Evaluation of the Effect of Nandrolone Decanoate on Experimental Spinal Cord Injury in Rats

Background: Acute spinal cord injury, a common cause of neurological dysfunction in humans and animals, impairs motor, sensory and autonomic functions and may result in permanent disability. Nandrolone decanoate (ND) is a steroid widely studied for its predominantly anabolic effect and low androgenic potential. Several researchers have described the positive interference of ND in neurological tissue, such as increased synthesis and release of neurotrophic substances, but to date no studies have evaluated the action of this steroid in acute spinal cord injury. The aim of this study was therefore to evaluate the effect of ND in rats subjected to acute spinal cord injury. Materials, Methods & Results: Thirty-two young adult Wistar rats (Rattus norvegicus), weighing between 240 and 260 g, were divided into three groups. The first group (GNAN) (n=13) was subjected to acute spinal cord injury and treated with ND; the control group (GCON) (n=13) was subjected to spinal cord injury without treatment; and the third group (GLAM) (n=6) underwent laminectomy without prior spinal cord injury, in order to control changes caused by the procedure. A 20 g metal device was released from a height of 25 cm to produce the spinal cord injury. After exposing the spinal canal, a 2-mm diameter metal rod was placed directly in contact with the spinal cord, and when the weight was released, the rod was struck, causing the spinal cord injury. An intramuscular injection of 2 mg/kg of ND was administered the immediate postoperative period. The animals were assessed to ascertain the recovery of their motor function on five occasions, namely at 24 h, 48 h, 72 h, 7 and 14 days after undergoing spinal cord injury. This assessment was performed using the Basso, Beattie and Bresnahan (BBB) model. The animals were euthanized 14 days post-op and fragments of the spinal cord and urinary bladder were collected for histological evaluation. Discussion: The animals subjected to spinal cord injury presented paraplegia, failing to score on the BBB scale in the first three assessments. Starting 7 days after surgery, the GNAN (0-13) and GCON (0-5) groups gradually began showing locomotor improvements, with scale variations. On day 14 after spinal cord injury, 22% of the animals in GNAN and 11% in GCON had failed to recover their locomotor function, scoring zero on the BBB scale. After spinal cord injury, all the animals showed urine retention. The urinary function returned on average on day 5 post surgery, with no significant difference between the groups. The locomotor assessment of the animals subjected to acute spinal cord injury revealed that the injury varied in intensity in GNAN and GCON, with signs of pelvic limb paraplegia and asymmetric non-ambulatory paraparesis. Time was a determining factor in the clinical evolution of the animals, with no evidence of the influence of ND. The histological findings revealed variations in the intensity of the injury, with a tendency for lower intensity in the cranial and epicentral segments of the lesion in the animals subjected to ND treatment, albeit without statistically significant evidence (P ≥ 0.05). The spinal cord assessments of the GLAM group indicated that the surgical procedure did not cause histological alterations, since the normal architecture of the neural tissue was preserved. The histopathological evaluations of the urinary bladder revealed an inflammatory response characterized by lymphohistiocytosis and neutrocytosis in the animals of GNAN and GCON, without interference of ND in the change (P ≥ 0.05). The method to elicit spinal cord injury reproduced functional, sensory and motor incapacity heterogeneously in rats. In the dose evaluated here, ND did not significantly influence the return of locomotor function and the intensity of spinal cord histopathological alterations.  

Right Laparoscopic Adrenalectomy in a Bitch

Background: The medical procedure of Laparoscopic adrenalectomy is common in human medicine; however, this is not true in veterinary medicine, where it isperformed rarely. The current treatment of choice for adrenal neoplasms is total adrenalectomy, unless there is a pre-operativediagnosis of metastasis that precludes surgery. The laparoscopic approach option becomes an interesting alternative because, through this technique,it has shown good results. In this report, we demonstrate the experience of a case in which we performed unilateral laparoscopic right adrenalectomy, without caudalvena cava invasion, in a dogsuffering from hyperadrenocorticism caused by adrenocortical carcinoma.Case: A 9-year-old beagle bitch, 12 kg in weight, showedpolyphagia, polydipsia, polyuria, pendular abdomen, thin and dark skin, lumbar alopecic areas and lethargy. The team carried out Complete Blood Count (CBC), blood chemistry (liver and renal functions) and urine sampling by cystocentesis for urinalysis and bacterial culture. All exams had normal results, except for ALP, which reached levels higher than 150 UIL-1. On abdominal radiographic examination, we noted mild adrenal enlargement, and by ultrasonography, it was possible to identify adrenal asymmetry and right adrenal enlargement (2.8x2x2.15 cm) in relation to the left gland (2x1x1.5 cm). As a treatment for adrenal neoplasm-dependent HAC,we recommended the execution of total right adrenalectomy execution. The videosurgery used four accesses arranged in the right hypogastric region; the diameters were 10 (two), 5, and 3mm. The adrenal gland was carefully dissected with the aid of laparoscopic forceps; during the intraoperative period, there was a small laceration of the abdominal phrenic vein that resulted in bleeding, which was overcome with two titanium clips. The dog had an excellent recovery, and the teamdischarged it 48 h after the procedure. The signs of hyperadrenocorticism disappeared about two weeks after surgery. One year after having the procedure, the animal remainswell and has no signs of tumor recurrence or Cushing’s syndrome.Discussion: The choice laparoscopic approach provided less invasiveness in surgical access, reduced animal convalescence, and provided image magnifcation for the more accurate dissection of the adrenal gland. Some reports that middle-aged to older bitches were the most predisposed to present adrenal neoplasm-dependent HAC, and generally, in unilateral form, characteristics which are presented in this report. Among the clinical signs and observed in this report, are polydipsia, polyphagia, tachypnea, alopecia, and skin hyperpigmentation. That recommended the low-dose dexamethasone suppression test to diagnose Cushing’s syndrome and the endogenous ACTH test to distinguish hypophysary from adrenocorticotrophic HAC. The same tests were performed in the case reported here, as these are also important to establish the fnal diagnosisand refer the total adrenalectomy realization. In the current case report, access to the right hypogastric region using four videosurgery portals provided good surgical access. Towards the hospital convalescence time, the animal was discharged early, just 48 h post-operatively; remission of HAC clinical signs occurredwithin three weeks, and the survival alreadyreached 12 months.To the best of the authors’ knowledge, this is the frst successful case of total right adrenalectomy without caudal vena cava invasion via the laparoscopic route as treatment for adrenocortical carcinoma in the national literature.Keywords: adrenal gland, neoplasm, videosurgery, dogs

Right Laparoscopic Adrenalectomy in a Bitch

Background: The medical procedure of Laparoscopic adrenalectomy is common in human medicine; however, this is not true in veterinary medicine, where it isperformed rarely. The current treatment of choice for adrenal neoplasms is total adrenalectomy, unless there is a pre-operativediagnosis of metastasis that precludes surgery. The laparoscopic approach option becomes an interesting alternative because, through this technique,it has shown good results. In this report, we demonstrate the experience of a case in which we performed unilateral laparoscopic right adrenalectomy, without caudalvena cava invasion, in a dogsuffering from hyperadrenocorticism caused by adrenocortical carcinoma.Case: A 9-year-old beagle bitch, 12 kg in weight, showedpolyphagia, polydipsia, polyuria, pendular abdomen, thin and dark skin, lumbar alopecic areas and lethargy. The team carried out Complete Blood Count (CBC), blood chemistry (liver and renal functions) and urine sampling by cystocentesis for urinalysis and bacterial culture. All exams had normal results, except for ALP, which reached levels higher than 150 UIL-1. On abdominal radiographic examination, we noted mild adrenal enlargement, and by ultrasonography, it was possible to identify adrenal asymmetry and right adrenal enlargement (2.8x2x2.15 cm) in relation to the left gland (2x1x1.5 cm). As a treatment for adrenal neoplasm-dependent HAC,we recommended the execution of total right adrenalectomy execution. The videosurgery used four accesses arranged in the right hypogastric region; the diameters were 10 (two), 5, and 3mm. The adrenal gland was carefully dissected with the aid of laparoscopic forceps; during the intraoperative period, there was a small laceration of the abdominal phrenic vein that resulted in bleeding, which was overcome with two titanium clips. The dog had an excellent recovery, and the teamdischarged it 48 h after the procedure. The signs of hyperadrenocorticism disappeared about two weeks after surgery. One year after having the procedure, the animal remainswell and has no signs of tumor recurrence or Cushing’s syndrome.Discussion: The choice laparoscopic approach provided less invasiveness in surgical access, reduced animal convalescence, and provided image magnifcation for the more accurate dissection of the adrenal gland. Some reports that middle-aged to older bitches were the most predisposed to present adrenal neoplasm-dependent HAC, and generally, in unilateral form, characteristics which are presented in this report. Among the clinical signs and observed in this report, are polydipsia, polyphagia, tachypnea, alopecia, and skin hyperpigmentation. That recommended the low-dose dexamethasone suppression test to diagnose Cushing’s syndrome and the endogenous ACTH test to distinguish hypophysary from adrenocorticotrophic HAC. The same tests were performed in the case reported here, as these are also important to establish the fnal diagnosisand refer the total adrenalectomy realization. In the current case report, access to the right hypogastric region using four videosurgery portals provided good surgical access. Towards the hospital convalescence time, the animal was discharged early, just 48 h post-operatively; remission of HAC clinical signs occurredwithin three weeks, and the survival alreadyreached 12 months.To the best of the authors’ knowledge, this is the frst successful case of total right adrenalectomy without caudal vena cava invasion via the laparoscopic route as treatment for adrenocortical carcinoma in the national literature.Keywords: adrenal gland, neoplasm, videosurgery, dogs