Nasolacrimal Duct Neoplasm in a Bitch

Background: Nasolacrimal duct tumors are divided into primary and secondary, with primary tumors being rare in all species. Secondary involvement of the lacrimal sac and duct can occur from any skin lesion involving the eyelid and/or conjunctiva and from any neoplastic process involving the paranasal sinuses. Lacrimal sac metastatic lesions may originate from any distant site and include carcinomas or melanomas, with squamous cell carcinoma being the most common type. The objectives of the present report were to describe a case of squamous cell carcinoma in the nasolacrimal duct and to emphasize the importance of a good ophthalmic evaluation.   Case: A 16-year-old spayed bitch white poodle was presented to the veterinary clinic. The owner complained that the animal had epiphora and mucoid secretion in the right eye, eyelid hyperemia in both eyes, and sporadic sneezing with blood. On ophthalmic examination, the animal was initially diagnosed with nasolacrimal duct obstruction and right eye (OD) blepharitis and OU uveitis. Fourteen days after the first evaluation, the nasolacrimal duct region increased, with the presence of bloody secretion. Biomicroscopy showed nodules inside the lacrimal duct, in the punctum region. The animal was sedated to obtain a fragment of the nodule for histopathological analysis, and a subsequent oral cavity evaluation identified a nodule in the transition region between the 4th premolar and 1st molar, which was sent for cytology. Cytology of the medial corner region of the RE showed epithelial and mesenchymal cells with malignancy characteristics, and the biopsy was suggestive of malignant epithelial neoplasia (carcinoma). A surgical procedure for nodule resection was ruled out because bone involvement was extensive, and chemotherapy was selected. The patient died 2 months after the 1st consultation. The diagnosis was confirmed through necropsy via immunohistochemical tests, demonstrating squamous cell carcinoma (SCC) both in the mouth and the nasal and ocular sinuses. Discussion: The most common conditions affecting the nasolacrimal drainage system in dogs are those causing obstructions. These may be congenital, arising from a developmental defect of micropunctum or agenesis of the punctum, they may be acquired, arising from infection and inflammation. SCC is a malignant neoplasm originating in the stratified squamous epithelium. The predisposing factors in cats and dogs include lack of adnexal pigmentation and, possibly, chronic irritation of the ocular surface. A light coat is considered a relevant factor, especially in regions with little hair coverage. In addition to a mass lesion, other clinical signs of eyelid or ocular surface tumors may include epiphora, conjunctival vascular injection, mucopurulent ocular discharge, 3rd eyelid protrusion, conjunctival/corneal roughness or ulceration, and corneal neovascularization or pigmentation. Clinical presentations are nonspecific. Neoplasms, whether nasal and/or in the maxillary sinus, can invade the nasolacrimal duct and spread to the nasal cavity, and neoplasms in the nasal cavity can invade the nasolacrimal duct. Ophthalmic evaluation along with good inspection of the oral cavity is a useful tool in the diagnosis of eye neoplasms that may have effects on the oral cavity or vice versa due to the strong association between them. Early diagnosis is crucial for the clinical or surgical management of each case of ophthalmic neoplasia and for therapeutic success. Keywords: neoplasm, tumor, nasolacrimal duct, dog, eye. Título: Neoplasia de ducto nasolacrimal em uma cadela Descritores: neoplasia, tumor, canalículo lacrimal cão, olho.

Presence of BRCA1 Gene Mutation in Bitches with Malignant Mammary Tumors

Background: Mammary tumors (MTs) in bitches are similar to breast cancers in women. Thus, they can be used as a model for human breast cancer and findings can be extrapolated for use in human medicine. BRCA1 is a tumor suppressor gene. When the gene has a mutation, it cannot repair damaged DNA, which causes genetic instability and tumorigenesis. Therefore, we aimed to study the frequency of single nucleotide polymorphisms (SNPs) in the BRCA1 gene that are associated with distinct histological types of malignant MT in bitches.Materials, Methods & Results: The study population consisted of 91 bitches, including a control group of 6 animals with healthy mammary glands and 85 animals with MTs. All animals underwent a presurgery evaluation consisting of a questionnaire administered to the person responsible for the animal, a physical examination, collection of peripheral blood for hematological and serum biochemistry evaluations, an electrocardiogram, and a preanesthesia evaluation. In addition, distant metastasis was studied via chest radiography and abdominal ultrasound. After evaluations were complete, the animals that could undergo surgery were administered general anesthesia and underwent a mastectomy or mammary gland sample collection. Histopathological examination and molecular analysis were performed to identify mutations in the BRCA1 gene. Histopathological examinations found 10 different types of malignant tumors in 36 sick animals. Tumor samples plus samples from the 6 control animals were subjected to DNA extraction, polymerase chain reaction (PCR) analysis, and genetic sequencing. The tumor with the highest incidence (33.33%) was a complex carcinoma, followed by carcinoma in mixed tumor (13.88), tubular carcinoma (13.88) and carcinosarcoma (13.88). Molecular analysis revealed 3 different SNP points in 5 samples (4006G>A, 3619A>G, and 3761C>T). The allelic variant 4006G>A (1/36) resulted in the alteration of the amino acid valine by isoleucine (V1336 I). The mutation 3619A>G (2/36) inserted the amino acid alanine instead of threonine (T1207 A). The mutation 3761C>T (2/36) led to the alteration of the amino acid serine by phenylalanine (S1254 F), a mutation for which there are no published reports. The histological types that showed BRCA1mutations were complex carcinoma (1/5), carcinoma in mixed tumor (1/5), papillary carcinoma (1/5) and tubular carcinoma (2/5). Software analysis identified the new SNP (nucleotide 3761) in BRCA1 and 2 points mutations in nucleotides 4006 and 3619 and responsible for genetic instability.Discussion: The development of breast cancer is caused by many endogenous and exogenous factors. The results of our study show that these factors have a greater presence in female, mixed breed, uncastrated, and older dogs, confirming the data in the veterinary literature. In the present study, we found different histological types of malignant breast tumors with mutations in the BRCA1 gene, as other authors have reported. However, we also found the mutation 3761C>T, which, to the best of our knowledge, has not been reported in the literature. This shows the need for studies in veterinary medicine that assess mutations in the BRCA1 gene and the most common histological types. In conclusion, SNPs in the BRCA1 gene cause genetic instability, resulting in additional mutations that lead to the development of breast tumors. They are point mutations that affect transcription, resulting in truncated proteins. These proteins may have a loss of function, leading to carcinogenesis.Keywords: polymorphism, BRCA1 gene, cancer, dogs.Descritores:polimorfismo, gene BRCA1, câncer, cães. Título: Presença da mutação do gene BRCA1 em cadelas com tumores mamários malignos.

Effects of 1% Topical Brinzolamide on Intraocular Pressure in Healthy Dogs

Background: Glaucoma is one of the most common causes of blindness in dogs, and is generally characterized by death of the retinal ganglion cells associated with a rapid loss of vision. Increased intraocular pressure (IOP) occurs in patients with primary glaucoma, due to genetic abnormalities in pectinal ligaments and the trabeculae of the iridocorneal angle, producing inadequate drainage of aqueous humor. IOP is the result of the dynamic equilibrium between the production and drainage of aqueous humor. Intraocular surgery, anterior lens luxation, systemic diseases, immune-mediated, neoplastic and infectious diseases lead to the breakdown of the blood-aqueous barrier and increase the amount of protein and cells in aqueous humor, which can block this drainage pathway. Under these conditions, becomes indispensable the pharmacological control of IOP by reducing aqueous humor production. The main objective of the present study was to evaluate the effects of topical 1% brinzolamide on intraocular pressure (IOP) in twelve healthy dogs.Materials, Methods & Results: The age range of affected dogs was 1-5 years, with a mean age of 2.5 years. Twelve dogs were included in this study. All animals were healthy based on clinical, ophthalmic and hematological examinations. Selected animals were kept in a room with 500 lux luminosity, 56.8% relative humidity, 20°C temperature, exposed to 12 h of light/dark cycle, were fed twice daily and water ad libitum. All animals were adaptation to the procedures and examiners and IOP was measured by applanation tonometry at 08:00 a.m., 11:00 a.m., 02:00 p.m., 05:00 p.m., and 08:00 p.m., for 7 days and 2 days of baseline. Subsequently, one eye of each dog was randomly assigned, the eye received one drop of 1% brinzolamide at 08:30 a.m., 02:30 p.m., and 08:30 p.m. during four consecutive days and adelfo eyes received one drop of sterile saline solution and were considered control eyes. During the treatment phase and on the day after the treatment had finished, all parameters were evaluated in a blind fashion at the same pre-established time points. The value for IOP during the baseline of the treated eye were 16.77 ± 0.22 mmHg. The baseline period, values did not differ significantly between treated and control eyes. Comparison between the first day of brinzolamide-treated eyes with the average daily values of the two days of the baseline period showed that IOP decreased significantly 8.88%. IOP after four days of daily instillations of brinzolamide was able to decrease overall IOP by 1.42 mmHg (8.47%) when compared with the baseline period. Overall IOP values in the brinzolamide-treated eyes decreased 1.02 mmHg (6.24%) when compared to the control eyes. There were no statistically significant differences when compared control eye to baseline. Three times daily instillations of 1% brinzolamide in healthy dogs significantly decrease 8.47% IOP. During the post-treatment period, the average daily values of the brinzolamide-treated eyes remained 1.52 mmHg below the average daily values observed at baseline period.Discussion: The present research showed that, the average daily IOP values in the brinzolamide-treated eyes decreased 1.49 mmHg (8.88%) at the end of the first day, 1.69 mmHg (10.07%) at the end of the fourth day, and the cumulative IOP values after four days of treatment, were able to decrease by 1.42 mmHg (8.53%). Three times daily instillations of 1% brinzolamide in healthy dogs significantly decrease IOP, and therefore may be indicated to management of intraocular hypertension and glaucoma

Avaliação pós-operatória da analgesia promovida pelo uso da dexmedetomidina isolada e associada à morfina em cadelas submetidas à ovariohisterectomia

Resumo Objetivou-se avaliar a eficácia analgésica pós-operatória da dexmedetomidina isolada e associada à morfina em pacientes submetidas à anestesia geral inalatória com isoflurano e submetidas à ovariohisterectomia eletiva (OH). Vinte cadelas saudáveis foram selecionadas a partir de exames físico e laboratoriais. Previamente ao estudo, foram submetidas a um período de 24 horas de adaptação ao ambiente e aos observadores. Ato contínuo, foram divididas aleatoriamente em dois grupos: grupo dexmedetomidina, na dose de 10 μg/Kg (GD) e grupo dexmedetomidina (10 μg/Kg) associado com morfina, na dose de 0,3 mg/Kg (GDM), administrados pela via intramuscular (IM). Ato contínuo, as pacientes foram induzidas com propofol e mantidas com isoflurano diluído em oxigênio 100% e administrado através de vaporizador calibrado. Para verificação da analgesia pós-operatória foram realizadas avaliações de dor por meio de escalas de Glasgow Modificada (EGM) e de Melbourne (EM). Para avaliação de sedação, por meio da escala de Dobbins (ED), em diferentes tempos: antes da administração da MPA (T0), e em mais 6 tempos no período pós-operatório, uma (T1), duas (T2), quatro (T3), oito (T4), 12 (T5) e 24 (T6) horas após a extubação orotraqueal. Não foram observadas diferenças estatísticas entre os grupos nas escalas de acordo com o teste de Kruskal-Wallis post-hoc de Dunn; e entre os tempos notou-se diferença estatística pelo teste de Friedman (p<0,05) para EGM e EM, porém não houve necessidade de resgate analgésico. Portanto, conclui-se que a dexmedetomidina isolada e associada a morfina produziu efeito analgésico adequado no período pós-operatório de cadelas submetidas a OH. Palavras-Chave: cães; α-2-agonista; opioides; dor

Comparison of the Effects of Maropitant, Lidocaine, and Dextroketamine Administered by the Intratesticular Route in Dogs Undergoing Elective Orchiectomy

Background: Balanced anesthesia achieved with combinations of inhaled and injectable drugs administered systemically or in loco-regional anesthetic blocks, is widely used in veterinary medicine. The use of anesthesia and/or local analgesia has already demonstrated benefits in the performance of elective orchiectomy in different species, there is no literature that evaluates the use of the maropitant intratesticular route. The present study evaluated the cardiorespiratory variables and analgesia produced by intratesticular blockade with maropitant, lidocaine, or dextroketamine during the trans-operative period along with the discharge and anesthetic recovery of dogs that underwent elective orchiectomy. Materials, Methods &amp; Results: Used twenty-four dogs from routine elective orchiectomy, considered healthy based on the results of clinical and hematological tests. The animals were randomly divided into three groups and was applied intratesticularly 2% lidocaine at a dose of 1 mg/kg (GL), 5% dextrocetamina at a dose of 2.5 mg/kg (GC), or 1% maropitant  at a dose of 1 mg/kg (GM). Anesthesia induction was performed with propofol (to effect), and stabilization of inhalational anesthesia was achieved with 1.7 V% of sevoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the animal's weight, being kept under spontaneous ventilation, After induction, we waited 10 min for stabilization of exhaled anesthetic concentration and then administered one of the treatments intratesticularly. After five min from the local block the surgical procedure was started during up to 15 min. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), oxygen saturation of hemoglobin (SatO2), end-tidal carbon dioxide partial pressure (EtCO2), end-tidal sevoflurane concentration (EtSevo) in exhaled air, and body temperature (T°C) were measured before intratesticular administration of the agent and at specific time points during surgery, in addition to assessments of analgesia and evaluation of discharge and anesthetic recovery. Statistical analysis was performed using the Kolmogorov-Smirnov test (P &gt; 0.10). The parameters HR, RR, SAP, DAP, MAP, T, EtCO2, and SatO2 were evaluated by analysis of variance (ANOVA), followed by the Scott-Knott test (Software R® 3.2.0 - 2013), considering a significance level of P &lt; 0.05. The results did not show inter-drug differences for the evaluated variables.Discussion: It was decided not to use premedication (MPA), so that we could accurately assess the analgesic effect of drugs, lidocaine, dextroketamine and maropitant, on intratesticular block during elective orchiectomy. In this study we demonstrated that these drugs promoted analgesia, because the trans-surgical values were relatively lower compared to baseline and within physiological limits for the species. In addition, it was noted that local analgesia used was efficient since even at the time of ligature and the incision spermatic cord which is described in the literature as the most painful part of the surgical procedure. The post-anesthetic recovery and discharge were quick in the absence of MPA, local analgesia without residual effects and the use of sevoflurane. The sevoflurane has a very low blood gas coefficient solubility, resulting in a recovery fast. Therefore, we can conclude that all of the drugs promoted analgesia and cardiorespiratory stability as well as rapid anesthetic recovery for elective orchiectomy in this species

Síndrome de Haw em felino: relato de caso / Feline haw syndrome: case report

A Síndrome de Haw é uma enfermidade comum aos felinos, sem distinção sexual, de ocorrência aos animais jovens, e é caracterizada pela protusão bilateral aguda da terceira pálpebra, devido uma posição inadequada anatômica da inervação autossômica simpática e quando o tônus muscular liso se torna diminuído ou ausente, seu  desenvolvimento  é idiopático podendo estar associada a infecções virais. O objetivo desse trabalho é relatar o caso de uma gata de 1 ano de idade, levada pelo tutor ao atendimento veterinário por apresentar dificuldade visual e de caça. Ao exame oftálmico observado protusão bilateral de terceira pálpebra e sem outros sinais sistêmicos. Foi adotado para conduta diagnóstica a instilação de agente simpaticomimético, sendo 1 gota de colírio de fenilefrina 10% em ambos os olhos, aguardado 20 minutos e observado o retorno da terceira pálpebra para o canto medial do olho, levando a confirmação diagnóstica de Síndrome de Haw. Vale ressaltar que alterações no sistema simpático pós ganglionar tendem a responder as medicações simpaticomiméticas em um período médio de 20 minutos, como observado nesse caso. Conclui-se que a síndrome de Haw é uma afecção de extrema importância na clínica oftálmica de felinos jovens, acarretando desconforto ao animal, pela dificuldade de enxergar, o que gera transtorno também ao tutor. Sendo assim, para os casos de Síndrome de Haw é de grande relevância que se faça o diagnóstico diferencial com outras patologias que apresentam sinais clínicos semelhantes, para que o diagnóstico seja correto e a conduta terapêutica de sucesso, proporcionando qualidade de vida ao animal como observado no caso apresentado

Exercício físico auxiliando no tratamento da hipertensão arterial / Physical exercise assisting in the treatment of arterial hypertension

A hipertensão arterial (HA) é uma síndrome de origem multifatorial, sendo um dos maiores problemas na área de saúde pública e tem sido reconhecida como grave fator de risco para as doenças cardiovasculares. Atualmente é definida de acordo com valores pressóricos, nas quais níveis iguais ou superiores a 140/90 mmHg, identificados em duas ou mais verificações da pressão arterial, diagnosticam a doença. Frequentemente associa-se a HA a distúrbios metabólicos, alterações funcionais e/ou estruturais de órgãos-alvo, sendo agravada pela presença de fatores de risco (FR), como dislipidemia, obesidade abdominal, intolerância à glicose e diabetes melito (DM). Esse trabalho tem como objetivo esclarecer sobre a terapêutica da HA auxiliada ao exercício físico e as mudanças no estilo de vida mostrando os benefícios que a prática de exercício físico, podem acarretar na saúde da população. Para sua realização foram utilizadas bases de dados científicos do google acadêmico e utilizados descritores como hipertensão arterial e exercício físico auxiliando na pressão sanguínea. A HA é uma das doenças que mais matam no mundo, caracterizando-se como importante doença na área da saúde pública, o tratamento da HA consiste basicamente na terapia medicamentosa e tratamento não-farmacológico anti-hipertensivo, também chamado de não medicamentoso ou mudança no estilo de vida. Para entender a correlação entre os exercícios físicos e a HA estudos prévios, afirmaram que pessoas sedentárias apresentam maior probabilidade de desenvolver hipertensão quando comparadas a pessoas fisicamente ativas. Das diversas intervenções não medicamentosas, o exercício físico está associado a múltiplos benefícios e se bem planejado e orientado de forma correta, quanto a sua duração e intensidade, pode ter um efeito hipotensor importante. Uma única sessão de exercício físico prolongado de baixa ou moderada intensidade provoca queda prolongada na pressão arterial e tem sido amplamente demonstrado que o treinamento físico aeróbio provoca importantes alterações autonômicas e hemodinâmicas que vão influenciar o sistema cardiovascular. O exercício físico realizado de forma adequada contribui para a prevenção e tratamento da HA, apresentando implicações clínicas importantes, pois a realização regular auxilia no controle dos níveis pressóricos, possibilitando em alguns casos redução de dose medicamentosa ou até mesmo na sua interrupção, possibilitando a redução do custo do tratamento para as Instituições de Saúde. Conclui-se que são necessárias, pesquisas criteriosas sobre essa temática, para que haja um bom embasamento cientifico no tratamento da HA associando terapia medicamentosa e o exercício físico. Novos estudos abordando a área da genética dos pacientes podem futuramente auxiliar no conhecimento da melhor abordagem terapêutica, assim como da efetividade do treinamento físico no paciente hipertenso, levando a resultados promissores diante dessa síndrome tão importante para a saúde. 

Ceratite eosinofílica em felino: relato de caso / Eosinophilic keratitis in feline: case report

Os felinos desenvolvem doenças restritas a espécie, o que geralmente leva a respostas inflamatórias moderadas. Dentre essas alterações exclusivas da espécie felina podemos destacar a CEF A ceratite eosinofílica felina (CEF) se manifesta através de uma massa que surge do limbo nasal ou temporal, córnea periférica e conjuntiva bulbar, de característica branca a rosada, irregular, vascularizada e edemaciada. A causa da CEF ainda é incerta, porém, possui correlação com resposta imunomediada, levantando a possibilidade de o herpes vírus felino (FHV-1) ter atuação na patogenia. O objetivo desse relato, é a descrição de um caso de CEF, em felino, fêmea, 4 anos, ressaltando a importância do diagnóstico e tratamento corretos. O animal foi atendido por serviço oftálmico especializado, após diversas tentativas de tratamentos anteriores e segundo a tutora, o animal apresentava vermelhidão e a presença de uma membrana na superfície ocular direita a vários dias. Ao exame oftálmico foi observado blefarite em olho direito (OD), hiperemia conjuntival em OD, reflexo de ameaça presente, reflexo pupilar direto e consensual presentes e pressão intraocular (PIO) 12 mmHg em OD e 15 mmHg em olho esquerdo (OS), teste de Jones positivo e notou-se em superfície de OD presença de celularidade eosinofílica que não permitia a visualização da câmara anterior. Os mesmos exames oftálmicos em (OS) não denotaram nenhuma alteração. Para certificação da suspeita diagnóstica foi realizada citologia ocular que apontou resultado compatível com quadro de ceratite eosinofílica felina. Adotado tratamento tópico do OD com os colírios, predfort®, 1 gota, QUID, tacrolimus 0,03%, 1 gota, BID e Adptis fresh, 1 gota, TID, todos realizados durante 15 dias consecutivos. Após 15 dias de tratamento o animal retornou ao serviço veterinário demonstrando significativa melhora do quadro que o levou ao atendimento inicial, e optou-se pela manutenção do colírio de tracrolimus 0,03%, 1 gota, BID em olho direito por mais 15 dias. É possível concluir através deste relato que a Ceratite eosinofílica felina é uma patologia de grande relevância na clínica oftálmica de felinos uma vez que existe grande incidência entre gatos do Herpes vírus felino e esse possivelmente estar relacionado a evolução da CEF. Sendo que o seu diagnóstico e adoção de tratamento corretos são de grande importância para o prognóstico favorável do quadro, acarretando sucesso terapêutico e qualidade de vida ao animal

Hemipelvectomia total em um gato com osteossarcoma osteoblástico

Background: Osteosarcoma (OSA) is a malignant neoplasm of mesenchymal tissue that exhibits various histological features and a differentiated biological clinical behavior. The combination of clinical, radiological, and histopathological features is important for diagnosis. Surgical treatment of neoplasms with pelvic involvement is a challenge. Primary bone tumors are rare in cats and are mostly reported in older animals. The objective of this paper was to report the case of a feline subjected to total hemipelvectomy as primary treatment of pelvic OSA; the surgical technique and histological analysis of the tumor are described. No signs of recurrence were seen during seven months of follow-up.Case: A 4-year-old female mixed breed cat weighing 3 kg was presented with a one year history of increased volume on the hip joint region. Palpation of the increased volume on the hip showed a firm, adhered, and painful mass. Radiographic examination of the pelvis in the dorso ventral projection exhibited a severe osteoblastic bone reaction on the proximal femur, as well as marked periosteal reaction of the hip joint with involvement of the acetabulum. A ventral approach total hemipelvectomy technique was adopted for excision of the tumor. The animal was placed on a lateral position and a circumferential skin incision was performed on the ipsilateral limb of the affected hemipelvis, on the medial portion of the femur, and was extended cranially up to the thoracolumbar region. The pubic symphysis was exposed with a periosteal elevator and a pubic symphysiotomy was performed on the midline using a Liston bone cutter; next, the sacroiliac junction was resected. No drain was used after surgery, only compressive bandages. The patient was hospitalized for post-operative monitoring which included opioids for pain management and a non-steroidal anti-inflammatory drug and a cephalosporin class antibiotic. The wound was cleaned with saline, rifamycin spray (Rifocina Spray®) was applied, and dressing was changed every 12 h. The excised bone was submitted for pathological analysis. Gross examination revealed a 4.2 cm hardened increase in volume on the area of the femoral head and acetabulum, with irregular surface; cut surface was hard and white with black and red spots. Histology revealed osteoblastic OSA with intense and solid fusiform and stellate cells distributed in a solid pattern with no capsular border, with marked infiltration of the bone tissue, marked osteolysis, moderate proliferation of osteoclasts, and moderate anisocytosis and anisokaryosis.Discussion: Bone tumors in cats are rare and develop spontaneously. They exhibit aggressive behavior and promote local bone destruction. Firm consistency and local swelling usually occur in more advanced cases when there is a delay between the onset of clinical signs and the veterinary consultation. Radiological findings such as bone destruction and bone formation are commonly seen in this type of tumor. Hemipelvectomy is considered an aggressive surgical technique, but necessary in many cases, especially when tumors are located in the pelvis and nearby tissues. In the case presented here, this surgery was the most viable and advised therapeutic option because of tumor location. No incidents (i.e. hemorrhage) occurred during the perioperative period. After surgery, the patient continued to perform all custom functions. The hind limb, which was affected in this case, is commonly reported to be affected in the literature; however, it is unusual to have involvement of both bones (pelvis and femur) since vascularization of these bones are independent. Diagnosis was confirmed by histopathology in which a characteristic malignant mesenchymal tumor of primitive bone cells was present, with production of osteoid of variable shapes and quantity with the presence of osteoclastic giant cells

Evaluation of Postoperative Residual Analgesia of Two Solutions Used for Local Anesthesia By Tumescence In Bitches who Underwent a Unilateral Mastectomy

Background: Breast tumors are common and require surgical treatment. A mastectomy causes edema, inflammation, and moderate to severe pain; therefore, analgesics should be used efficiently during the trans- and postoperative periods. Tumescence anesthesia has been studied in veterinary medicine; however, there is limited literature on the comparison of the constituents of the different solutions and the most suitable protocol. The objective of this study was to evaluate the residual postoperative analgesia of two solutions through the Melbourne, Modified Glasgow for dogs (EGM), and Visual Analogue (EVA) scales in bitches who underwent a unilateral mastectomy.Materials, Methods &amp; Results: Twelve bitches, weighing between 5 and 15 kilograms and aged between 5 and 13 years old, were included in the study. To determine if the animals were medically fit to undergo the procedure, they were evaluated by clinical examination, laboratory testing (complete blood count, serum biochemistry [urea, creatinine and alanine aminotransferase/ALT], and imaging (thorax x-ray and abdominal ultrasonography). Patients were randomly divided into two groups. One group received a lidocaine-containing tumescent solution (GTL) that consisted  of 210 mL of lactated Ringer's solution (at a temperature between 8 and 12°C), 40 mL of 2% lidocaine hydrochloride without vasoconstrictor, and 0.5 mL of adrenaline (1 mg/mL). The other group received ropivacaine (GTR) with 233.3 mL of lactated Ringer's solution (at the same temperature as the previous group’s), 16.7 mL of ropivacaine (7.5 mg/mL), and 0.5 mL of adrenaline (1 mg/mL). Both groups received a combination of acepromazine (0.04 mg/kg) and meperidine (2 mg/kg) as preanesthetic medication (MPA), followed by induction using propofol (to effect) and maintenance using isoflurane. The solutions were infused  subcutaneously (SC) 5 min after stabilization of the anesthetic plane. For the mastectomy, the solutions were distributed throughout the mammary chain to be withdrawn, starting at the thoracic and abdominal regions and ending in the inguinal region. In the postoperative period, the animals were evaluated using three different scales (Melbourne, Glasgow modified for dogs [EGM], and Visual Analogue [EVA] scales), at six time points: one, two, four, eight, 12 and 24 h after extubation, or until the time of analgesic rescue when the animal presented with a score higher than 3.33 on the EGM scale. There were no statistical differences between the groups (P &gt; 0.05) in any of the scales evaluated; however, most of the animals demonstrated analgesic rescue in the first hour of evaluation. GTR showed an additional rescue compared to GTL.Discussion: Analgesic rescue occurred in the first hour of the postoperative period. This differs from other studies that used morphine in MPA and observed higher analgesia. This occurred because meperidine, the drug used in the study, has a shorter duration and is a less potent analgesic than morphine. We opted for this opioid because of its minimal interaction with the drug used in MPA and to better identify the residual effect of the administered solution. In addition, it does not interact with the other drugs used in the anesthetic protocol. It is known that the tumescence technique prolongs the analgesic effect of MPA because of subcutaneous absorption of a portion of the injected solution adjacent to the area being operated on. However, this was not observed as 50% of the animals in each group were rescued during the first hour of the evaluation. From this study, it was concluded that the tumescent solutions used in the trans-operative period should not be expected to have analgesic effects during the postoperative period of mastectomies because of the short duration of action