Diagnóstico e tratamento da persistência do ducto arterioso em cães

O presente estudo reuniu diversos artigos técnico-científicos de relevância, entre os quais foram escolhidos 19 deles, baseado no objetivo do trabalho. Assim sendo, este artigo aborda pontos básicos e essenciais arterioso em cães. O objetivo do artigo foi potencializar o conhecimento sobre esta doença aos estudantes e profissionais, incentivando a continuidade da pesquisa sobre o tema e a busca contínua por melhorias. A persistência de ducto arterioso é uma doença cardíaca congênita comum na medicina veterinária, especialmente em cães. No geral, quando corretamente tratada tem um prognóstico favorável. A fim de se tomar a melhor decisão possível, é necessário conhecimento sobre técnicas diagnósticas, de classificação e correção. Do contrário, o prognóstico é reservado. Desta forma, é importante a elucidação da classe médica sobre a importância da investigação clínica em filhotes, para um diagnóstico precoce

ABORDAGEM VENTRAL PARA MANDIBULECTOMIA EM 10 CÃES

O cão é frequentemente acometido por neoplasias orais de diferentes origens celulares. Com potencial metastático e invasivo muito variável, a heterogeneidade dos tumores orais tem em comum a necessidade de realizar exérese ampla por meio de mandibulectomias ou maxilectomias. A extensão da ressecção depende do estadiamento do tumor (Liptak, 2020). As técnicas tradicionais para mandibulectomia frequentemente envolvem acessos intraorais, zigomatectomia e lesão à estruturas faciais importantes como nervos e vasos. Uma técnica de abordagem ventral foi descrita com o intuito de superar essas questões (De Mello Souza et al., 2019). Objetiva-se descrever as vantagens e complicações intra e pós-operatórias observadas com o uso da técnica de abordagem ventral para mandibulectomia em cães. Foram selecionados retrospectivamente 10 cães submetidos a mandibulectomia por meio de abordagem ventral para remoção de neoplasias orais. Destes animais, seis realizaram mandibulectomia total unilateral, dois mandibulectomia segmentar e dois mandibulectomia rostral. Na abordagem proposta os animais foram posicionados em decúbito dorsal com a cabeça elevada e então realizada uma incisão sobre o corpo da mandíbula na região ventral da sínfise até o processo angular. Prosseguiu-se com a dissecção da face lingual e gengival da mandíbula. A sinfisiotomia mandibular foi realizada utilizando serra oscilatória. Foi feita a ligadura da artéria alveolar no aspecto medial caudal da mandíbula. O musculo masseter foi solto na sua inserção próximo ao digástrico e elevado da fossa massetérica, na sequência a musculatura pterigoide foi desinserida do processo angular e condilar. A desarticulação temporomandibular foi realizada incisando sua cápsula, preservando a artéria maxilar localizada caudomedial a ela. Por fim, as últimas inserções musculares foram removidas. A síntese se deu por meio do fechamento das camadas mucosa, muscular e subcutânea utilizando suturas absorvíveis em padrão contínuo simples. Suturas de pele foram aplicadas rotineiramente. Os animais foram acompanhados quanto as complicações de curto prazo durante ao menos 30 dias e após por meio de contato telefônico, para complicações de longo prazo. A abordagem ventral permitiu uma boa visualização das estruturas anatômicas, pouco contato com a face intraoral e facilidade de exposição e incisão da capsula articular temporomandibular nos casos de mandibulectomia total. Somente um animal apresentou complicações intraoperatórias. Neste caso houve dano inadvertido a artéria maxilar que levou a hemorragia, no entanto esta foi controlada facilmente. Devido a esta lesão vascular o animal apresentou cegueira e anosmia temporária. No pós operatório foi observado quatro casos de deiscência de sutura, sendo que dois exigiram intervenção cirúrgica e um caso de má oclusão mandibular contralateral. Todos os animais retornaram à alimentação espontânea dentro de 5 dias pós operatório. No longo prazo, a única complicação observada foi o deslocamento lateral da língua, que ocorreu em todos os casos de mandibulectomia total. O resultado estético foi considerado satisfatório pelos proprietários. A técnica de mandibulectomia por abordagem ventral se mostrou viável e associada a baixas complicações. Subjetivamente, parece ser de mais fácil execução que a técnica tradicional

Vulvar Lymphangiosarcoma in a Bitch

Background: Lymphangiosarcoma (LSA) is a rare, highly malignant and infiltrative neoplasm of the lymphatic endothelium of dogs and cats. It is mostly reported in medium to large breed dogs, over 5-year-old, with no sexual predisposition. Affected animals present fluctuating and diffuse swelling, covering both dermis and subcutaneous tissue, spreading through lymphatic and haematic vessels. Histologically, LSA is characterized by connected channels devoid of conspicuous haematic elements. Treatment depends on location of the neoplasm, staging, and possibility of curative surgical excision. Chemotherapy and radiotherapy can increase survival time. In this report, we describe a rare case of vulvar LSA in a dog. This is the first Brazilian report of LSA in dogs so far.Case: A 3-year-old, female, mixed breed dog was presented for evaluation of vesicle-bullous lesions in the vulvar and perivulvar region with progressive growth along 6 month. Histopathology revealed neoplastic proliferation in the superficial dermis, advancing through the profound dermis. The histological lesion pattern was consistent with angiosarcoma, which united along with macroscopic pattern of the tumor, and the presence of multiple anastomosed vascular structures without erythrocytes within it at microscopy, was compatible with LSA. No evidence of metastasis or lymphadenopathy was found on survey radiography and ultrasound. We performed a surgical excision, and remaining wound was reconstructed with an advancement skin flap. Despite wide surgical resection, neoplastic cells could be found in surgical borders, as well as a metastatic inguinal lymph node. Postoperative chemotherapy based on doxorubicin as a single agent was administrated. Disease free interval (DFI) was one month after surgery, when small bullous lesions were observed near the surgical site, and histopathological exam confirmed LSA. Three months after the surgical procedure, the patient presented with worsening of the lesions, anorexia, and apathy. The owner opted for euthanasia. Total survival time was five months.Discussion: The LSA occurs often in dogs above five years old, unlike this case, in which the patient was 3 years old. Several anatomic locations were cited in other reports. In this case, the lesion was in both the vulvar and perivulvar regions, which is an uncommon location of LSA, described as secondarily affected region in one report only. Despite absence of metastasis in this case, lungs, kidneys, bone marrow, and spleen can be affected. Histopathologic exam is the golden standard for a definitive diagnose of LSA. Diagnosing LSA may be challenging due to its resemblance to hemangiosarcoma, and confirmation is only possible if histopathology detects an absence of red blood cells in the lymphatic channels. Prognosis is poor due to LSA aggressive and infiltrative features. Doxorubicin demonstrated good clinical response in other dogs. Chemotherapy protocols, whether alone or in combination with cyclophosphamide, have been proving to be promising in dogs with soft tissue sarcomas, such as LSA. Surgical approach is the most appropriate and it may be associated with radiotherapy or chemotherapy, especially if complete resection of the tumor is not possible. In this report, even though it was a young animal, the location and extension of the lesion did not contribute to the good prognosis, even after adding adjuvant chemotherapy to the treatment

Sedative and cardiorespiratory effects of methadone, alone or in combination with acepromazine or xylazine, in cats

Seis felinos com peso médio de 3,3±0,3 kg foram aleatoriamente submetidos a 6 tratamentos, com intervalo mínimo de 1 semana. Os animais receberam a administração intramuscular de solução fisiológica (controle), metadona (0,3 mg/kg), acepromazina (0,1 mg/kg), xilazina (1,0 mg/kg), acepromazina (0,05 mg/kg) + metadona (0,3 mg/kg) ou xilazina (0,5 mg/kg) + metadona (0,3 mg/kg). As freqüências cardíaca (FC) e respiratória (FR), a pressão arterial sistólica (PAS), a temperatura retal, o grau de sedação e o reflexo interdigital foram avaliados antes (basal) e após a administração dos tratamentos em intervalos específicos por 90 minutos. Nos animais tratados com xilazina ou xilazina/metadona, houve diminuição em FR, FC e na temperatura retal. Nos mesmos tratamentos, 1/6 e 2/6 animais não apresentaram reflexo interdigital em pelo menos um dos momentos avaliados. Nos animais que receberam a administração de 0,1 mg/kg de acepromazina, houve diminuição em PAS. Os escores de sedação foram mais elevados nos animais que receberam a administração de xilazina ou xilazina associada à metadona. A administração da metadona isolada ou associada à acepromazina resultou em sedação considerada insatisfatória e sinais de excitação em alguns animais. O uso da metadona isolado ou em associação à acepromazina foi considerado ineficaz quando se objetiva sedação moderada à intensa. A associação da metadona à xilazina produz sedação moderada à intensa, sendo esse efeito semelhante àquele observado após a administração da xilazina isoladamente em dose mais elevada.Six cats weighting 3.3±0.3 kg were randomly allocated to 6 treatments, with at least one-week intervals. The cats received intramuscular administration of physiological saline (control), methadone (0.3 mg/kg), acepromazine (0,1 mg/kg), xylazine (1.0 mg/kg), acepromazine (0.05 mg/kg) plus methadone (0.3 mg/kg) or xylazine (0.5 mg/kg) plus methadone (0.3 mg/kg). Heart rate (HR), respiratory rate (RR), indirect systolic arterial pressure (SAP), rectal temperature, sedation score and pedal withdrawal reflex were evaluated before (baseline) and at selected intervals after treatment administration for 90 minutes. Respiratory rate, HR and rectal temperature decreased in cats given xylazine or xylazine plus methadone. In 1 out of 6 cats given xylazine and 2 out of 6 cats given xylazine/methadone, pedal withdrawal reflex was absent. In cats given 0.1 mg/kg of acepromazine, SAP decreased compared to baseline. Sedation scores were greater in cats given xylazine or xylazine plus methadone. Methadone alone or in combination with acepromazine did not produce a satisfactory degree of sedation and resulted in signs of excitement in some of the cats. Methadone alone or combination with acepromazine was not considered an effective protocol when moderate to deep sedation is required in cats. Methadone in combination with xylazine produces moderate to deep sedation, being this effect comparable to that achieved with a higher dose of xylazine alone

Comparação entre pericárdio bovino preservado em glicerina e malha de poliéster no reparo de falhas da parede abdominal em ratos Comparison of glycerin preserved bovine pericardium and a polyester mesh for the repair of abdominal wall defects in rats

OBJETIVO: Comparar uma malha comercial de poliéster com o pericárdio bovino preservado em glicerina na reconstituição de defeitos da parede abdominal. MÉTODOS: Foram utilizados 30 ratos, divididos em dois grupos eqüitativos. Efetuou-se uma excisão retangular de 2,5 x 2 cm, incluindo toda a musculatura abdominal e peritônio. No grupo I a parede abdominal foi reparada com malha de poliéster e no grupo II com pericárdio bovino conservado em glicerina. Os animais foram sacrificados aos 15, 60 e 90 dias de pós-operatório, sendo o local cirúrgico avaliado macroscópica e histologicamente. RESULTADOS: Os animais do grupo I apresentaram aderências mais severas e em maior número quando comparados aos do grupo II; porém, sem comprometimento funcional. A análise histológica revelou incorporação dos tecidos aos implantes, com maior resposta fibroblástica nos animais do grupo I. CONCLUSÃO: A malha de poliéster oferece maior resistência estrutural e resposta fibroblástica mais intensa; contudo, promove grande quantidade de aderências às vísceras abdominais, quando comparada ao pericárdio bovino.<br>PURPOSE: The aim of the study was to compare polyester mesh and glycerin preserved bovine pericardium for the repair of abdominal wall defects. METHODS: Thirty rats divided into two equal experimental groups were used. A 2.5 x 2 cm rectangular defect including all abdominal muscles and peritoneum was performed. The defect was reconstructed using polyester mesh in group I and glycerin preserved bovine pericardium in group II. The animals were submitted to euthanasia at 15, 60 and 90 days postoperatively, and the surgical area was evaluated by macroscopic and microscopic examination. RESULTS: The animals of the Group I had more abdominal adhesions and those were more severe than the animals of the Group II. The microscopic examination showed incorporation of the tissues in the implants with accentuated fibroblastic reaction in the animals of the group I. CONCLUSION: The polyester mesh offers more structural resistance and more fibroblastic response; however, leads to greater amount of abdominal viscera adhesions when compared to preserved bovine pericardium

Sciatic Nerve Injection Palsy in a Dog: Electrodiagnostic Testing and Microsurgical Treatment

Background: Iatrogenic damage to the ischiatic nerve is considered uncommon and may cause dysfunction with variable clinical signs dependent on type and severity of injury. Due to important role of this nerve in locomotion and weightbearing limb, a poor prognosis for recovery may be observed in many cases. Electromyography analysis may suggest the neuroanatomic localization, diagnosis information, and severity of lesion to determine better therapeutic intervention. Therefore, the aim of this report is to describe the possible cause, diagnosis and treatment of a postinjection ischiatic nerve injury in a dog with complete recovery.Case: A 3-year-old neutered male dachshund dog was referred to the Veterinary Hospital due to inability to weight support in the right hind limb after diminazene diaceturate intramuscular injection. The gait evaluation showed dropped-hock and knuckling into the digits of the right hind limb and neurologic examination revealed moderate muscle atrophy below tofemorotibial joint of the right hind limb with sensory analgesia (superficial and deep) on the lateral, dorsal, and plantar surfaces, absent patellar reflex, and proprioceptive deficit. Electrophysiologic testing was done under general anesthesia in a 2-channel Nicolet Compass Meridian apparatus. Absence of compound muscle action potentials after right fibular and tibial nerve stimulations, and abnormal spontaneous activity in cranial tibial, gastrocnemius and deep digital extensor muscles were observed. A diagnosis of moderate/severe axonotmesis of sciatic nerve was achieved. Under microscope magnification, all adherent adjacent tissue and epineural sheat were removed. Due this, a small epineural window was created. On neurological examination performed 30 days after surgery, complete recovery of sensitivity of the right hind limb, and normal proprioception were observed. The muscle atrophy was also noted to have improved.Discussion: The ischiatic nerve mechanisms of injury include direct needle trauma, the drug or vehicle used for injection, or secondary constriction by scar, factors that may be associated to damage nerve observed in the present case. During a sciatic nerve injection, the combination of intrafascicular placement of a needle and high-pressure injection may cause severe fascicular damage and persistent neurologic deficits. In the present case, damage to the nerve probably was not caused bythe injection needle, but due to injection agent. Chemical irritation or toxic reaction to the agent may cause different degrees of nerve injury. The electrophysiologic testing is an important tool for determining alteration of function and integrity of the axonal motor unit. In the present report, the electrophysiologic testing showed denervation potentials in the musclesinnervated by the sciatic nerve (positive waves and fibrillation potentials), and the absence of compound muscle action potentials was indicative of severe axonal damage of the right ischiatic nerve. In human patients with postinjection ischiatic nerve injury, early surgical treatment with neurolysis or resection and anastomosis are the procedures recommended. In the present report, external neurolysis and epineural window were used showing excellent functional results. The epineural window was performed due to adherence of tissue and scar surrounding the nerve, permitting neural decompression.Keywords: axonotmesis, neurophysiology, neurolysis, dogs

Comparative study on the sedative effects of morphine, methadone, butorphanol or tramadol, in combination with acepromazine, in dogs

To compare the effects of morphine (MOR), methadone (MET), butorphanol (BUT) and tramadol (TRA), in combination with acepromazine, on sedation, cardiorespiratory variables, body temperature and incidence of emesis in dogs.Prospective randomized, blinded, experimental trial.Six adult mixed-breed male dogs weighing 12.0 +/- 4.3 kg.Dogs received intravenous administration (IV) of acepromazine (0.05 mg kg(-1)) and 15 minutes later, one of four opioids was randomly administered IV in a cross-over design, with at least 1-week intervals. Dogs then received MOR 0.5 mg kg(-1); MET 0.5 mg kg(-1); BUT 0.15 mg kg(-1); or TRA 2.0 mg kg(-1). Indirect systolic arterial pressure (SAP), heart rate (HR), respiratory rate (f(R)), rectal temperature, pedal withdrawal reflex and sedation were evaluated at regular intervals for 90 minutes.Acepromazine administration decreased SAP, HR and temperature and produced mild sedation. All opioids further decreased temperature and MOR, BUT and TRA were associated with further decreases in HR. Tramadol decreased SAP whereas BUT decreased f(R) compared with values before opioid administration. Retching was observed in five of six dogs and vomiting occurred in one dog in MOR, but not in any dog in the remaining treatments. Sedation scores were greater in MET followed by MOR and BUT. Tramadol was associated with minor changes in sedation produced by acepromazine alone.When used with acepromazine, MET appears to provide better sedation than MOR, BUT and TRA. If vomiting is to be avoided, MET, BUT and TRA may be better options than MOR