an important prerequisite for IMPP stabilization. The IMPP association is mainly indicated in cases of comminuted fractures, when it is anatomically impossible to reduce fracture fragments, as occurred with nine patients in this study. The plate did not break of fail in any of the cases, as the association of an intramedullary pin with the plate significantly reduces tension on the plate, increasing bending strength up to ten times. One of the animals presented severe postoperative pain and could not adequately lean on the operated limb. Orthopedic and neurological evaluation led to the conclusion that the long pin in the region of the subtrochanteric fossa could be injuring the sciatic nerve and the animal was reoperated to cut the pin shorter. Pain stopped and after seven months the animal could lean on the limb and move normally, being proprioceptive and showing no pain on palpation and manipulation. The pin used in the IMPP technique should fill 30 to 40% of the diameter of the intramedullary canal at its narrowest portion. Of the 13 patients included in this study, six received pins within the recommended diameter, one received a pin larger than recommended, and five received pins smaller than recommended. The mean diameter of the pin related to the diameter of the medullary canal was 32.3% (19% - 54.8%). The bone healing rate described for IMPP is high (98%), three patients returned for this study reevaluation and all of them presented visible radiographic bone healing. We concluded that osteosynthesis associated with the use of intramedullary pin and plate resulted in adequate stabilization of fractures in the femur, tibia and humerus, allowing fast functional recovery with low complication rates

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)