Juvenile Panhypopituitarism in a Dog – What are the Therapeutic Challenges?

Background: Juvenile panhypopituitarism is an endocrinopathy that affects young dogs and must be differentiated from other causes of height disorders, as one could have a deficiency of one or more adenohypophysis hormones, besides growth hormone. Diagnosis consists of excluding endocrine and non-endocrine causes. Treatment requires administration of heterologous porcine growth hormone or progestins, as well as supplementing other hormones that are deficient in the circulation. The prognosis for these patients tends to be unfavorable and they have a shorter life expectancy. The present case aimed to report the therapeutic challenges in a dog diagnosed with juvenile panhypopituitarism. Case: This study presents the case of a 6-month-old crossbred Labrador/Brazilian Fila dog, not neutered, 6.7 kg of body weight (body condition score 5/9), with a growth disorder and persistence of the puppy coat, when compared to other members of the same litter. During inspection, it was possible to observe an undersized dog and soft puppy coat, besides no bone irregularities or joint tenderness was noted. The other physical examination parameters were within the normal range for the species. No changes in complete blood count and only increases in urea, cholesterol and alkaline phosphatase activity were observed. Thyroid and abdominal ultrasound (US) examination did not reveal any remarkable changes. After serum dosage of insulin-like growth factor, thyroxine, thyrostimulating hormone, and cortisol, the patient was diagnosed with juvenile panhypopituitarism and underwent therapy with medroxyprogesterone and thyroid hormone supplementation. Monitoring was instituted at intervals of 3, 6, and 12 weeks, and currently every 3 or 4 months and the IGF-1 values normalized after 6 months with. After 8 months of therapy, the patient had good body growth and bone mineralization compared to the time of diagnosis. However, skeletal development was completed only 12 months after hormone replacement, accompanied by the presence of vertebral osteophytes and coxofemoral osteoarticular alterations. Considering chronic use of progestins, ovariosalpingohysterectomy (OSH) was recommended, but for personal reasons, the owners chose to do not submit her to surgery. After 18 months of treatment, the dog starts to exhibit prostration, selective appetite, and increased abdominal volume. After imaging exam, she was forwarded for OSH, due to consistent findings of pyometra. Subsequently, even the supervision of possible comorbidities involved in the chronic use of progestins was maintained at half-yearly intervals, the bitch returned to the service with skin thickening, increased limb volume, and macroglossia after 60 months of therapy. At this point IGF-1 values were higher when compared to the previous measurements and the application of medroxyprogesterone was suspended. Its supplementation was reintroduced only after 8 months when IGF-1 was significantly reduced. To date, the patient is close to 6 years of age and with a good quality of life. Discussion: The greatest therapeutic challenge for these patients involves dealing with the adverse effects of progestins, mainly related to reproductive disorders and alopecia at the application site, as well as maintaining adequate hormone replacement in order to avoid hypersomatotropism. Although longevity is lower in these individuals, the patient in this report has achieved six years of age and has had an excellent quality of life so far. Keywords: adenohypophysis, growth hormone, pituitary dwarfism, thyrostimulating hormone

Canine Cystitis - Biofilm Formation by Bacterial Isolates

Background: Biofilms have been reported as important virulent markers associated with drug resistance in urinary tract infections (UTIs) in humans and dogs. However, in veterinary medicine, researches involving biofilm formation, treatments and preventions have been limited; yet, it is still possible to find few studies demonstrating biofilm-forming bacteria associated with different comorbidities such as otitis, wound infections, UTIs, and endometritis. These studies generally select dogs with chronic and recurrent infections, which could be an important factor in antibiotic resistance. We aimed to evaluate biofilms in sporadic cystitis regarding prevalence and drug resistance.Materials, Methods & Results: Urine samples were collected by cystocentesis from 36 client-owned dogs under clinical and laboratory suspicion of non-recurrent urinary bladder infection (cystitis). Urine was aseptically plated onto blood agar, MacConkey, and CLED, followed by incubation for 24 to 48 h. Definitive identification of a potential pathogen was made by subculture collected from an isolated colony to obtain a pure culture. The gram staining method and specific biochemical tests (phenol red fermentation, lysine, phenylalanine, citrate, sulfide-indole-motility, and urease) were used to distinguish and classify the bacteria. After identification, the bacteria were tested for antimicrobial susceptibility by a standard disk diffusion method, using the following antimicrobials: amoxicillin with clavulanic acid, ampicillin, ceftriaxone, ciprofloxacin, clindamycin, cefazolin, cephalothin, erythromycin, gentamicin, norfloxacin, and sulfamethoxazole-trimethoprim. The biofilm-forming ability was determined based on a culture in Congo red agar (CRA), where biofilm producer strains formed black colonies with a dry crystalline surface, while non-biofilm producer strains formed red colonies with a smooth surface. A crystal violet dye assay was used to confirm the CRA results. Of the 36 urine samples collected from dogs with suspected cystitis, a total of 37 isolates were obtained, from mixed or pure cultures. The most prevalent bacteria were Escherichia coli (11/37), followed by Staphylococcus spp. (8/37), Proteus spp. (7/37), and Enterococcus spp. (5/37). Other less prevalent bacteria were Klebsiella spp., Streptococcus spp., and Enterobacter spp. As for biofilm-forming ability, 67.6% (25/37) of the 37 bacterial isolates had biofilm formation in CRA and 54.05% (20/37) on the microplates containing crystal violet dye. There was no statistical difference in antimicrobial susceptibility between biofilm producer and non-biofilm producer bacteria.Discussion: We found a high proportion (> 54%) of in vitro biofilm-forming ability by different bacteria, which may indicate that biofilms may also be formed in vivo, in simple cystitis. Antimicrobial resistance was not noticed in bacteria capable of forming a biofilm; however, in a future study it is important to evaluate bacterial resistance in vivo, considering the possibility of having a different response than in vitro. In addition, the problem of the presence of a biofilm in vivo is that it can nullify the antimicrobial efficacy of therapeutic agents even with in vitro susceptibility. Besides the possibility of slow or incomplete diffusion of antibiotics through the extracellular matrix of the biofilm, aspects like hydration level, pCO2, pO2, pH, pyrimidine, and divalent cation concentration that negatively influence antimicrobial activity in vitro can also cause undesirable effects at the profound layers of the biofilm. In conclusion, all of the genera of bacteria isolated from dog’s sporadic cystitis in this study were able to form a biofilm in vitro. The pathogenicity and antibiotic resistance of bacteria appears unrelated to biofilm formation in vitro.Keywords: sessile bacteria, urine, simple cystitis, antibiotic resistance

Enfermedad Pulmonar Obstructiva Crónica en Pequeños Animales

Chronic obstructive pulmonary disease (COPD) is a disease of the lower airways, which result in remodelling of the pulmonary tract and culminates with narrowing airway causing progressive obstruction. The disease mainly affects elderly animals and the cause is generally unknown. This review aims to describe the clinical significance, diagnostic tools, main differences between the diagnosis of asthma and bronchitis, as well as therapeutic alternatives that offer better results and fewer side effects for patients.La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad de las vías aéreas inferiores, la cual resulta en el remodelado de las vías aéreas y culmina con su estrechamiento provocando obstrucción progresiva. Esta enfermedad afecta principalmente a animales de mediana edad y de edad avanzada y en la mayoría de los casos se desconoce su causa. El presente trabajo de revisión tiene como objetivo mostrar la importancia clínica, las herramientas diagnósticas, las principales diferencias entre el diagnóstico de asma y bronquitis, y las alternativas terapéuticas que ofrecen mejores resultados y menores efectos secundarios para los pacientes

Sensitivity of urolithiasis detection using urinary, radiography and ultrasound parameters

Although many information has been published regarding canine urolithiasis, sensitivity of radiography, ultrasound and urinary parameters have been poorly correlated with number, size, and composition of the stones. One hundred and thirteen clinical files of dogs with diagnosis of urolithiasis were retrospectively selected. Information regarding number, appearance, location, size, and composition of the stones were noted after surgical removed. Urolithiasis data was compared with radiographs and ultrasound images and urinalysis parameters. Pure struvite was found in 42.4% and calcium oxalate in 35.6%. Survey radiographs enabled the detection of radiopaque stones and when an ultrasound examination was also performed, the sensitivity was increased. Double contrast radiography enabled identification in 100% of radiolucent stones, and allowed for size measurement and number counts in 76.9% of radiolucent stones. Crystalluria had low sensitivity (31.5%) and specificity (58.8%). Hematuria (96.3%) and leukocyturia (61.1%) were the most common parameters found. We concluded that double contrast radiography can be considered the method of choice for detection of radiolucent stones. Crystalluria is not a good parameter to detect or predict type of stone. Hematuria and leukocyturia, although non-specific findings, can be used as triage for investigation of urolithiasis

Alterações glomérulo-tubulares em cadelas com carcinoma mamário

The present study evaluated the glomerular and tubular alterations associated with mammary carcinoma in bitches. Eleven animals was used for control and 32 bitches with diagnosis of mammary carcinoma was assisted by Oncology and Obstetrics Service of the Veterinary Teaching Hospital Governador Laudo Natel of Faculdade de Ciências Agrárias e Veterinárias - UNESP, câmpus de Jaboticabal. The experimental protocol included obtaining clinical history and examination inherent to the blood count, serum biochemistry, urinary fractional excretion of sodium, electrophoresis of serum and urinary protein and blood pressure in combination with the evaluation of renal tissue obtained by tru-cut after the achievement of ovariohysterectomy (OH), which were evaluated by light, immunofluorescence and transmission electron microscopy (TEM). Serological tests, PCR and hormonal tests were used for animal’s exclusion or inclusion in their respective groups. Carcinoma group had higher concentration of globulins, haptoglobin and serum transferrin, indicating probable stimulation and production of substances from mammary carcinoma. Proteinuria associated with higher frequency of low, medium and high molecular weights of urinary proteins and their relationship with glomerular and tubular alterations evidenced by light microscopy and the association of these findings to the deposit of different classes of immunoglobulins and complement C3 (C3) in renal immunofluorescence, and the presence of subendothelial electron-deposits in the glomerulus might support the hypothesis of existence of renal alterations associated with mammary carcinomaO presente estudo buscou avaliar as alterações glomerulares e tubulares associadas com o carcinoma mamário em cadelas. Para tanto foram utilizadas 11 fêmeas caninas como controle e 32 com diagnóstico de carcinoma mamário, atendidas pelo Serviço de Oncologia e Obstetrícia do Hospital Veterinário “Governador Laudo Natel” da Faculdade de Ciências Agrárias e Veterinárias - UNESP, câmpus de Jaboticabal, SP. O protocolo experimental incluiu a obtenção de histórico clínico e exames inerentes ao hemograma, bioquímica sérica, excreção fracionada de sódio, eletroforese de proteínas séricas e urinárias e pressão arterial sistêmica em conjunto da avaliação do tecido renal obtido por tru-cut logo após a realização da ováriohisterectomia (OH), os quais foram avaliados por microscopia de luz, imunofluorescência e microscopia eletrônica de transmissão. Vale ainda ressaltar que exames sorológicos, PCR e testes hormonais foram utilizados para exclusão/inclusão de animais nos seus respectivos grupos. O grupo carcinoma apresentou maior concentração de globulinas, haptoglobina e transferrina séricas, indicando provável estímulo e produção de substâncias provenientes do carcinoma mamário. A proteinúria associada a maior frequência no aparecimento de proteínas urinárias de baixo, médio e alto pesos moleculares e sua relação com as alterações da microscopia de luz evidência que existem tanto alterações glomerulares quanto tubulares. Ademais a associação desses achados ao depósito de diferentes classes de imunoglobulinas e complemento C3 (C3) na imunofluorescência renal, e a presença de depósitos eletrodensos subendoteliais no glomérulo confirmam a existência de importantes alterações renais relacionados ao carcinoma mamário em cadela

Toxicidade do dimetilsulfóxido em cães hígidos e doentes renais crônicos

The objective of this study was to evaluate the effects of dimethyl sulfoxide (DMSO) treatment on aspects of renal function, serum profile, total blood count parameters and clinical condition of health or chronic kidney disease (CKD) dogs. The evaluations were done before, during and after the administration of DMSO 10% at a dose of 0.5g kg-1, each 24h, for three days. DMSO resulted in some adverse effects in both healthy and CKD dogs, however the effects were more frequent and worse in CKD dogs. Despite these adverse effects, both groups don't have contraindications to use the drug in a short time. The severity of adverse effects related to the DMSO and its possible association with death in stage 4 CKD dogs, are contraindications for the drug in this group of patients.O objetivo do presente trabalho foi avaliar os efeitos do tratamento com dimetilsulfóxido (DMSO) sobre aspectos pertinentes à função renal, perfil bioquímico sérico, parâmetros hematológicos e condição clínica de cães sadios e de cães com doença renal crônica (DRC). As avaliações foram feitas antes, durante e após a administração de DMSO a 10% na dose de 0,5g kg-1, cada 24h, por três dias. O DMSO resultou em alguns efeitos adversos nos cães sadios e também nos cães com DRC, nos quais os efeitos foram mais frequentes e mais graves. Apesar desses efeitos adversos, tanto em cães sadios quanto para cães com DRC 2-3, não há contraindicações para o uso do fármaco quando em curto espaço de tempo. A gravidade dos efeitos adversos relacionados ao tratamento com DMSO e possível associação com o óbito em cães com DRC em estádio 4, constituem fatores para contraindicação do fármaco nesse grupo de pacientes

Juvenile Panhypopituitarism in a Dog – What are the Therapeutic Challenges?

Background: Juvenile panhypopituitarism is an endocrinopathy that affects young dogs and must be differentiated from other causes of height disorders, as one could have a deficiency of one or more adenohypophysis hormones, besides growth hormone. Diagnosis consists of excluding endocrine and non-endocrine causes. Treatment requires administration of heterologous porcine growth hormone or progestins, as well as supplementing other hormones that are deficient in the circulation. The prognosis for these patients tends to be unfavorable and they have a shorter life expectancy. The present case aimed to report the therapeutic challenges in a dog diagnosed with juvenile panhypopituitarism. Case: This study presents the case of a 6-month-old crossbred Labrador/Brazilian Fila dog, not neutered, 6.7 kg of body weight (body condition score 5/9), with a growth disorder and persistence of the puppy coat, when compared to other members of the same litter. During inspection, it was possible to observe an undersized dog and soft puppy coat, besides no bone irregularities or joint tenderness was noted. The other physical examination parameters were within the normal range for the species. No changes in complete blood count and only increases in urea, cholesterol and alkaline phosphatase activity were observed. Thyroid and abdominal ultrasound (US) examination did not reveal any remarkable changes. After serum dosage of insulin-like growth factor, thyroxine, thyrostimulating hormone, and cortisol, the patient was diagnosed with juvenile panhypopituitarism and underwent therapy with medroxyprogesterone and thyroid hormone supplementation. Monitoring was instituted at intervals of 3, 6, and 12 weeks, and currently every 3 or 4 months and the IGF-1 values normalized after 6 months with. After 8 months of therapy, the patient had good body growth and bone mineralization compared to the time of diagnosis. However, skeletal development was completed only 12 months after hormone replacement, accompanied by the presence of vertebral osteophytes and coxofemoral osteoarticular alterations. Considering chronic use of progestins, ovariosalpingohysterectomy (OSH) was recommended, but for personal reasons, the owners chose to do not submit her to surgery. After 18 months of treatment, the dog starts to exhibit prostration, selective appetite, and increased abdominal volume. After imaging exam, she was forwarded for OSH, due to consistent findings of pyometra. Subsequently, even the supervision of possible comorbidities involved in the chronic use of progestins was maintained at half-yearly intervals, the bitch returned to the service with skin thickening, increased limb volume, and macroglossia after 60 months of therapy. At this point IGF-1 values were higher when compared to the previous measurements and the application of medroxyprogesterone was suspended. Its supplementation was reintroduced only after 8 months when IGF-1 was significantly reduced. To date, the patient is close to 6 years of age and with a good quality of life. Discussion: The greatest therapeutic challenge for these patients involves dealing with the adverse effects of progestins, mainly related to reproductive disorders and alopecia at the application site, as well as maintaining adequate hormone replacement in order to avoid hypersomatotropism. Although longevity is lower in these individuals, the patient in this report has achieved six years of age and has had an excellent quality of life so far. Keywords: adenohypophysis, growth hormone, pituitary dwarfism, thyrostimulating hormone

Intrascrotal testicular torsion and seminoma in a dog with chronic renal failure

A 10-year-old mongrel dog was presented with signs of vomiting, prostration, anorexia, abdominal pain, dyspnea, dysuria, and enhanced scrotal volume. Clinical, laboratory, and radiological examinations showed intrascrotal testicular pathology and chronic renal failure. Emergency treatment was carried out; however, the patient died. Necropsy diagnosed an intrascrotal testicular torsion and seminoma. The aim of the present report is to describe an intrascrotal testicular torsion associated with chronic renal failure in a dog. © Tübïtak

Canine Cystitis - Biofilm Formation by Bacterial Isolates

Background: Biofilms have been reported as important virulent markers associated with drug resistance in urinary tract infections (UTIs) in humans and dogs. However, in veterinary medicine, researches involving biofilm formation, treatments and preventions have been limited; yet, it is still possible to find few studies demonstrating biofilm-forming bacteria associated with different comorbidities such as otitis, wound infections, UTIs, and endometritis. These studies generally select dogs with chronic and recurrent infections, which could be an important factor in antibiotic resistance. We aimed to evaluate biofilms in sporadic cystitis regarding prevalence and drug resistance.Materials, Methods & Results: Urine samples were collected by cystocentesis from 36 client-owned dogs under clinical and laboratory suspicion of non-recurrent urinary bladder infection (cystitis). Urine was aseptically plated onto blood agar, MacConkey, and CLED, followed by incubation for 24 to 48 h. Definitive identification of a potential pathogen was made by subculture collected from an isolated colony to obtain a pure culture. The gram staining method and specific biochemical tests (phenol red fermentation, lysine, phenylalanine, citrate, sulfide-indole-motility, and urease) were used to distinguish and classify the bacteria. After identification, the bacteria were tested for antimicrobial susceptibility by a standard disk diffusion method, using the following antimicrobials: amoxicillin with clavulanic acid, ampicillin, ceftriaxone, ciprofloxacin, clindamycin, cefazolin, cephalothin, erythromycin, gentamicin, norfloxacin, and sulfamethoxazole-trimethoprim. The biofilm-forming ability was determined based on a culture in Congo red agar (CRA), where biofilm producer strains formed black colonies with a dry crystalline surface, while non-biofilm producer strains formed red colonies with a smooth surface. A crystal violet dye assay was used to confirm the CRA results. Of the 36 urine samples collected from dogs with suspected cystitis, a total of 37 isolates were obtained, from mixed or pure cultures. The most prevalent bacteria were Escherichia coli (11/37), followed by Staphylococcus spp. (8/37), Proteus spp. (7/37), and Enterococcus spp. (5/37). Other less prevalent bacteria were Klebsiella spp., Streptococcus spp., and Enterobacter spp. As for biofilm-forming ability, 67.6% (25/37) of the 37 bacterial isolates had biofilm formation in CRA and 54.05% (20/37) on the microplates containing crystal violet dye. There was no statistical difference in antimicrobial susceptibility between biofilm producer and non-biofilm producer bacteria.Discussion: We found a high proportion (> 54%) of in vitro biofilm-forming ability by different bacteria, which may indicate that biofilms may also be formed in vivo, in simple cystitis. Antimicrobial resistance was not noticed in bacteria capable of forming a biofilm; however, in a future study it is important to evaluate bacterial resistance in vivo, considering the possibility of having a different response than in vitro. In addition, the problem of the presence of a biofilm in vivo is that it can nullify the antimicrobial efficacy of therapeutic agents even with in vitro susceptibility. Besides the possibility of slow or incomplete diffusion of antibiotics through the extracellular matrix of the biofilm, aspects like hydration level, pCO2, pO2, pH, pyrimidine, and divalent cation concentration that negatively influence antimicrobial activity in vitro can also cause undesirable effects at the profound layers of the biofilm. In conclusion, all of the genera of bacteria isolated from dog’s sporadic cystitis in this study were able to form a biofilm in vitro. The pathogenicity and antibiotic resistance of bacteria appears unrelated to biofilm formation in vitro.Keywords: sessile bacteria, urine, simple cystitis, antibiotic resistance