Otitis Media and Internal with Brainstem Extension in a French Bulldog

Background: Otitis is a frequent condition in dogs, with a multifactorial etiology covering primary causes, predisposing and perpetuating factors. It is characterized by an inflammatory process of structures that make up the auditory system, with prevalence data ranging from 15 to 20%, which can occur in any age group and without sex predisposition. According to the location, it can be classified as uni or bilateral, affecting the outer, middle and / or inner ear, the latter two being associated with neurological changes such as vestibulopathy, facial nerve paresis and Horner's syndrome. The morbidity and mortality of otitis media and internal may increase with delay in diagnosis, resulting in delay in the correct treatment, and the extension to brainstem is described in felines and considered rare in dogs. The present study aims to report an atypical case of otitis media and internal, with extension to the brain parenchyma in a brachycephalic dog.Case: A 3-year-old bitch French Bulldog canine was seen, weighing 12 kg, with a history of vomiting, apathy, nystagmus, ataxia and acute evolution hemiparesis. As a result of adoption, it was not known about the animal's morbid past. On special physical and clinical examination, depressed mental status, changes in postural reactions, nostril stenosis with unilateral mucopurulent nasal discharge, corneal ulcer, palpebral and labial ptosis, absence of eyelid reflex and spontaneous strabismus were observed, all of these findings observed on the left side of the face. No signs of otitis external to otoscopy were found. The clinical signs found characterize left facial nerve paresis and peripheral and central vestibulopathy. Otitis media / internal and meningoencephalitis were suspected. Hemogram, serum biochemistry (glucose, urea, creatinine, alanine aminotransferase, total proteins, albumin, globulin, alkaline phosphatase, gamma glutamyltransferase, phosphorus, total bilirubin, cholesterol and total calcium), urinalysis, rapid tests for erlichiosis, anaplasms , borreliosis, heartworm, distemper and leishmaniasis, CSF analysis, neurological panel performed by PCR (Polymerase Chain Reaction) that tested the animal for Bartonellosis, Lyme Disease (Borrelia burgdorferi), Blastomyces dermatitidis, Cryptococcus sp., Virus West Nile, Distemper, Toxoplasmosis, Neosporose and Coccidioides sp. using conjunctival swab, whole blood, urine and CSF samples. The samples were negative for all of these tests. As an image exam, brain magnetic resonance was performed. In the latter, otitis media and left internal was observed with extension of the lesion to the brain parenchyma. CSF analysis showed cytological changes compatible with a non-suppurative inflammatory process, mild pleocytosis with predominantly mononuclear leukocyte infiltrate. As a form of treatment, antibiotic therapy and total ablation of the auditory canal with lateral bulectomy were performed, showing good results with reduced clinical symptoms.Discussion: It is concluded that although the diagnosis of otitis media and internal with extension to brainstem is more common in cats, it should be included as a differential for central vestibular disorders in dogs, and that the diagnosis together with early and effective treatment are important, since that the evolution of the infection to the central nervous system represents a risk to the patient.Keywords: vestibulopathy, meningoencephalitis, brachycephalic.Descritores: vestibulopatia, meningoencefalite, braquicefálico.Título: Otite média e interna com extensão para tronco encefálico em cão buldogue francês

Eventration in Green Iguana (Iguana iguana)

Background: The reptile class could be considered one of the biggest vertebrate groups and are divided in orders and suborders according to their characteristics. These animals’ maintenance in captivity, either at home, captive bred or at zoos, can generate risk to their health, if the required cares are not given for each respective species. The lack of individual cares could lead to bone and muscular diseases and to traumatic lesions in soft tissues, mainly in the coelomic cavity. The report that is being presented aims to describe the case of a green iguana (Iguana iguana) that presented an increase of volume in the coelomic cavity. The animal belongs to the squad of the Zoo “Dr. Fábio de Sá Barreto”.Case: A green iguana arrived at the Zoo in February 2019 coming from another Zoo, with already an increase of volume in the coelomic cavity. The animal was put in quarantine and later on, it was put in display at a terrarium in the Zoo considered adequate to reptiles, with another seven green iguanas along with an argentine tegu (Salvator rufescens). Their feed was offered in the morning and was composed of fruits, vegetables and flowers like hibiscus. In the end of July 2019, it was reported by the attendant that the animal was presented with anorexia and prostration, and these symptoms progressed to neurologic signs, as it walked in circles. So, the animal was evaluated by the Zoo veterinarians and on exam they noticed lethargy, dehydration, absence of reflexes (pupillary, eyelid and painful), locomotion difficulty and when the iguana moves, it walks in circles. The increase in volume had the same size as reported in February and a soft consistency. After that, the animal was interned and treated according to the symptoms and the clinical evolution. Ten days after the hospitalization, the animal was still not eating, and locomotion stopped completely. It was performed in an ultrasonographic exam evaluating all the coelomic cavity, in which a great anechoic area was visualized, and a true hernia was diagnosed. However, the content of the hernia was not identified. In the next day, the animal died, and, in the necropsy, it was possible to verify that the increase in volume was actually a bladder eventration. The eventration occurred due to a laceration in the coelomic cavity musculature that allows the passage of the bladder to the subcutaneous space and its incarceration. So, the elimination of the urine and of nitrogen compounds was difficult and a large accumulation of uric acid from the bladder to the urodeo.Discussion: Iguana iguana is a uricotelic animal, which means that the main nitrogenous waste product is uric acid. Nevertheless, ammonia is also eliminated in less quantity, because of the excess of protein in the diet. These animals eliminate around 98 to 99% of the nitrogen compounds as uric acid and less than 1% as ammonia, which prove that it is possible for the accumulation of ammonia in reptiles, if any obstacle in its elimination exists. The excess of ammonia is extremely toxic to the organism, leading to emesis, irritability, lethargy, anorexia, ataxia, motor difficulties, behavioral and neurological changes, and could progress to coma or even death. The bladder incarceration reported in this case, made it impossible for the excretion of urine, uric acid and ammonia, and these compounds remained accumulated. So, the clinical signs, along with the necropsy findings, were suggestive of intoxication by ammonia accumulation which could be responsible for the signs presented by the animal and the evolution to neurologic symptoms, coma and death

Systemic Lupus Erythematosus Associated with Neurological Manifestations in a Border Collie Bitch

Background: Systemic lupus erythematosus (SLE) is an immune-mediated and multisystemic disorder which etiology is believed to be multifactorial. Its clinical signs vary accordingly to affected organs, cutaneous lesions being the most frequently observed. There are few reports of SLE in dogs with neurological manifestations. Therefore, the aim of this report is to describe a case of SLE in a dog with indicative signs of nervous system involvement.Case: A 6-year-old Border Collie bitch was referred to the Veterinary Hospital (HVU) of the University of Uberaba (UNIUBE) with a history of  with cluster seizures, inappetence and urinary incontinence. Erythema and flaking of nasal plan were noted on physical examination, and splenomegaly on abdominal palpation. Thrombocytopenia and slightly increased ALT were found on blood tests. Ehrlichiosis was suspected and doxycycline was prescribed together with phenobarbital for the control of seizures. In the follow-up visit, the dog was still presenting urinary incontinence, thrombocytopenia and splenomegaly. Also, an ulcer on the nasal mucocutaneous junction was observed. The patient went through a neurological examination which indicated thalamocortical lesion. Cerebrospinal fluid samples were obtained for cytology, culture and canine distemper test, and serology tests for leishmaniasis, toxoplasmosis and neosporosis were done. No alterations were found in these exams. The histopathology of the nasal lesion was proceeded and showed results consistent with lupus erythematosus. It was prescribed a 15-day course of prednisolone at immunosuppressive dose. The patient showed clinical improvement with this treatment. Azathioprine was started along with gradual removal of prednisolone. After twenty days of discontinuation of this drug, the dog presented epileptic seizures, urinary incontinence, thrombocytopenia, increased ALT and worsened nasal lesion. Prednisolone at immunosuppressive dose was reintroduced and the dose of azathioprine, increased. One week past this, the patient showed inappetence and an extensive hematoma in the thoracic region. Lab exams confirmed drug-induced acute pancreatitis. All medications were interrupted, the patient was hospitalized, and treatment for pancreatitis was initiated, but the dog passed away.Discussion: For involving multiple body systems and for presenting varied clinical signs, diagnosing SLE can be challenging in clinical routine. The dog from this report was a Border Collie; this breed is considered to be predisposed to this disease. The animal had a history of being exposed to solar radiation for a large part of the day, had dyspigmentation of nasal plan and had no application of sunscreen, predisposing the occurrence of SLE. Neurological signs are uncommon in SLE, but the seizures and the urinary incontinence were the main reasons for the dog’s guardian to look for medical assistance. The suspicion for SLE was raised due to cutaneous manifestations and persistent thrombocytopenia along with splenomegaly. Histopathological findings are essential for diagnosing SLE, as well as antinuclear antibody tests. Nonetheless, due to financial limitations, this last test was not performed. Azathioprine is an immunomodulating drug largely used along with glucocorticoids when treating SLE; however, this medication is prone to induce side effects as the ones presented by the dog from this report. Therefore, it is concluded that SLE should be considered as a differential diagnosis in patients showing cutaneous, hematological, systemic and neurological manifestations, considering the variety of signs caused by this disorder.Keywords: seizures, dog, immune-mediated encephalopathy. Lúpus eritematoso sistêmico associado a manifestações neurológicas em cadela da raça Border CollieDescritores: crises epilépticas, cão, encefalopatia imunomediada

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

Cutaneous Mast Cell Tumor in a Bitch

Background: The diagnostic of neoplasia in dogs has risen significantly in the last years and this fact is mostly attributed to the longer life expectancy of these animals, which contributes to a greater chance of exposure to carcinogenic agents. In between the diverse tumors that could compromise skin, the mastocytoma is the third most commonly diagnosed neoplasia. It is characterized by being a form of neoplasia with round cells, these being the mast cells. The objective of the present study consisted in relating a case of cutaneous mastocytoma in a 7-year-old bitch mixed-breed treated at the Veterinary Medical Teaching Hospital of the University of Uberaba (UNIUBE) - Uberaba, MG, Brazil.Case: The bitch initially presented a localized nodule external to the right ear pinna with cytology test suggesting a mastocytoma. The nodule was surgically removed and, posteriorly, an histopatholgy was not requested. After 5 months since the emergence of the nodule and a month after its surgical resection, the tutor noticed the presence of a new growth in the ipsilateral cervical region to the previous nodule. At this moment, the responsible veterinarian decided to refer the animal to an oncologist. During the appointment with the oncologist, alterations such as hyporexia and anemia were related, and the presence of a nodule in the right cervical region measuring 4.5 to 4 cm of diameter was verified. Material for cytologic evaluation of the neoplasia was collected and again the result suggested a mastocytoma. The new tumor was also surgically removed but was then referred to histopathological evaluation for diagnostic confirmation, grading and evaluation of surgical margins. The tumor was classified as an infiltrative subcutaneous mastocytoma presenting, additionally, compromised surgical margins. After its excision, the association with a chemotherapy treatment using a protocol of Vimblastina 2 mg/m², i.v. in unique dosage per section, associated with Predinisona 1 mg/kg, v.o, SID was indicated. Each section was realized with an interval of 7 days in between. Only 2 chemotherapy sessions took place. Because of the worsening of the clinical condition associated with a very weakened animal the veterinarian opted for the euthanasia of the animal.Discussion: The diagnostic of mastocytoma must be realized through the association of cytology and histopathology, in case histopathological evaluation is needed to confirm the obtained cytology result, to grade the tumor and to evaluate the compromising of surgical margins. In this sense, it was observed that the bitch was submitted only to cytology diagnostic when it presented the nodule in the ear pavilion. Yet, at the second approach realized by the oncologist, it was possible to realize adequate diagnose methods. However, the animal was not submitted to clinical staging of the mastocytoma due to the non-authorization of the exam by the tutor. Such measure is very important, as it reflects directly in the treatment and prognostic of the animal. Thus, image exams such as abdominal ultrasonography and chest X-ray should have been realized, as well as cytological and histopathological evaluation of the regional lymph nodes, in order to search for metastasis points in these places. As the data suggests, the importance of clinical staging of animals affected by this neoplasia and the importance of cytological evaluation associated with histopathology for a correct diagnosis, prognosis and mastocytoma treatment is noted. It is emphasized that many times veterinarians face impediment related to requesting all necessary exams coming from tutors, which compromises treatment success.Keywords: canine, mast cell, cytology, histopathology, neoplasia, tumor, chemotherapy. Título: Mastocitoma Cutâneo em uma cadela Descritores: canino, mastócito, citologia, histopatologia, neoplasia, tumor, quimioterapia

Corticosteroid Responsive Tremor Syndrome Associated with Estrus in a Female Dog

Background: Corticosteroid responsive tremor syndrome is an immune-mediated disorder that primarily affects small dogs aged 1 to 5 years. It is manifested by generalized tremors of high frequency and low amplitude, with involvement of head, trunk and limbs. The diagnosis is based on history, clinical signs and laboratory tests to rule out other conditions, as well as on the response to corticosteroid treatment. The aim of the present study was to report a case of a female dog with corticosteroid responsive tremor syndrome that began after estrus.Case: A 1-year-old, undetermined dog, weighing 4.9 kg, was attended at the Veterinary Hospital of Uberaba, with generalized tremors that impaired her walking and feeding. The picture had an acute onset, there was no history of intoxication, trauma, but the animal had an organophosphate-based collar. The bitch was not castrated and had been in heat for a month. In the clinical evaluation, it was observed that besides the tremors, the dog had hypermetria and hyperthermia. Suspected adverse reaction to organophosphorus or encephalitis. The collar was removed from the animal. Hemogram, serum biochemistry, analysis and culture of cerebrospinal fluid and test for distemper were performed. The hemogram was leukopenia due to lymphopenia. No alterations were observed in serum biochemistry CSF culture and the distemper test were negative. The CSF analyte revealed pleocytosis with predominantly lymphocytes, density and glucose increased slightly. The diagnosis of encephalitis of inflammatory etiology was established. Treatment with prednisone and diazepam was performed. Clinical signs improved after seven days of therapy. Approximately one and a half years after the initial clinical picture, the animal presented recurrence of the tremors associated with estrus again. The same treatment was instituted and the dog underwent ovariohysterectomy. There was no relapse of the clinical picture.Discussion: Syndromes characterized by generalized tremors were initially described in white-coated dogs. Later, they were observed in dogs of other pelts and in cats. It currently receives different nomenclatures such as idiopathic tremor syndrome or corticosteroid responsive tremor syndrome. The animal history of the present case allowed to exclude the main differential diagnoses of tremors caused by medication, intoxication and hypomyelination. The clinical manifestations of hyperthermia, hypermetry and generalized tremors of high frequency and low amplitude were also described by other authors in cases of corticosteroid responsive tremor syndrome. The age and size of the animal is consistent with previous reports that observed a higher frequency in animals from 1 to 5 years of age of small breed. The absence of alterations in the tests that indicated an infectious process allowed the diagnosis of inflammatory disease and the rapid improvement of the clinical signs after treatment with prednisone allowed to establish the diagnosis of the syndrome of the responsive corticosteroid tremor. Recurrence of the clinical picture again after estrus suggests that the variation of the hormones estrogen and progesterone during this phase may influence neuronal excitability as well as stimulate an inflammatory reaction. Further studies are needed to clarify the pathophysiology of corticosteroid responsive tremor syndrome and to investigate this hypothesis of sex hormone involvement in inflammation

Reactive Seizures Due to Hyperlipidemia in a Maltese Dog

Background: Primary hyperlipidemia is a condition that affects some specific breeds. It has been previously described in Miniature Shnauzer, Beagles, Shetland Shepdog and West Highland White Terrier. There are no reports of primary hyperlipidemia in Maltese dogs. It is a hereditary disorder of lipoprotein metabolism. The etiology is unknown and may be related to a genetic problem in lipoprotein lipase or to the absence of apaprotein CII. Clinical signs include spontaneous arterosclerosis, retinal lipemia, cutaneous xanthomas, abdominal pain, lethargy, vomiting and / or diarrhea. Neurological manifestations such as seizures and behavioral changes may also occur. The aim of this report is to describe a case of reactive seizures due to hyperlipidemia in a dog.Case: A 5-year-old male Maltese dog was admitted with a history of seizures. Hypertension and abdominal distension with large amounts of intestinal gases were found in general physical examination. Neurological examination revealed impaired nasal septum sensory perception, which was slightly bilaterally reduced, and pain on cervical palpation and in the brachial plexus region. Based on history and clinical examination, it was possible to locate the lesion in the thalamocortical region and to suspect idiopathic epilepsy, reactive seizures, and symptomatic epilepsy due to meningoencephalitis of unknown origin. The diagnosis of primary hyperlipidemia was made by exclusion with the aid of laboratory tests and ultrasound. After the establishment of a fat restriction diet, bezafibrate, phenobarbital, and omega-3 supplementation, the animal improved significantly with the reduction of epileptic seizures.Discussion: The initial clinical suspicion was hyperadrenocorticism as the primary cause of hyperlipidemia. This suspicion was based on the presence of polyphagia, polydipsia, polyuria and abdominal distension, together with laboratory results of thrombocytosis, increased ALT and AF, and hyposenuria; but ultrasound images and ACTH stimulation test ruled out this differential diagnosis. Hypothyroidism was also ruled out since LDL values were normal and the animal was extremely active. Regarding nephrotic syndrome, it was also excluded for some alterations would be present, such as severe proteinuria, cholesterol reduction and hypoalbuminemia. As for diabetes mellitus, it was discarded because of the dog’s young age and due to the absence of suggestive clinical signs. The suspicion of primary hyperlipidemia was based on increased levels of triglycerides, and the presumptive diagnosis was of reactive seizures due to hyperlipidemia. It is essential, when treating hyperlipidemia, to readjust to a low-calorie diet with fat concentration below 8% and protein level above 18%. Generally, these restricted diets are for life. Omega-3 supplementation can be performed to help maintain low levels of triglycerides. Drug therapy is usually carried out with bezafibrate, which is used in human medicine as treatment for hypertriglyceridemia, and has showed good results in the control of hypertriglyceridemia and hypercholesterolemia in dogs with primary and secondary hyperlipidemia. Six months after the beginning of the treatment, the animal no longer presented abdominal distension and pain, cholesterol values and its fractions were controlled, as well as triglycerides. Seizures were also under control. Therefore, hyperlipidemia is an important differential diagnosis in cases of patients presenting seizures, especially when dealing with young animals showing signs of metabolic diseases

Mucopolysaccharidosis Type I in a Dog

Background: Mucopolysaccharidoses (MPS) are a group of rare illnesses caused by deficient activity of enzymes required for degradation of glycosaminoglycans (GAGs). Each type of MPS is caused by mutations in one of the genes that encode the 11 acid hydrolases involved in this degradation process, which are present in the lysosomes. Progressive accumulation of GAGs in the lysosomes result in cellular dysfunction and multisystemic clinical signs, with consequent decrease in quality of life and lifespan of the affected patients. The objective of the present work is to report a case of MPS type I in a dog.Case: A mixed-breed male dog of approximately 2-month-old weighing 2.5 kg was referred to Hospital Veterinário de Uberaba with a distended abdomen. At the clinical examination, the patient exhibited a regular nutritional status, pale mucous membranes, 7% dehydration, an arterial pulse rate of 120 beats per minute, a respiratory rate of 40 breaths per minute, and a heart rate of 120 beats per minute. There were increased abdominal volume and tension, and hepatosplenomegaly. The abdominal percussion exam produced a dull tone. Additional findings included muscular atrophy, increased volume in the metaphyseal areas of the thoracic and pelvic limbs, valgus limb deformity in the thoracic limbs, and instability of the hip joint. Radiographic examination revealed a series of bone alterations such as reduced vertebral bodies, a generalized decrease in radiopacity, thin cortical areas in long bones, narrowing of the pelvic canal, and marked deformation and irregularities in acetabular and epiphyseal (both proximal and distal) areas of the femurs and tibias. Ankylosis of the tibiotarsal and tarsometatarsal joints was also observed. There was also loss of trabecular structure and irregularities on the surfaces of all epiphyses of the bones, epiphyseal lines markedly open, and bones that were shorter and thicker than normal. The suspected diagnoses were pseudoachondroplasia and mucopolysaccharidosis. In view of the clinical and radiographic findings, tests were performed to investigate the clinical suspicion of MPS. Consequently, qualitative and quantitative tests of GAGs in the urine, as well as a blood enzymatic essay, were requested; results confirmed the diagnosis of MPS type I. Intensive treatment allowed the patient to reach adulthood. Whenever new clinical signs emerged, they were treated palliatively. As the disease became more severe, the patient died at the age of 3 years.Discussion: Mucopolysaccharidosis type I is a rare disease that exhibits variable clinical signs and for which there is no specific treatment in dogs; these characteristics hinder diagnosis and treatment of patients as the one described in this report. The major clinical signs observed in this case are in agreement with those reported in the literature, according to which the disease can cause severe alterations such as bone defects, increased volume and deformities in the joints of the limbs, corneal opacity, and enlargement of abdominal organs such as the liver and spleen. In considering diagnostic methods for MPS, the main screening test is quantification of GAGs in the urine. The confirmatory test for MPS consists of analysis of the activity of specific lysosomal enzymes in a blood sample; this test allowed the establishment of a diagnosis in this case. Enzyme replacement therapy, in which a recombinant enzyme is used, have yielded good results in humans and dogs. However, this treatment does not cure the disease – it only attenuates the clinical signs and enables the patient to reach adulthood. Access to enzyme replacement therapy was not possible in the present case. As a conclusion, MPS should be included in the differential diagnosis of developmental diseases in puppies. This highlights the importance of further studies and reports on this disease

Megaureter gigante por ectopia ureteral intramural em cão

Background: The urinary tract is composed by kidneys, urinary bladder and urethra. The kidneys produce urine that achieve urinary bladder by ureters. These have the origin in the renal pelvis, run through the retroperitoneum, end up at the dorsolateral superficies of the urinary bladder, and empty at the trigone. Ureters abnormalities are the rarest congenital defects in the canine urinary tract and ureteroceles are cystic dilatations of the distal segment of the ureter that could be associated to partial or complete urinary obstructions and could lead to megaureter and hydronephrosis. So, the aim of the present study was to describe a case of megaureter by intramural ureteral ectopia in a bitch. Case: A 1-year-old-and-8-month bitch Akita, weighing 18 kg, was referred to the Uniube Veterinary Hospital with vaginal secretion, prostration, hypodipsia, hyporexia and pyrexia related by the tutor. On physical examination, an increase in vulva volume and a vaginal discharge were observed. Nevertheless, others physical exams, blood count and biochemical tests were considered to be within normal parameters. Urinalysis showed cloudy aspect, proteinuria, occult blood, erythrocytes, pyuria, leucocytes, and discreet presence of bacteria. Abdominal ultrasonography revealed a megaureter with right uterocele and excretory urography showed absence of glomerular filtration by right kidney. The patient was submitted to surgery for right kidney and ureter exeresis. Histopathology evaluation showed intense dilation of the ureter and severe multifocal renal fibrosis. The surgery was well succeeded, and the patient recovered completely.  Discussion: Once megaureter are associated with congenital abnormalities like ectopic ureter and ureterocele, it is usually diagnosed in young patients with medium age of 10 months, which is below the age of the patient in this case report. Additionally, in the patient here reported, the unilateral alteration could explain the absence of kidney fail symptoms. In more than 90% of the cases, the ureteral ectopia was associated with multiple anomalies in the urinary tract, as was observed in this patient, that presented besides ectopic ureter, ureterocele, megaureter and renal dystrophy. All these morphological alterations made impossible the complete urine elimination, which predispose to urinary tract infection, that was observed in this report. According to literature, urinary tract anomalies are associated with infection in 64 to 85% and 50% of the cases also present hydronephrosis and hydroureter. It was also described that ureteral ectopia is diagnosed by visualization of hydroureter in abdominal ultrasonography. The findings present in this report differs a little, once the right kidney was atrophic possibly by malformation or even so by a chronic renal lesion due to the difficulty in urine flow. The excretory urography showed no filtration in the right kidney, indicating non-functionality that was confirmed by histopathology, in which was observed small glomerulus and large amount of connective tissue deposition. In cases of unilateral megaureter with ipsilateral kidney commitment, there is indication of nephroureterectomy, that was performed in the patient of the present report. As far as we know, this is the first report of megaureter, ureterocele and ectopia ureteral together in the same patient. In conclusion, the procedure was secure, efficient and promote a better quality of life for the patient and prevent the recurrence of urinary tract infections. Keywords: Urinary system, malformation, nephroureterectomy, surgery, cystitis. Título: Megaureter gigante por ectopia ureteral intramural em cadela. Descritores: Sistema urinário, malformação, nefroureterectomia, cirurgia, cistite. ystitis.O sistema urinário é composto por rins, ureteres, bexiga e uretra. Os rins produzem a urina que chegará à bexiga por meio dos ureteres. Estes têm origem na pelve renal, correm pelo retroperitônio e desembocam na superfície dorsolateral caudal da bexiga e se esvaziam no trígono. Alterações nos ureteres são os defeitos congênitos mais raros do sistema urogenital de cães. Ureteroceles são dilatações císticas do segmento distal do ureter e podem estar associadas a obstruções urinárias parciais ou completas e podem levar ao megaureter e a hidronefrose. O presente estudo tem o objetivo de descrever um caso de megaureter por ectopia ureteral intramural em uma cadela. Caso: Uma cadela Akita, csecreção vaginal, prostração, hipodipsia, hiporexia e pirexia. Ao realizar o exame físico observou-se aumento de volume vulvar, corrimento vaginal. Os parâmetros do exame físico estavam normais. Não foram observadas alterações no hemograma e nem nos exames bioquímicos. Diversas alterações foram observadas na urinalise como aspecto turvo, proteinúria, sangue oculto, eritrócitos, piuria, leucócitos e presença discreta de bactérias. A ultrassonografia abdominal mostrou um megaureter com ureterocele direitos e a urografia excretora mostrou ausência de filtração glomerular no rim direito. O paciente foi submetido cirurgia para exérese do rim ureter direitos. A avaliação histopatológica do rim e ureter direitos mostrou dilatação intensa de ureter e fibrose renal multifocal intensa.O procedimento cirúrgico foi bem-sucedido e o animal se recuperou bem. Discussão: Por estar associado a alterações congênitas como ureter ectópico e ureterocele, o megaureter é diagnosticado em pacientes jovens com idade média de 10 meses, idade inferior ao paciente do presente relato. Adicionalmente, no animal aqui relatado, a alteração unilateral pode explicar  a falta de sinais de falha renal. Mais de 90% dos casos, a ectopia ureteral está associada a múltiplas anomalias do trato urinário, assim como o observado no paciente deste relato, que além do ureter ectópico, apresentava ureterocele, megaureter e atrofia renal. Com todas essas alterações morfológicas que impossibilitavam a eliminação completa da urina, observa-se, como consequência, a predisposição a infecções do trato urinário, o que de fato foi observado. A literatura aponta que anomalias do trato urinário estão associadas com infecção em 64 a 85% dos casos, ainda citaram que cerca de 50% dos casos apresentam hidronefrose e hidroureter.  Foi também descrito que ureteres ectópicos são diagnosticados em decorrência do hidroureter visibilizado na ultrassonografia abdominal. Os achados neste relato diferem um pouco do que foi descrito, visto que o rim direito estava atrofiado, possivelmente em decorrência de uma má formação ou até mesmo de uma lesão renal crônica causada pela dificuldade de escoamento da urina no lado direito, como citado anteriormente. A urografia excretora realizada no paciente do presente relatou evidenciou que não havia filtração no rim direito, indicando afuncionalidade, o que foi confirmado pela avaliação histopatológica, em que foi possível observar glomérulos diminutos e grande quantidade de deposição de tecido conjuntivo fibroso. Em casos de megaureter unilateral com presença de comprometimento grave do rim ipsilateral, há indicação de nefroureterectomia, como foi realizado no paciente deste relato. Até onde se sabe, esse é o primeiro relato de megaureter, ureterocele e ectopia ureteral em um mesmo paciente. Em conclusão, o procedimento executado foi seguro e se mostrou eficiente no tratamento do defeito anatômico congênito, promovendo assim uma melhor qualidade de vida para o paciente e prevenção de recorrência de infecções do trato urinário. Descritores: Sistema urinário; malformação; nefroureterectomia; cirurgia; cistite

MEGAESÔFAGO SECUNDÁRIO A ESTENOSE ESOFÁGICA EM GATO: RELATO DE CASO

Megaesôfago é caracterizado por uma dilatação esofágica com comprometimento do seu peristaltismo. O presente estudo relata um caso clínico de megaesôfago secundário a estenose esofágica uma gata, siamesa, com 1 ano de idade, com histórico de regurgitação crônica refratária ao tratamento. O animal apresentava histórico de vômito recorrente após ser submetida à castração e receber medicação pós-operatória na forma de comprimidos. O paciente apresentava emagrecimento progressivo, regurgitação crônica e grave desidratação. O exame radiográfico mostrou acúmulo de conteúdo no esôfago torácico sugerindo obstrução que foi confirmado no exame contrastado. A paciente foi estabilizado e submetido à esofagectomia para restabelecimento do fluxo da ingesta no esôfago. No pós-operatório recebeu tratamento suporte com fluido intravenoso, antibiótico e anti-inflamatório e foi instituído manejo alimentar com dieta líquida ministrada com o animal em posição bipedal. A recuperação do paciente foi satisfatória. Concluindo-se que a estenose esofágica é uma alteração grave que pode levar ao megaesôfago e que seu tratamento pela esofagectomia parcial e manejo alimentar é eficiente permitindo a completa recuperação do animal