Adenocarcinoma pancreático em um gato : relato de caso

Apesar de ser raro em animais domésticos, o adenocarcinoma pancreático é o tumor maligno mais comum do pâncreas felino, sendo também classificado como uma das maiores causas de mortalidade por câncer no mundo em pessoas. Por promover sinais clínicos inespecíficos em felinos e semelhantes a pancreatite, geralmente seu diagnóstico é tardio, quando há estágio avançado da doença. E em sua maioria, os pacientes já se encontram com disseminação metastática agressiva, com um prognóstico grave. Os estudos sobre terapias e métodos diagnósticos mais específicos e menos invasivos são escassos. Neste sentido o o exame citopatológico e histopatológico deve ser realizado, para obter-se o diagnóstico definitivo, e assim, possibilitar o uso de alguma terapia mais eficiente. O presente trabalho relata um caso de um gato idoso com adenocarcinoma pancreático, que foi atendido no Serviço de Medicina Felina do Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul que apresentou sinais clínicos inespecíficos, efusão abdominal e massa abdominal palpável. Porém, devido a sua piora clínica, o diagnóstico histopatológico ante-mortem não pode ser realizado. Entretanto, diversos exames complementares, histórico e sinais clínicos puderam direcionar o caso para a neoplasia glandular maligna. Com base no relato de caso, este trabalho visa também, demonstrar a importância clínica dessa neoplasia para a medicina felina principalmente, devido a grande dificuldade de diagnóstico precoce antes da doença metastática. Além disso, busca revisar as principais características do adenocarcinoma pancreático, as possíveis formas de se alcançar seu diagnóstico e as dificuldades do tratamento. Destaca também, a apresentação de carcinomatose no paciente acometido.Despite being rare in domestic animals, pancreatic adenocarcinoma is the most common malignant tumor of the feline pancreas, being also classified as a major world cancer mortality in people. Because it promotes nonspecific clinical signs in cats and similar to pancreatitis, its diagnosis is usually late, when there is an advanced stage of the disease. And most of the patients are already with aggressive metastatic spread, with a serious prognosis. Studies on more specific and less invasive therapies and diagnostic methods are scarce. Regarding this, several complementary exams need to be performed, mainly, the cytopathological and histopathological exam, to obtain the definitive diagnosis, and thus, allow the use of some more efficient therapy. The aim of this work is to report a pancreatic adenocarcinoma in an elderly cat presented at Feline Medicine Service of the Hospital de Clínicas Veterinárias of the Federal University of Rio Grande do Sul, with nonspecific clinical signs, abdominal effusion and a palpable abdominal mass. However, due to its clinical worsening, the ante-mortem histopathological diagnosis cannot be performed. However, several complementary exams, history and clinical signs could direct the case to malignant glandular neoplasia. Based on the case report, this work also aims to demonstrate the clinical importance of this neoplasm for feline medicine mainly, due to the great difficulty of early diagnosis before metastatic disease. In addition, it seeks to review the main characteristics of pancreatic adenocarcinoma, the possible ways to reach its diagnosis and the difficulties of treatment. It also highlights the presentation of carcinomatosis in the affected patient

Acidente botrópico em um canino: abordagem terapêutica – relato de caso / Botropic accident in a canine: therapeutic approach – case report

Acidentes com a serpente do gênero Bothrops são muito comuns em animais de companhia, devido a agressividade destas serpentes e a curiosidade dos pequenos animais, principalmente caninos. Estes animais peçonhentos possuem uma toxina que produz um efeito anticoagulante, vasculotóxico e nefrotóxico causando sinais clínicos graves em animais de companhia. Este trabalho tem como objetivo relatar um acidente botrópico em um canino fêmea sem raça definida, de dez anos de idade, pesando 19kg, apresentando sangramento na cavidade oral e dispneia. Logo no atendimento emergencial foi coletado exames de sangue e, ao eritrograma, evidenciou-se considerável trombocitopenia. Inicialmente foi realizado terapia de suporte com oxigenioterapia e fluidoterapia. Foi administrado soro antiofídico polivalente, sendo este essencial para melhora do quadro do paciente. Além disso, foi administrado analgésicos devido alto grau de algia do paciente. A antibioticoterapia realizada também foi indispensável no tratamento devido áreas necrosadas causadas pela picada, além de infecções secundárias. A administração de corticosteroides e pré infusão de soro antiofídico reduz reações imediatas, como dispneia, tosses, náuseas, pruridos e urticaria. Pode se concluir que a conduta clínica e terapêutica utilizada, baseada nos sinais clínicos apresentados e resultados de exames de sangue mostrou-se eficiente. O soro antiofídico polivalente foi capaz de neutralizar o veneno inoculado e a associação terapêutica utilizada foi fundamental para a melhora significativa do animal.

Adenocarcinoma Pancreático em um Gato: Relato De Caso

Background: Despite being rare in domestic animals, pancreatic adenocarcinoma is the most common malignant tumor of the feline pancreas. Due non-specificity of clinical signs in cats and the late diagnosis of the neoplasm, it is necessary tounderstand this disease better, to contribute for the knowledge of its early recognition and treatment. Thus, this study aims to report a case of metastatic pancreatic ductal adenocarcinoma in a cat, focusing on the main clinical aspects, diagnosis, and prognosis of this disease, in addition to the description of the presentation of peritoneal  carcinomatosis.Case: A 14-year-old male neutered mixed breed cat, was referred to the Feline Medicine Service (MedFel) of the Hospital de Clínicas Veterinárias (HCV) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, with a history of hyporexia, constipation and increased abdominal volume for 3 days, besides mild difficulty in locomotion and progressive weight loss in the last 6 months. On the physical examination, the patient was alert, with a body condition score of 6/9; muscle condition score 1/4 and moderate dehydration of 7%. Popliteal lymph nodes were enlarged, and abdominal distension was evident. Around 200 mL of a slightly cloudy, straw-yellow liquid were drained from the abdominal cavity. After draining the fluid, a new abdominal palpation was performed, and there were fecal retention and a palpable mass in the right hypogastric region. The result of the cytological analysis of the fluid was consistent with a protein-rich transudate, suggesting neoplastic effusion of epithelial origin. Hematological and biochemical changes included leukocytosis due to neutrophilia, monocytosis, lymphopenia, thrombocytosis and azotemia. On abdominal ultrasound, the patient had free fluid in the abdominal cavity, and the gallbladder had discreet of biliary sludge. The intestines showed some corrugated segments with other segments lacking definition of its layers, and without peristaltic movements, suggesting intestinal neoplasia. Pancreas and adrenals were not visualized. On the chest X-ray, moderate opacification of lung fields with a diffuse interstitial pattern was observed, suggesting lung metastasis. The patient presented an acute worsening of the clinical condition and the owner requested euthanasia. The patient was referred for necropsy and based on the macroscopic and microscopic changes, the post-mortem diagnosis was metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis.Discussion: The clinical presentation of cats with exocrine pancreatic neoplasia is nonspecific, as clinical signs are common to several diseases, such as anorexia, vomiting, abdominal pain, weight loss with normal appetite, jaundice, depression, and lethargy. Complementary blood tests also do not provide data that could lead to the suspicion of pancreatic neoplastic disease. In the present case, the diagnosis of metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis was only possible post mortem. The pancreas is a difficult organ to assess adequately using most diagnostic imaging methods, so histopathology is still the method of choice for differentiating pancreatic tissue comorbidities. Therefore, exploratory laparotomy should be instituted to provide tissue samples from the pancreas and its metastases for histopathological diagnosis, whenever ultrasound or other imaging methods indicate suspicious abdominal changes. The literature reports that less than 10% of affected cats treated with complete surgical removal of the mass and chemotherapy alone will survive more than a year, and the average time for untreated cats is only 6 days. The prognosis of this disease is bad and most cats are euthanized, due to rapid clinical worsening. Therefore, diagnosis is essential to determine an adequate prognosis in advanced cases and to support therapeutic decisions or euthanasia. Keywords: pancreatic neoplasia, abdominal carcinomatosis, ductal adenocarcinoma, feline. Título: Adenocarcinoma pancreático em um gato Descritores: neoplasia pancreática, carcinomatose abdominal, adenocarcinoma ductal, felino.Background: Despite being rare in domestic animals, pancreatic adenocarcinoma is the most common malignant tumor of the feline pancreas. Due non-specificity of clinical signs in cats and the late diagnosis of the neoplasm, it is necessary to understand this disease better, to contribute for the knowledge of its early recognition and treatment. Thus, this study aims to report a case of metastatic pancreatic ductal adenocarcinoma in a cat, focusing on the main clinical aspects, diagnosis, and prognosis of this disease, in addition to the description of the presentation of peritoneal carcinomatosis. Case:  A 14-year-old, mixed breed, neutered male cat, was presented to the Feline Medicine Service (MedFel) of the Hospital de Clínicas Veterinárias da UFRGS (HCV-UFRGS) with a history of hyporexia, constipation and increased abdominal volume for three days, besides mild difficulty in locomotion and progressive weight loss in the last six months. On the physical examination, the patient was alert, with a body condition score of 6/9; muscle condition score 1/4 and moderate dehydration of 7%. Popliteal lymph nodes were enlarged, and abdominal distension was evident. Around 200 ml of a slightly cloudy, straw-yellow liquid were drained from the abdominal cavity. After draining the fluid, a new abdominal palpation was performed, and there were fecal retention and a palpable mass in the right hypogastric region. The result of the cytological analysis of the fluid was consistent with a protein-rich transudate, suggesting neoplastic effusion of epithelial origin. Hematological and biochemical changes included leukocytosis due to neutrophilia, monocytosis, lymphopenia, thrombocytosis and azotemia. On abdominal ultrasound, the patient had free fluid in the abdominal cavity, and the gallbladder had discreet of biliary sludge. The intestines showed some corrugated segments with other segments lacking definition of its layers, and without peristaltic movements, suggesting intestinal neoplasia. Pancreas and adrenals were not visualized. On the chest X-ray, moderate opacification of lung fields with a diffuse interstitial pattern was observed, suggesting lung metastasis. The patient presented an acute worsening of the clinical condition and the owner requested euthanasia. The patient was referred for necropsy and based on the macroscopic and microscopic changes, the post-mortem diagnosis was metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis. Discussion: The clinical presentation of cats with exocrine pancreatic neoplasia is nonspecific, as clinical signs are common to several diseases, such as anorexia, vomiting, abdominal pain, weight loss with normal appetite, jaundice, depression, and lethargy. Complementary blood tests also do not provide data that could lead to the suspicion of pancreatic neoplastic disease. In the present case, the diagnosis of metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis was only possible post-mortem. The pancreas is a difficult organ to assess adequately using most diagnostic imaging methods, so histopathology is still the method of choice for differentiating pancreatic tissue comorbidities. Therefore, exploratory laparotomy should be instituted to provide tissue samples from the pancreas and its metastases for histopathological diagnosis, whenever ultrasound or other imaging methods indicate suspicious abdominal changes. The literature reports that less than 10% of affected cats treated with complete surgical removal of the mass and chemotherapy alone will survive more than a year, and the average time for untreated cats is only six days. The prognosis of this disease is bad and most cats are euthanized, due to rapid clinical worsening. Therefore, diagnosis is essential to determine an adequate prognosis in advanced cases and to support therapeutic decisions or euthanasia

Adenocarcinoma Pancreático em um Gato: Relato De Caso

Background: Despite being rare in domestic animals, pancreatic adenocarcinoma is the most common malignant tumor of the feline pancreas. Due non-specificity of clinical signs in cats and the late diagnosis of the neoplasm, it is necessary tounderstand this disease better, to contribute for the knowledge of its early recognition and treatment. Thus, this study aims to report a case of metastatic pancreatic ductal adenocarcinoma in a cat, focusing on the main clinical aspects, diagnosis, and prognosis of this disease, in addition to the description of the presentation of peritoneal  carcinomatosis.Case: A 14-year-old male neutered mixed breed cat, was referred to the Feline Medicine Service (MedFel) of the Hospital de Clínicas Veterinárias (HCV) - Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, with a history of hyporexia, constipation and increased abdominal volume for 3 days, besides mild difficulty in locomotion and progressive weight loss in the last 6 months. On the physical examination, the patient was alert, with a body condition score of 6/9; muscle condition score 1/4 and moderate dehydration of 7%. Popliteal lymph nodes were enlarged, and abdominal distension was evident. Around 200 mL of a slightly cloudy, straw-yellow liquid were drained from the abdominal cavity. After draining the fluid, a new abdominal palpation was performed, and there were fecal retention and a palpable mass in the right hypogastric region. The result of the cytological analysis of the fluid was consistent with a protein-rich transudate, suggesting neoplastic effusion of epithelial origin. Hematological and biochemical changes included leukocytosis due to neutrophilia, monocytosis, lymphopenia, thrombocytosis and azotemia. On abdominal ultrasound, the patient had free fluid in the abdominal cavity, and the gallbladder had discreet of biliary sludge. The intestines showed some corrugated segments with other segments lacking definition of its layers, and without peristaltic movements, suggesting intestinal neoplasia. Pancreas and adrenals were not visualized. On the chest X-ray, moderate opacification of lung fields with a diffuse interstitial pattern was observed, suggesting lung metastasis. The patient presented an acute worsening of the clinical condition and the owner requested euthanasia. The patient was referred for necropsy and based on the macroscopic and microscopic changes, the post-mortem diagnosis was metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis.Discussion: The clinical presentation of cats with exocrine pancreatic neoplasia is nonspecific, as clinical signs are common to several diseases, such as anorexia, vomiting, abdominal pain, weight loss with normal appetite, jaundice, depression, and lethargy. Complementary blood tests also do not provide data that could lead to the suspicion of pancreatic neoplastic disease. In the present case, the diagnosis of metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis was only possible post mortem. The pancreas is a difficult organ to assess adequately using most diagnostic imaging methods, so histopathology is still the method of choice for differentiating pancreatic tissue comorbidities. Therefore, exploratory laparotomy should be instituted to provide tissue samples from the pancreas and its metastases for histopathological diagnosis, whenever ultrasound or other imaging methods indicate suspicious abdominal changes. The literature reports that less than 10% of affected cats treated with complete surgical removal of the mass and chemotherapy alone will survive more than a year, and the average time for untreated cats is only 6 days. The prognosis of this disease is bad and most cats are euthanized, due to rapid clinical worsening. Therefore, diagnosis is essential to determine an adequate prognosis in advanced cases and to support therapeutic decisions or euthanasia. Keywords: pancreatic neoplasia, abdominal carcinomatosis, ductal adenocarcinoma, feline. Título: Adenocarcinoma pancreático em um gato Descritores: neoplasia pancreática, carcinomatose abdominal, adenocarcinoma ductal, felino.Background: Despite being rare in domestic animals, pancreatic adenocarcinoma is the most common malignant tumor of the feline pancreas. Due non-specificity of clinical signs in cats and the late diagnosis of the neoplasm, it is necessary to understand this disease better, to contribute for the knowledge of its early recognition and treatment. Thus, this study aims to report a case of metastatic pancreatic ductal adenocarcinoma in a cat, focusing on the main clinical aspects, diagnosis, and prognosis of this disease, in addition to the description of the presentation of peritoneal carcinomatosis. Case:  A 14-year-old, mixed breed, neutered male cat, was presented to the Feline Medicine Service (MedFel) of the Hospital de Clínicas Veterinárias da UFRGS (HCV-UFRGS) with a history of hyporexia, constipation and increased abdominal volume for three days, besides mild difficulty in locomotion and progressive weight loss in the last six months. On the physical examination, the patient was alert, with a body condition score of 6/9; muscle condition score 1/4 and moderate dehydration of 7%. Popliteal lymph nodes were enlarged, and abdominal distension was evident. Around 200 ml of a slightly cloudy, straw-yellow liquid were drained from the abdominal cavity. After draining the fluid, a new abdominal palpation was performed, and there were fecal retention and a palpable mass in the right hypogastric region. The result of the cytological analysis of the fluid was consistent with a protein-rich transudate, suggesting neoplastic effusion of epithelial origin. Hematological and biochemical changes included leukocytosis due to neutrophilia, monocytosis, lymphopenia, thrombocytosis and azotemia. On abdominal ultrasound, the patient had free fluid in the abdominal cavity, and the gallbladder had discreet of biliary sludge. The intestines showed some corrugated segments with other segments lacking definition of its layers, and without peristaltic movements, suggesting intestinal neoplasia. Pancreas and adrenals were not visualized. On the chest X-ray, moderate opacification of lung fields with a diffuse interstitial pattern was observed, suggesting lung metastasis. The patient presented an acute worsening of the clinical condition and the owner requested euthanasia. The patient was referred for necropsy and based on the macroscopic and microscopic changes, the post-mortem diagnosis was metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis. Discussion: The clinical presentation of cats with exocrine pancreatic neoplasia is nonspecific, as clinical signs are common to several diseases, such as anorexia, vomiting, abdominal pain, weight loss with normal appetite, jaundice, depression, and lethargy. Complementary blood tests also do not provide data that could lead to the suspicion of pancreatic neoplastic disease. In the present case, the diagnosis of metastatic pancreatic ductal adenocarcinoma with peritoneal carcinomatosis was only possible post-mortem. The pancreas is a difficult organ to assess adequately using most diagnostic imaging methods, so histopathology is still the method of choice for differentiating pancreatic tissue comorbidities. Therefore, exploratory laparotomy should be instituted to provide tissue samples from the pancreas and its metastases for histopathological diagnosis, whenever ultrasound or other imaging methods indicate suspicious abdominal changes. The literature reports that less than 10% of affected cats treated with complete surgical removal of the mass and chemotherapy alone will survive more than a year, and the average time for untreated cats is only six days. The prognosis of this disease is bad and most cats are euthanized, due to rapid clinical worsening. Therefore, diagnosis is essential to determine an adequate prognosis in advanced cases and to support therapeutic decisions or euthanasia